SARS-CoV-2 and other respiratory pathogens are detected in continuous air samples from congregate settings.

Two years after the emergence of SARS-CoV-2, there is still a need for better ways to assess the risk of transmission in congregate spaces. We deployed active air samplers to monitor the presence of SARS-CoV-2 in real-world settings across communities in the Upper Midwestern states of Wisconsin and Minnesota. Over 29 weeks, we collected 527 air samples from 15 congregate settings.

SARS-CoV-2 and other respiratory pathogens are detected in continuous air samples from congregate settings.

Two years after the emergence of SARS-CoV-2, there is still a need for better ways to assess the risk of transmission in congregate spaces. We deployed active air samplers to monitor the presence of SARS-CoV-2 in real-world settings across communities in the Upper Midwestern states of Wisconsin and Minnesota. Over 29 weeks, we collected 527 air samples from 15 congregate settings and detected 106 SARS-CoV-2 positive samples, demonstrating SARS-CoV-2 can be detected in air collected from daily and weekly sampling intervals.

Hospital-acquired Legionella pneumonia outbreak at an academic medical center: Lessons learned.

Background: An outbreak of Legionella pneumonia occurred at a university hospital using copper-silver ionization for potable water disinfection. We present the epidemiological and laboratory investigation of the outbreak, and associated case-control study.

Methods: Cases were defined by syndrome compatible with Legionella pneumonia with laboratory-confirmed Legionella infection.

Fatal Case of Legionnaires' Disease After Home Exposure to Legionella pneumophila Serogroup 3 - Wisconsin, 2018.

In January 2018, the Wisconsin Department of Health Services, Division of Public Health (DPH), received a report of a culture-confirmed case of Legionnaires' disease. The patient, who was immunocompromised, had died at a local hospital 10 days after being admitted. DPH and an infection preventionist from the hospital investigated to determine the source of the infection and prevent additional cases.

A Prospective, Randomized Comparison of Duodenoscope Reprocessing Surveillance Methods.

Duodenoscope use in healthcare facilities has been associated with transmission of multidrug resistant pathogens between patients. To assist healthcare facilities in monitoring the quality of their duodenoscope reprocessing procedures and limit patient risk of infection, the Centers for Disease Control and Prevention (CDC) deployed voluntary interim duodenoscope sampling and culturing surveillance protocols in 2015. Though the interim methods were widely adopted, alternative surveillance protocols were developed and implemented at individual institutions.

Racial disparities in the transgenerational transmission of low birthweight risk.

To examine the association of maternal low birthweight (LBW) with infant LBW and infant LBW subgroups (i.e. moderate and very LBW), overall and among non-Hispanic (NH) white and NH black mothers.

Transgenerational Transmission of Preterm Birth Risk: The Role of Race and Generational Socio-Economic Neighborhood Context.

Objectives We investigated associations of mothers' preterm birth (PTB) status with her infants' PTB risk. We also examined whether this relationship differs by mothers' race and generational socio-economic neighborhood context. Methods Participants were 6592 non-Hispanic (NH) white and NH black mother-infant pairs born in 2009-2011 and 1979-1998, respectively, in Allegheny County, Pennsylvania.

Incorporation of Leadership Rounds in CAUTI Prevention Efforts.

Leadership engagement is an important aspect of integrating best practices at the bedside. The catheter-associated urinary tract infection (CAUTI) prevention workgroup at our academic medical center implemented leadership rounding in partnership with clinical staff to increase participation in CAUTI prevention initiatives on inpatient units. There was an associated decrease in urinary catheter utilization and CAUTI rates.

Intimate partner violence, partner notification, and expedited partner therapy: a qualitative study.

Over one-third of women experience intimate partner violence (IPV) in their lifetime. IPV increases the risk of infection and re-infection with sexually transmitted infections (STIs). The extent to which health care providers consider IPV when recommending partner notification and expedited partner therapy is unknown.

Healthcare providers' perspectives on expedited partner therapy for chlamydia: a qualitative study.

Objectives: Expedited partner therapy (EPT) effectively reduces rates of reinfection with chlamydia and increases the number of partners treated for the infection. Healthcare provider (HCP) provision of EPT is low. The objective of this qualitative study was to understand HCP views and opinions regarding the use of EPT in a state where EPT is permissible but underused.

Pharmacist participation in infection prevention: an innovative approach to monitoring compliance with the Five Moments for Hand Hygiene in a large academic medical center.

Using pharmacy residents as covert observers, we evaluated compliance with hand hygiene and contact precautions among 101 unique health care workers on entrance, exit, and inside rooms of patients with known or suspected Clostridium difficile infection. Overall compliance rates with hand hygiene upon entering and exiting patient rooms were 63.4% and 69.

Emergency neurological life support: traumatic spine injury.

Traumatic spine injuries (TSIs) carry significantly high risks of morbidity, mortality, and exorbitant health care costs from associated medical needs following injury. For these reasons, TSI was chosen as an ENLS protocol. This article offers a comprehensive review on the management of spinal column injuries using the best available evidence.

Financial distress and depressive symptoms among African American women: identifying financial priorities and needs and why it matters for mental health.

Prior research found that financial hardship or distress is one of the most important underlying factors for depression/depressive symptoms, yet factors that contribute to financial distress remain unexplored or unaddressed. Given this, the goals of the present study were (1) to examine the relationship between perceived financial distress and depressive symptoms, and (2) to identify financial priorities and needs that may contribute to financial distress. Surveys from 111 African American women, ages 18-44, who reside in Allegheny County, PA, were used to gather demographic information and measures of depressive symptoms and financial distress/financial well-being.

Synthesis and stereochemistry of occidenol, a 4,5-dihydrooxipin-containing sesquiterpene: a pericyclic approach.

The first synthesis of occidenol (1), a 4,5-dihydrooxipin-containing sesquiterpene, is reported. The stereochemistry is corrected from that postulated by Tomita and Hirose, by a synthesis starting with natural occidentalol (4), the stereochemistry of which was also initially in error. The route (schemes 1 and 2) utilizes a retro-electrocyclic [2+2+2] fragmentation with N2 expulsion from 9 to produce, quantitatively, the acid sensitive dihydrooxipin system.

Advances in abdominal trauma.

Emergency practitioners routinely encounter patients who suffer from abdominal trauma, be it blunt or penetrating. These injuries are often confounded by altered mental status, distracting injuries, or lack of historical information, and may present challenges in management. However, in the last several years new approaches to the diagnosis and management of abdominal trauma, including bedside ultrasound, newer generation computed tomography scans, laparoscopy, and the ability for selected nonoperative management expedite identification of life threatening injury and offer new options in treatment.

Addition of the phenoxathiin cation radical to alkenes and nonconjugated dienes. Formation of (E)- and (Z)-(10-phenoxathiiniumyl)alkenes and (E)- and (Z)-(10-phenoxathiiniumyl)dienes on basic alumina.

Addition of phenoxathiin cation radical (PO*+) to acyclic alkenes in acetonitrile (MeCN) solution occurred stereospecifically to form bis(10-phenoxathiiniumyl)alkane adducts. Stereospecific trans addition is ascribed to the intermediacy of an episulfonium cation radical. The alkenes used were cis- and trans-2-butene, cis- and trans-2-pentene, cis- and trans-4-methyl-2-pentene, cis- and trans-4-octene, trans-3-hexene, trans-3-octene, trans-5-decene, cis-2-hexene, and cis-2-heptene.

Effectiveness of preemptive barrier precautions in controlling nosocomial colonization and infection by methicillin-resistant Staphylococcus aureus in a burn unit.

Background: We report the effectiveness of preemptive enhanced barrier precautions in containing a methicillin-resistant Staphylococcus aureus (MRSA) outbreak in a university hospital burn unit and further controlling endemic nosocomial MRSA infection in the unit during the succeeding 27 months.

Methods: During a 6-month period, 12 patients in a 7-bed burn unit were found to be colonized (7) or infected (5) by MRSA. An epidemiologic study was undertaken.

Adducts of thianthrene- and phenoxathiin cation radical tetrafluoroborates to 1-alkynes. Structures and formation of 1-(5-thianthreniumyl)- and 1-(10-phenoxathiiniumyl)alkynes on alumina leading to alpha-ketoylides and alpha-ketols.

[structure: see text] Thianthrene cation radical tetrafluoroborate (Th*+ BF4(-)) added to the terminal alkynes 1-pentyne, 1-hexyne, 1-heptyne, 1-octyne, 1-nonyne, and 1-decyne to form trans-1,2-bis(5-thianthreniumyl)alkene tetrafluoroborates (1-6). Similarly, addition of phenoxathiin cation radical tetrafluoroborate (PO*+ BF4(-)) to the same alkynes gave 1,2-bis(10-phenoxathiiniumyl)alkene tetrafluoroborates (7-12). The trans configuration of two of the adducts (1 and 4) was shown with X-ray crystallography.

Adducts of thianthrene- and phenoxathiin cation radical salts with symmetrical alkynes. Structure and formation of cumulenes on alumina leading to alpha-diketones, alpha-hydroxyalkynes, and alpha-acetamidoalkynes.

[reaction: see text] Thianthrene cation radical tetrafluoroborate (Th*+ BF4-) added to 2-butyne, 3-hexyne, 4-octyne, and 5-decyne in MeCN to form trans bisadducts R(Th+)C=C(Th+)R, where R = Me, Et, Pr, Bu (7a-d). Phenoxathiin cation radical tetrafluoroborate (PO*+ BF4-) added similarly to the last three alkynes to form adducts R(PO+)C=C(PO+)R, 8b-d. Cyclic monoadducts were not found.

Decomposition of alkene adducts of thianthrene cation radical in nitrile solvents. Formation of alkyl-2-oxazolines and a new class of four-component products: 5-[(1-alkoxyalkylidene)ammonio]alkylthianthrenium diperchlorates.

The monoadducts (4a-d) of thianthrene cation radical perchlorate (1a) and isobutene, 2-methylbutene, 2-methyl-2-butene, and 2-methylpentene decompose spontaneously in acetonitrile (MeCN) solution, with the formation of thianthrene (Th). Decomposition of 4a (1,2-(5,10-thianthreniumdiyl)-2-methylpropane diperchlorate) and 4a', the corresponding dihexafluorophosphate, was studied in depth and extensively with (1)H and (13)C NMR spectroscopy. Decomposition of 4a was found to involve the solvent itself as well as water in the solvent, remaining from incomplete drying, and gave, apart from Th, successively, the perchlorate salts of 2,4,4-trimethyl-2-oxazoline (6) and 2-amino-2-methylpropyl acetate (7).

Nosocomial infection with vancomycin-dependent enterococci.

We report three patients infected with unique strains of vancomycin-dependent enterococci. Two were first infected by genetically identical strains of vancomycin-resistant enterococci (VRE). All three patients had much greater exposure to vancomycin and third-generation cephalosporins than did two control groups (patients infected with VRE and hospitalized patients without enterococcal infections).

FAST (focused assessment with sonography in trauma) accurate for cardiac and intraperitoneal injury in penetrating anterior chest trauma.

Objective: To evaluate the FAST (focused assessment with sonography in trauma) examination for determining traumatic pericardial effusion and intraperitoneal fluid indicative of injury in patients with penetrating anterior chest trauma.

Methods: An observational prospective study was conducted over a 30-month period at an urban level I trauma center. FAST was performed in the emergency department by emergency physicians and trauma surgeons.

Adducts of phenoxathiin and thianthrene cation radicals with alkenes and cycloalkenes.

Phenoxathiin cation radical perchlorate (PO.+ClO4(-)) added stereospecifically to cyclopentene, cyclohexene, cycloheptene, and 1,5-cyclooctadiene to give 1,2-bis(5-phenoxathiiniumyl)cycloalkane diperchlorates (4-7) in good yield. The diaxial configuration of the PO+ groups was confirmed with X-ray crystallography.