Impact of SARS-CoV-2 Arrival Surveillance Screening by Nucleic Acid Amplification Versus Rapid Antigen Detection on Subsequent COVID-19 Infections in Military Trainees.

BACKGROUND: For persons entering congregate settings, optimal severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) arrival surveillance screening method, nucleic acid amplification test (NAAT) versus rapid antigen detection test (RADT), is debated. To aid this, we sought to determine the risk of secondary symptomatic coronavirus disease 19 (COVID-19) among military trainees with negative arrival NAAT or RADT screening. METHODS: Individuals who arrived for US Air Force basic military training from 1 January-31 August 2021 were placed into training groups and screened for SARS-CoV-2 via NAAT or RADT. Secondary symptomatic COVID-19 cases within 2 weeks of training were then measured. A case cluster was defined as ≥5 individual symptomatic COVID-19 cases. RESULTS: 406 (1.6%) of 24 601 trainees screened positive upon arrival. The rate of positive screen was greater for those tested with NAAT versus RADT (2.5% vs 0.4%; RR: 5.4; 95% CI: 4.0-7.3; P < .001). The proportion of training groups with ≥1 positive individual screen was greater in groups screened via NAAT (57.5% vs 10.8%; RR: 5.31; 95% CI: 3.65-7.72; P < .001). However, NAAT versus RADT screening was not associated with a difference in number of training groups to develop a secondary symptomatic case (20.3% vs 22.5%; RR: .9; 95% CI: .66-1.23; P = .53) or case cluster of COVID-19 (4% vs 6.6%; RR: .61; 95% CI: .3-1.22; P = .16). CONCLUSIONS: NAAT versus RADT arrival surveillance screening method impacted individual transmission of COVID-19 but had no effect on number of training groups developing a secondary symptomatic case or case cluster. This study provides consideration for RADT arrival screening in congregate settings.

Infectious etiologies among post-donation deferrals in a military blood donation center.

BACKGROUND: The burden of transfusion-transmitted infections among blood recipients remains low due to extensive pre- and post-donation screening. However, the military has the unique challenge of providing blood in austere environments with limited testing capabilities. This study evaluates the infectious etiologies of deferred blood donors at a large military blood donation center. METHODS: All blood donors at the Armed Service Blood Bank Center, San Antonio, between 2017 and 2022 with positive post-donation screening for hepatitis C (HCV), hepatitis B (HBV), human immunodeficiency virus (HIV), human T-lymphotropic virus (HTLV-I/II), Zika (2018-2021), West Nile virus, Trypanosoma cruzi, Treponema pallidum, or Babesia microti (2020-2022) were evaluated. Donors were deferred based on Food and Drug Administration (FDA) guidance. RESULTS: Two-hundred and thirteen (213) donors met FDA criteria for deferral. T. pallidum (n = 45, 50.3 per 100,000), HCV (n = 34, 38.0 per 100,000), and HBV (n = 19, 21.2 per 100,000) were the most common pathogens among those with both positive screening and confirmatory testing. The majority of HIV (95%), Chagas (78%), HTLV-I/II (50%) deferrals were due to indeterminate confirmatory tests following initial positive screens. The majority of deferrals for HBV were for a second occurrence of a positive screen despite negative confirmatory testing. CONCLUSION: The rates of post-donation deferral for transfusion-transmissible infections were low in this military cohort. Our findings suggest that donor testing in deployed service members should focus on HBV, HCV, and T. pallidum and highlight the need for better diagnostics for HIV, Chagas, and HTLV-I/II.

Follow-up of Military Blood Donors Who Test Positive for Syphilis.

BACKGROUND: Several large studies have demonstrated that syphilis carries a risk of future sexually transmitted infections (STI), such as human immunodeficiency virus. There are limited data on outcomes of syphilis infections that occur in populations that undergo universal syphilis screening, such as blood donors. Military trainees who donate blood can be followed through their military career to determine the future risk of STIs. METHODS: Blood donor data were gathered from the Armed Services Blood Bank Center-San Antonio for those with positive Treponema pallidum antibodies between 2014 and 2021. The medical chart of each case was compared with 6 sex- and military accession date-matched controls with negative T. pallidum antibodies to determine the risk of STI in the 3 years after donation. RESULTS: A total of 63,375 individuals donated blood during the study period. A total of 23 military trainees (0.36 per 1000 donors) had positive T. pallidum antibodies. A minority (n = 7; 30%) of cases were treated for early syphilis. Only 6 cases (26%) received a follow-up nontreponemal test within 1 year. Donors who tested positive had a significantly higher risk of developing an STI within 3 years after blood donation compared with blood donors who tested negative (relative risk, 3.8; 95% confidence interval, 1.3-10.5; P = 0.01) including gonorrhea (9% vs. 0%, P = 0.02) and syphilis (9% vs. 0%, P = 0.02). CONCLUSIONS: This study shows the presence of T. pallidum antibodies in blood donors was associated with an increased risk of future STIs. These cases support the need for close follow-up and broad STI testing in blood donors with positive T. pallidum antibodies.

Sensitivity of Symptom-Based Screening for COVID-19 in Active Duty Basic Trainees.

INTRODUCTION: Symptomatic Coronavirus Disease 2019 (COVID-19) screening has been a cornerstone of case identification during the pandemic. Despite the myriad of COVID-19 symptoms, symptom screens have primarily focused on symptoms of influenza-like illnesses such as fever, cough, and dyspnea. It is unknown how well these symptoms identify cases in a young, healthy military population. This study aims to evaluate the utility of symptom-based screening in identifying COVID-19 through three different COVID-19 waves. MATERIALS AND METHODS: A convenience sample of 600 military trainees who arrived at Joint Base San Antonio-Lackland in 2021 and 2022 were included. Two hundred trainees with symptomatic COVID-19 before the emergence of the Delta variant (February-April 2021), when Delta variant was predominant (June-August 2021), and when Omicron was the predominant variant (January 2022) had their presenting symptoms compared. At each time point, the sensitivity of a screen for influenza-like illness symptoms was calculated. RESULTS: Of the 600 symptomatic active duty service members who tested positive for COVID-19, the most common symptoms were sore throat (n = 385, 64%), headache (n = 334, 56%), and cough (n = 314, 52%). Although sore throat was the most prominent symptom during Delta (n = 140, 70%) and Omicron (n = 153, 77%), headache was the most common before Delta (n = 93, 47%). There were significant differences in symptoms by vaccination status; for example, ageusia was more common in patients who were not completely vaccinated (3% vs. 0%, P = .01). Overall, screening for fever, cough, or dyspnea had a 65% sensitivity with its lowest sensitivity in the pre-Delta cases (54%) and highest sensitivity in Omicron cases (78%). CONCLUSIONS: In this descriptive cross-sectional study evaluating symptomatic military members with COVID-19, symptom prevalence varied based on predominant circulating COVID-19 variant as well as patients' vaccination status. As screening strategies evolve with the pandemic, changing symptom prevalence should be considered.

Contiguous High-Mobility Interphase Surrounding Nano-Precipitates in Polymer Matrix Solid Electrolyte.

We establish that an interfacial region develops around amorphous Li1.3Al0.3Ti1.7(PO4)3 (LATP) nanoparticles in a poly(ethylene oxide) (PEO), which exhibits a 30 times higher Li+ mobility than the polymer matrix. To take advantage of this gain throughout the material, nanoparticles must be uniformly dispersed across the matrix, so that the interphase formation is minimally blocked by LATP particle agglomeration. This is achieved using a water-based in situ precipitation method, carefully controlling the temperature schedule during processing. A maximum conductivity of 3.80 × 10-4 S cm-1 at 20 °C for an ethylene oxide to Li ratio of 10 is observed at 25 wt % (12.5 vol %) particle loading, as predicted by our tri-phase model. Comparative infrared spectroscopy reveals softening and broadening of the C-O-C stretching modes, reflecting increased disorder in the polymer backbone that is consistent with opening passageways for cation migration. A transition state theory-based approach for analyzing the temperature dependence of the ionic conductivity reveals that thermally activated processes within the interphase benefit more from higher activation entropy than from the decrease in activation enthalpy. The lithium infusion from LATP particles is small, and the charge carriers tend to concentrate in a space-charge configuration near the particle/polymer interface.

Response to a Serogroup B Meningococcal Disease Case Among Military Trainees.

We describe the public health response to a military trainee who developed serogroup B meningococcal disease while sharing underwater breathing equipment. Despite high transmission risk, with rapid isolation and postexposure prophylaxis administration, there were no secondary cases. This case supports carefully weighing serogroup B meningococcal vaccination in high-risk settings.

Amplifying the Sensitivity of Polydiacetylene Sensors: The Dummy Molecule Approach.

There is an increasing need for fast and accurate assessment of various health conditions, where polydiacetylenes (PDA), having unique stress-sensitive optical properties, have great potential. When the conjugated backbone of PDA is disturbed by steric repulsion between the receptor-target complexes formed at the PDA surface via specific recognition events, the bandgap of PDA increases and produces color change and fluorescent emission as a dual sensory signal. However, this detection mechanism suggests an intrinsic sensitivity limit of PDA platform because unless adjacent receptors are occupied by target molecules no signal is anticipated. A novel approach to improve the sensitivity and limit of detection of PDA sensors has been developed by preoccupying the surface of PDA liposomes with an optimized amount of artificial target molecules named as dummy molecules. The sensitivity and limit of detection (LOD) showed large improvement by the surface-bound dummy molecules. In addition, the dummy strategy was synergically integrated with another sensitivity enhancing method with a different working mechanism in a PDA sensor for Neomycin detection. When optimized, the LOD of the PDA sensor was improved to 7 nM from 80 nM of the control and the signal intensity increased consistently throughout the entire tested concentration range of the target Neomycin. Finally, the general applicability of the dummy strategy to other target molecules was successfully confirmed by implementing the dummy strategy in a PDA sensor for Surfactin detection.

Sequencing SARS-CoV-2 from antigen tests.

Genomic surveillance empowers agile responses to SARS-CoV-2 by enabling scientists and public health analysts to issue recommendations aimed at slowing transmission, prioritizing contact tracing, and building a robust genomic sequencing surveillance strategy. Since the start of the pandemic, real time RT-PCR diagnostic testing from upper respiratory specimens, such as nasopharyngeal (NP) swabs, has been the standard. Moreover, respiratory samples in viral transport media are the ideal specimen for SARS-CoV-2 whole-genome sequencing (WGS). In early 2021, many clinicians transitioned to antigen-based SARS-CoV-2 detection tests, which use anterior nasal swabs for SARS-CoV-2 antigen detection. Despite this shift in testing methods, the need for whole-genome sequence surveillance remains. Thus, we developed a workflow for whole-genome sequencing with antigen test-derived swabs as an input rather than nasopharyngeal swabs. In this study, we use excess clinical specimens processed using the BinaxNOW™ COVID-19 Ag Card. We demonstrate that whole-genome sequencing from antigen tests is feasible and yields similar results from RT-PCR-based assays utilizing a swab in viral transport media.

The role of halogen bonding in metal free phosphors.

The enhanced spin-orbit coupling necessary for phosphorescence is thought to be due to the halogen bonding that is present in the all-organic crystalline systems. To elucidate the underlying mechanism, the electronic and optical properties of purely organic phosphor candidates are investigated using density functional theory calculations. The unit cell structure of a known organic phosphor containing bromine is used to validate the accuracy of the computational methodology. Compared to experiments, the calculated lattice constants deviate by less than 1 percent for each lattice constant. The same computational approach is then used to predict the lattice constants for molecular analogs containing fluorine, chlorine, and iodine. Electronic structure and photonic properties of the predicted crystals are computed. Finally, the presence of halogen bonding is corroborated, with fluorine forming the weakest and iodine the strongest halogen bonding interactions. Our findings demonstrate how computational methods can be effectively used for the predictive design of organic materials in lighting devices.

Mental health disorders, behavioral health problems, fatigue and sleep outcomes in remotely piloted aircraft/manned aircraft pilots, and remotely piloted aircraft crew, U.S. Air Force, 1 October 2003-30 June 2019.

U.S. Air Force (USAF) manned aircraft (MA) pilots and remotely piloted aircraft (RPA) pilots and their non-pilot crew form part of the forward-most contingent of airpower. Limited information exists on the incidence of mental health (MH) disorders, behavioral health (BH) problems, sleep disorders, and fatigue among these groups. Incidence rates and incidence rate ratios of these conditions were calculated among all active component USAF members during the period from 1 October 2003 to 30 June 2019. Compared to those in all other USAF occupations, RPA and MA pilots had statistically significantly lower risk of MH and BH outcomes while RPA crew shared a risk similar to other USAF members, although with higher risk of post-traumatic stress disorder and lower risk of substance- and alcohol-related disorders. This pattern was similar for fatigue outcomes except RPA crew had slightly higher risk. All 3 occupational groups had elevated risk for sleep disorders, and RPA pilots had 32% higher risk compared to those in all other USAF occupations. This study highlights that pilots have lower risk and/or reporting tendency for MH disorders, BH problems, and fatigue, while sleep disorders are common among service members in all of these (RPA/MA pilot, RPA crew) occupations.

Charge Transfer as the Key Parameter Affecting the Color Purity of Thermally Activated Delayed Fluorescence Emitters.

The key factors determining the emission bandwidth of thermally activated delayed fluorescence (TADF) are investigated by combining computational and experimental approaches. To achieve high internal quantum efficiencies in a metal-free organic light-emitting diode via TADF, the first triplet (T1) to first singlet (S1) reverse intersystem crossing is promoted by configuring molecules in an electron donor-acceptor (D-A) alternation with a large dihedral angle, which results in a small energy gap (ΔEST) between S1 and T1 levels. This allows for effective non-radiative up-conversion of triplet excitons to singlet excitons that fluoresce. However, this traditional molecular design of TADF results in broad emission spectral bands (full-width at half-maximum = 70-100 nm). Despite reports suggesting that suppressing the D-A dihedral rotation narrows the emission band, the origin of emission broadening remains elusive. Indeed, our results suggest that the intrinsic TADF emission bandwidth is primarily determined by the charge transfer character of the molecule, rather than its propensity for rotational motion, which offers a renewed perspective on the rational molecular design of organic emitters exhibiting sharp emission spectra.

Conjugated Copolymers That Shouldn't Be.

Multiple studies have explored using cage silsesquioxanes (SQs) as backbone elements in hybrid polymers motivated by their well-defined structures and physical and mechanical properties. As part of this general exploration, we report unexpected photophysical properties of copolymers derived from divinyl double decker (DD) SQs, [vinyl(Me)Si(O0.5 )2 ][PhSiO1.5 ]8 [(O0.5 )2 Si(Me)vinyl] (vinylDDvinyl). These copolymers exhibit strong emission red-shifts relative to model compounds, implying unconventional conjugation, despite vinyl(Me)Si(O-)2 siloxane bridges. In an effort to identify minimum SQ structures that do/do not offer extended conjugation, we explored Heck catalyzed co-polymerization of vinyl-ladder(LL)-vinyl compounds, vinyl(Me/Ph)Si(O0.5 )2 [PhSiO1.5 ]4 (O0.5 )2 Si(Me/Ph)vinyl, with Br-Ar-Br. Most surprising, the resulting oligomers show 30-60 nm emission red-shifts beyond those seen with vinylDDvinyl analogs despite lacking a true cage. Further evidence for unconventional conjugation includes apparent integer charge transfer (ICT) between LL-co-thiophene, bithiophene, and thienothiophene with 10 mol % F4 TCNQ, suggesting potential as p-type doped organic/inorganic semiconductors.

"We have been magnified for years - Now you are under the microscope!": Co-researchers with Learning Disabilities Created an Online Survey to Challenge Public Understanding of Learning Disabilities.

Public attitudes towards learning disabilities (LDs) are generally reported as positive, inclusive and empathetic. However, these findings do not reflect the lived experiences of people with LDs. To shed light on this disparity, a team of co-researchers with LDs created the first online survey to challenge public understanding of LDs, asking questions in ways that are important to them and represent how they see themselves. Here, we describe and evaluate the process of creating an accessible survey platform and an online survey in a research team consisting of academic and non-academic professionals with and without LDs or autism. Through this inclusive research process, the co-designed survey met the expectations of the co-researchers and was well-received by the initial survey respondents. We reflect on the co-researchers' perspectives following the study completion, and consider the difficulties and advantages we encountered deploying such approaches and their potential implications on future survey data analysis.

Ce-Substituted Nanograin Na3Zr2Si2PO12 Prepared by LF-FSP as Sodium-Ion Conductors.

The urgent need for high-performance solid electrolytes has aroused considerable focus on NASICON ceramics. Optimization of processing routes to dense, defect-free materials has yet to receive sufficient attention to date. Although traditional solid-state reaction methods followed by repetitive ball milling and sintering up to 10 h above 1200 °C are common place, the resulting average particle sizes are usually too large to produce dense, robust structures because of excessive grain growth. In this study, nanopowders (NPs) are produced, which offer a superior opportunity to make dense, high-phase-purity sintered bodies. Here, we report on the effect of sintering conditions on the microstructures and phase of Ce4+-substituted NASICON samples, Na3CexZr2-xSi2PO12 (x = 0, 0.1, 0.2, 0.3). NPs permit processing fine-grained solid-state electrolytes with 98% relative density at 1100 °C/5 h. In addition, Rietveld refinement was applied to evaluate 3-D Na-ion diffusion channels among different NASICON samples. Also, it is found that adding 5 at % Ce4+ does not change the phase structure but dramatically enlarges the Na+ diffusion "bottleneck" from 5.4 to 5.6 Å2. This may be one reason for these samples to exhibit conductivities of 2.4 × 10-2 S cm-1 at 140 °C.

New Hybrid Method for the Calculation of the Solvation Free Energy of Small Molecules in Aqueous Solutions.

The ability to accurately predict the solvation free energies of ionic species using the appropriate thermodynamic cycle is of great importance in many areas of chemistry and biochemistry. To improve the accuracy of calculating solvation free energies, we devised a hybrid cluster-continuum approach, where explicit solvent molecules are added to the traditionally employed continuum model. Our computational workflow consists of the following steps: First, the minimum number of explicit water molecules beyond which additional water molecules no longer improve the accuracy of the cluster-continuum model is carefully established. Next, the convergence values for fully relaxed molecular configurations are compared with those obtained by sampling thermally disordered configurations using single-point calculations. We find that the dielectric constant does not have a significant influence on the solvation free energy, while accounting for the placement of a counterion is necessary for the accurate calculation of the solvation free energy.

Molecular Design Approach Managing Molecular Orbital Superposition for High Efficiency without Color Shift in Thermally Activated Delayed Fluorescent Organic Light-Emitting Diodes.

Molecular design principles of thermally activated delayed fluorescent (TADF) emitters having a high quantum efficiency and a color tuning capability was investigated by synthesizing three TADF emitters with donors at different positions of a benzonitrile acceptor. The position rendering a large overlap between the highest occupied molecular orbital (HOMO) and the lowest unoccupied molecular orbital (LUMO) enhances the quantum efficiency of the TADF emitter. Regarding the orbital overlap, donor attachments at 2- and 6-positions of the benzonitrile were more beneficial than 3- and 5-substitutions. Moreover, an additional attachment of a weak donor at the 4-position further increased the quantum efficiency without decreasing the emission energy. Therefore, the molecular design strategy of substituting strong donors at the positions allowing a large molecular orbital overlap and an extra weak donor is a good approach to achieve both high quantum efficiency and a slightly increased emission energy.

Chemoprophylaxis against group A streptococcus during military training.

Chemoprophylaxis with intramuscular benzathine penicillin G has been used widely by the U.S. military to prevent epidemics of group A streptococcus infections during basic training. The recent global shortage of benzathine penicillin prompted a detailed analysis of this issue in 2017 by military preventive medicine and infectious disease authorities in San Antonio, Texas, and San Diego, California, USA. This paper explores the history of group A streptococcus and chemoprophylaxis in the U.S. military training environment, current policy and practice, and challenges associated with widespread chemoprophylaxis. In light of the history presented, preventive medicine authorities at basic training centers should be extremely cautious about discontinuing benzathine penicillin chemoprophylaxis.

Design principles for the energy level tuning in donor/acceptor conjugated polymers.

To identify reliable molecular design principles for energy level tuning in donor/acceptor conjugated polymers (CPs), we studied the governing factors by means of ab initio calculations based on density-functional theory (DFT). We investigated a series of CPs in which we independently and systematically varied the electron withdrawing power of the acceptor unit and the electron donating power of the donor unit, while maintaining the same conjugated chain conformation. We observed that the introduction of a stronger acceptor unit, while keeping the same donor unit in the CP, lowers the LUMO level, but leaves the HOMO level almost unchanged. Conversely, enhancing the strength of the donor unit for the same acceptor unit raises the HOMO level, while maintaining the LUMO level. We identified strong correlations between the frontier orbital energy levels and the degree of orbital localization, which depends on the electron donating or withdrawing power of the molecular groups carrying the orbitals. Moreover, the HOMO/LUMO gap of the CP is directly proportional to the charge transfer between donating and accepting units, which provides a robust design criterion for CPs.