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Near-infrared spectroscopy (NIRS), coupled with modeling and chemometrics, has been used to age grade anopheline and aedine mosquitoes; however, NIRS has not been widely used in field studies to assign mosquitoes to age classes. One reason is the relative cost of NIRS spectrometers. We developed a spectrometer system incorporating a miniature optical engine generating spectra in the shortwave infrared region, calibrated it using laboratory-reared Aedes aegypti, and evaluated its utility to age grade wild-caught cattail mosquitoes, Coquillettidia perturbans. As a refinement of the method, we compared a scoring system based on spectral data point outliers with the typical chemometrics that have been used with NIRS. This inexpensive system (

Background We carried out a study of the aptamer proteomic assay, SomaScan V4, to evaluate the analytical and biological variability of the assay in plasma samples of patients with moderate to severe chronic kidney disease (CKD). Methods Plasma samples were selected from 2 sources: (a) 24 participants from the Chronic Renal Insufficiency Cohort (CRIC) and (b) 49 patients from the Brigham and Women’s Hospital–Kidney/Renal Clinic. We calculated intra-assay variability from both sources and examined short-term biological variability in samples from the Brigham clinic. We also measured correlations of aptamer measurements with traditional biomarker assays. Results A total of 4656 unique proteins (4849 total aptamer measures) were analyzed in all samples. Median (interquartile range [IQR] intra-assay CV) was 3.7% (2.8–5.3) in CRIC and 5.0% (3.8–7.0) in Brigham samples. Median (IQR) biological CV among Brigham samples drawn from one individual on 2 occasions separated by median (IQR) 7 (4–14) days was 8.7% (6.2–14). CVs were independent of CKD stage, diabetes, or albuminuria but were higher in patients with systemic lupus erythematosus. Rho correlations between aptamer and traditional assays for biomarkers of interest were cystatin C = 0.942, kidney injury model-1 = 0.905, fibroblast growth factor-23 = 0.541, tumor necrosis factor receptors 1 = 0.781 and 2 = 0.843, P < 10−100 for all. Conclusions Intra-assay and within-subject variability for SomaScan in the CKD setting was low and similar to assay variability reported from individuals without CKD. Intra-assay precision was excellent whether samples were collected in an optimal research protocol, as were CRIC samples, or in the clinical setting, as were the Brigham samples.

Climate change is a major risk factor for overall health, including reproductive health, and well-being. Increasing temperatures, due mostly to increased greenhouse gases trapping excess heat in the atmosphere, result in erratic weather patterns, wildfires, displacement of large communities, and stagnant water resulting in vector-borne diseases that, together, have set the stage for new and devastating health threats across the globe. These conditions disproportionately affect disadvantaged and vulnerable populations, including women, pregnant persons, young children, the elderly, and the disabled. This review reports on the evidence for the adverse impacts of air pollution, wildfires, heat stress, floods, toxic chemicals, and vector-borne diseases on male and female fertility, the developing fetus, and obstetric outcomes. Reproductive health care providers are uniquely positioned and have an unprecedented opportunity to educate patients and policy makers about mitigating the impact of climate change to assure reproductive health in this and future generations.

Aims Chronic kidney disease (CKD) is widely prevalent and independently increases cardiovascular risk. Cardiovascular risk prediction tools derived in the general population perform poorly in CKD. Through large-scale proteomics discovery, this study aimed to create more accurate cardiovascular risk models. Methods and results Elastic net regression was used to derive a proteomic risk model for incident cardiovascular risk in 2182 participants from the Chronic Renal Insufficiency Cohort. The model was then validated in 485 participants from the Atherosclerosis Risk in Communities cohort. All participants had CKD and no history of cardiovascular disease at study baseline when ∼5000 proteins were measured. The proteomic risk model, which consisted of 32 proteins, was superior to both the 2013 ACC/AHA Pooled Cohort Equation and a modified Pooled Cohort Equation that included estimated glomerular filtrate rate. The Chronic Renal Insufficiency Cohort internal validation set demonstrated annualized receiver operating characteristic area under the curve values from 1 to 10 years ranging between 0.84 and 0.89 for the protein and 0.70 and 0.73 for the clinical models. Similar findings were observed in the Atherosclerosis Risk in Communities validation cohort. For nearly half of the individual proteins independently associated with cardiovascular risk, Mendelian randomization suggested a causal link to cardiovascular events or risk factors. Pathway analyses revealed enrichment of proteins involved in immunologic function, vascular and neuronal development, and hepatic fibrosis. Conclusion In two sizeable populations with CKD, a proteomic risk model for incident cardiovascular disease surpassed clinical risk models recommended in clinical practice, even after including estimated glomerular filtration rate. New biological insights may prioritize the development of therapeutic strategies for cardiovascular risk reduction in the CKD population.

OBJECTIVES Neutrophil-lymphocyte ratio (NLR) is an inflammatory biomarker that has been evaluated across a variety of surgical disciplines and is widely predictive of poor postoperative outcome, but its value in cardiac surgery is unclear. The authors did this systematic review and meta-analysis to determine the impact of elevated perioperative NLR on survival after cardiac surgery. DESIGN Systematic review and meta-analysis of study-level data. SETTING Multiple hospitals involved in an international pool of studies. PARTICIPANTS Adults undergoing cardiac surgery. INTERVENTIONS None. MEASUREMENTS AND MAIN RESULTS The authors searched multiple databases from inception until November 2020. They generated summary hazard ratios (HR) and odds ratios (OR) for the association of elevated preoperative NLR with long-term and short-term mortality following cardiac surgery. They separately reported on elevated postoperative NLR. Between-study heterogeneity was explored using metaregression. The authors included 12 studies involving 13,262 patients undergoing cardiac surgery. Elevated preoperative NLR was associated with worse long-term (>30 days) (hazard ratio [HR] 1.56; 95% CI [confidence interval], 1.18-2.06; 8 studies) and short-term (

Myotonic dystrophy type 1 (DM1) is the most common adult form of muscular dystrophy, presenting with a constellation of systemic findings secondary to a CTG triplet expansion of the noncoding region of the DMPK gene. Cardiac involvement is frequent, with conduction disease and supraventricular and ventricular arrhythmias being the most prevalent cardiac manifestations, often developing from a young age. The development of cardiac arrhythmias has been linked to increased morbidity and mortality, with sudden cardiac death well described. Strategies to mitigate risk of arrhythmic death have been developed. In this review, we outline the current knowledge on the pathophysiology of rhythm abnormalities in patients with myotonic dystrophy and summarize available knowledge on arrhythmic risk stratification. We also review management strategies from an electrophysiological perspective, attempting to underline the substantial unmet need to address residual arrhythmic risks for this population.

Ethanol ablation (EA) is an alternative option for subjects with ventricular arrhythmias (VAs) refractory to conventional medical and ablative treatment. However, data on the efficacy and safety of EA remain sparse.A systematic literature search was conducted. The primary outcomes were 1) freedom from the targeted VA and 2) freedom from any VAs post-EA. Additional safety outcomes were also analyzed.Ten studies were selected accounting for a population of 174 patients (62.3 ± 12.5 years, 94% male) undergoing 185 procedures. The overall acute success rate of EA was 72.4% (confidence interval [CIEA is a valuable therapeutic option for VAs refractory to conventional treatment and can result in 1-year freedom from VA recurrence in 60%-75% of the patients. However, anatomical or technical challenges preclude acute success in almost 30% of the candidates and the rate of complication is not insignificant, highlighting the importance of well-informed patient selection. The certainty of the evidence is low, and further research is necessary.

Background Methods for inferring the three-dimensional (3D) configuration of chromatin from conformation capture assays that provide strictly pairwise interactions, notably Hi-C, utilize the attendant contact matrix as input. More recent assays, in particular split-pool recognition of interactions by tag extension (SPRITE), capture multi-way interactions instead of solely pairwise contacts. These assays yield contacts that straddle appreciably greater genomic distances than Hi-C, in addition to instances of exceptionally high-order chromatin interaction. Such attributes are anticipated to be consequential with respect to 3D genome reconstruction, a task yet to be undertaken with multi-way contact data. However, performing such 3D reconstruction using distance-based reconstruction techniques requires framing multi-way contacts as (pairwise) distances. Comparing approaches for so doing, and assessing the resultant impact of long-range and multi-way contacts, are the objectives of this study. Results We obtained 3D reconstructions via multi-dimensional scaling under a variety of weighting schemes for mapping SPRITE multi-way contacts to pairwise distances. Resultant configurations were compared following Procrustes alignment and relationships were assessed between associated Procrustes root mean square errors and key features such as the extent of multi-way and/or long-range contacts. We found that these features had surprisingly limited influence on 3D reconstruction, a finding we attribute to their influence being diminished by the preponderance of pairwise contacts. Conclusion Distance-based 3D genome reconstruction using SPRITE multi-way contact data is not appreciably affected by the weighting scheme used to convert multi-way interactions to pairwise distances.

Rationale: The Southeast Asian tuberculosis burden is high, and it remains unclear if urban indoor air pollution in this setting is exacerbating the epidemic. Objectives: To determine the associations of latent tuberculosis with common urban indoor air pollution sources (secondhand smoke, indoor motorcycle emissions, and cooking) in Southeast Asia. Methods: We enrolled child household contacts of patients with microbiologically confirmed active tuberculosis in Vietnam, from July 2017 to December 2019. We tested children for latent tuberculosis and evaluated air pollution exposures with questionnaires and personal aerosol sampling. We tested hypotheses using generalized estimating equations. Measurements and Main Results: We enrolled 72 patients with tuberculosis (27% with cavitary disease) and 109 of their child household contacts. Latent tuberculosis was diagnosed in 58 (53%) household contacts at baseline visit. Children experienced a 2.56-fold increased odds of latent tuberculosis for each additional household member who smoked (95% confidence interval, 1.27-5.16). Odds were highest among children exposed to indoor smokers and children

Background In October 2020, the Royal Melbourne Hospital implemented a Respiratory Protection Program (RPP), which was initiated by the Victorian Government. This study was to evaluate the effectiveness of the program. Methods A cohort of 158 employees, who were identified as high risk to respiratory biohazard exposure, were invited to participate in the RPP. We provided a bundle of interventions, which included an online training package, and mandatory quantitative fit testing. The main outcomes included the participants' knowledge and attitude toward respiratory protection equipment (RPE), which were assessed via an online survey. Their donning and doffing skills, and user seal check techniques on four different types of N95 respirators were also assessed by an observer using a pre-determined marking sheet. We compared these outcomes before and after participation in the program. Results There was a total of 125 participants, all of whom completed the knowledge and attitude assessment, and 69 completed the skill assessment before and after the program. There was a statistically significant improvement in their knowledge scores, donning and doffing skills, and user seal check techniques after participation in the RPP. Participants also reported significant increased level of confidence in their RPE knowledge, training and skills; and workplace safety. Conclusion This initial report of the implementation of a novel RPP in a Victorian major tertiary hospital provides guidance on the benefits to respiratory protection, staff knowledge, skills, confidence and morale that can be acquired from a scalable online training package combined with mandatory quantitative fit testing.

Objective:We compared the rates of hospital-onset secondary bacterial infections in patients with coronavirus disease 2019 (COVID-19) with rates in patients with influenza and controls, and we investigated reports of increased incidence of Enterococcus infections in patients with COVID-19.Design:Retrospective cohort study.Setting:An academic quaternary-care hospital in San Francisco, California.Patients:Patients admitted between October 1, 2019, and October 1, 2020, with a positive SARS-CoV-2 PCR (N = 314) or influenza PCR (N = 82) within 2 weeks of admission were compared with inpatients without positive SARS-CoV-2 or influenza tests during the study period (N = 14,332).Methods:National Healthcare Safety Network definitions were used to identify infection-related ventilator-associated complications (IVACs), probable ventilator-associated pneumonia (PVAP), bloodstream infections (BSIs), and catheter-associated urinary tract infections (CAUTIs). A multiple logistic regression model was used to control for likely confounders.Results:COVID-19 patients had significantly higher rates of IVAC and PVAP compared to controls, with adjusted odds ratios of 4.7 (95% confidence interval [CI], 1.7–13.9) and 10.4 (95 % CI, 2.1–52.1), respectively. COVID-19 patients had higher incidence of BSI due to Enterococcus but not BSI generally, and whole-genome sequencing of Enterococcus isolates demonstrated that nosocomial transmission did not explain the increased rate. Subanalyses of patients admitted to the intensive care unit and patients who required mechanical ventilation revealed similar findings.Conclusions:COVID-19 is associated with an increased risk of IVAC, PVAP, and Enterococcus BSI compared with hospitalized controls, which is not fully explained by factors such as immunosuppressive treatments and duration of mechanical ventilation. The mechanism underlying increased rates of Enterococcus BSI in COVID-19 patients requires further investigation.

Background Cardiac tamponade is a high morbidity complication of transseptal puncture (TSP). Purpose We examined the associations of TSP-related cardiac tamponade (TRCT) for all patients undergoing left atrial ablation at our centre from 2016–2020. Methods Patient and procedural variables were extracted retrospectively. Cases of cardiac tamponade were scrutinised to adjudicate TSP culpability. Adjusted multivariate analysis examined predictors of TRCT. Results 3,239 consecutive TSPs were performed; cardiac tamponade occurred in 51 patients (incidence: 1.6%) and was adjudicated as TSP-related in 35 (incidence: 1.1%; 68.6% of all tamponades). Patients of above-median age (OR 2.4 (1.19–4.2), p=0.006) and those undergoing re-do procedures (OR 1.95 (1.29–3.43, p=0.042) were at higher risk of TRCT. Of the operator-dependent variables, choice of transseptal needle (Endrys vs Brockenbrough, p>0.1) or puncture sheath (Swartz vs Mullins vs Agilis vs Vizigo vs Cryosheath, all p>0.1) did not predict TRCT. Adjusting for operator, equipment and demographics, failure to cross the septum first pass increased TRCT risk (OR 4.42 (2.45–8.2), p=0.001), whilst top quartile operator experience (OR 0.4 (0.17–0.85, p=0.002), transoesophageal echocardiogram (TOE prevalence: 26%, OR 0.51 (0.11–0.94), p=0.023), and use of the SafeSept guidewire (OR 0.22 (0.08–0.62), p=0.001) reduced TRCT risk. An increase in SafeSept wire use over time (2016: 15.6%, 2020: 60.2%) correlated with an annual reduction in TRCT (R2=0.72, p Conclusions During left atrial ablation, the independent predictors of TRCT were patient age, re-do procedure, operator experience, unsuccessful first pass, TOE-guidance, and use of the SafeSept wire. A novel classification system for the causes of cardiac tamponade is proposed (table 1); this may be of interest to clinical trialists or auditors evaluating patient safety. Funding Acknowledgement Type of funding sources: None.

This study aimed to identify electrocardiographic (ECG) predictors of a prolonged His-ventricular (HV) interval in patients with type 1 myotonic dystrophy (DM1).Patients with DM1 have an increased risk of sudden cardiac death. The presence of His-Purkinje system disease/prolonged HV interval (≥70 ms) is associated with a higher risk of potentially life-threatening bradyarrhythmic events.Electrophysiology studies (EPSs) were performed in all DM1 patients referred to 2 tertiary centers for routine cardiac assessment. In a subgroup of patients, the EPS was repeated at varying intervals.A total of 154 patients (mean age: 43.7 ± 13.3; 58.1% male) underwent 202 diagnostic EPSs. HV ≥70 ms was found on 58 EPSs (28.7%); 9 of 59 patients (15.2%) with PR 200 ms and QRS interval 110 ms on baseline ECG had an HV ≥70 ms on EPS. Among those with PR ≥200 ms and/or QRS interval ≥100 ms, only 33.9% had an HV ≥70 ms on EPS. There were 38 patients who underwent repeated EPS, in which 28.8% demonstrated a prolongation of the HV interval overall compared with baseline. QRS duration demonstrated the most powerful discriminative capacity for HV ≥70 ms (area under the receiver operating characteristic curve: 0.76; 95% confidence interval [CI]: 0.68 to 0.84; p 0.001). On multivariate analysis, QRS interval ≥112 ms had the highest predictive value for HV ≥70 ms (odds ratio: 7.94; 95% CI: 3.85 to 16.37.ECG parameters have a poor predictive value for infra-Hisian conduction block in DM1 patients. QRS and PR intervals are normal in up to 15.2% of DM1 patients with prolonged HV, and 66.1% of those with PR ≥200 ms and/or QRS ≥100 ms do not have advanced His-Purkinje conduction system disease on EPS. Electrophysiology testing should be a mandatory part of screening for all patients to guide prophylactic pacemaker implantation.

Objective Irisin is a hormone released by muscle in response to exercise that acts on white adipose cells to stimulate browning of adipose tissue. We aimed to examine irisin correlates and consequences of irisin in patients receiving hemodialysis. Design and Methods A prospective cohort study was conducted using data from 749 prevalent patients receiving hemodialysis. Multivariable linear regression and multivariable generalized estimating equations were used to determine correlates of baseline and change in serum irisin concentration. Proportional hazards (Cox) regression was used to assess the association between serum irisin concentration and time to death. Results Age and body mass index were inversely associated with baseline and change in serum irisin concentration. Lower muscle mass as estimated by serum creatinine concentration was associated with lower irisin concentration (−1.38% per mg/dL (95% confidence interval [CI]: −2.45, −0.21) and with a 0.72% decrease in irisin concentration (95% CI: −1.48, −0.04) from baseline to 12 months. Each 50% higher serum interleukin-6 (IL-6) concentration was associated with 1.52% higher serum irisin concentration (95% CI: 0.38, 2.66) at baseline and an increase of 1.04% in irisin concentration over 1 year (95% CI: 0.47, 1.61). Irisin concentration at baseline was associated with higher hazard of death (hazards ratio: 1.45, 95% CI: 1.05 2.00); an increase in irisin concentration over 1 year was associated with a higher hazard of death (hazards ratio: 1.34, 95% CI: 1.01, 1.79). In formal mediation analysis, serum IL-6 was a mediator in the association between serum irisin and mortality. Conclusions Lower serum creatinine (reflecting lower muscle mass) and higher serum IL-6 were associated with higher serum irisin concentrations. Higher serum irisin concentrations were associated with higher mortality, which may be mediated by inflammation.

The use of high flow nasal oxygen in the care of COVID-19-positive adult patients remains an area of contention. Early guidelines have discouraged the use of high flow nasal oxygen therapy in this setting due to the risk of viral spread to healthcare workers. However, there is the need to balance the relative risks of increased aerosol generation and virus transmission to healthcare workers against the role high flow nasal oxygen has in reducing hypoxaemia when managing the airway in high-risk patients during intubation or sedation procedures. The authors of this article undertook a narrative review to present results from several recent papers. Surrogate outcome studies suggest that the risk of high flow nasal oxygen in dispersing aerosol-sized particles is probably not as great as first perceived. Smoke laser-visualisation experiments and particle counter studies suggest that the generation and dispersion of bio-aerosols via high flow nasal oxygen with flow rates up to 60 l/min is similar to standard oxygen therapies. The risk appears to be similar to oxygen supplementation via a Hudson mask at 15 l/min and significantly less than low flow nasal prong oxygen 1–5 l/min, nasal continuous positive airway pressure with ill-fitting masks, bilevel positive airway pressure, or from a coughing patient. However, given the limited safety data, we recommend a cautious approach. For intubation in the COVID-positive or suspected COVID-positive patient we support the use of high flow nasal oxygen to extend time to desaturation in the at-risk groups, which include the morbidly obese, those with predicted difficult airways and patients with significant hypoxaemia, ensuring well-fitted high flow nasal oxygen prongs with staff wearing full personal protective equipment. For sedation cases, we support the use of high flow nasal oxygen when there is an elevated risk of hypoxaemia (e.g. bariatric endoscopy or prone-positioned procedures), but recommend securing the airway with a cuffed endotracheal tube for the longer duration procedures when theatre staff remain in close proximity to the upper airway, or considering the use of a surgical mask to reduce the risk of exhaled particle dispersion.

BACKGROUND: The long term performance of the Riata family of leads has recently come under increasing scrutiny. We aimed to determine the long term performance of the Riata 1580 leads compared with Endotak 0158 leads. METHODS: All patients with Riata 1580 or Endotak 0158 leads implanted from 2003-2008 at the Heart Hospital, UCLH were analysed. Significant electrical changes were: threshold increase >1V at a set pulse width between pacing checks, persistent R wave fall to 50%, noise, pacing impedance change to 1500 Ω, HV change to 200Ω, HV change ± 15Ω, pacing impedance change > 400Ω over 12 months. RESULTS: 333 Riata and 356 Endotak leads were implanted. Median follow up time + interquartile range, after exclusion of censored events including loss to follow up: Riata 3652 + 655 days, Endotak 3730 + 810 days. A total of 51 (15.9%) Riata leads and 21 (6.3%) Endotak leads were affected. A greater risk of failure was found for the Riata lead compared with the Endotak lead (p = 0.0001). An additional time-dependent effect was found, with the Riata lead 1.9 times more likely to fail in the first 6 years following lead implantation and 5.3 times more likely to fail after 6 years. CONCLUSIONS: Riata leads have a higher risk of failure compared to Endotak leads over time. The importance of careful ongoing performance surveillance late in the leads' lifetime is reflected in this ten year follow up study. This article is protected by copyright. All rights reserved.

In this study, we compared the risk of coronavirus disease 2019 (COVID-19) between clinical and nonclinical healthcare workers (HCWs) while adjusting for home ZIP codes. Clinical HCWs did not have a higher risk of COVID-19, but living in higher-risk ZIP codes was associated with increased infection rates. However, environmental services workers showed increased risk of COVID-19.

Background Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) has had a significant impact on hospitals, including the occupational health departments in charge of handling healthcare worker (HCW) staffing during high rates of exposure and infection of HCWs. HCWs who were exposed to a patient or community member infected with SARS-CoV-2 were required to isolate from work for a minimum of 14 days from the date of exposure. Aims This study was aimed to assess the relative risk of SARS-CoV-2 infection following different types of workplace and community exposures. Methods We analyzed the details of workplace and community exposures of HCWs to SARS-CoV-2 at Montefiore Medical Center in New York between 22 June 2020 and 22 November 2020. Results Of 562 HCW SARS-CoV-2 exposures analyzed, 218 were from the community and 345 were from the workplace. Twenty-nine per cent of community exposures resulted in infection, which was significantly greater than workplace exposure infection (2%). Household community exposures resulted in a larger frequency of infection than non-household community exposures. Of the seven infections after workplace exposures, five had qualifying exposures to a co-worker and two were exposed to an infected patient during a non-aerosolized procedure. Conclusions HCW exposure to SARS-CoV-2 continues to present staffing challenges to healthcare systems. Even with deviations from standard personal protective equipment protocol, workplace exposures resulted in low frequencies of infection. In our study, the primary source of HCW infection was exposure in the community. Our findings support investing in efforts to educate around continued masking and social distancing in the community in addition to interventions targeted at addressing vaccine hesitancy.

Background The rapid spread of the novel coronavirus (COVID-19) has presented immeasurable challenges to health care workers who remain at the frontline of the pandemic. A rapidly evolving body of literature has quantitatively demonstrated significant psychological impacts of the pandemic on health care workers. However, little is known about the lived experience of the pandemic for frontline medical staff. Objective This study aimed to explore the qualitative experience of perioperative staff from a large trauma hospital in Melbourne, Australia. Methods Inductive thematic analysis using a critical realist approach was used to analyze data from 9 semistructured interviews. Results Four key themes were identified. Hospital preparedness related to the perceived readiness of the hospital to respond to the pandemic and encompassed key subthemes around communication of policy changes, team leadership, and resource availability. Perceptions of readiness contributed to the perceived psychological impacts of the pandemic, which were highly varied and ranged from anger to anxiety. A number of coping strategies were identified in response to psychological impacts which incorporated both internal and external coping mechanisms. Finally, adaptation with time reflected change and growth over time, and encompassed all other themes. Conclusions While frontline staff and hospitals have rapidly marshalled a response to managing the virus, relatively less consideration was seen regarding staff mental health in our study. Findings highlight the vulnerability of health care workers in response to the pandemic and reinforce the need for a coordinated approach to managing mental health.

Objective:Discomfort and device-related pressure injury (DRPI) caused by N95 filtering facepiece respirators (FFRs) are common. The use of prophylactic hydrocolloid dressings is one of the strategies that may improve comfort and reduce DRPI. In this study, we investigated the impact of these dressings on N95 respirator fit.Methods:We performed a repeat quantitative fit testing through the Respiratory Protection Program on 134 healthcare workers (HCWs), who applied hydrocolloid dressings on the bridge of their nose under the N95 FFRs that they passed the initial fit test with, but reported discomfort with the FFR.Results:With the hydrocolloid dressings in place, the fit-test pass rate for the semirigid cup style (3M 1860) was 94% (108 of 115); for the the vertical flat-fold style (BYD), the pass rate was 85% (44 of 52); for the duckbill style (BSN medical ProShield and Halyard Fluidshield), the pass rate was 81% (87 of 108); and for the 3-panel flat-fold style (3M Aura) N95 FFRs, the pass rate was 100% (3 of 3). There was a statistically significant reduction in the overall fit factors for both the vertical flat-fold and duckbill type N95 respirators after the application of hydrocolloid dressings.Conclusions:Hydrocolloid dressings are likely to disturb the mask seal for nonrigid-style N95 FFRs, particularly the vertical flat-fold style and the duckbill style N95 FFRs. Given the risk of mask seal disturbance of N95 respirators as shown in this study, we advocate that any HCW requiring the use of prophylactic dressings should undergo repeat quantitative fit testing with the dressing in place prior to using the dressing and mask in combination.

The recent (April 25, 2018) second data release (DR2) of the European Space Agency satellite Gaia provides a dramatic increase in the extent and precision of stellar attributes for an unprecedented...

The three dimensional organization of genomes remains mostly unknown due to their high degree of condensation. Biophysical studies predict that condensation promotes the topological entanglement of chromatin fibers and the inhibition of function. How organisms balance between functionally active genomes and a high degree of condensation remains to be determined. Here we hypothesize that the Rabl configuration, characterized by the attachment of centromeres and telomeres to the nuclear envelope, helps to reduce the topological entanglement of chromosomes. To test this hypothesis we developed a novel method to quantify chromosome entanglement complexity in 3D reconstructions obtained from Chromosome Conformation Capture (CCC) data. Applying this method to published data of the yeast genome, we show that computational models implementing the attachment of telomeres or centromeres alone are not sufficient to obtain the reduced entanglement complexity observed in 3D reconstructions. It is only when the centromeres and telomeres are attached to the nuclear envelope (i.e. the Rabl configuration) that the complexity of entanglement of the genome is comparable to that of the 3D reconstructions. We therefore suggest that the Rabl configuration is an essential player in the simplification of the entanglement of chromatin fibers.