Mitigation Protocols Research Articles

Mitigation of Data Packet Loss in Bluetooth Low Energy-Based Wearable Healthcare Ecosystem.

Bluetooth Low Energy (BLE) plays a critical role in wireless data transmission in wearable technologies. The previous work in this field has mostly focused on optimizing the transmission throughput and power consumption. However, not much work has been reported on a systematic evaluation of the data packet loss of BLE in the wearable healthcare ecosystem, which is essential for reliable and secure data transmission. Considering that diverse wearable devices are used as peripherals and off-the-shelf smartphones (Android, iPhone) or Raspberry Pi with various chipsets and operating systems (OS) as hubs in the wearable ecosystem, there is an urgent need to understand the factors that influence data loss in BLE and develop a mitigation solution to address the data loss issue. In this work, we have systematically evaluated packet losses in Android and iOS based wearable ecosystems and proposed a reduced transmission frequency and data bundling strategy along with queue-based packet transmission protocol to mitigate data packet loss in BLE. The proposed protocol provides flexibility to the peripheral device to work with the host either in real-time mode for timely data transmission or offline mode for accumulated data transmission when there is a request from the host. The test results show that lowered transmission frequency and data bundling reduce the packet losses to less than 1%. The queue-based packet transmission protocol eliminates any remaining packet loss by using re-request routines. The data loss mitigation protocol developed in this research can be widely applied to the BLE-based wearable ecosystem for various applications, such as body sensor networks (BSN), the Internet of Things (IoT), and smart homes.

Bat intrusions at a tertiary care center in Iowa, 2018-2020.

We described the epidemiology of bat intrusions into a hospital and subsequent management of exposures during 2018-2020. Most intrusions occurred in older buildings during the summer and fall months. Hospitals need bat intrusion surveillance systems and protocols for bat handling, exposure management, and intrusion mitigation.

Lessons in Media Ethics: Popular Culture, Religion and Digital Media

Over the past year, I rarely worked in my campus office due to mitigation protocols to limit the spread of COVID-19 on our campus. When I returned in late spring, I was delighted to find two new bo...

Factors Impacting Video Telehealth Appointment Completion During COVID-19 Pandemic Among People Living with HIV in a Community-Based Health System

As the threat of COVID-19 on vulnerable populations continues, mitigation protocols have escalated the use of telehealth platforms, secure 2-way video platforms with audio capabilities. The goal of the current study was to examine factors associated with successful completion of video telehealth appointments in HIV care. We utilized a random effects logistic model to assess characteristics of patient encounters that predicted completed telehealth visits. Results show that factors such as identifying as black (AOR = 0.30, 95% CI 0.23–0.40, p < 0.01), identifying as heterosexual (AOR = 0.40, 95% CI, 0.29–0.55, p < 0.01), identifying as Hispanic/Latinx (AOR = 0.67, 95% CI, 0.48–0.95), having public insurance (e.g., Ryan White funding, Medicare/Medicaid) (AOR = .25, 95% CI 0.19–0.33, p < .001), and having detectable viral load (AOR = .049, 95% CI, 0.31–0.76) are negatively associated with completion of telehealth appointments. Results suggest that greater efforts to address the digital divide are needed to increase access to video telehealth.

Viral mitigation and the COVID-19 pandemic: factors associated with adherence to social distancing protocols and hygienic behaviour

Objective To investigate the factors associated with adherence to viral mitigation protocols during the COVID-19 pandemic. Design This epidemiological cross-sectional study examines adherence to behaviour in 4158 adults and its relationship with sources of information. Main outcome measures Adherence to social distancing protocols (SDPs) and adherence to hygienic behaviour (HB) recommendations. Results Individuals aged 18–30 reported lowest adherence to SDPs and HB. Alcohol consumption was associated with lower adherence. Increased risk perception, fear of infection and altruistic attitude were associated with greater adherence. Males, single and childless individuals reported lower adherence. Extroverts and urban residents reported lower adherence to SDPs, but not HB. In contrast to earlier stages of the pandemic, voluntary social distancing was associated with greater adherence to SDPs as opposed to rule-enforced social distancing. Regarding information obtainment, increased time spent acquiring information from recognised newspapers had the strongest favourable association with adherence. Relying on information from friends and family was associated with decreased adherence to SDPs. Sensitivity analyses replicated the findings, supporting the stability and robustness of the proposed models. Conclusion This study identifies factors associated with favourable and detrimental adherence behaviour along with substantial dissemination routes, presenting strategies that may be of utility towards fostering adherence to contemporaneously implemented mitigation protocols.

The incidence and magnitude of the health costs of in-person schooling during the COVID-19 pandemic.

The health costs of in-person schooling during the pandemic, if any, fall primarily on the families of students, largely owing to the fact that students significantly outnumber teachers. Data from North Carolina, Wisconsin, Australia, England, and Israel covering almost 80 million person-days in school during 2020 help assess the magnitude of the fatality risks of in-person schooling, accounting for mitigation protocols as well as the age and living arrangements of students and teachers. The risks of in-person schooling to unvaccinated teachers are, for those not yet elderly, small enough to challenge comprehension. Valued at a VSL of $10 million, the average daily fatality cost ranges from $0.01 for a young teacher living alone to as much as $29 for an elderly teacher living with an elderly spouse. For each 22 million unvaccinated students and teachers schooling in-person for a 5-day week during the pandemic, the expected number of fatalities among teachers and their spouses is one or less.

COVID-19 in schools: Mitigating classroom clusters in the context of variable transmission.

Widespread school closures occurred during the COVID-19 pandemic. Because closures are costly and damaging, many jurisdictions have since reopened schools with control measures in place. Early evidence indicated that schools were low risk and children were unlikely to be very infectious, but it is becoming clear that children and youth can acquire and transmit COVID-19 in school settings and that transmission clusters and outbreaks can be large. We describe the contrasting literature on school transmission, and argue that the apparent discrepancy can be reconciled by heterogeneity, or "overdispersion" in transmission, with many exposures yielding little to no risk of onward transmission, but some unfortunate exposures causing sizeable onward transmission. In addition, respiratory viral loads are as high in children and youth as in adults, pre- and asymptomatic transmission occur, and the possibility of aerosol transmission has been established. We use a stochastic individual-based model to find the implications of these combined observations for cluster sizes and control measures. We consider both individual and environment/activity contributions to the transmission rate, as both are known to contribute to variability in transmission. We find that even small heterogeneities in these contributions result in highly variable transmission cluster sizes in the classroom setting, with clusters ranging from 1 to 20 individuals in a class of 25. None of the mitigation protocols we modeled, initiated by a positive test in a symptomatic individual, are able to prevent large transmission clusters unless the transmission rate is low (in which case large clusters do not occur in any case). Among the measures we modeled, only rapid universal monitoring (for example by regular, onsite, pooled testing) accomplished this prevention. We suggest approaches and the rationale for mitigating these larger clusters, even if they are expected to be rare.

Radiation Resistance of C57Bl/6 Mouse Bone Marrow Stromal Cell Lines Induced By Apoptosis Inhibitor JP4-039 or Necroptosis Inhibitor Necrostatin-1, but Not By Simultaneous Administration of Both Mitigators

Introduction: Necroptosis is a TNFa activated, caspase-independent cell death pathway that involves active disintegration of mitochondrial, lysosomal and plasma membranes (Vandenabeele, et al, Nat Rev Mol Cell Biol., 2010 Oct; 11(10):700-14). We measured clonogenic radiation survival of C57/Bl6 mouse bone marrow stromal cell lines in the presence of a mitochondrial targeted inhibitor of apoptosis (JP4-039), an inhibitor of necroptosis (Necrostatin-1) or both drugs.Materials and Methods: C57BL/6 mouse long term bone marrow cultures (LTBMCs) were established from adult female C57Bl/6 mice. Bone marrow stromal cell lines were derived from the adherent layers of LTBMCs. Radiosensitivity of C57Bl/6 bone marrow stromal cell lines and fresh bone marrow CFU-GEMM (semisolid medium with added hemopoietic growth factors) was measured in clonogenic radiation survival curves. Stromal Cells were irradiated to doses of 0 to 8 Gy, plated in T-75 tissue culture flasks, incubated for 8 days at 37oC, stained with crystal violet and colonies of greater than 50 cells counted at day 7. CFU-GEMMs from fresh bone marrow were scored at day 14. Both cultured cell populations were tested with addition of radiation mitigators: JP4-039 (10µM), Necrostatin-1 (40µM), or both drugs added to culture medium 30 minutes post irradiation. C57BL/6 mouse LTBMCs generated hemopoietic cells for 20 weeks. Marrow stromal cell lines were derived from 20 week old hemopoieticly-inactive culture adherent layer cells. Statistical analysis was performed using Student's t-test, with a two-tail p-value < 0.05 considered significant.Results: Radiation survival curves showed that C57Bl/6 fresh bone marrow CFU-GEMM and stromal cell lines were comparable to those for other mouse strains (CFU-GEMM Do = 1.67 ± 0.02, stromal cells Do=1.43 ± 0.14). Both fresh marrow CFU-GEMM and stromal cells (ň = 5.26 ± 0.72) were radioresistant when grown in presence of JP4-039 (ň = 8.85 ± 1.23, p = 0.012) or necrostatin-1 (n=7.97 ± 1.12, p = 0.024). Addition of both JP4-039 and Necrostatin-1 (ň = 5.79 ± 1.44) at the same time after irradiation (30 min) did not improve clonogenic survival of either fresh marrow CFU-GEMM or stromal cell lines.Conclusions: Both freshly explanted CFU-GEMM marrow hematopoietic progenitor cells and LTBMC derived marrow stromal cell lines display radioresistance when treated with each of two radiation mitigators that target different cell death pathways. While each drug delivered independently induced radioresistance, combined delivery of JP4-039 and Necrostatin-1 at 30 min after irradiation did not. Thus, the timing of delivery of drugs that target different cell death pathways is likely critical in designing effective protocols for radiation mitigation. DisclosuresNo relevant conflicts of interest to declare.

Impact of correlations and heavy tails on quantum error correction

We show that space- and time-correlated single-qubit rotation errors can lead to high-weight errors in a quantum circuit when the rotation angles are drawn from heavy-tailed distributions. This leads to a breakdown of quantum error correction, yielding reduced or, in some cases, no protection of the encoded logical qubits. While heavy-tailed phenomena are prevalent in the natural world, there is very little research as to whether noise with these statistics exists in current quantum processing devices. Furthermore, it is an open problem to develop tomographic or noise spectroscopy protocols that could test for the existence of noise with such statistics. These results suggest the need for quantum characterization methods that can reliably detect or reject the presence of such errors together with continued first-principles studies of the origins of space- and time-correlated noise in quantum processors. If such noise does exist, physical or control-based mitigation protocols must be developed to mitigate this noise as it would severely hinder the performance of fault-tolerant quantum computers.

Public Health Strengths During the COVID-19 Response.

Public Health Strengths During the COVID-19 Response.

The Backward Art of Slowing the Spread? Congregation Efficiencies during COVID-19

Were workers more likely to be infected by COVID-19 in their workplace, or outside it? While both economic models of the pandemic and public health policy recommendations often presume that the workplace is less safe, this paper seeks an answer both in micro data and economic theory. The available data from schools, hospitals, nursing homes, food processing plants, hair stylists, and airlines show employers adopting mitigation protocols in the spring of 2020. Coincident with the adoption, infection rates in workplaces typically dropped from well above household rates to well below. When this occurs, the sign of the disease externality from participating in large organizations changes from negative to positive, even while individuals continue to have an incentive to avoid large organizations due to the prevention costs they impose on members. Rational cooperative prevention sometimes results in infectious-disease patterns that are opposite of predictions from classical epidemiology.

Description and implementation of an On-farm Wildlife Risk Mitigation Protocol at the wildlife-livestock interface: Tuberculosis in Mediterranean environments

Animal tuberculosis (TB), which is caused by the Mycobacterium tuberculosis complex (MTC), is a zoonotic disease of global concern, and has a wide variety of wild and domestic reservoirs that can establish complex epidemiological systems. Of all the strategies employed to control TB, reducing the risks of interaction at the wildlife-livestock interface is a cornerstone. However, detailed protocols with which to assess and implement farm-specific preventive actions that can be employed against interactions with wildlife are lacking for extensive production systems. We describe an On-farm Wildlife Risk Mitigation Protocol that is applicable to beef cattle farming in Mediterranean environments in order to control the wildlife-livestock interaction and MTC transmission through the use of Farm-specific Action Plans (FsAP). We assessed the implementation and verification of FsAP in terms of its practical feasibility and acceptability by farmers (n=55 farms). Of the potential risk points, waterers (41.3 %) and waterholes (24.4 %) were the most common. Waterholes and springs were identified as the points with the greatest risks. Actions related to water management were essential on most farms (99 % of the high-risk points), as were those regarding wildlife management (36.4 % of the farms provided wild boar or cervids with supplementary food for hunting purposes). Overall, 75 % of the farmers adopted the plans to some extent, with an average of 31.8 % of actions implemented, but with high variability depending on the type of actions proposed. Farmers prioritised low-cost measures. Our results, in their entirety, indicate that the adoption of this On-farm Wildlife Risk Mitigation Protocol is practical and feasible in Mediterranean ecosystems, and can be easily transferred to professionals and adapted to other bioregions or epidemiological systems. The subsequent evaluation of FsAPs in terms of efficacy and cost-effectiveness, along with increasing their acceptance by farmers, are necessary steps for the further development of TB Risk Mitigation Programmes at a nationwide level.

COVID-19 and Financial Sustainability of Academic Institutions

The COVID-19 pandemic has had a significant impact on higher education. Steering academic institutions through the pandemic is a complex and multifaceted task that can be supported with model-based scenario analysis. This article studies the short-term and long-term effects of the pandemic on the financial health of a college using scenario analysis and stress testing with a system dynamics model of a representative tuition-dependent college. We find that different combinations of the pandemic mitigation protocols have varying effects on the financial sustainability of an academic institution. By simulating six individual components of the COVID-19 shock, we learn that due to the causal complexity, nonlinear responses and delays in the system, the negative shocks can propagate widely through the college, sometimes with considerable delays and disproportionate effects. Scenario analysis shows that some pandemic mitigation choices may destabilize even financially healthy institutions. The article concludes that higher education needs new sustainable business models.

Protein biomarker elucidation for the verification of biological agents in the taxonomic group of Gammaproteobacteria using tandem mass spectrometry.

Some pathogenic microbes can be used for nefarious applications and instigate population-based fear. In a bio-threat scenario, rapid and accurate methods to detect biological agents in a wide range of complex environmental and clinical matrices, is of paramount importance for the implementation of mitigation protocols and medical countermeasures. This study describes targeted and shot-gun tandem MS based approaches for the verification of biological agents from the environmental samples. The marker proteins and peptides were elucidated by an exhaustive literature mining, in silico analysis of prioritized proteins, and MS/MS analysis of abundant proteins from selected bacterial species. For the shot-gun methodology, tandem MS analysis of abundant peptides was carried from spiked samples. The validation experiments employing a combination of shot-gun tandem MS analysis and a targeted search reported here is a proof of concept to show the applicability of the methodology for the unambiguous verification of biological agents at sub-species level, even with limited fractionation of crude protein extracts from environmental samples.

The Experience of 2 Independent Schools With In-Person Learning During the COVID-19 Pandemic.

ABSTRACTBACKGROUNDIn 2020, US schools closed due to SARS‐CoV‐2 but their role in transmission was unknown. In fall 2020, national guidance for reopening omitted testing or screening recommendations. We report the experience of 2 large independent K‐12 schools (School‐A and School‐B) that implemented an array of SARS‐CoV‐2 mitigation strategies that included periodic universal testing.METHODSSARS‐CoV‐2 was identified through periodic universal PCR testing, self‐reporting of tests conducted outside school, and contact tracing. Schools implemented behavioral and structural mitigation measures, including mandatory masks, classroom disinfecting, and social distancing.RESULTSOver the fall semester, School‐A identified 112 cases in 2320 students and staff; School‐B identified 25 cases (2.0%) in 1400 students and staff. Most cases were asymptomatic and none required hospitalization. Of 69 traceable introductions, 63 (91%) were not associated with school‐based transmission, 59 cases (54%) occurred in the 2 weeks post‐thanksgiving. In 6/7 clusters, clear noncompliance with mitigation protocols was found. The largest outbreak had 28 identified cases and was traced to an off‐campus party. There was no transmission from students to staff.CONCLUSIONSAlthough school‐age children can contract and transmit SARS‐CoV‐2, rates of COVID‐19 infection related to in‐person education were significantly lower than those in the surrounding community. However, social activities among students outside of school undermined those measures and should be discouraged, perhaps with behavioral contracts, to ensure the safety of school communities. In addition, introduction risks were highest following extended school breaks. These risks may be mitigated with voluntary quarantines and surveillance testing prior to reopening.

Surveillance for COVID-19 in the English Football League 2019-2020

ABSTRACT Medical surveillance and risk mitigation protocols to reduce viral transmission have underpinned the return of elite football during the COVID-19 pandemic. This article describes the evidence-informed approach and surveillance findings from the English Football League across a 9-week period at the end of the 2019–20 season. Protocols were devised by the lead EFL Medical Advisor with specialist occupational medicine input. Isolation requirements for cases and contacts were in-line with UK Government regulations, with external contact tracing conducted by local public health authorities. Quantitative PCR testing was conducted twice weekly and within 72 hours of fixtures. Forty-three individuals, including 18 players returned positive tests. No positive results were returned after week 5 (round 10). Our findings support those from other leagues that with appropriate compliance, elite football can continue safely during this pandemic. We recommend that protocols and compliance should be revised as necessary according to community prevalence and changes in viral transmission dynamics.

Asymptomatic SARS-CoV-2 infection: Incidental findings on FDG PET/CT

Rationale and ObjectivesIdentify the incidental findings of Covid-19 pneumonitis on 18F-FDG PET/CT scan in asymptomatic oncologic patients. The goal was to detect clinically unsuspected Covid-19 infections to prevent community spread. Materials and MethodsRetrospective analysis was conducted to recognize the pattern of metabolic and radiographic alterations on 18F-FDG PET/CT scans in Covid-19 patients. 492 18F-FDG PET/CT scans were reviewed for pulmonary and systemic abnormalities. Results18F-FDG PET/CT demonstrated new lung infiltrates in 29 asymptomatic patients. 13/29 patients had Covid-19 infection confirmed by nasopharyngeal nucleic acid PCR test. The most common lung abnormality was pure ground-glass opacity (GGO) (90%) in peripheral distribution (100%), involving 1 lobe in four patients (30.8%), 2–3 lobes in four patients, and 4-5 lobes in five patients (38.4%). Mean SUVmax was 4.7 (range 1.3–13.1). Ten patients developed symptoms, mainly fever, fatigue, and dry cough, within 6.4 ± 7.8 days (range 1–24). Of the available laboratory data of 12 patients, eight developed lymphopenia, and five patients had neutrophilia. Five patients required hospitalization, and two died of complications. ConclusionFor a given geographic region in the later stage of a pandemic, such as Covid-19, community spread of the disease is common. Therefore, it is not surprising to find it in asymptomatic being imaged for other indications. Recognition of its manifestation and effectively mounting mitigation protocols is essential to further reduce SARS-CoV-2 spread, especially to susceptible groups, predominantly the elderly and people with comorbidities.

Physical Distancing and Mental Health During the COVID-19 Pandemic: Factors Associated With Psychological Symptoms and Adherence to Pandemic Mitigation Strategies

In this epidemiological investigation, we assessed the prevalence of depression and anxiety symptoms during the COVID-19 pandemic. A total of 10,061 adults participated in the study. Symptoms of depression and anxiety were 2 to 3 times higher compared with prepandemic samples. Participants who predominantly socially distanced themselves revealed substantially higher symptoms than their counterparts. Females, ethnic and sexual-orientation minorities, younger adults, unemployed individuals, and participants with a psychiatric diagnosis reported higher prevalence of psychological symptoms. Worry about prolonged duration of physical-distancing protocols and frustration of autonomy was associated with elevation in symptoms of depression and anxiety. Increased competence to deal with the pandemic crisis was associated with fewer adverse symptoms. Physical exercise, experiencing nature, and distraction with activities were associated with reduced depressive symptoms but not anxiety. The extent of information access about the pandemic was associated with reduced anxiety symptoms. Furthermore, adherence to mitigation protocols was investigated. Younger adults and males reported lowest adherence. Altruistic attitudes, in addition to mandatory as opposed to voluntary adherence, were associated with higher adherence rates. Worrying about the health of significant others was associated with higher adherence rates, whereas worry about duration of pandemic protocols was associated with lower adherence rates.

The Incidence and Magnitude of the Health Costs of In-person Schooling during the COVID-19 Pandemic

The health costs of in-person schooling during the pandemic, if any, fall primarily on the families of students, largely due to the fact that students significantly outnumber teachers. Data from North Carolina, Wisconsin, Australia, England, and Israel covering almost 80 million person-days in school help assess the magnitude of the fatality risks of in-person schooling (with mitigation protocols), accounting for the age and living arrangements of students and teachers. The risks of in-person schooling to teachers are comparable to the risks of commuting by automobile. Valued at a VSL of $10 million, the average daily fatality cost ranges from $0.01 for an unvaccinated young teacher living alone to as much as $29 for an elderly and unvaccinated teacher living with an elderly and unvaccinated spouse. COVID-19 risk avoidance may also be more amenable to Bayesian updating and selective protection than automobile fatalities are. The results suggest that economic behaviors can sometimes invert epidemiological patterns when it comes to the spread of infectious diseases in human populations.

Golden seaweed tides accumulated in Pyropia aquaculture areas are becoming a normal phenomenon in the Yellow Sea of China

In January 2020, golden seaweed tides accumulated in the world's largest Pyropia aquaculture areas in the Yellow Sea of China again, resulting in great economic loss to local seaweed farmers. A large number (~40,000 km2) of Sargassum thalli floated around Pyropia aquaculture areas until May 2020, drifting northeastward and becoming an ecological threat to the coastal areas of Jiangsu and Shandong provinces. In response, the local government is developing an emergency plan to prevent future golden tides, and this process requires an understanding of the mechanisms by which form the Sargassum blooms. As the global climate continues to change and the increase in human activities, sea surface temperatures rise, nutrient emissions and other factors that affect Sargassum blooms may lead to gradually enlarged ecological crises in the Pacific Northwest unless mitigation protocols are developed.