"The perfect storm": community worker perspectives on the impact of COVID-19 on New York City immigrants and migrant-serving organizations.

Background: Immigrants in New York City (NYC) have higher COVID-19 mortality than the general population. While migrant-serving organizations (MSOs) provide access to a breadth of services, they are disproportionately impacted by the COVID-19 pandemic due to staffing limitations, funding cuts, and resource limitations of communities served. Methods: Six focus-group discussions were conducted to explore the experiences of MSOs in NYC during the COVID-19 pandemic from November 2021 to March 2022. Study participants csomprised a subsample of survey respondents from a larger study identified via lists of MSOs. Results: Twenty-seven organizational representatives from 11 MSOs across NYC participated in the discussions. In addition to providing information on communities served, services offered, and organizational characteristics, the following themes emerged from the convenings: mental health challenges and resources needed for immigrants; immigration-related challenges; factors exacerbating hardships for immigrants during COVID-19; interorganizational collaborations and partnerships; policy change; and needs/requests of MSOs. MSOs provide a wide range of services as non-profit organizations and use interorganizational collaboration to improve service delivery. The proximity of MSOs to immigrant communities helps providers understand the needs of immigrants relating to the COVID-19 pandemic and factors that shape telehealth services. Conclusion: MSOs are important providers and advocates for immigration policy in the US given their relationship with the populations they serve. These findings have implications for how to support MSOs that serve immigrants in NYC. Strategies to achieve this include timelier availability and exchange of information, policies, and research as well as strengthening the experience-based advocacy of these groups.

Recent enhancements in the performance of the Orion high-resolution x-ray spectrometers.

During the past few years, the Orion high-resolution x-ray spectrometers have been successful tools for measuring x-ray spectra from plasmas generated in the Orion laser facility. Duplicate spectrometers also operate successfully at the Livermore EBIT-I and SuperEBIT electron beam ion traps for measuring x-ray polarization. We have recently implemented very high-quality, optically bonded, spherically bent quartz crystals to remove the structure in the x-ray image that had been observed in earlier measurements. The structure had been caused by focusing defects and limited the accuracy of our measurements. We present before and after images that show a drastic improvement. We, furthermore, have implemented a spherically bent potassium acid phthalate (KAP) crystal on one of our spectrometers. The KAP crystal was prepared in a similar fashion, and we present measurements of the N Ly-ß and Ne Lyß lines taken in first- and second-order reflections at 600 and 1200 eV, respectively. These measurements confirm that KAP crystals can be produced at a quality suitable for extending the spectral coverage to wavelengths longer than those accessible by different quartz crystals, especially those that cover the astrophysically important lines of iron.

Preparations for a European R&D roadmap for an inertial fusion demo reactor.

A European consortium of 15 laboratories across nine nations have worked together under the EUROFusion Enabling Research grants for the past decade with three principle objectives. These are: (a) investigating obstacles to ignition on megaJoule-class laser facilities; (b) investigating novel alternative approaches to ignition, including basic studies for fast ignition (both electron and ion-driven), auxiliary heating, shock ignition, etc.; and (c) developing technologies that will be required in the future for a fusion reactor. A brief overview of these activities, presented here, along with new calculations relates the concept of auxiliary heating of inertial fusion targets, and provides possible future directions of research and development for the updated European Roadmap that is due at the end of 2020. This article is part of a discussion meeting issue 'Prospects for high gain inertial fusion energy (part 2)'.

Whole-beam self-focusing in fusion-relevant plasma.

Fast ignition inertial confinement fusion requires the production of a low-density channel in plasma with density scale-lengths of several hundred microns. The channel assists in the propagation of an ultra-intense laser pulse used to generate fast electrons which form a hot spot on the side of pre-compressed fusion fuel. We present a systematic characterization of an expanding laser-produced plasma using optical interferometry, benchmarked against three-dimensional hydrodynamic simulations. Magnetic fields associated with channel formation are probed using proton radiography, and compared to magnetic field structures generated in full-scale particle-in-cell simulations. We present observations of long-lived, straight channels produced by the Habara-Kodama-Tanaka whole-beam self-focusing mechanism, overcoming a critical barrier on the path to realizing fast ignition. This article is part of a discussion meeting issue 'Prospects for high gain inertial fusion energy (part 2)'.

A new double crystal calibration system for absolute x-ray emission measurements down to ∼1 keV energies.

Over the past few years, work has been conducted at AWE to accurately characterize x-ray diffraction crystals to allow for absolute measurements of x-ray emission for our Orion opacity campaigns. Diffraction crystals are used in spectrometers on Orion to record the dispersed spectral features emitted by the laser produced plasma to obtain a measurement of the plasma conditions. Previously, based on a Manson x-ray source, our calibration system struggled to attain a high signal at the low energies required in calibration for the use of aluminum as a tracer for higher atomic number experiments. Here, we present data from the newly commissioned CTX400 x-ray source, a twin anode water cooled system, showing it to be a bright source even for ∼1 keV energies. Rocking curve measurements for three of the most commonly used crystals, namely, pentaerythritol, cesium acid phthalate, and germanium, are presented for both convex and flat forms.

High resolution, high signal-to-noise crystal spectrometer for measurements of line shifts in high-density plasmas.

The Orion high-resolution x-ray (OHREX) spectrometer has been a successful tool for measuring the shapes of density-broadened spectral lines produced in short-pulse heated plasmas at the Orion laser facility. We have recently outfitted the instrument with a charge-couple device (CCD) camera, which greatly increased the accuracy with which we can perform line-shift measurements. Because OHREX is located on the outside of the Orion target chamber, no provisions for the shielding of electromagnetic pulses are required. With the CCD, we obtained a higher signal-to-noise ratio than we previously obtained with an image-plate detector. This allowed us to observe structure in the image produced by the diffraction from the two OHREX crystals, which was highly reproducible from shot to shot. This structure will ultimately limit the accuracy of our spectroscopic measurements.

International outbreak of multiple Salmonella serotype infections linked to sprouted chia seed powder - USA and Canada, 2013-2014.

Salmonella is a leading cause of bacterial foodborne illness. We report the collaborative investigative efforts of US and Canadian public health officials during the 2013-2014 international outbreak of multiple Salmonella serotype infections linked to sprouted chia seed powder. The investigation included open-ended interviews of ill persons, traceback, product testing, facility inspections, and trace forward. Ninety-four persons infected with outbreak strains from 16 states and four provinces were identified; 21% were hospitalized and none died. Fifty-four (96%) of 56 persons who consumed chia seed powder, reported 13 different brands that traced back to a single Canadian firm, distributed by four US and eight Canadian companies. Laboratory testing yielded outbreak strains from leftover and intact product. Contaminated product was recalled. Although chia seed powder is a novel outbreak vehicle, sprouted seeds are recognized as an important cause of foodborne illness; firms should follow available guidance to reduce the risk of bacterial contamination during sprouting.

Challenges and opportunities in evaluating a digital sexual health intervention in a clinic setting: Staff and patient views.

OBJECTIVES: The aim of the study was to gather the views of sexual health clinic staff and male clinic users regarding digital sexual health promotion and online trial procedures. METHODS: The Men's Safer Sex website was offered on tablet computers to men in the waiting rooms of three sexual health clinics, in a feasibility online randomised controlled trial (RCT). Interviews were conducted with 11 men who had participated in the trial and with nine clinic staff, to explore their views of the website and views of the online trial. Interviews were audio-recorded and transcribed, and we conducted a thematic analysis of interviews and of 281 free text comments from the online RCT outcome questionnaires. RESULTS: Clinic users and staff felt that digital interventions such as the Men's Safer Sex website are useful, especially if NHS endorsed. Pre-appointment waiting time presents a good opportunity for intervention but clinic users and staff felt that a website should supplement rather than replace face-to-face healthcare. The RCT procedures fitted well around clinical activities, but men did not self-direct to the tablet computers. Staff were more concerned about consent and confidentiality than clinic users, and staff and patients were frustrated by multiple technical problems. The trial outcome questionnaire was thought-provoking and could constitute an intervention in itself. Participants felt that clinics would need to promote a digital intervention and/or offer the site routinely to promote engagement. CONCLUSION: Digital interventions could usefully supplement in-person sexual health care, but there are important obstacles in terms of IT access in NHS settings, and in promoting engagement.

Surveillance for Lyme disease in Canada: 2009-2015.

OBJECTIVE: To summarize seven years of surveillance data for Lyme disease cases reported in Canada from 2009 to 2015. METHODS: We describe the incidence over time, seasonal and geographic distribution, demographic and clinical characteristics of reported Lyme disease cases. Logistic regression was used to explore differences between age groups, sex and year to better understand potential demographic risk factors for the occurrence of Lyme disease. RESULTS: The number of reported Lyme disease cases increased more than six-fold, from 144 in 2009 to 917 in 2015, mainly due to an increase in infections acquired in Canada. Most locally acquired cases were reported between May and November. An increase in incidence of Lyme disease was observed in provinces from Manitoba eastwards. This is consistent with our knowledge of range expansion of the tick vectors in this region. In the western provinces the incidence has remained low and stable. All cases reported by Alberta, Saskatchewan and Newfoundland and Labrador were acquired outside of the province, either elsewhere in Canada or abroad. There was a bimodal distribution for Lyme disease by age with peaks at 5-9 and 45-74 years of age. The most common presenting symptom was a single erythema migrans rash (74.2%) and arthritis (35.7%). Variations in the frequency of reported clinical manifestations were observed among age groups and years of study. CONCLUSION: Lyme disease incidence continues to increase in Canada as does the geographic range of ticks that carry the Lyme disease bacteria. Ongoing surveillance, preventive strategies as well as early disease recognition and treatment will continue to minimize the impact of Lyme disease in Canada.

Lineshape spectroscopy with a very high resolution, very high signal-to-noise crystal spectrometer.

We have developed a high-resolution x-ray spectrometer for measuring the shapes of spectral lines produced from laser-irradiated targets on the Orion laser facility. The instrument utilizes a spherically bent crystal geometry to spatially focus and spectrally analyze photons from foil or microdot targets. The high photon collection efficiency resulting from its imaging properties allows the instrument to be mounted outside the Orion chamber, where it is far less sensitive to particles, hard x-rays, or electromagnetic pulses than instruments housed close to the target chamber center in ten-inch manipulators. Moreover, Bragg angles above 50° are possible, which provide greatly improved spectral resolution compared to radially viewing, near grazing-incidence crystal spectrometers. These properties make the new instrument an ideal lineshape diagnostic for determining plasma temperature and density. We describe its calibration on the Livermore electron beam ion trap facility and present spectral data of the K-shell emission from highly charged sulfur produced by long-pulse as well as short-pulse beams on the Orion laser in the United Kingdom.

Fructose content and composition of commercial HFCS-sweetened carbonated beverages.

OBJECTIVE: The obesigenic and related health effects of caloric sweeteners are subjects of much current research. Consumers can properly adjust their diets to conform to nutritional recommendations only if the sugars composition of foods and beverages is accurately measured and reported, a matter of recent concern. We tested the hypothesis that high-fructose corn syrup (HFCS) used in commercial carbonated beverages conforms to commonly assumed fructose percentages and industry technical specifications, and fulfills beverage product label regulations and Food Chemicals Codex-stipulated standards. DESIGN: A high-pressure liquid chromatography method was developed and verified for analysis of sugars in carbonated beverages sweetened with HFCS-55. The method was used to measure percent fructose in three carbonated beverage categories. Method verification was demonstrated by acceptable linearity (R(2)>0.99), accuracy (94-104% recovery) and precision (RSD < 2%). RESULT: Fructose comprised 55.58% of total sugars (95% confidence interval 55.51-55.65%), based on 160 total measurements by 2 independent laboratories of 80 randomly selected carbonated beverages sweetened with HFCS-55. The difference in fructose measurements between laboratories was significant but small (0.1%), and lacked relevance. Differences in fructose by product category or by product age were not statistically significant. Total sugars content of carbonated beverages showed close agreement within product categories (95% confidence interval = 0.01-0.54%). CONCLUSIONS: Using verified analytical methodology for HFCS-sweetened carbonated beverages, this study confirmed the hypothesis that fructose as a percentage of total sugars is in close agreement with published specifications in industry technical data sheets, published literature values and governmental standards and requirements. Furthermore, total sugars content of commercial beverages is consistent with common industry practices for canned and bottled products and met the US Federal requirements for nutritional labeling and nutrient claims. Prior concerns about composition were likely owing to use of improper and unverified methodology.

Surveillance for Lyme disease in Canada, 2009 to 2012.

OBJECTIVES: To summarize the first four years of national surveillance for Lyme disease in Canada from 2009 to 2012 and to conduct a preliminary comparison of presenting clinical manifestations in Canada and the United States. METHODS: The numbers and incidence of reported cases by province, month, year, age and sex were calculated. Logistic regression was used to examine trends over time. Acquisition locations were mapped and presenting clinical manifestations reported for jurisdictions where data was available. Variations by province, year, age and sex as well as presenting clinical symptoms were explored by logistic regression. An initial comparative analysis was made of presenting symptoms in Canada and the United States. RESULTS: The numbers of reported cases rose significantly from 144 in 2009 to 338 in 2012 (coefficient = 0.34, standard error = 0.07, P <0.05), mostly due to an increased incidence of infections acquired in Canada. More cases were classified as 'confirmed' (71.5%) than 'probable' (28.5%). Most cases occurred in locations where vector tick populations were known to be present. More men than women were affected (53.4% versus 46.6%), incidence was highest in adults aged 55 to 74 years and in children aged five to 14 years. Most cases (95%) were acquired from April to November. Of cases acquired in endemic areas, 39.7% presented with manifestations of early Lyme disease, while 60.3% had manifestations of disseminated Lyme disease. There were significant differences among age groups, sexes and provinces in the frequencies of reported clinical manifestations. The proportion of cases acquired in endemic areas presenting with early Lyme disease was lower than that reported in the US. CONCLUSION: Lyme disease incidence is increasing in Canada. Most cases are acquired where vector tick populations are spreading and this varies geographically within and among provinces. There is also variation in the frequency of age, season and presenting manifestations. The lower proportion of cases presenting with early Lyme disease in Canada compared with the US suggests lower awareness of early Lyme disease in Canada, but this requires further study.

Observations of the effect of ionization-potential depression in hot dense plasma.

The newly commissioned Orion laser system has been used to study dense plasmas created by a combination of short pulse laser heating and compression by laser driven shocks. Thus the plasma density was systematically varied between 1 and 10 g/cc by using aluminum samples buried in plastic foils or diamond sheets. The aluminum was heated to electron temperatures between 500 and 700 eV allowing the plasma conditions to be diagnosed by K-shell emission spectroscopy. The K-shell spectra show the effect of the ionization potential depression as a function of density. The data are compared to simulated spectra which account for the change in the ionization potential by the commonly used Stewart and Pyatt prescription and an alternative due to Ecker and Kröll suggested by recent x-ray free-electron laser experiments. The experimental data are in closer agreement with simulations using the model of Stewart and Pyatt.

Hospital mortality under surgical care.

INTRODUCTION: The 'hospital standardised mortality ratio' (HSMR) has been used in England since 1999 to measure NHS hospital performance. Large variations in reported HSMR between English hospitals have recently led to heavy criticism of their use as a surrogate measure of hospital performance. This paper aims to review the mortality data for a consultant general surgeon contributed by his NHS trust over a 3-year period as part of the trust's HSMR calculation and evaluate the accuracy of coding the diagnoses and covariates for case mix adjustment. SUBJECTS AND METHODS: The Dr Foster Intelligence database was interrogated to extract the NHS trust's HSMR benchmark data on inpatient mortality for the surgeon from 1 April 2006 to 31 March 2009 and compared to the hospital notes. RESULTS: 30 patients were identified of whom 12 had no evidence of being managed by the surgeon. This represents a potential 40% inaccuracy rate in designating consultant responsibility. The remaining 18 patients could be separated into 'operative' (11 patients) and 'non-operative' (7 patients) groups. Only 27% in the operative group and 43% of the non-operative mortality group respectively had a Charlson co-morbidity index recorded despite 94% of the cases having significant co-morbidities CONCLUSIONS: Highlighting crude and inaccurate clinician-specific mortality data when only 1-5% of deaths under surgical care may be associated with avoidable adverse events seems potentially irresponsible.

Serologic and hexon phylogenetic analysis of ruminant adenoviruses.

The objectives of this study were to determine the antigenic relationship among ruminant adenoviruses and determine their phylogenetic relationship based on the deduced hexon gene amino acid sequence. Results of reciprocal cross-neutralization tests demonstrated antigenic relationships in either one or both directions among bovine adenovirus type 6 (BAdV-6), BAdV-7, ovine adenovirus type 7 (OAdV-7), caprine adenovirus type 1 (GAdV-1), and deer adenovirus (Odocoileus adenovirus 1, OdAdV-1). No antigenic cross-reactivity was observed among BAdV-1 through -5, and -8 and the other putative ruminant adenoviruses. Two PCR primer sets, one for mastadenovirus and atadenovirus that amplified an approximately 2,700-bp region in the hexon genes were used for comparative studies. Phylogenetic analysis of the deduced hexon amino acid sequences clustered the ruminant adenoviruses on the Mastadenovirus and Atadenovirus genus branches of the Adenoviridae tree. The recent classification of BAdV-6, and -7 as members of the genus Atadenovirus was supported by phylogenetic distance matrix analysis of their deduced hexon amino acid sequences. Further, we propose that BAdV-6 and -7 be recognized as members of new Atadenovirus species, Bovine adenovirus E and Bovine adenovirus F, respectively. Phylogenetic analysis of OdAdV-1 places this virus in the genus Atadenovirus with a proposed new species Odocoileus adenovirus A. OAdV-6 and GAdV-2 are proposed as members of new Mastadenovirus species Ovine adenovirus C and Goat adenovirus A, respectively.

The ultrastructure of the plasma-sprayed hydroxyapatite-bone interface predisposing to bone bonding.

The deposition of biological apatite and subsequent formation of bone on hydroxyapatite implants depends on the partial dissolution of the implant surface and the reprecipitation of carbonated apatite from the biological milieu. Previous investigations in vitro have shown that the degree of dissolution and reprecipitation decreases as the coating crystallinity increases. These findings prompted the current study of the effects of coating crystallinity on the mechanism of bone bonding. The process of mineralization of bone associated with a hydroxyapatite coating was compared to the normal process of ossification. Plasma-sprayed hydroxyapatite (PSHA) coated titanium alloy (6% Al-4% V) rods as received and annealed for 0.7 h at 600 degrees C in air to increase the coating crystallinity were implanted in the proximal and distal femora and proximal tibiae of adult mongrel dogs for 3 h, 3 and 10 days. Bony sites containing the implant were prepared for ultramicrotomy and transmission electron microscopy using an anhydrous embedding procedure: fixation in ethylene glycol and embedment in Spurr's resin. The results demonstrated the precipitation of biological apatite crystallites on non-annealed PSHA coatings in vivo within 3 h of implantation. After 3 and 10 days there were differences in the ultrastructure of the mineral phase on the surfaces of non-annealed and annealed surfaces. Observations showed that there was little difference in the mechanism of mineralization of bone associated with HA-coated prostheses and the normal process of ossification.

The ultrastructure of anorganic bovine bone and selected synthetic hyroxyapatites used as bone graft substitute materials.

The objective of this study was to investigate the morphology and organization of apatite crystallites in mature mammalian bone. Anorganic bovine bone was studied in this investigation to allow for the examination of the mineral crystallites after removal of the organic phase. Field-emission low-voltage scanning electron microscopy (FE-LVSEM) was employed to obtain images at nanometer resolution without the application of a conductive coating. Transmission electron microscopy (TEM) of the samples was also performed to confirm the identification of features observed in the SEM and to allow for comparison with earlier studies of bone mineral architecture. For comparison, in order to demonstrate how the interaction of collagen and apatite results in the architecture and crystal structure of bone mineral, two synthetic hydroxyapatite materials were also analyzed: OsteoGen and OsteoGraf/LD300. FE-LVSEM revealed distinctive features of bone mineral: a fibrillar organization of crystallites, a periodic spacing of crystallites along the fibrils consistent with the banding pattern of collagen, inter-fibrillar bridging crystallites, and a plate-like habit of the crystallites. These findings supported the hypothesis, derived from the earlier TEM data of others, that the mineralization of collagen comprising osteoid proceeds by the formation of apatite crystallites within the fibers at selected periodic sites along their length. Moreover, the very presence in this anorganic material of distinct fibers comprised of the crystallites is demonstration of inter-crystallite bonding. The crystallites of the synthetic hydroxyapatite materials did not display any of these ultrastructural features.

Ovine adenovirus serotype 7-associated mortality in lambs in the United States.

Adenoviral infections were diagnosed in three neonatal lambs that died spontaneously, and no other etiologic agents were identified. Clinical signs were anorexia, weakness, abdominal distention, and sudden death. Microscopic lesions consisted of multifocal necrotizing hepatitis, multifocal subacute interstitial nephritis, and loss of enterocytes from intestinal villi. Adenovirus inclusions were identified by light microscopy in the kidneys only. Adenoviral antigen, however, was identified in the liver, kidney, and intestine of the lambs by immunohistochemical techniques. An ovine adenovirus serotype 7, not previously isolated from sheep in the United States, was characterized from these lambs.

Evaluation of a silicone occlusive dressing after laser skin resurfacing.

BACKGROUND: Closed dressings are thought to promote postoperative wound healing after laser skin resurfacing; however, quantitative data are lacking. OBJECTIVE: To compare postoperative healing after combination carbon dioxide and erbium:YAG full-face laser skin resurfacing in patients who were treated with a silicone occlusive dressing (Silon-TSR; Bio Med Sciences, Inc, Bethlehem, Pa) vs open-wound care consisting of soaks and ointment application. DESIGN: Thirty-five patients with closed dressings compared retrospectively with 35 control subjects with open-wound care. In a prospective evaluation, 27 patients with closed dressings were then compared with 27 historical controls matched by age, sex, skin type, and treatment technique. Erythema, crusting, swelling, pain, pruritus, purpura, long-term complications, and dressing comfort were evaluated. SETTING: Referral-based academic practice. RESULTS: Prospectively, closed-dressing and open-wound care groups differed significantly in maximum erythema severity (1.8 vs 2.0 on a scale of 0-3; P =.03), noticeable erythema duration (15.4 vs 31.1 days; P =.04), and time until complete erythema resolution (41.8 vs 96.1 days; P =.02). Swelling resolution was more rapid in the dressing group (12.1 vs 29.5 days; P =.02). Crusting was limited to uncovered areas in the dressing group, and crusting duration was shorter (5.0 vs 9.1 days; P<.001). Pain was more likely to be reported prospectively, but severity was mild, in the closed-dressing group. Other short- and long-term complications did not differ significantly. Subjective patient attitudes toward the dressing were positive. CONCLUSIONS: Occlusive silicone dressing application decreases immediate postoperative morbidity with significantly reduced severity and duration of erythema and decreased duration of swelling and crusting. Long-term results and complication rates remain unchanged.

Characterization of a new adenovirus isolated from black-tailed deer in California.

An adenovirus associated with systemic and localized vascular damage was demonstrated by transmission electron microscopy and immunohistochemistry in a newly recognized epizootic hemorrhagic disease in California black-tailed deer. In this study, we describe the cultural, physicochemical and serological characteristics of a virus isolated from lung using neonatal white-tail deer lung and turbinate cell cultures. The virus had the cultural, morphological and physicochemical characteristics of members of the Adenoviridae family. The virus would not replicate in low passage fetal bovine, caprine or ovine cells. Antiserum to the deer adenovirus, strain D94-2569, neutralized bovine adenovirus type-6 (BAdV-6), BAdV-7, and caprine adenovirus type-1 (GAdV-1). Antiserum to BAdV-6 did not neutralize the deer adenovirus but antiserum to BAdV-7 and GAdV-1 neutralized the deer adenovirus. Cross-neutralization with the other bovine, caprine and ovine adenovirus species was not observed. Restriction endonuclease patterns generated for the deer adenovirus were unique compared to those for the currently recognized bovine, caprine and ovine adenovirus types. Amino acid sequence alignments of the hexon gene from the deer adenovirus strain D94-2569 indicate that it is a member of the proposed new genus (Atadenovirus) of the Adenoviridae family. While closely related antigenically to BAdV-7 and GAdV-1, the deer adenovirus appears sufficiently distinct culturally and molecularly to justify consideration as a new adenovirus type.