Urgent COVID-19 Vaccination of Healthcare Workers via a Quality Improvement Initiative.

The COVID-19 pandemic has posed a significant threat to US healthcare workers' mental and physical health. The US Food and Drug Administration approved the first mRNA COVID-19 vaccine for Emergency Use Authorization on December 11, 2020. High-risk healthcare workers were determined to be Phase 1a. Goal: Complete the two-dose vaccine series in all interested phase 1a staff immediately after the COVID-19 vaccine was available and distributed to our institution, December 14, 2020. METHODS: A multidisciplinary team involving key stakeholders performed process mapping to develop four key drivers for vaccination success: rapid vaccine procurement, proper storage and handling, well-defined vaccine administration and follow-up plan, and system preparation. We tested interventions using plan-do-study-act cycles. We included employees and providers with direct patient care responsibilities, age 18 years or older, employed at the children's health system, or the affiliated academic medical center. We examined the total number of dose 1 and dose 2 vaccines administered for our primary outcome, and the balancing measure included the percent of wasted vaccines. RESULTS: Three thousand nine-hundred twenty-one healthcare personnel completed the survey, and 73% reported intent to receive the COVID-19 vaccine immediately or at a later time. After 57 clinic days, we vaccinated 83% (n = 5,231) of healthcare personnel at our institution, and 99% completed the two-dose series. Due to surplus vaccines, we vaccinated an additional 1,258 community members with 99% completion of the two-dose series. Vaccine waste was minimal 0.1%. CONCLUSION: We describe the development and implementation of a successful COVID-19 employee and community vaccination program.

Stillbirth Risk during the 1918 Influenza Pandemic in Arizona, USA.

The 1918 influenza pandemic, the deadliest pandemic on record, affected approximately 1/3rd of the population worldwide. The impact of this pandemic on stillbirth risk has not been studied in depth. In this study, we assessed the stillbirth risk during the 1918 influenza pandemic in Arizona, USA. We carried out a retrospective study using 21,334 birth records for Maricopa County, Arizona, for the period 1915-1925. We conducted logistic regression analyses to assess the effect of that pandemic on stillbirth risk. Though we did not find a statistically significant impact on stillbirth risk during the pandemic, there was a higher risk of stillbirth in July 1919 (42 stillbirths/1000 births), 9 months after the peak pandemic mortality, and a stillbirth risk of 1.42 (95% CI: 1.17, 1.72) in women ≥35 years compared to the women aged <35 years. The risk of stillbirth was lowest if the mother's age was approximately 26 years at the time of birth. We also report peaks in stillbirth risk 9-10 months after the peak pandemic mortality. Our findings add to our current understanding of the link between pandemic influenza and stillbirth risk.

Ethylene induced cotton leaf abscission is associated with higher expression of cellulase (GhCel1) and increased activities of ethylene biosynthesis enzymes in abscission zone.

Ethylene induced cotton (Gossypium hirsutum var RST-39) leaf abscission has been characterized by measuring the activities of ACC synthase (ACS, E.C. 4.4.1.14), ACC oxidase (ACO, E.C. 1.14.17.4) and cellulase (E.C. 3.2.1.4). In addition, a leaf abscission specific cDNA (GhCel1) has been cloned from cotton, which belongs to the alpha(2) subgroup of cellulases that possess a C-terminus carbohydrate-binding domain. Measurement of enzyme activity in the abscission zones of cotton leaf explants exposed to ethylene for 48h compared to non-treated controls indicated a more than 5-fold increase in the activity of ACS, 1.2-fold increase in the activity of ACO and about 2.7-fold increase in the activity of cellulase in the ethylene treated explants. This increase was accompanied by a substantial decrease in the force required to separate the petiole from the stem (break strength) and an increased accumulation of cellulase transcript in the abscission zone. Treatment of explants with 1-Methylcyclopropene (1-MCP) prior to ethylene resulted in significant inhibition of enzyme activities and transcript accumulation. It is concluded that ethylene response of cotton leaf abscission leads to higher cellulase expression and increased activities of ethylene biosynthesis enzymes in the abscission zone.