Pandemic Responsiveness in an Acute Care Setting: A Community Hospital's Utilization of Operational Resources During COVID-19.

Background: To ensure continuity of services while mitigating patient surge and nosocomial infections during the coronavirus disease 2019 (COVID-19) pandemic, acute care hospitals have been required to make significant operational adjustments. Here, we identify and discuss key administrative priorities and strategies utilized by a large community hospital located in Ontario, Canada.

Methods: Guided by a qualitative descriptive approach, we performed a thematic analysis of all COVID-19-related documentation discussed by the hospital's emergency operation centre (EOC) during the pandemic's first wave.

St. Louis Encephalitis Virus in the Southwestern United States: A Phylogeographic Case for a Multi-Variant Introduction Event.

Since the reemergence of St. Louis Encephalitis (SLE) Virus (SLEV) in the Southwest United States, identified during the 2015 outbreak in Arizona, SLEV has been seasonally detected within spp. populations throughout the Southwest United States.

Characterization of neonatal opioid withdrawal syndrome in Arizona from 2010-2017.

In this paper, we describe a population of mothers who are opioid dependent at the time of giving birth and neonates exposed to opioids in utero who experience withdrawal following birth. While there have been studies of national trends in this population, there remains a gap in studies of regional trends. Using data from the Arizona Department of Health Services Hospital Discharge Database, this study aimed to characterize the population of neonates with neonatal opioid withdrawal syndrome (NOWS) and mothers who were opioid dependent at the time of giving birth, in Arizona.

Sample pooling methods for efficient pathogen screening: Practical implications.

Due to the large number of negative tests, individually screening large populations for rare pathogens can be wasteful and expensive. Sample pooling methods improve the efficiency of large-scale pathogen screening campaigns by reducing the number of tests and reagents required to accurately categorize positive and negative individuals. Such methods rely on group testing theory which mainly focuses on minimizing the total number of tests; however, many other practical concerns and tradeoffs must be considered when choosing an appropriate method for a given set of circumstances.

Selective whole genome amplification and sequencing of Coxiella burnetii directly from environmental samples.

Whole genome sequencing (WGS) is a widely available, inexpensive means of providing a wealth of information about an organism's diversity and evolution. However, WGS for many pathogenic bacteria remain limited because they are difficult, slow and/or dangerous to culture. To avoid culturing, metagenomic sequencing can be performed directly on samples, but the sequencing effort required to characterize low frequency organisms can be expensive.

Phylogenetic analysis of West Nile Virus in Maricopa County, Arizona: Evidence for dynamic behavior of strains in two major lineages in the American Southwest.

West Nile Virus (WNV) has been detected annually in Maricopa County, Arizona, since 2003. With this in mind, we sought to determine if contemporary strains are endemic to the county or are annually imported. As part of this effort, we developed a new protocol for tiled amplicon sequencing of WNV to efficiently attain greater than 99% coverage of 14 WNV genomes collected directly from positive mosquito pools distributed throughout Maricopa County between 2014 and 2017.

Guano exposed: Impact of aerobic conditions on bat fecal microbiota.

Bats and their associated guano microbiota provide important terrestrial and subterranean ecosystem services and serve as a reservoir for a wide range of epizootic and zoonotic diseases. Unfortunately, large-scale studies of bats and their guano microbiotas are limited by the time and cost of sample collection, which requires specially trained individuals to work at night to capture bats when they are most active. Indirectly surveying bat gut microbiota through guano deposits could be a more cost-effective alternative, but it must first be established whether the postdefecation exposure to an aerobic environment has a large impact on the guano microbial community.

Variant site strain typer (VaST): efficient strain typing using a minimal number of variant genomic sites.

Background: Targeted PCR amplicon sequencing (TAS) techniques provide a sensitive, scalable, and cost-effective way to query and identify closely related bacterial species and strains. Typically, this is accomplished by targeting housekeeping genes that provide resolution down to the family, genera, and sometimes species level. Unfortunately, this level of resolution is not sufficient in many applications where strain-level identification of bacteria is required (biodefense, forensics, clinical diagnostics, and outbreak investigations).

Differentiating Botulinum Neurotoxin-Producing Clostridia with a Simple, Multiplex PCR Assay.

Diverse members of the genus produce botulinum neurotoxins (BoNTs), which cause a flaccid paralysis known as botulism. While multiple species of clostridia produce BoNTs, the majority of human botulism cases have been attributed to groups I and II. Recent comparative genomic studies have demonstrated the genomic diversity within these BoNT-producing species.

Factors affecting river health and its assessment over broad geographic ranges: the Western Australian experience.

AusRivAS is an Australia-wide program that measures river condition using predictive models to compare the macroinvertebrate families occurring at a river site with those expected if the site were in natural condition. Results of assessment of 685 sites across all major rivers in Western Australia are presented. Most rivers were in relatively natural condition in the northern half of the state where the human population is low and pastoralism is the major land use.

Short-acting general anaesthesia facilitates therapeutic ERCP in frail elderly patients with benign extra-hepatic biliary disease.

Aims And Objectives: To ascertain whether therapeutic endoscopic retrograde cholangiopancreatography (ERCP) for benign biliary disease in frail elderly patients with comorbid conditions can be safely undertaken in a district general hospital, and whether the procedure is facilitated by the use of short-acting general anaesthesia.

Setting: District general hospital in South East England.

Design Of Study: Clinical study of 25 consecutive patients with benign biliary disease.

Gene for M1 subunit of ribonucleotide reductase is amplified in hydroxyurea-resistant hamster cells.

The hydroxyurea-resistant Chinese hamster cell line 600H has been shown to have greatly elevated quantities of ribonucleotide reductase. This increase in enzyme activity is due to an increased level of both the M1 and M2 subunit activities. The M1 subunit has been purified from the 600H cell line and shown to consist of a series of six protein spots with apparent molecular weights of 88,000 daltons, but with varying isoelectric points in the range of pH 6.

Temperature-sensitive herpes simplex virus type 1 mutants defective in the shutoff of cellular DNA synthesis and host polypeptide synthesis.

Two temperature-sensitive herpes simplex virus type 1 mutants, ts 1-8 and ts 199, belonging to different complementation groups, were isolated. Both mutants were defective in the shutoff of host DNA synthesis at 39.5 degrees C (nonpermissive temperature).

Chemotherapy in pancreatic cancer: results of a controlled, prospective, randomised, multicentre trial.

Forty patients with inoperable pancreatic cancer were included in a prospective, randomised, controlled trial of multiple chemotherapy. The survival of 19 untreated control patients was compared with that of 21 patients who received an initiation course of intravenous fluorouracil, cyclophosphamide, methotrexate, and vincristine given over five days followed by intravenous fluorouracil and mitomycin given over three or five days at six-week intervals thereafter. Median survival in treated patients was 44 weeks, which was significantly longer than the nine weeks seen in controls.

Chemotherapy in advanced gastric cancer: a controlled, prospective, randomised multi-centre study.

Seventy-six patients with advanced gastric adenocarcinoma were studied in a prospecitive, randmoised, controlled trial using vincristine, methotrexate, cyclophosphamide, and 5-fluorouracil in an initiation course and mitomycin-C with 5-fluorouracil as maintenance therapy. Thirty-seven patients were inoperable and 39 had the primary tumour resected with histological evidence of residual disease. Survival in the inoperable group was short and showed no significant difference between treated and control patients.

Upper gastro-intestinal endoscopy and radiology in the elderly.

The results of oesophago-gastro-duodenoscopy (OGD) and radiology in one hundred consecutive elderly patients were reviewed to assess the efficacy, safety and acceptability of endoscopy in this age group. False positive radiological features occurred in two of nine patients with normal endoscopic examinations. The remaining ninety-one patients had 138 lesions, sixty-four of which were diagnosed by both techniques.

Blood volume studies in chronic obstructive non-specific lung disease: a comparison of the bronchitic and emphysematous patients.

Blood volume measurements were made on forty-five patients with chronic obstructive non-specific lung disease. Thirty patients were considered to have the features of predominant emphysema, and fifteen had more bronchitic characteristics. Mean red cell volume was 100·8% of the predicted normal volume in the emphysematous group, whereas that of the bronchitic patients was 121·8% predicted.

Pyloric reflux and the healing of gastric ulcers.

Pyloric reflux is rare in healthy subjects but is common in those with benign gastric ulcer. Healing of a gastric ulcer is associated with a diminution of reflux, and occasionally the pylorus becomes fully competent.

Clinical features of polycythaemic patients with chronic obstructive non-specific lung disease.

Forty-five patients with chronic hypoxic lung disease were studied to ascertain whether those with polycythaemia had specific distinguishing features. Thirty-three patients had red cell volumes less than 120% of the predicted normal values, and 12 patients had red cell volumes greater than this level and were regarded as polycythaemic. The latter were found to have a higher incidence of the features associated with obstructive bronchitis, whereas the nonpolycythaemic subjects had more emphysematous characteristics.