Minimal Population Prevalence and Mortality of Coronavirus Disease 2019 in Healthcare Personnel.

Among 3926 healthcare personnel in a multisite healthcare system, the minimal population prevalence of coronavirus disease 2019 (COVID-19) was 4.4% (bootstrap 95% confidence interval [CI], 3.7%-5.0%), and the infection fatality rate was 0.6% (bootstrap 95% CI, 0.0%-1.7%). Rates reflected both local community prevalence and hospital exposures but not specifically exposure on COVID-19 units.

An application to support COVID-19 occupational health and patient tracking at a Veterans Affairs medical center.

OBJECTIVE: Reducing risk of coronavirus disease 2019 (COVID-19) infection among healthcare personnel requires a robust occupational health response involving multiple disciplines. We describe a flexible informatics solution to enable such coordination, and we make it available as open-source software. MATERIALS AND METHODS: We developed a stand-alone application that integrates data from several sources, including electronic health record data and data captured outside the electronic health record. RESULTS: The application facilitates workflows from different hospital departments, including Occupational Health and Infection Control, and has been used extensively. As of June 2020, 4629 employees and 7768 patients and have been added for tracking by the application, and the application has been accessed over 46 000 times. DISCUSSION: Data captured by the application provides both a historical and real-time view into the operational impact of COVID-19 within the hospital, enabling aggregate and patient-level reporting to support identification of new cases, contact tracing, outbreak investigations, and employee workforce management. CONCLUSIONS: We have developed an open-source application that facilitates communication and workflow across multiple disciplines to manage hospital employees impacted by the COVID-19 pandemic.

Medical Degree Disparity Among Authors of Original Research in Pediatric Journals.

INTRODUCTION: Research and scholarly output are integral parts of residency training for both residents and faculty. With the transition to a single accreditation system, scholarly activity and output of osteopathic physicians have garnered significant interest. Previous research has shown that osteopathic physicians in emergency medicine and obstetrics and gynecology infrequently publish original research in high impact journals. OBJECTIVE: To determine whether there is a disparity between osteopathic and allopathic physicians among authors who publish original research manuscripts in three high-impact pediatric journals. METHODS: The medical degree designation of the first and senior author (last author) and any advanced degree either author may have obtained were retrieved from the Journal of Pediatrics (J Pediatr), Pediatrics, and JAMA Pediatrics (JAMA Pediatr) for the years 2000, 2005, 2010 and 2015. Data was analyzed using simple descriptive statistics and linear regression. RESULTS: In total, 2232 manuscripts and 4296 authors were reviewed with 0.58% (25/4296) of all authors being osteopathic physicians. A total of 0.81% (18/2232) of first authors and 0.34% (7/2064) of senior authors were osteopathic physicians. For those with a dual degree, a total of 0.64% (5/777) of first and 0.33% (3/904) of senior authors were osteopathic physicians. No statistical trend could be established for increased first (p=0.24), senior (p=0.16), dual degree first (p=0.08) or dual degree senior (p=0.06) osteopathic physician authorship. Likewise, no statistical trend for increased authorship could be established for any Doctor of Osteopathic Medicine (DO) authorship role in the three journals over the time period studied. CONCLUSION: Very few osteopathic physicians have served as either the first or senior author in published original research manuscripts for the Journal of Pediatrics, Pediatrics, or JAMA Pediatrics for the years studied. Also, no statistical trend could be established for increased osteopathic physician publication over the same years.

Moving toward health and fitness: a collaborative academic and community mental health services partnership.

For individuals with serious mental illness, physical fitness is a health imperative. This article describes the progression of an ongoing interprofessional partnership formed between a university's school of health professions and a community mental health services agency to find ways to improve the physical health status of individuals served by the agency. Clinical and research initiatives involving nursing and physical therapy faculty and students have contributed to the establishment of a growing physical fitness and health promotion program championed by agency administrators, staff, and service users. The groundwork has been laid for future collaborative efforts. More needs to be done to turn the tide on the chronic disease tsunami that prematurely takes the lives of people struggling with mental disorders.

Functional alterations in protein kinase C beta II expression in melanoma.

Protein kinase C (PKC) is a heterogeneous family of serine/threonine protein kinases that have different biological effects in normal and neoplastic melanocytes (MCs). To explore the mechanism behind their differential response to PKC activation, we analyzed the expression profile of all nine PKC isoforms in normal human MCs, HPV16 E6/E7 immortalized MCs, and a panel of melanoma cell lines. We found reduced PKCbeta and increased PKCzeta and PKCiota expression at both the protein and mRNA levels in immortalized MCs and melanoma lines. We focused on PKCbeta as it has been functionally linked to melanin production and oxidative stress response. Re-expression of PKCbeta in melanoma cells inhibited colony formation in soft agar, indicating that PKCbeta loss in melanoma is important for melanoma growth. PKCbetaII, but not PKCbetaI, was localized to the mitochondria, and inhibition of PKCbeta significantly reduced UV-induced reactive oxygen species (ROS) in MCs with high PKCbeta expression. Thus alterations in PKCbeta expression in melanoma contribute to their neoplastic phenotype, possibly by reducing oxidative stress, and may constitute a selective therapeutic target.

Tremor frequency profile as a function of level of mental retardation.

The characteristic slowness of movement initiation and execution in adult individuals with mental retardation may be driven by the slower frequency profile of the dynamics of the system. To investigate this hypothesis, we examined the resting and postural finger tremor frequency profile (single and dual limb) of adults as a function of level of mental retardation (moderate, severe, profound). There was a progressive increase in the contribution of slow frequency components to the enhanced amplitude of tremor as a function of mental retardation, particularly in the group with profound mental retardation. Findings support the hypothesis of mental retardation inducing a slower frequency to the system dynamics that may fundamentally drive the characteristic slowness of movement behavior.

Force-velocity and power-velocity relationships during maximal short-term rowing ergometry.

INTRODUCTION: Maximal rowing power-velocity relationships that exhibit ascending and descending limbs and a local maximum have not been reported. Further, duty cycle (portion of the stroke occupied by the pull phase) is unconstrained during rowing and is known to influence average muscular power output. PURPOSE: Our purposes for conducting this study were to fully describe maximal short-term rowing force-velocity and power-velocity relationships. Within the context of those purposes, we also aimed to determine the apex of the power-velocity relationship and the influence of freely chosen duty cycle on stroke power. METHODS: Collegiate varsity male rowers (N = 11, 22.9 +/- 2.3 yr, 84.1 + 12.1 kg, 184 +/- 7 cm) performed five maximal rowing trials using an inertial load ergometer. For each stroke, we determined force and power averaged for the pull phase and the complete stroke, instantaneous peak force and power, average handle velocity for the pull phase, handle velocity at peak instantaneous force and power, pull time, recovery time, and freely chosen duty cycle. Force-velocity and power-velocity relationships were characterized using regression analyses, and optimal velocities were determined from the regression coefficients. RESULTS: Pull force-velocity (r2 = 0.99) and peak instantaneous force-velocity (r2 = 0.93) relationships were linear. Stroke power (r2 = 0.98), pull power (r2 = 0.99), and instantaneous peak power (r2 = 0.99) were quadratic, with apexes at 2.04, 3.25, and 3.43 m x s(-1), respectively. Maximum power values were 812 +/- 28 W (9.8 +/- 0.4 W x kg(-1)), 1995 +/- 67 W (23.9 +/- 0.7 W x kg(-1)), and 3481 +/- 112 W (41.9 +/- 1.3 W x kg(-1)) for stroke, pull, and instantaneous power, respectively. Freely chosen duty cycle decreased from 58 +/- 1% on the first stroke to 26 +/- 1% on the fifth stroke. CONCLUSIONS: These data characterized the maximal rowing force-velocity and power-velocity relationships and identified the optimal velocity for producing maximal rowing power. Differences in maximum pull and stroke power emphasized the importance of duty cycle.

Effect of a carbohydrate-protein supplement on endurance performance during exercise of varying intensity.

Increasing the plasma glucose and insulin concentrations during prolonged variable intensity exercise by supplementing with carbohydrate has been found to spare muscle glycogen and increase aerobic endurance. Furthermore, the addition of protein to a carbohydrate supplement will enhance the insulin response of a carbohydrate supplement. The purpose of the present study was to compare the effects of a carbohydrate and a carbohydrate-protein supplement on aerobic endurance performance. Nine trained cyclists exercised on 3 separate occasions at intensities that varied between 45% and 75% VO2max for 3 h and then at 85% VO2max until fatigued. Supplements (200 ml) were provided every 20 min and consisted of placebo, a 7.75% carbohydrate solution, and a 7.75% carbohydrate/1.94% protein solution. Treatments were administered using a double-blind randomized design. Carbohydrate supplementation significantly increased time to exhaustion (carbohydrate 19.7 +/- 4.6 min vs. placebo 12.7 +/- 3.1 min), while the addition of protein enhanced the effect of the carbohydrate supplement (carbohydrate-protein 26.9 +/- 4.5 min, p < .05). Blood glucose and plasma insulin levels were elevated above placebo during carbohydrate and carbohydrate-protein supplementation, but no differences were found between the carbohydrate and carbohydrate-protein treatments. In summary, we found that the addition of protein to a carbohydrate supplement enhanced aerobic endurance performance above that which occurred with carbohydrate alone, but the reason for this improvement in performance was not evident.

Onset of dyskinesia and changes in postural task performance during the course of neuroleptic withdrawal.

The effect of neuroleptic withdrawal on postural task performance of 20 adults with mental retardation was examined. Dyskinesia was measured using the DISCUS rating scale and postural stability using a force platform during a prospective longitudinal neuroleptic medication withdrawal protocol. Assessments were conducted at baseline and monthly intervals, extending to approximately one year following complete medication withdrawal, when significant changes in amount of postural motion and sequential pattern of postural movement complexity were observed. Postural task performance tended to return to near baseline levels at periods of up to 1 year following medication withdrawal, although one third of the subjects continued to display atypical postural motion profiles at follow-up. Results provide within-subject evidence that tardive dyskinesia is associated with generalized changes in motor control and not simply peripheral disturbances of movement.

Whistleblowing: a very unpleasant avocation.

This article presents a first-person account of the events surrounding the investigation and sanctioning of Stephen E. Breuning for scientific fraud. The adverse consequences to the whistleblower in this case are also discussed in detail.