U.S. Preparedness and Response to Increasing Clade I Mpox Cases in the Democratic Republic of the Congo - United States, 2024.

Clade I monkeypox virus (MPXV), which can cause severe illness in more people than clade II MPXVs, is endemic in the Democratic Republic of the Congo (DRC), but the country has experienced an increase in suspected cases during 2023-2024. In light of the 2022 global outbreak of clade II mpox, the increase in suspected clade I cases in DRC raises concerns that the virus could spread to other countries and underscores the importance of coordinated, urgent global action to support DRC's efforts to contain the virus. To date, no cases of clade I mpox have been detected outside of countries in Central Africa where the virus is endemic. CDC and other partners are working to support DRC's response. In addition, CDC is enhancing U.S. preparedness by raising awareness, strengthening surveillance, expanding diagnostic testing capacity for clade I MPXV, ensuring appropriate specimen handling and waste management, emphasizing the importance of appropriate medical treatment, and communicating guidance on the recommended contact tracing, containment, behavior modification, and vaccination strategies.

Bench Press Range-of-Motion and Velocity-based Repetition Control: Effects on Ballistic Push-up Performance in Males.

The purpose of this study was to investigate whether the ballistic push-up (BPU) is responsive to post-activation performance enhancement (PAPE) after a bench press conditioning exercise using velocity-based repetition control. Additionally, we aimed to evaluate the effects of range of motion (ROM) conditions on subsequent BPU performance. In a randomized crossover design, 18 males performed two conditions (full ROM and self-selected partial ROM) of bench press at 80% of their 1RM until mean concentric velocity dropped 10%. Each participant performed two pre- and six post-test BPUs to assess the PAPE effect. Paired sample t-tests assessed bench press performance measures. Multiple two-way repeated measures ANOVAs assessed differences in flight time, impulse, and peak power for the pre- and post-test BPUs. No significant differences existed between ROM conditions for total repetitions, volume load, or peak velocity. Compared to partial ROM, full ROM showed greater displacement (0.42 ± 0.05 vs. 0.34 ± 0.05 m), work (331.99 ± 67.72 vs. 270.92 ± 61.42 J), and mean velocity (0.46 ± 0.09 vs. 0.44 ± 0.08 m/s). Neither bench press ROM condition enhanced the BPU and were detrimental in some cases. Several time points showed partial ROM (flight time: 2 min post, impulse: 12 min post, peak power: 12 min post) significantly greater than full ROM, possibly indicating less fatigue accumulation. The BPU may require a different stimulus or may not be practical for PAPE effects in college-aged males. Partial ROM can be an alternative that achieves similar peak velocities while requiring less overall work.

An Evaluation of the Quality of CPR Chest Compressions Performed on Football-Equipped and Obese Simulation Manikins.

OBJECTIVE: Protective athletic equipment may hamper the delivery of effective chest compressions. Unfortunately, an algorithm for managing cardiac arrest emergencies with equipment-laden athletes has yet to be established by national CPR certifying agencies. Further, athletes classified as being overweight or obese carry adipose in the thoracic region, which has been reported to inhibit the ability of rescuers to provide quality chest compressions. Thus, the purpose of this study was two-fold. The first purpose was to assess the ability of emergency responders to perform CPR chest compressions on an obese manikin. The second purpose was to analyze the effect of American football protective equipment on the performance of chest compressions by emergency responders. METHODS: Fifty emergency responders completed four 2-minute bouts of compression-only CPR. The scenarios included performing chest compressions on both traditional and obese CPR manikins, and performing chest compressions over a set of shoulder pads/chest protector that is used in the sport of American football on both traditional and obese manikins. RESULTS: The most notable outcomes in this study were related to chest compression depth, which fell well below the minimum recommended depth published by the American Heart Association in all conditions. Mean compression depth was significantly lower when performed on the obese manikin (avg over pads = 32.8, SD = 9.2 mm; avg no pads = 38.2, SD = 9.1 mm) compared to the traditional manikin (avg over pads = 40.0, SD = 10.9 mm; avg no pads = 40.8, SD = 14.8 mm), with statistical analyses revealing a significant effect due to both manikin size (p < 0.001) and the presence of equipment (p = 0.003), and a statistically significant interaction effect (p = 0.035). Chest recoil data revealed a statistically significant effect due to both manikin size (p = 0.017) and the presence of chest/shoulder safety pads (p = 0.003). CONCLUSION: Within this sample of emergency responders, chest compressions were adversely affected both by the equipment and obesity. Additionally, the traditional manikin received comparable chest compressions regardless of the presence or absence of football protective equipment, albeit both conditions resulted in poor depth performance.

Using Electronic Handgrip Dynamometry and Accelerometry to Examine Multiple Aspects of Handgrip Function in Master Endurance Athletes: A Pilot Study.

ABSTRACT: Klawitter, LA, Hackney, KJ, Christensen, BK, Hamm, JM, Hanson, M, and McGrath, R. Using electronic handgrip dynamometry and accelerometry to examine multiple aspects of handgrip function in master endurance athletes: A Pilot Study. J Strength Cond Res 37(9): 1777-1782, 2023-Electronic handgrip dynamometry and accelerometry may provide novel opportunities to comprehensively measure muscle function for human performance, especially for master athletes. This investigation sought to determine the multivariate relationships between maximal strength, asymmetry, rate of force development, fatigability, submaximal force control, bimanual coordination, and neuromuscular steadiness to derive one or more handgrip principal components in master-aged endurance athletes. We included n = 31 cyclists and triathletes aged 35-70 years. Maximal strength, asymmetry, rate of force development, fatigability, submaximal force control, bimanual coordination, and neuromuscular steadiness were measured twice on each hand using electronic handgrip dynamometry and accelerometry. The highest performing measures were included in the analyses. A principal component analysis was conducted to derive a new collection of uncorrelated variables from the collected handgrip measurements. Principal components with eigenvalues >1.0 were kept, and individual measures with a factor loading of |>0.40| were retained in each principal component. There were 3 principal components retained with eigenvalues of 2.46, 1.31, and 1.17. The first principal component, "robust strength," contained maximal strength, rate of force development, submaximal force control, and neuromuscular steadiness. The second principal component, "bilateral synergy," contained asymmetry and bimanual coordination, whereas the third principal component, "muscle conditioning," contained fatigability. Principal components 1, 2, and 3 explained 44.0, 31.6, and 24.4% of the variance, respectively. Different dimensions of muscle function emerged from our findings, suggesting the potential of a muscle function battery. Further research examining how these measures are associated with appropriate human performance metrics and lower extremity correlates is warranted.

Prevalence and Trends of Weakness Among Middle-Aged and Older Adults in the United States.

ABSTRACT: McGrath, R, FitzSimmons, S, Andrew, S, Black, K, Bradley, A, Christensen, BK, Collins, K, Klawitter, L, Kieser, J, Langford, M, Orr, M, and Hackney, KJ. Prevalence and trends of weakness among middle-aged and older adults in the United States. J Strength Cond Res 37(12): 2484-2490, 2023-Muscle weakness, which is often determined with low handgrip strength (HGS), is associated with several adverse health conditions; however, the prevalence and trends of weakness in the United States is not well-understood. We sought to estimate the prevalence and trends of weakness in Americans aged at least 50 years. The total unweighted analytic sample included 22,895 Americans from the 2006-2016 waves of the Health and Retirement Study. Handgrip strength was measured with a handgrip dynamometer. Men with weakness were below at least one of the absolute or normalized (body mass, body mass index) cut points: <35.5 kg, <0.45 kg/kg, <1.05 kg/kg/m 2 . The presence of any weakness in women was also identified as being below one of the absolute or normalized HGS cut points: <20.0 kg, <0.34 kg/kg, or <0.79 kg/kg/m 2 . There was an increasing trend in the prevalence of any weakness over time ( p < 0.001). The prevalence of weakness was 45.1% (95% confidence interval [CI]: 44.0-46.0) in the 2006-2008 waves and 52.6% (CI: 51.5-53.7) in the 2014-2016 waves. Weakness prevalence was higher for older (≥65 years) Americans (64.2%; CI: 62.8-65.5) compared with middle-aged (50-64 years) Americans (42.2%; CI: 40.6-43.8) in the 2014-2016 waves. Moreover, the prevalence of weakness in the 2014-2016 waves was generally higher in women (54.5%; CI: 53.1-55.9) than in men (50.4%; CI: 48.7-52.0). Differences existed in weakness prevalence across races and ethnicities. The findings from our investigation suggest that the prevalence of weakness is overall pronounced and increasing in Americans. Efforts for mitigating and better operationalizing weakness will elevate in importance as our older American population grows.

Examining the role of different weakness categories for mobility and future falls in older Americans.

BACKGROUND: Recently developed absolute and body size normalized handgrip strength (HGS) cut-points could be used individually and collectively to predict mobility problems and falls. AIMS: We examined the associations of (1) each absolute and normalized weakness cut-point, (2) collective weakness categories, and (3) changes in weakness status on future falls in older Americans. METHODS: The analytic sample included 11,675 participants from the 2006-2018 waves of the Health and Retirement Study. Falls were self-reported. Men were classified as weak if their HGS was < 35.5-kg (absolute), < 0.45 kg/kg (body mass normalized), or < 1.05 kg/kg/m2 (body mass index normalized). While, women were considered weak if their HGS was < 20.0-kg, < 0.337 kg/kg, or < 0.79 kg/kg/m2. Collective weakness categorized those below 1, 2, or all 3 cut-points. The collective weakness categories were also used to observe changes in weakness status over time. RESULTS: Older Americans below each absolute and normalized cut-point had greater odds for future falls: 1.23 (95% confidence interval (CI): 1.15-1.32) for absolute weakness, 1.20 (CI 1.11-1.29) for body mass index normalized weakness, and 1.26 (CI 1.17-1.34) for body mass normalized weakness. Persons below 1, 2, or all 3 weakness cut-points had 1.17 (CI 1.07-1.27), 1.29 (CI 1.18-1.40), and 1.36 (CI 1.24-1.48) greater odds for future falls, respectively. Those in some changing weakness categories had greater odds for future falls: 1.26 (CI 1.08-1.48) for persistent and 1.31 (CI 1.11-1.55) for progressive. DISCUSSION: Collectively using these weakness cut-points may improve their predictive value. CONCLUSION: We recommend HGS be evaluated in mobility and fall risk assessments.

Reliability of a Novel Automated Ultrasound Technology for Body Composition Assessment and Comparisons with Dual Energy X-Ray Absorptiometry.

Body composition tools vary in reliability, portability, and accessibility. The purpose of this study was to evaluate test-retest reliability of MuscleSound® (MS) and dual-energy x-ray absorptiometry (DXA) for both two compartment (region) and three compartment (tissue) models. A secondary aim was to compare body composition values produced by both devices. Fifty participants (n = 25 male, n = 25 female) aged 18-39 years completed two body composition assessments, twice in a single session. Participants arrived at the lab after a 12-hour fast. DXA required participants to lay supine for 10-15 minutes during the scanning process. Thereafter, MS was utilized to measure subcutaneous adipose tissue thickness at seven sites: chest, subscapula, triceps, axilla, suprailium, abdomen, and mid-thigh. MS automatically estimated body composition utilizing a modified Jackson-Pollock equation and the Siri equation within the software. The sequence of assessments was then repeated. Statistical analysis included paired T-tests with Pearson correlations, intraclass correlation coefficients (ICC), and least significant change (LSC). Both methods were strongly reliable (ICCMS = .997, ICCDXA-region = .999, ICCDXA-tissue = .999). MS and DXA-region body fat percentages were significantly different (mean difference (%): 2.60 ± 1.32, p < .001) but highly correlated (r = .928, p < .001). Notably, the mean difference was within DXA-region's calculated least significant change of 3.24%. MS is reliable for assessing body fat percentage in young and middle-aged adults and operators can utilize MS to collect body composition data in the field.

The Association Between Handgrip Strength Asymmetry Severity and Future Morbidity Accumulation: Results from the Health and Retirement Study.

Analyzing the severity of handgrip strength (HGS) asymmetry in aging populations may help to screen for morbidities and add utility to handgrip dynamometer testing. Our study sought to determine the relationships between HGS asymmetry severity and future accumulating morbidities in older Americans. Secondary analyses from the 2006-2016 waves of the Health and Retirement Study included 18,506 adults ≥ 50 years old. The highest recorded HGS values from each hand were used to calculate HGS asymmetry ratio (non-dominant HGS/dominant HGS). If the HGS asymmetry ratio < 1.0, it was inversed to make all asymmetry ratios ≥ 1.0. Participants were categorized into groups based on the severity of their HGS asymmetry ratio: 1) 0.0% - 10.0%, 2) 10.1% - 20.0%, 3) 20.1% - 30.0%, and 4) > 30.0%. Healthcare provider-diagnosed morbidities (hypertension, diabetes, cancer, chronic lung disease, cardiovascular disease, stroke, arthritis, and psychiatric problems) were self-reported. Covariate-adjusted ordinal generalized estimating equations evaluated the relationships between HGS asymmetry severity on future accumulating morbidities. Results showed 8,936 (48.3%) participants had HGS asymmetry 0.0%-10.0%, 6,105 (33.0%) participants had HGS asymmetry 10.1%-20.0%, 2,411 (13.0%) participants had HGS asymmetry 20.1%-30.0%, and 1,054 (5.7%) participants had HGS asymmetry > 30.0%. Overall, every 10% increase in HGS asymmetry was associated with a 1.17 (CI: 1.05, 1.32) greater odds of future morbidity accumulation. Additionally, asymmetry between 10.1% - 20.0%, 20.1% - 30.0%, and > 30.0% was associated with a 1.10 (CI: 1.05, 1.15), 1.11 (CI: 1.04, 1.18), and 1.20 (CI: 1.09, 1.33) greater odds for morbidity accumulation during aging. These findings suggest that severe functional asymmetries may elevate the odds for accumulating morbidities.

Monkeypox in a Traveler Returning from Nigeria - Dallas, Texas, July 2021.

Monkeypox is a rare, sometimes life-threatening zoonotic infection that occurs in west and central Africa. It is caused by Monkeypox virus, an orthopoxvirus similar to Variola virus (the causative agent of smallpox) and Vaccinia virus (the live virus component of orthopoxvirus vaccines) and can spread to humans. After 39 years without detection of human disease in Nigeria, an outbreak involving 118 confirmed cases was identified during 2017-2018 (1); sporadic cases continue to occur. During September 2018-May 2021, six unrelated persons traveling from Nigeria received diagnoses of monkeypox in non-African countries: four in the United Kingdom and one each in Israel and Singapore. In July 2021, a man who traveled from Lagos, Nigeria, to Dallas, Texas, became the seventh traveler to a non-African country with diagnosed monkeypox. Among 194 monitored contacts, 144 (74%) were flight contacts. The patient received tecovirimat, an antiviral for treatment of orthopoxvirus infections, and his home required large-scale decontamination. Whole genome sequencing showed that the virus was consistent with a strain of Monkeypox virus known to circulate in Nigeria, but the specific source of the patient's infection was not identified. No epidemiologically linked cases were reported in Nigeria; no contact received postexposure prophylaxis (PEP) with the orthopoxvirus vaccine ACAM2000.

Analysis of Total and Segmental Body Composition Relative to Fitness Performance Measures in Law Enforcement Recruits.

Law enforcement agencies often test the fitness performance and body composition of incoming recruits. This study investigated the relationships between whole and segmental body composition, and fitness tests in law enforcement recruits. A retrospective analysis of 72 male and 11 female recruits was performed. Bioelectrical impedance analysis (BIA) variables were: lean mass (LM), upper-extremity lean mass (UELM), trunk LM, lower-extremity lean mass (LELM), fat mass (FM), upper-extremity fat mass (UEFM), trunk FM, and lower-extremity fat mass (LEFM). Fitness tests included: vertical jump (VJ), peak anaerobic power (PAPw), 75-yard pursuit run (75PR), push-ups, sit-ups, 2-kg medicine ball throw (MBT), and the multi-stage fitness test (MSFT). Partial correlations and ANCOVAs between quartiles assessed relationships between body composition and performance. Significant moderate-to-large relationships were found; LM, UELM, trunk LM, LELM all related to PAPw (r = 0.500-0.558) and MBT (r = 0.494-0.526). FM, UEFM, trunk FM, LEFM all related to VJ (r = -0.481 to -0.493), 75PR (r = 0.533-0.557), push-ups (r = -0.484 to -0.503), sit-ups (r = -0.435 to -0.449), and MSFT (r = -0.371 to -0.423). The highest LM quartile (4) had superior PAPw and MBT than LM quartiles 1-3. Higher FM quartiles performed poorer in VJ, push-ups, and sit-ups. The 75PR quartiles 2, 3, and 4 were slower than quartile 1, and MSFT quartile 4 completed less shuttles. Total and segmental measures of LM and FM shared the same relationships; lower FM and higher LM related to better performance. Monitoring body composition could help guide training to optimize performance.

The Associations between Asymmetric Handgrip Strength and Chronic Disease Status in American Adults: Results from the National Health and Nutrition Examination Survey.

This study examined the associations between asymmetric handgrip strength (HGS) and multimorbidity in American adults. Secondary analyses of data from persons aged at least 40 years from the 2011-2012 and 2013-2014 waves of the National Health and Nutrition Examination Survey were conducted. A handheld dynamometer collected HGS on each hand and persons with a strength imbalance >10% between hands were classified as having asymmetric HGS. Adults with the presence of ≥2 of the following conditions had multimorbidity: cardiovascular disease, chronic obstructive pulmonary disease, chronic kidney disease, asthma, arthritis, cancer, obesity, stroke, hypertension, high cholesterol, and diabetes. Of the n = 3483 participants included, n = 2700 (77.5%) had multimorbidity. A greater proportion of adults with multimorbidity had HGS asymmetry (n = 1234 (45.7%)), compared to persons living without multimorbidity (n = 314 (40.1%); p < 0.05). Relative to individuals without asymmetry, adults with asymmetric HGS had 1.31 (95% confidence interval (CI): 1.03-1.67) greater odds for multimorbidity. Moreover, persons with HGS asymmetry had 1.22 (CI: 1.04-1.44) greater odds for accumulating morbidities. Asymmetric strength, as another indicator of diminished muscle function, is linked to chronic morbidity status. Healthcare providers should recommend healthy behaviors for reducing asymmetries to improve muscle function and mitigate morbidity risk after completing asymmetry screenings.

Differences in Muscle Activity and Kinetics Between the Goblet Squat and Landmine Squat in Men and Women.

ABSTRACT: Collins, KS, Klawitter, LA, Waldera, RW, Mahoney, SJ, and Christensen, BK. Differences in muscle activity and kinetics between the goblet squat and landmine squat in men and women. J Strength Cond Res 35(10): 2661-2668, 2021-Squat exercise variations are widely used and extensively researched. However, little information exists on the goblet squat (GBS) and landmine squat (LMS) and differences between men and women. This study investigated the differences in muscle activity and kinetics between the GBS and the LMS in 16 men and 16 women. Five repetitions of each squat type were performed loaded at 30% of their body mass. Vertical and anteroposterior ground reaction forces for the eccentric and concentric phases and peak vertical force were recorded with a force plate. Electromyographic (EMG) signals were recorded for the vastus medialis (VM), vastus lateralis (VL), semitendinosus (ST), and biceps femoris (BF). Normalized mean EMG values and ground reaction forces were analyzed with repeated measures analysis of variance (p < 0.05). Significant main effects for squat condition and sex were found. The LMS reduced activity in the quadriceps (VM and VL) muscles and vertical forces, while increasing posterior horizontal forces. In the LMS, men showed decreased ST activity, whereas women had decreased BF activity. Women exhibited greater quadriceps activity in both the GBS and LMS and greater ST in the LMS. Women also produced greater eccentric vertical force in both the GBS and LMS and less posterior horizontal forces in the LMS. The LMS may be useful to balance hamstring to quadriceps activity, increase horizontal loading, and reduce vertical loading. Conversely, the GBS can better target quadriceps activity and increase vertical loading. Sex differences should be considered for training programs that include the GBS and LMS.

Investigation of a Suspect Severe Acute Respiratory Syndrome Coronavirus-2 and Influenza A Mixed Outbreak: Lessons Learned for Long-Term Care Facilities Nationwide.

A suspected outbreak of influenza A and severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) at a long-term care facility in Los Angeles County was, months later, determined to not involve influenza. To prevent inadvertent transmission of infections, facilities should use highly specific influenza diagnostics and follow Centers for Disease Control and Prevention (CDC) guidelines that specifically address infection control challenges.

Increased velocity at VO2max and load carriage performance in army ROTC cadets: prescription using the critical velocity concept.

The purpose of this study was to evaluate the effects of using the critical velocity (CV) concept to prescribe two separate high-intensity interval training (HIT) exercise programs aimed at enhancing CV and load carriage performance. 20 young adult participants (male = 15, female = 5) underwent a 4-week training period where they exercised 2 d wk-1. Participants were randomly assigned into two groups: (1) HIT or (2) Load Carriage-HIT (LCHIT). Pre- and post-training assessments included running 3-minute All-Out Test (3MT) to determine critical velocity (CV) and distance prime (D') and two load carriage tasks (400 and 3200 m). There were significant increases in CV (p = 0.005) and velocity at V˙ O2max (vV˙ O2max) (p = 0.037) among the sample but not between training groups. Improvements were observed in 3200 m load carriage performance time (p < 0.001) with a 9.8 and 5.4% decrease in the LCHIT and HIT groups, respectively. Practitioner summary: Critical velocity has shown efficacy as a marker for performance in tactical populations. With the addition of load carriage, there is a reduction in the individual's CV. The CV-concept-prescribed exercises (HIT and LCHIT) 2 days per week for 4 weeks showed improvements in CV, vV˙ O2max and load carriage performance. The use of the CV concept provides a method to prescribe HIT to increase running and load carriage performances in tactical populations.

Handgrip Strength Asymmetry and Weakness are Differentially Associated with Functional Limitations in Older Americans.

Background: Handgrip strength (HGS) is a convent measure of strength capacity and associated with several age-related health conditions such as functional disability. Asymmetric strength between limbs has been linked to diminished function. Therefore, both HGS asymmetry and weakness could be associated with functional disability. We examined the associations of HGS asymmetry and weakness on functional limitations in a nationally representative sample of older Americans. Methods: Data were analyzed from 2689 adults ≥ 60 years who participated in the 2011-2012 and 2013-2014 waves of the National Health and Nutrition Examination Survey. Weakness was defined as HGS < 26 kg for men and < 16 kg for women. Asymmetry was determined from the ratio of the dominant and non-dominant HGS. Those with HGS ratio 0.9-1.1 were considered as having HGS symmetry, and those outside this range had asymmetry. Results: Compared to those with symmetric HGS and were not weak, those with weakness alone, and both weakness and HGS asymmetry had 2.47 (95% confidence interval [CI]: 1.14-5.35) and 3.93 (CI: 1.18-13.07) greater odds for functional limitations, respectively. However, HGS asymmetry alone was not associated with functional limitations (odds ratio: 0.80; CI: 0.62-1.03). Conclusion: The use of HGS asymmetry in protocols could improve the prognostic value of handgrip dynamometers.

The Effect of Static Stretching, Mini-Band Warm-Ups, Medicine-Ball Warm-Ups, and a Light Jogging Warm-Up on Common Athletic Ability Tests.

Proper warm-up is important for facilitating peak athletic performance and reducing injury risk; yet, warm-up procedures vary considerably amongst coaches and athletes. The purpose of this study was to assess the effect of a static stretching, medicine-ball, and mini-band warm-ups relative to a light jogging warm-up only on athletic ability test performance. It was hypothesized that static stretching would negatively affect performance, while medicine-ball and mini-band warm-ups would positively affect performance relative to light jogging only. Twelve female collegiate soccer players (19.3 ± 1.2y, 65.2 ± 7.5kg, 1.67 ± 0.07m) participated in this study. Athletes completed each warm-up protocol and all of the athletic performance tests over four sessions in a semi-randomized, counterbalanced order. An omnibus MANOVA with vertical jump height, medicine ball throw distance, 10m and 20m sprint time, and T-test time as the dependent variables was not significant indicating that warm up did not have an effect on subsequent athletic ability test performance [Wilks' λ = 0.64, F(15,110) = 1.28, p = 0.23, η2 = 0.14]. Static stretching warm-up did not negatively influence athletic potential compared to mini-band and medicine ball warm-ups, though the most optimal warm-up is likely athlete specific.

A Guide to Investigating Suspected Outbreaks of Mucormycosis in Healthcare.

This report serves as a guide for investigating mucormycosis infections in healthcare. We describe lessons learned from previous outbreaks and offer methods and tools that can aid in these investigations. We also offer suggestions for conducting environmental assessments, implementing infection control measures, and initiating surveillance to ensure that interventions were effective. While not all investigations of mucormycosis infections will identify a single source, all can potentially lead to improvements in infection control.

Outbreak investigation of Pseudomonas aeruginosa infections in a neonatal intensive care unit.

A Pseudomonas aeruginosa outbreak was investigated in a neonatal intensive care unit that had experienced a prior similar outbreak. The 8 cases identified included 2 deaths. An investigation found the cause of the outbreak: tap water from contaminated hospital plumbing which was used for humidifier reservoirs, neonatal bathing, and nutritional preparation. Our findings reinforce a recent Centers for Medicare & Medicaid Services memo recommending increased attention to water management to improve awareness, identification, mitigation, and prevention of water-associated, health care-associated infections.

Simulated Casualty Evacuation Performance Is Augmented by Deadlift Peak Force.

INTRODUCTION: The purpose of the current study was to examine if isometric peak force and rate of force development (RFD) were related to the ability to successfully perform a simulated casualty evacuation task in both unweighted and weighted conditions. METHODS: Eighteen male participants from Army Reserve Officers' Training Corps (ROTC) completed a maximum isometric deadlift on a force plate (IRB#HE16227). Isometric peak force and RFD were calculated from ground reaction force. Two simulated casualty evacuation performance trials were then completed. The unweighted trial consisted of lifting and carrying a 75 kg dummy as quickly as possible for 50 m. The weighted trial was similar except 9 kg vests were added to both the simulation dummy and the participant to represent 18 kg of duty gear. Independent sample t-tests and Pearson correlations were performed to compare the characteristics of those who passed and failed the weighted trial. RESULTS: All of the participants (n = 18) completed the unweighted casualty evacuation trial, while 72% (n = 13) were able to complete the weighted casualty evacuation trial. The participants that successfully completed the weighted evacuation trial had significantly (p < 0.05) greater isometric peak force (1420 ± 165 vs. 1076 ± 256 N) and lean mass (74.18 ± 3.89 vs. 65.34 ± 3.89 kg) when compared to participants (n = 5) that could not complete the weighted evacuating task trial. Additionally, greater Army Physical Fitness Test scores (288 ± 13 vs. 269 ± 16 arbitrary units) and significantly faster (30.34 ± 4.41 vs. 44.92 ± 10.62 seconds) unweighted evacuation trial times were observed in participants that could complete the weighted evacuation task. Peak force was also significantly correlated with lean mass (r = 0.51, p < 0.05). There was no relationship between RFD and performance of the unweighted or weight trial. CONCLUSION: Isometric deadlift peak force represents an important determinant for the success of a simulated casualty evacuation task and may be a useful marker to include in periodic fitness evaluations of military personnel.