Mass casualty decontamination following a chemical incident: evaluating improvised and interim decontamination protocols in a controlled cross-over volunteer study.

Background: On-scene improvised and interim decontamination protocols in the Initial Operational Response to chemical incidents aim for rapid intervention to minimise injury before specialist capabilities arrive. This study examines the effectiveness of UK improvised and interim protocols conducted in sequence.

Method: A simulant with methyl salicylate (MeS) in vegetable oil and a fluorophore was applied to participants' shoulders, arms and legs.

Search for Soft Unclustered Energy Patterns in Proton-Proton Collisions at 13 TeV.

The first search for soft unclustered energy patterns (SUEPs) is performed using an integrated luminosity of 138  fb^{-1} of proton-proton collision data at sqrt[s]=13  TeV, collected in 2016-2018 by the CMS detector at the LHC. Such SUEPs are predicted by hidden valley models with a new, confining force with a large 't Hooft coupling. In events with boosted topologies, selected by high-threshold hadronic triggers, the multiplicity and sphericity of clustered tracks are used to reject the background from standard model quantum chromodynamics.

Search for the Z Boson Decay to ττμμ in Proton-Proton Collisions at sqrt[s]=13 TeV.

The first search for the Z boson decay to ττμμ at the CERN LHC is presented, based on data collected by the CMS experiment at the LHC in proton-proton collisions at a center-of-mass energy of 13 TeV and corresponding to an integrated luminosity of 138  fb^{-1}. The data are compatible with the predicted background. For the first time, an upper limit at the 95% confidence level of 6.

Search for Baryon Number Violation in Top Quark Production and Decay Using Proton-Proton Collisions at sqrt[s]=13 TeV.

A search is presented for baryon number violating interactions in top quark production and decay. The analysis uses data from proton-proton collisions at a center-of-mass energy of 13 TeV, collected with the CMS detector at the LHC with an integrated luminosity of 138  fb^{-1}. Candidate events are selected by requiring two oppositely charged leptons (electrons or muons) and exactly one jet identified as originating from a bottom quark.

The wash-in effect and its significance for mass casualty decontamination.

Decontamination of skin by washing may increase dermal absorption, a phenomenon known as the wash-in effect. The wash-in effect is frequently discussed in studies investigating casualty decontamination where potentially life-saving interventions may enhance the dermal penetration of toxic chemicals, leading to an increase in incidence of morbidity and rates of mortality. However, the wash-in effect is seldom investigated within the context of mass casualty decontamination and real-life consequences are therefore poorly understood.

Identification of Novel Simulants for Toxic Industrial Chemicals and Chemical Warfare Agents for Human Decontamination Studies: A Systematic Review and Categorisation of Physicochemical Characteristics.

Chemical simulants have long been used in human trials of mass decontamination to determine the efficacy of decontamination interventions against more toxic agents. Until now, reliance has mostly been on individual chemicals as surrogates to specific agents (e.g.

Evaluating the impact of decontamination interventions performed in sequence for mass casualty chemical incidents.

The Initial Operational Response (IOR) to chemical incidents is a suite of rapid strategies including evacuation, disrobe and improvised and interim decontamination. IOR and Specialist Operational Response (SOR) decontamination protocols involving mass decontamination units would be conducted in sequence by UK emergency services following a chemical incident, to allow for safe onward transfer of casualties. As part of a series of human volunteer studies, we examined for the first time, the effectiveness of UK IOR and SOR decontamination procedures alone and in sequence.

Mass Casualty Decontamination for Chemical Incidents: Research Outcomes and Future Priorities.

Planning for major incidents involving the release of hazardous chemicals has been informed by a multi-disciplinary research agenda which has sought to inform all aspects of emergency response, but with a focus in recent years on mass casualty decontamination. In vitro and human volunteer studies have established the relative effectiveness of different decontamination protocols for a range of chemical agents. In parallel, a programme of research has focused on communicating with and managing large numbers of contaminated casualties at the scene of an incident.

Human volunteer study of the decontamination of chemically contaminated hair and the consequences for systemic exposure.

The decontamination of exposed persons is a priority following the release of toxic chemicals. Efficacious decontamination reduces the risk of harm to those directly affected and prevents the uncontrolled spread of contamination. Human studies examining the effectiveness of emergency decontamination procedures have primarily focused on decontaminating skin, with few examining the decontamination of hair and scalp.

A controlled cross-over study to evaluate the efficacy of improvised dry and wet emergency decontamination protocols for chemical incidents.

The UK Initial Operational Response (IOR) to chemical incidents includes improvised decontamination procedures, which use readily available materials to rapidly reduce risk to potentially exposed persons. A controlled, cross-over human volunteer study was conducted to investigate the effectiveness of improvised dry and wet decontamination procedures on skin, both alone, and in sequence. A simulant contaminant, methyl salicylate (MeS) in vegetable oil with a fluorophore was applied to three locations (shoulder, leg, arm).

Analysis of Chemical Simulants in Urine: A Useful Tool for Assessing Emergency Decontamination Efficacy in Human Volunteer Studies.

Introduction: To date, all human studies of mass-casualty decontamination for chemical incidents have relied on the collection and analysis of external samples, including skin and hair, to determine decontamination efficacy. The removal of a simulant contaminant from the surface of the body with the assumption that this translates to reduced systemic exposure and reduced risk of secondary contamination has been the main outcome measure of these studies. Some studies have investigated systemic exposure through urinary levels of simulant metabolites.

GC-MS/MS quantification of benzyl salicylate on skin and hair: A novel chemical simulant for human decontamination studies.

Human studies investigating the efficacy of emergency decontamination protocols for chemical incidents require the use of non-hazardous chemical simulants. Methyl salicylate (MeS) has almost exclusively been used for this purpose. Whilst MeS is a simulant of the chemical warfare agent (CWA) sulphur mustard, it is not an ideal simulant for many other chemical threats with greater persistence and lower volatility.

The mechanisms of boronate ester formation and fluorescent turn-on in ortho-aminomethylphenylboronic acids.

ortho-Aminomethylphenylboronic acids are used in receptors for carbohydrates and various other compounds containing vicinal diols. The presence of the o-aminomethyl group enhances the affinity towards diols at neutral pH, and the manner in which this group plays this role has been a topic of debate. Further, the aminomethyl group is believed to be involved in the turn-on of the emission properties of appended fluorophores upon diol binding.

Optimisation and validation of a GC-MS/MS method for the analysis of methyl salicylate in hair and skin samples for use in human-volunteer decontamination studies.

Methyl salicylate has a long history of use as a chemical warfare agent simulant for volatile lipophilic compounds such as sulphur mustard. An improved isotope dilution GC-MS/MS method was developed, optimised and validated for the analysis of methyl salicylate in human skin and hair samples, for use in emergency decontamination volunteer studies. Following derivatisation, quantification was measured on a triple quadrupole mass spectrometer, set to EI mode and conducting multiple reaction monitoring of target ions.

Chemical warfare agent simulants for human volunteer trials of emergency decontamination: A systematic review.

Incidents involving the release of chemical agents can pose significant risks to public health. In such an event, emergency decontamination of affected casualties may need to be undertaken to reduce injury and possible loss of life. To ensure these methods are effective, human volunteer trials (HVTs) of decontamination protocols, using simulant contaminants, have been conducted.

Differences in Radiation Activity Between Glass and Resin 90Y Microspheres in Treating Unresectable Hepatic Cancer.

The purpose of this study was to compare the difference in prescribed radiation activity between glass and resin yttrium-90 (Y) microspheres for radioembolization of unresectable hepatocellular carcinoma (HCC) or liver metastases at a tertiary care teaching institution. The authors performed a retrospective analysis on 126 patients with primary HCC and hepatic metastatic disease from extrahepatic primary cancers who underwent radioembolization with glass or resin particles between 2008 and 2013 at their institution. Radiation activity estimates for prescribed treatments, as well as for the alternate embolization particles, were calculated using commonly employed formulae for both glass and resin particles for all treatments.

Disentangling host, pathogen, and environmental determinants of a recently emerged wildlife disease: lessons from the first 15 years of amphibian chytridiomycosis research.

The amphibian fungal disease chytridiomycosis, which affects species across all continents, recently emerged as one of the greatest threats to biodiversity. Yet, many aspects of the basic biology and epidemiology of the pathogen, Batrachochytrium dendrobatidis (Bd), are still unknown, such as when and from where did Bd emerge and what is its true ecological niche? Here, we review the ecology and evolution of Bd in the Americas and highlight controversies that make this disease so enigmatic. We explore factors associated with variance in severity of epizootics focusing on the disease triangle of host susceptibility, pathogen virulence, and environment.

Initiation of Antiretroviral Therapy in Early Asymptomatic HIV Infection.

Background: Data from randomized trials are lacking on the benefits and risks of initiating antiretroviral therapy in patients with asymptomatic human immunodeficiency virus (HIV) infection who have a CD4+ count of more than 350 cells per cubic millimeter.

Methods: We randomly assigned HIV-positive adults who had a CD4+ count of more than 500 cells per cubic millimeter to start antiretroviral therapy immediately (immediate-initiation group) or to defer it until the CD4+ count decreased to 350 cells per cubic millimeter or until the development of the acquired immunodeficiency syndrome (AIDS) or another condition that dictated the use of antiretroviral therapy (deferred-initiation group). The primary composite end point was any serious AIDS-related event, serious non-AIDS-related event, or death from any cause.

Filling schemes at submicron scale: development of submicron sized plasmonic colour filters.

The pixel size imposes a fundamental limit on the amount of information that can be displayed or recorded on a sensor. Thus, there is strong motivation to reduce the pixel size down to the nanometre scale. Nanometre colour pixels cannot be fabricated by simply downscaling current pixels due to colour cross talk and diffraction caused by dyes or pigments used as colour filters.

Liquid|liquid electrochemical bicarbonate and carbonate capture facilitated by boronic acids.

Reversible bicarbonate and carbonate liquid|liquid ion transfer processes from aqueous solution into an organic 4-(3-phenylpropyl)pyridine phase are driven electrochemically with TPPMn(III/II) and shown to be facilitated over a wide pH range by 2-naphthylboronic acid (bicarbonate transfer potential -0.08 V vs. SCE; binding constant K(AB) = 10(2) mol(-1) dm(3) and carbonate dianion transfer potential 0.

Assessment of clinical renal preservation by phosphorus-31 magnetic resonance spectroscopy.

To evaluate the role of magnetic resonance spectroscopy (MRS) and to develop surface coils for assessing cadaveric renal viability during hypothermic storage, we used the monophosphate/inorganic phosphate ratio (MP/Pi) to monitor phosphorous metabolites in intact kidneys during various renal preservation maneuvers. Eighteen canine kidneys and 16 cadaveric kidneys were studied as follows: Group 1 (N = 4) in situ kidneys were monitored by implanted MRS coils; Group 1 (N = 4) ex vivo kidneys were immediately attached to vascular cannulas and monitored by MRS surface coils during normothermic perfusion; Group 3 (N = 4) kidneys were removed, cold-flushed and, after 24 hours of 4C storage, monitored by MRS surface coils before and during four hours of reperfusion via vascular cannulas; Group 4 (N = 6) kidneys were removed, cold-flushed and monitored by surface coils during cold storage up to 72 hours. In addition, 16 cadaveric kidneys were studied while in sterile cold-storage containers.

The effect of 2-amino-4-phosphonobutyrate (APB) on acetylcholine release from the rabbit retina: evidence for on-channel input to cholinergic amacrine cells.

The light-evoked release of acetylcholine (ACh) from the rabbit retina was taken as a measure of cholinergic amacrine cell activity. The glutamate analogue DL-(+/-)-2-amino-4-phosphonobutyric acid (APB) prevented the light-evoked release of ACh and also selectively abolished the ON-responses of ganglion cells and the ERG b-wave. It is concluded that the input to cholinergic amacrine cells involves mainly the depolarizing bipolar cells, which subserve ON-channels.