Clinical Practice Guidelines by the Infectious Diseases Society of America (IDSA), American Academy of Neurology (AAN), and American College of Rheumatology (ACR): 2020 Guidelines for the Prevention, Diagnosis and Treatment of Lyme Disease.

This evidence-based clinical practice guideline for the prevention, diagnosis, and treatment of Lyme disease was developed by a multidisciplinary panel representing the Infectious Diseases Society of America (IDSA), the American Academy of Neurology (AAN), and the American College of Rheumatology (ACR). The scope of this guideline includes prevention of Lyme disease, and the diagnosis and treatment of Lyme disease presenting as erythema migrans, Lyme disease complicated by neurologic, cardiac, and rheumatologic manifestations, Eurasian manifestations of Lyme disease, and Lyme disease complicated by coinfection with other tick-borne pathogens. This guideline does not include comprehensive recommendations for babesiosis and tick-borne rickettsial infections, which are published in separate guidelines. The target audience for this guideline includes primary care physicians and specialists caring for this condition such as infectious diseases specialists, emergency physicians, internists, pediatricians, family physicians, neurologists, rheumatologists, cardiologists and dermatologists in North America.

Clinical Practice Guidelines by the Infectious Diseases Society of America (IDSA), American Academy of Neurology (AAN), and American College of Rheumatology (ACR): 2020 Guidelines for the Prevention, Diagnosis and Treatment of Lyme Disease.

This evidence-based clinical practice guideline for the prevention, diagnosis, and treatment of Lyme disease was developed by a multidisciplinary panel representing the Infectious Diseases Society of America (IDSA), the American Academy of Neurology (AAN), and the American College of Rheumatology (ACR). The scope of this guideline includes prevention of Lyme disease, and the diagnosis and treatment of Lyme disease presenting as erythema migrans, Lyme disease complicated by neurologic, cardiac, and rheumatologic manifestations, Eurasian manifestations of Lyme disease, and Lyme disease complicated by coinfection with other tick-borne pathogens. This guideline does not include comprehensive recommendations for babesiosis and tick-borne rickettsial infections, which are published in separate guidelines. The target audience for this guideline includes primary care physicians and specialists caring for this condition such as infectious diseases specialists, emergency physicians, internists, pediatricians, family physicians, neurologists, rheumatologists, cardiologists and dermatologists in North America.

Recent Decline of Atmospheric Mercury Recorded by Androsace tapete on the Tibetan Plateau.

We combined the mercury passive sampling method and plant biomonitoring together to understand the long-term changes of atmospheric mercury concentrations on the Tibetan Plateau. Through the analysis of leaves of Androsace tapete that represent growing periods spanning the past decade, we explored the historical records of atmospheric mercury from 2006 to 2015. Mercury concentration was stable in the leaves of Androsace tapete during the period between 2006 and 2009, while a significant decrease occurred after the year of 2010. The decreasing trend is consistent with the monitoring data of the ground-based stations in other regions globally. Despite the potential uncertainties using a passive sampling method and biomonitoring technique, we suggest that Androsace tapete is a potential biomarker that could provide reliable and effective historical records of atmospheric mercury concentrations and offer new perspectives in monitoring mercury and perhaps other atmospheric pollutants in regions where long-term active monitoring was missing.

Elemental mercury vapor interaction with individual gold nanorods.

We show that single gold nanorods can act as highly sensitive mercury vapor sensors with attogram resolution. We exposed assorted gold nanorods, with aspect ratios ranging from 2.8-4.1, to µg m(-3) concentrations of mercury vapor in air for 1 hour. Pre- and post-exposure, the nanorods were examined with a combination of dark field spectroscopy and transmission electron microscopy. Because we isolated individual particles, we can describe the shape and size effects distinctly rather than statistically (a constraint of studying heterogeneous nanoparticle films). No measurable changes occurred to the shape and size of the nanorods due to their saturation with mercury vapor. The localized surface plasmon resonance (LSPR) of the mercury-saturated nanorods blue shifted 2.6-3.8 nm; the magnitude of the shift depended on the initial shape and size of the nanorod. Larger aspect ratios and surface-area-to-volume ratios both enhance the LSPR shift seen in saturated nanoparticles. The predictions of a core-shell model mirrors the shape and size effects observed experimentally. These results increase our understanding of mercury-adsorption by gold surfaces, and help to optimize nanoparticle-based plasmonic mercury sensing.

Gold nanoparticle films as sensitive and reusable elemental mercury sensors.

We demonstrate the utility of gold nanoparticles (AuNPs) as the basis of a stand-alone, inexpensive, and sensitive mercury monitor. Gold nanoparticles absorb visible light due to localized surface plasmon resonance (LSPR), and the absorbance changes when mercury combines with the gold nanoparticles. The sensitivity of the peak absorbance is proportional to the surface-area-to-volume ratio. We chose 5 nm spheres because they have the largest surface-area-to-volume ratio while still having a peak absorption in the visible range. The adsorption of 15 atoms of Hg causes a 1 nm shift in the LSPR wavelength of these particles. Assembled into a film using the Langmuir-Blodgett method, the AuNP LSPR can be tracked with a simple UV-vis spectrometer. The rate of shift in the peak absorbance is linear with mercury concentrations from 1 to 825 µg(Hg)/m(air)(3). Increasing the flow velocity (and mass transfer rate) increases the peak shift rate making this system a viable method for direct ambient mercury vapor measurements. Regeneration of the sensing films, done by heating to 160 °C, allows for repeatable measurements on the same film.

The distribution between the dissolved and the particulate forms of 49 metals across the Tigris River, Baghdad, Iraq.

The distribution of dissolved and particulate forms of 49 elements was investigated along transect of the Tigris River (one of the major rivers of the world) within Baghdad city and in its major tributary (Diyala River) from 11 to 28 July 2011. SF-ICP-MS was used to measure total and filterable elements at 17 locations along the Tigris River transect, two samples from the Diyala River, and in one sample from the confluence of the two rivers. The calculated particulate forms were used to determine the particle-partition coefficients of the metals. No major changes in the elements concentrations down the river transect. Dissolved phases dominated the physical speciation of many metals (e.g., As, Mo, and Pt) in the Tigris River, while Al, Fe, Pb, Th, and Ti were exhibiting high particulate fractions, with a trend of particle partition coefficients of [Ti(40) > Th(35) > Fe(15) > Al(13) > Pb(4.5)] ∗ 10(6) L/kg. Particulate forms of all metals exhibited high concentrations in the Diyala River, though the partition coefficients were low due to high TSS (~270 mg/L). A comparison of Tigris with the major rivers of the world showed that Tigris quality in Baghdad is comparable to Seine River quality in Paris.

Source attribution of black and Brown carbon near-UV light absorption in Beijing, China and the impact of regional air-mass transport.

Black and Brown Carbon (BC, BrC) are key parameters of climate forcing, yet significant challenges exist assigning emission source contributions to light-absorption by carbonaceous aerosols. Additionally, BC and BrC emissions add to extreme air pollution events in Chinese mega-cities, which harm human health and detract from the natural and built environment. To address these concerns, the ability to estimate atmospheric light absorption related to emission sources and global inventories is a highly valuable tool for climate modelers and policy makers. Three months of BC and BrC data was collected using an Aethalometer in parallel to PM2.5 filter sampling during a stringent emission controls period and post controls period, including during the regional heating season. In this study reconstructed 370 nm wavelength absorption was calculated by applying source specific Mass Absorption Cross-Sections to PMF apportioned EC and OC results. Reconstructed absorption showed good agreement with the ambient measured absorption for both BC and BrC. In Beijing, the major contributor to near-UV absorption was mobile sources, which accounted for 45-54% of absorption by BC and 14-18% by BrC. BrC absorption from secondary aerosols, biomass burning, and soil dust was also estimated, with these sources contributing from 1 to 9% individually. Meteorological cluster analysis showed that air mass origin did not impact the absorption reconstruction and that the highest regional contribution to near-UV light absorption originated primarily in areas south and east of Beijing. The study shows ambient near-UV light absorption can be predicted using BC and BrC MAC values from sources. However, the current number of multi-wavelength and source specific BrC MAC values reported in the literature is limited. The reconstruction approach allows for a more robust method of assigning light absorption to source categories, allowing the expansion of aethalometer derived BrC apportionment to multiple sources, including biomass burning.

Clinical Practice Guidelines by the Infectious Diseases Society of America, American Academy of Neurology, and American College of Rheumatology: 2020 Guidelines for the Prevention, Diagnosis, and Treatment of Lyme Disease.

This evidence-based clinical practice guideline for the prevention, diagnosis, and treatment of Lyme disease was developed by a multidisciplinary panel representing the Infectious Diseases Society of America (IDSA), the American Academy of Neurology (AAN), and the American College of Rheumatology (ACR). The scope of this guideline includes prevention of Lyme disease, and the diagnosis and treatment of Lyme disease presenting as erythema migrans, Lyme disease complicated by neurologic, cardiac, and rheumatologic manifestations, Eurasian manifestations of Lyme disease, and Lyme disease complicated by coinfection with other tick-borne pathogens. This guideline does not include comprehensive recommendations for babesiosis and tick-borne rickettsial infections, which are published in separate guidelines. The target audience for this guideline includes primary care physicians and specialists caring for this condition such as infectious diseases specialists, emergency physicians, internists, pediatricians, family physicians, neurologists, rheumatologists, cardiologists and dermatologists in North America.

Indications for Fine Needle Aspiration Biopsy of Posterior Segment Intraocular Tumors.

PURPOSE: To define 4 indication categories of fine needle aspiration biopsies (FNABs) of solid intraocular tumors and describe the differences among the patients, tumors, and results of biopsy in these 4 indication categories. METHODS: Retrospective descriptive analysis of 880 FNABs of a solid intraocular tumor of the posterior ocular segment performed by in the authors' ocular oncology practice during the period July 1980 through July 2014. RESULTS: FNABs were performed as a separate procedure in 372 cases (42.3%), at plaque implantation in 279 (31.7%), post-enucleation in 225 (25.6%), and post-resection/pre-laser in 4 (0.4%). FNABs were categorized as diagnostic in 292 (33.2%), confirmatory in 121 (13.8%), investigational in 187 (21.3%), and prognostic in 280 (31.8%). Prior to the biopsy, all patients who underwent diagnostic FNAB had a tumor of uncertain pathologic type, while all patients who underwent confirmatory FNAB had a clinically diagnosed malignant intraocular neoplasm. In contrast, all patients who underwent a prognostic FNAB had an unequivocal primary posterior uveal melanoma clinically, while patients who underwent an investigational biopsy all had an unequivocal or probable malignant intraocular tumor of a specific type. Most diagnostic FNABs were performed transvitreously (n = 255, 87.3%) compared to prognostic FNABs (n = 143, 51.1%) (P < .001). Overall, 733 FNABs (83.3%) yielded a sufficient specimen for cytologic diagnosis. Diagnostic and confirmatory FNABs were the most likely to yield an insufficient aspirate (28.4% and 20.7%, respectively), while investigational and prognostic FNABs were most likely to yield sufficient specimens (94.7% and 90.0%, respectively) (P < .001). Mean post-FNAB follow-up of the entire group was 62.7 months (standard deviation [SD] = 59.8, 95% confidence interval [CI] = 58.7-66.6). Mean posttreatment follow-up or total follow-up of untreated patients was 53.7 months (SD = 58.7, 95% CI = 49.8-57.6). CONCLUSIONS: Because of the substantial differences shown among FNAB cases performed for different indications, it seems appropriate to report results of FNAB or other biopsy methods according to the category (indication) of the biopsy. NOTE: Publication of this article is sponsored by the American Ophthalmological Society.

Boutique neutrons advance 40Ar/39Ar geochronology.

We designed and tested a compact deuteron-deuteron fusion neutron generator for application to 40Ar/39Ar geochronology. The nearly monoenergetic neutrons produced for sample irradiation are anticipated to provide several advantages compared with conventional fission spectrum neutrons: Reduction of collateral nuclear reactions increases age accuracy and precision. Irradiation parameters within the neutron generator are more controllable compared with fission reactors. Confidence in the prediction of recoil energies is improved, and their likely reduction potentially broadens applicability of the dating method to fine-grained materials without vacuum encapsulation. Resolution of variation in the 39K(n,p)39Ar neutron capture cross section at 1.3 to 3.2 MeV and discovery of a strong resonance at ~2.4 MeV illuminate future pathways to improve the technique for 40Ar/39Ar dating.

A comparison of ten USEPA approved total coliform/E. coli tests.

Since 2002, the United States Environmental Protection Agency (USEPA) has approved ten enzyme-based total coliform and E. coli detection tests for examination of drinking water. These tests include: Colilert, Colilert-18, Colisure, m-Coli Blue 24, Readycult Coliforms 100, Chromocult, Coliscan, E * Colite, Colitag and MI Agar. The utility of the enzyme based test systems is based on both the ability of the test to detect the target organisms at low levels and the ability of the test system to suppress the growth of non-target organisms that might result in false positive results. Differences in the ability of some of these methods to detect total coliform and E. coli, as well as suppress Aeromonas spp., a common cause of "false positive" results, have been observed. As a result, this study was undertaken to elucidate the strengths and weaknesses of each method. Water samples were collected from three geographically and chemically diverse groundwaters in Wisconsin. One-hundred milliliter aliquots were individually spiked with both low concentrations (one to ten organisms) and high concentrations (fifty to one-hundred) of each of five different total coliform organisms (Serratia, Citrobacter, Enterobacter, E. coli, & Klebsiella). These spiked samples were used to test the capability of ten enzyme-based test systems to both detect and enumerate the spiked organisms. In addition, 100 ml samples were independently spiked with two different strains of Aeromonas spp. at six different levels, to assess the ability of each enzyme-based test to suppress Aeromonas spp. Analysis of the data indicated that wide variability exists among USEPA approved tests to detect and quantify total coliforms, as well as suppress Aeromonas spp.

Connecting science with industry: lessons learned transferring a novel plasmonic mercury sensor from the bench to the field.

Mercury is a pollutant of pressing global concern. National and international efforts are focused on reducing mercury in the environment to prevent its adverse health impacts. Better sensors would aid in these efforts. This paper details ongoing efforts to deploy novel plasmonic mercury sensors. The authors describe the research efforts to develop the fundamental technology in a research lab and the experience translating that fundamental research into a viable field-ready sensor. Lessons learned along the way are explored.

Associations between anthropometric characteristics and physical performance in male law enforcement officers: a retrospective cohort study.

BACKGROUND: Police officers are often required to undertake physically demanding tasks, like lifting, dragging and pursuing a suspect. Therefore, physical performance is a key requirement. METHODS: Retrospective data for 76 male police officers (mean age = 39.42 ± 8.41 years; mean weight = 84.21 ± 12.91 kg) was obtained. Data included anthropometric (skinfolds, estimated percentage body fat, lean body mass and fat mass) and physical performance (1 Repetition Maximum Bench Press, 1-min sit-ups, 1-min push-ups, vertical jump, 300 m run, 1.5 mile run) measures and correlations between anthropometric measurement and fitness score were obtained. RESULTS: Estimated percentage body fat was significantly (p ≤ .001) and negatively correlated with all performance measures, except sit-ups and 300 m and 1.5 mile run performance. Estimated lean body mass was significantly and positively (p ≤ .001) correlated with push-ups, bench press and vertical jump measures, while increasing estimated fat mass was significantly (p ≤ .001) associated with reduced performance on sit-up, vertical jump, 1.5 mile run and estimated maximal voluntary oxygen uptake. CONCLUSIONS: A targeted approach, going beyond just decreasing percentage body fat to also selectively increasing lean mass, should be applied for optimal improvement in physical fitness performance.

Relative impact of emissions controls and meteorology on air pollution mitigation associated with the Asia-Pacific Economic Cooperation (APEC) conference in Beijing, China.

The Beijing government and its surrounding provinces implemented a series of measures to ensure haze-free skies during the 22(nd) Asia-Pacific Economic Cooperation (APEC) conference (November 10(th)-11(th), 2014). These measures included restrictions on traffic, construction, and industrial activity. Twelve hour measurements of the concentration and composition of ambient fine particulate matter (PM2.5) were performed for 5 consecutive months near the APEC conference site before (September 11(th)-November 2(nd), 2014), during (November 3(rd)-12(th), 2014) and after (November 13(th), 2014-January 31(st), 2015). The measurements are used in a positive matrix factorization model to determine the contributions from seven sources of PM2.5: secondary aerosols, traffic exhaust, industrial emission, road dust, soil dust, biomass burning and residual oil combustion. The source apportionment results are integrated with backward trajectory analysis using Weather Research and Forecast (WRF) meteorological simulations, which determine the relative influence of new regulation and meteorology upon improved air quality during the APEC conference. Data show that controls are very effective, but meteorology must be taken into account to determine the actual influence of the controls on pollution reduction. The industry source control is the most effective for reducing concentrations, followed by secondary aerosol and biomass controls, while the least effective control is for the residual oil combustion source. The largest reductions in concentrations occur when air mass transport is from the west-northwest (Ulanqab). Secondary aerosol and traffic exhaust reductions are most significant for air mass transport from the north-northwest (Xilingele League) origin, and least significant for northeast transport (Chifeng via Tangshan conditions). The largest reductions of soil dust, biomass burning, and industrial source are distinctly seen for Ulanqab conditions and least distinct for Xilingele League.

Structural and Functional MRI Differences in Master Sommeliers: A Pilot Study on Expertise in the Brain.

Our experiences, even as adults, shape our brains. Regional differences have been found in experts, with the regions associated with their particular skill-set. Functional differences have also been noted in brain activation patterns in some experts. This study uses multimodal techniques to assess structural and functional patterns that differ between experts and non-experts. Sommeliers are experts in wine and thus in olfaction. We assessed differences in Master Sommeliers' brains, compared with controls, in structure and also in functional response to olfactory and visual judgment tasks. MRI data were analyzed using voxel-based morphometry as well as automated parcellation to assess structural properties, and group differences between tasks were calculated. Results indicate enhanced volume in the right insula and entorhinal cortex, with the cortical thickness of the entorhinal correlating with experience. There were regional activation differences in a large area involving the right olfactory and memory regions, with heightened activation specifically for sommeliers during an olfactory task. Our results indicate that sommeliers' brains show specialization in the expected regions of the olfactory and memory networks, and also in regions important in integration of internal sensory stimuli and external cues. Overall, these differences suggest that specialized expertise and training might result in enhancements in the brain well into adulthood. This is particularly important given the regions involved, which are the first to be impacted by many neurodegenerative diseases.

Design Criteria for Future Fuels and Related Power Systems Addressing the Impacts of Non-CO2 Pollutants on Human Health and Climate Change.

Concerns over the economics, supply chain, and emissions of greenhouse gases associated with the wide use of fossil fuels have led to increasing interest in developing alternative and renewable fuels for stationary power generation and transportation systems. Although there is considerable uncertainty regarding the economic and environmental impacts of alternative and renewable fuels, there is a great need for assessment of potential and emerging fuels to guide research priorities and infrastructure investment. Likewise, there is a great need to identify potential unintended adverse impacts of new fuels and related power systems before they are widely adopted. Historically, the environmental impacts of emerging fuels and power systems have largely focused on carbon dioxide emissions, often called the carbon footprint, which is used to assess impacts on climate change. Such assessments largely ignore the large impacts of emissions of other air pollutants. Given the potential changes in emissions of air pollutants associated with the large-scale use of new and emerging fuels and power systems, there is a great need to better guide efforts to develop new fuels and power systems that can avoid unexpected adverse impacts on the environment and human health. This review covers the nature of emissions, including the key components and impacts from the use of fuels, and the design criteria for future fuels and associated power systems to assure that the non-CO2 adverse impacts of stationary power generation and transportation are minimized.

Prognostic implications of cytopathologic classification of melanocytic uveal tumors evaluated by fine-needle aspiration biopsy.

PURPOSE: Determine whether cytopathologic classification of melanocytic uveal tumors evaluated by fine-needle aspiration biopsy (FNAB) is a significant prognostic factor for death from metastasis. METHODS: Retrospective analysis of cases of clinically diagnosed uveal melanoma evaluated by fine-needle aspiration biopsy from 1980 to 2006. Main outcome evaluated was death from metastasis. Associations between baseline clinical variables and cytopathologic classification were evaluated using cross-tabulation. Prognostic significance of cytopathologic classification was evaluated by Kaplan-Meier and Cox proportional hazards analysis. RESULTS: Of 302 studied biopsies, 260 (86.1%) yielded sufficient cells for cytopathologic classification. Eighty of the 260 patients who had a sufficient specimen have already died (P=0.021), 69 from metastatic uveal melanoma. Cell type assigned by cytopathology was strongly associated with metastasis/metastatic death in this series (P=0.0048). Multivariate analysis showed cytopathologic classification to be an independently significant prognostic factor for metastatic death (P=0.0006). None of the 42 patients whose tumor yielded insufficient aspirates (sampled in at least two sites) have developed metastasis or died of metastasis thus far. CONCLUSION: In this series, cytopathology of fine-needle aspiration biopsy samples obtained from uveal melanomas was strongly prognostic of death from metastasis. Insufficiently aspirates (2 or more sites sampled) proved to be prognostic of a favorable outcome (i.e., not developing metastasis).