Clustered cases of human adenovirus types 4, 7, and 14 infections in US Department of Defense Beneficiaries during the 2018-2019 season.

Human adenoviruses (HAdV) are genetically diverse and can infect a number of tissues with severities varied from mild to fatal. HAdV types 3, 4, 7, 11, 14, 21, and 55 were associated with acute respiratory illnesses outbreaks in the United States and in other countries. The risk of outbreaks can be effectively controlled by HAdV vaccination or mitigated by screening and preventive measures. During the influenza season 2018-2019, the DoD Global Respiratory Pathogen Surveillance Program (DoDGRS) received 24 300 respiratory specimens. HAdV samples that produced positive cytopathic effects in viral cultivation were subjected to next-generation sequencing for genome sequence assembly, genome typing, whole genome phylogeny, and sequence comparative analyses. A variety of HAdV types were identified in this study, including HAdV types 1-7, 14, 55, and 56. HAdV types 4, 7, and 14 were found in clustered cases in Colorado, Florida, New York, and South Carolina. Comparative sequence analyses of these isolates revealed the emergence of novel genetic mutations despite the stability of adenovirus genomes. Genomic surveillance of HAdV suggested possible undetected outbreaks and shed light on prevalence, genetic divergence, and viral evolution of HAdV. Continued surveillance will inform risk assessment and countermeasures.

Assembly of nanocrystal clusters by solvent evaporation: icosahedral order and the breakdown of the Maxwell regime.

We carry out molecular dynamics simulations of N gold alkylthiolated nanocrystals (0 ≤ N ≤ 29) contained in liquid droplets of octane, nonane and decane coexisting with its vapor. The equilibrium structures that result when all the solvent dries up consist of highly symmetric nanocrystal clusters with different degrees of icosahedral order that are thoroughly characterized. We show that the relaxation times follow two regimes, a first for small nanocrystal packing fraction, dominated by the diffusion of vapor molecules (Maxwell regime, relaxation times independent of N) and another, for larger packing fractions, where the solvent diffuses through the cluster (with relaxation times growing like N2/3). We discuss the connection to the assembly of superlattices, prediction of lattice constants and evaporation models.

Hydrogen Bond Network Disruption by Hydration Layers in Water Solutions with Salt and Hydrogen-Bonding Polymers (PEO).

A mean field theory model describing the interaction of ion hydration layers with the network of hydrogen bonds of both water and the nonionic polymer poly(ethylene oxide) (PEO) is presented. The predictions of the model for types and statistics of hydrogen bonds, the number of water molecules bound to PEO, or their dependence on temperature are successfully verified from all-atom simulations at different NaCl and PEO concentrations. Furthermore, our simulations show that the binding of cations to PEO increases monotonically with salt concentration, in agreement with recent experimental results, through a mechanism in which the sum of the number of bound water and cations is independent of salt concentration. The model introduced is general and can describe any salt or hydrogen-bond-forming polymer.

An Email Coaching Option Increases Participant Program Utilization and Coach Productivity.

PURPOSE: To assess impact of adding an email option to phone-based coaching on the number of coaching sessions completed. DESIGN: Retrospective analysis of a change in program design. SETTING: A health plan health and wellness coaching service. SUBJECTS: Six thousand six hundred twenty four individuals who scheduled at least one coaching session. INTERVENTION: Adding an email option to phone coaching May 1 to August 31, 2020. MEASURES: Association of a participant using an email coaching option with completing 3 coaching sessions; overall number of participants completing 3 coaching sessions when email is offered; participant satisfaction rates; and, average number of participants coached per coach by month. ANALYSIS: χ2; linear and logistic regression with gender, age, and education as covariates. RESULTS: When we offered email coaching, 29.6% of eligible participants used the option, and compared with the same months the prior year, the proportion of participants completing 3 sessions during those months was higher (73% vs 67%). (P < .0001) 96.5% of participants who used email, vs 92.0% who did not, completed 3 sessions before their employer's benefit qualifying deadline. (P < .0001) More than 85% who responded to the email coaching survey expressed satisfaction. On average, each coach served 43% (486 vs 340) more participants per month when we offered email coaching. (P < .0001). CONCLUSION: Adding email coaching to phone coaching can increase program utilization by individuals who use email, increase overall program utilization, generate high levels of participant satisfaction, and increase the number of participants served per coach.

Structural Study of Sulfur-Added Carbon Nanohorns.

In the past few decades, nanostructured carbons (NCs) have been investigated for their interesting properties, which are attractive for a wide range of applications in electronic devices, energy systems, sensors, and support materials. One approach to improving the properties of NCs is to dope them with various heteroatoms. This work describes the synthesis and study of sulfur-added carbon nanohorns (S-CNH). Synthesis of S-CNH was carried out by modified chemical vapor deposition (m-CVD) using toluene and thiophene as carbon and sulfur sources, respectively. Some parameters such as the temperature of synthesis and carrier gas flow rates were modified to determine their effect on the properties of S-CNH. High-resolution scanning and transmission electron microscopy analysis showed the presence of hollow horn-type carbon nanostructures with lengths between 1 to 3 µm and, diameters that are in the range of 50 to 200 nm. Two types of carbon layers were observed, with rough outer layers and smooth inner layers. The surface textural properties are attributed to the defects induced by the sulfur intercalated into the lattice or bonded with the carbon. The XRD patterns and X-ray microanalysis studies show that iron serves as the seed for carbon nanohorn growth and iron sulfide is formed during synthesis.

A growing global network's role in outbreak response: AFHSC-GEIS 2008-2009.

A cornerstone of effective disease surveillance programs comprises the early identification of infectious threats and the subsequent rapid response to prevent further spread. Effectively identifying, tracking and responding to these threats is often difficult and requires international cooperation due to the rapidity with which diseases cross national borders and spread throughout the global community as a result of travel and migration by humans and animals. From Oct.1, 2008 to Sept. 30, 2009, the United States Department of Defense's (DoD) Armed Forces Health Surveillance Center Global Emerging Infections Surveillance and Response System (AFHSC-GEIS) identified 76 outbreaks in 53 countries. Emerging infectious disease outbreaks were identified by the global network and included a wide spectrum of support activities in collaboration with host country partners, several of which were in direct support of the World Health Organization's (WHO) International Health Regulations (IHR) (2005). The network also supported military forces around the world affected by the novel influenza A/H1N1 pandemic of 2009. With IHR (2005) as the guiding framework for action, the AFHSC-GEIS network of international partners and overseas research laboratories continues to develop into a far-reaching system for identifying, analyzing and responding to emerging disease threats.

Complete Genome Sequences of Two Human Adenovirus Type 55 Isolates from South Korea and the United States.

Here, we report two complete genome sequences of human adenovirus 55 (HAdV-55) isolates, from a patient in Pennsylvania in 2006 and a U.S. military member in South Korea in 2019. The findings demonstrate the continued global transmission of HAdV-55 viruses in both military and civilian populations.

Identification of H3N2 NA and PB1-F2 genetic variants and their association with disease symptoms during the 2014-15 influenza season.

The 2014-15 influenza season saw the emergence of an H3N2 antigenic drift variant that formed the 3C.2a HA clade. Whole viral genomes were sequenced from nasopharyngeal swabs of ninety-four patients with confirmed influenza A virus infection and primary human nasal epithelial cell cultures used to efficiently isolate H3N2 viruses. The isolates were classified by HA clade and the presence of a new set of co-selected mutations in NA (a glycosylation site, NAg+) and PB1-F2 (H75P). The NA and PB1-F2 mutations were present in a subset of clade 3C.2a viruses (NAg+F2P), which dominated during the subsequent influenza seasons. In human nasal epithelial cell cultures, a virus with the novel NAg+F2P genotype replicated less well compared with a virus with the parental genotype. Retrospective analyses of clinical data showed that NAg+F2P genotype viruses were associated with increased cough and shortness of breath in infected patients.

Public Health Response to Zika Virus Exposure of Air Force Members Deployed to Caribbean Islands, 2016.

INTRODUCTION: The emergence of Zika virus disease (ZVD) in areas of military operations provided a new opportunity for force health protection. ZVD infection had an estimated 4:1 asymptomatic-to-symptomatic ratio and can cause neurologic sequelae. MATERIALS AND METHODS: We provide a brief report of a field investigation utilizing laboratory-based surveillance and survey instruments to characterize ZVD risk among personnel deployed to the Dominican Republic in support of Operation NEW HORIZONS (NH). Additionally, we describe a cluster of 3 ZVD cases among 8 aircrew on a short mission to St. Croix (U.S. Virgin Islands). RESULTS: Following Operation NH, 6 of a total 189 deployed cohort members tested positive for ZVD by immunoglobulin M and confirmatory plaque reduction neutralization test (3.2%). Reverse transcription polymerase chain reaction testing in urine or serum was positive in 4 of those 6 cases. All 6 cases reported at least one symptom, with 5 reporting subjective fever and arthralgia and 4 reporting rash. Cases were less likely to have air-conditioned living quarters (odds ratio = 0.1; 95% confidence interval 0.02-0.77; P < 0.03), but were otherwise similar to non-cases. Likewise, in St. Croix, 3/8 tested positive by immunoglobulin M and plaque reduction neutralization test for an attack rate of 38%. Similar to Operation NH, all three cases were symptomatic with subjective fever (67%), arthralgia (67%), and/or rash (100%). CONCLUSIONS: This field investigation identified differing, mission location-dependent ZVD attack rates and a 0:9 asymptomatic-to-symptomatic case ratio. As this was unexpected based on a previous report of a 4:1 ratio, it emphasizes the need to be cautious before generalizing outbreak characteristics between populations while also offering additional practical experience for force health protection.

Novel Influenza A (H1N1) outbreak at the U.S. Air Force Academy: epidemiology and viral shedding duration.

BACKGROUND: The U.S. Air Force Academy is an undergraduate institution that educates and trains cadets for military service. Following the arrival of 1376 basic cadet trainees in June 2009, surveillance revealed an increase in cadets presenting with respiratory illness. Specimens from ill cadets tested positive for novel influenza A (H1N1 [nH1N1])-specific ribonucleic acid (RNA) by real-time reverse transcriptase-polymerase chain reaction. PURPOSE: The outbreak epidemiology, control measures, and nH1N1 shedding duration are described. METHODS: Case patients were identified through retrospective and prospective surveillance. Symptoms, signs, and illness duration were documented. Nasal-wash specimens were tested for nH1N1-specific RNA. Serial samples from a subset of 53 patients were assessed for presence of viable virus by viral culture. RESULTS: A total of 134 confirmed and 33 suspected cases of nH1N1 infection were identified with onset date June 25-July 24, 2009. Median age of case patients was 18 years (range, 17-24 years). Fever, cough, and sore throat were the most commonly reported symptoms. The incidence rate among basic cadet trainees during the outbreak period was 11%. Twenty-nine percent (31/106) of samples from patients with temperature <100 degrees F and 19% (11/58) of samples from patients reporting no symptoms for > or = 24 hours contained viable nH1N1 virus. Of 29 samples obtained 7 days from illness onset, seven (24%) contained viable nH1N1 virus. CONCLUSIONS: In the nH1N1 outbreak under study, the number of cases peaked 48 hours after a social event and rapidly declined thereafter. Almost one quarter of samples obtained 7 days from illness onset contained viable nH1N1 virus. These data may be useful for future investigations and in scenario planning.

Influenza A (H3N2) outbreak, Nepal.

In July 2004, an outbreak of influenza A (H3N2) was detected at 3 Bhutanese refugee camps in southeastern Nepal. Hemagglutination inhibition showed that approximately 40% of the viruses from this outbreak were antigenically distinct from the A/Wyoming/3/03 vaccine strain. Four amino acid differences were observed in most of the 26 isolates compared with the A/Wyoming/3/2003 vaccine strain. All 4 substitutions are located within or adjacent to known antibody-binding sites. Several isolates showed a lysine-to-asparagine substitution at position 145 (K145N) in the hemagglutinin molecule, which may be noteworthy since position 145 is located within a glycosylation site and adjacent to an antibody-binding site. H3N2 viruses continue to drift from the vaccine strain and may remain as the dominant strains during the 2005-2006 influenza season. Thus, the 2005-2006 Northern Hemisphere vaccine strain was changed to A/California/7/2004, a virus with all 4 amino acid substitutions observed in these Nepalese isolates.

Sistema de vigilancia epidemiológica en las infecciones hospitalarias y control de enfermería / Epidemiological surveillance system in hospital infections and nursing control

Se realizó un análisis del sistema de vigilancia epidemiológica en las infecciones hospitalarias y del control de la enfermera vigilante epidemiológica, con la finalidad de describir las actividades desarrolladas por ella, destacar la importancia de las labores educativas que lleva a cabo, así como precisar el comportamiento de la sepsis nosocomial desde junio de 1994 hasta marzo de 1995 en el Hospital General Santiago de Cuba. Para ello fue necesario revisar los controles estadísticos y los informes del comité de sepsis, donde aparecieron notificadas 52 infecciones hospitalarias, 44 intrahospitalarias y 8 en la comunidad. El sexo femenino resultó ser el más afectado, así como el grupo etario de 15 a 64 años, por servicios, el hogar nutricional y cirugía general presentaron las más altas tasas, mientras que la infección se localizó más comúnmente en la herida quirúrgica y el tracto respiratorio

Efectos de la Oxigenación Hiperbárica en la Queratitis en el Hospital General Santiago durante un cuatrimestre / Effects of hyperbaric oxygenation for keratitis in Santiago de Cuba General Hospital during a 4-year period

Se realizó un estudio retrospectivo, descriptivo y comparativo sobre el tratamiento convencional y con oxigenación hiperbárica en 40 pacientes con queratitis en el Hospital General Santiago, desde diciembre de 1993 hasta marzo de 1994, con la finalidad de evaluar la eficacia de esta terapéutica en dicha afección. Se comprobó que las mujeres en edad laboral fueron las más afectadas, que los tratados con oxigenación hiperbárica evolucionaron más favorablemente en menor tiempo y que por concepto de seguridad social se pagó el 75 por ciento menos en este grupo con referencia al otro

Papel de la enfermera en el programa de diagnóstico precoz del cáncer cervicouterino en el policlínico Julián Grimau García / Role played by the nurse in the program for early diagnosis of cervix cancer at the Julián Grimau García Polyclinic

Se realizó un estudio retrospectivo relacionado con la participación de la enfermera en el Programa de diagnóstico precoz del cáncer cervicouterino en el área de salud "Julián Grimau García" durante 1993, en el cual de 3 881 pruebas citológicas realizadas, 100 resultaron no útiles. Los resultados obtenidos pusieron de relieve que la mayor incidencia de citologías no útiles se encontró en las edades comprendidas entre 30 y 34 años, y que las causas más frecuentes fueron leucocitosis masiva y extendido superficial. El mayor porcentaje de las pacientes acudió en el primer mes a repetirse la prueba, lo que evidencia la destacada labor de la enfermera mediante visitas domiciliarias y charlas de educación sanitaria, entre otras actividades; además de mantener las tarjetas actualizadas y en óptimas condiciones