Notes

Can smog fast companies to implement environmentally friendly administration? Data coming from China.
national integrated health care system. Our results suggest that publishing evidence-based guidelines alone-such as the Choosing Wisely campaign-may not sufficiently influence individual physician behavior, and that system-level efforts to directly deimplement LVTs may therefore necessary to effect sustained change.
Despite existing guidelines, use of LVTs prior to cataract surgery is both common and costly within a large, national integrated health care system. Our results suggest that publishing evidence-based guidelines alone-such as the Choosing Wisely campaign-may not sufficiently influence individual physician behavior, and that system-level efforts to directly deimplement LVTs may therefore necessary to effect sustained change.
Nivolumab and pembrolizumab are approved for treating platinum-refractory recurrent or metastatic head and neck squamous cell carcinoma (R/M HNSCC). Physicians and patients are uncertain which drug is preferable, rendering a cost-effectiveness comparison between them necessary.

To evaluate the cost-effectiveness of nivolumab vs pembrolizumab in treating platinum-refractory R/M HNSCC.

Both the network meta-analysis and cost-effectiveness analysis included patients from the CheckMate 141 and the KEYNOTE 040 phase 3 randomized clinical trials. The Checkmate 141 trial started on May 1, 2014, with the present analysis based on a September 2017 data cutoff. The KEYNOTE 040 trial started on November 17, 2014, with the present analysis based on a May 15, 2017, data cutoff. A bayesian network meta-analysis that included 856 patients was carried out, and a cost-effectiveness analysis that included 487 patients was conducted by developing a partitioned survival model, both between February and November 2020. The r kg, nivolumab (3 mg/kg, biweekly) was considered cost-effective; otherwise, pembrolizumab was preferable. When the WTP threshold was $150 000 per QALY, nivolumab (3 mg/kg biweekly) was considered cost-effective for patients weighing less than 75 kg; otherwise, fixed-dose nivolumab (240 mg biweekly or 480 mg monthly) provided more cost savings.
Many people use cannabis for medical reasons despite limited evidence of therapeutic benefit and potential risks. Little is known about medical practitioners' documentation of medical cannabis use or clinical characteristics of patients with documented medical cannabis use.

To estimate the prevalence of past-year medical cannabis use documented in electronic health records (EHRs) and to describe patients with EHR-documented medical cannabis use, EHR-documented cannabis use without evidence of medical use (other cannabis use), and no EHR-documented cannabis use.

This cross-sectional study assessed adult primary care patients who completed a cannabis screen during a visit between November 1, 2017, and October 31, 2018, at a large health system that conducts routine cannabis screening in a US state with legal medical and recreational cannabis use.

Three mutually exclusive categories of EHR-documented cannabis use (medical, other, and no use) based on practitioner documentation of medical cannabis use in pared to discuss potential risks and benefits of cannabis use with patients.A mortality event involving at least 14 Western Gulls (Larus occidentalis) was observed on 10 October 2019 on Huntington State Beach, Orange County, California, US. Clinical signs of affected gulls included generalized weakness and difficulty standing and flying. Six additional Western Gulls with similar clinical signs were admitted for rehabilitation between 24 October and 7 November, including birds from Newport Beach and Laguna Beach, south of Huntington Beach. Eleven carcasses were submitted for postmortem examination, including nine gulls collected on 10 October from Huntington Beach, one collected on 24 October from Laguna Beach, and one collected on 6 November from Newport Beach. Six of seven gulls tested were positive for Clostridium botulinum toxin type A by mouse bioassay, including five collected on 10 October from Huntington Beach and one from Laguna Beach, approximately 23 km south, on 24 October, suggesting the toxin was available to scavenging birds for nearly 2 wk following the original exposure. Botulism type C, and less commonly type E, are most frequently documented in wild birds, including waterfowl and fish-eating birds, respectively. In contrast, botulism type A is the most common cause of foodborne botulism in humans, acquired from food contaminated with C. botulinum spores, but it has not previously been associated with mortality in free-ranging wild birds.
The coronavirus disease 2019 (COVID-19) pandemic has been an unprecedented global health challenge. Traditional modes of knowledge dissemination have not been feasible. A rapid solution was needed to share guidance and implementation examples within the global infection prevention and control (IPC) community. We designed the IPC Global Webinar Series to bring together subject matter experts and IPC professionals in the fight against COVID-19.

The Extension for Community Healthcare Outcomes (ECHO) model was adapted to create an interactive global knowledge network. Speakers and panelists provided presentations and answers to questions. Webinars were simultaneously interpreted into 5 languages and recorded for later access.

Thirteen webinar sessions were completed from 14 May through 6 August 2020. On average, 634 participants attended each session (range, 393-1181). Each session was represented by participants from, on average, more than 100 countries.

Through the IPC Global Webinar Series, critical inar sessions reached a broader audience than many in-person events. The webinar series was rapidly scaled and can be rapidly reactivated as needed. Our lessons learned in designing and implementing the series can inform the design of other global health virtual knowledge networks. The continued and expanded use of adapted virtual communities of practice and other learning networks for the IPC community can serve as a valuable tool for addressing COVID-19 and other infectious disease threats.The infection prevention and control (IPC) Global Webinar Series convened subject matter experts and IPC professionals from more than 100 countries to establish a global learning community for COVID-19. We advocate for expanded use of virtual knowledge networks.Sticky traps are standard tools for monitoring German cockroaches (Blattella germanica L.); however, because they lack an attractant, their ability to catch cockroaches is by chance and largely dependent upon the location of placement and length of time they are left in place. Currently, highly effective and economical cockroach attractants are not available. Food-based attractants have the potential to be employed in sticky traps and enhance their effectiveness on trapping German cockroaches. We conducted laboratory and field experiments to evaluate the effectiveness of novel food-based attractants. Laboratory results showed that sticky traps containing the following attractants apple oil, blueberry oil, orange oil, or their combination, fish oil, peanut butter, Roach lure tablet, and bacon extract had significantly higher trap catch compared to those traps that do not contain an attractant. Apple plus blueberry oil mixture and Roach lure tablet enhanced the trap catch by ≥ 103%, and bacon extract enhanced the trap catch by 92% in the field assays. Apple plus blueberry oil mixture and Roach lure tablet were the most promising attractants based on laboratory and field experiments. Apple plus blueberry oil mixture aged for 2 wk was as attractive to German cockroaches as fresh mixture.Commentary on "Paediatric Flatfeet a 2020 Guide for Clinicians to Identify the Boomerangs" (http//doi.org/10.7547/20-103).Borrelia miyamotoi is a hard tick-associated relapsing fever spirochete that is geographically widespread in Ixodes spp. (Acari Ixodidae) ticks, but typically occurs at low prevalence. Genetic variability has been described among strains derived from Asia, Europe, and North America, and among tick species that carry the infection, but little variability has been described within foci or tick species. Capitalizing on access to B. miyamotoi nucleic acid extracted from host-seeking Ixodes scapularis Say or Ixodes pacificus Cooley & Kohls from 16 states, we explored genetic variability based on sequence analysis of four amplicons described herein. Consistent with previous studies, we detected significant genetic differences between strains derived from I. selleck scapularis (eastern United States) and I. pacificus (western United States) and identified two distinct sequences in the western United States (Am-West-1 and Am-West-2). Unique to this study, we identified two distinct sequences in the eastern United States (Am-East-1 and Am-East-2). Based on the 161 samples we analyzed, Am-East-1 was the only type represented in 50 B. miyamotoi-infected ticks collected from the Northeast (Vermont, Maine, New York, Connecticut, and Rhode Island), whereas ticks collected from the North-Central and Mid-Atlantic states harbored B. miyamotoi comprised of both Am-East-1 and Am-East-2. Further studies are needed to better characterize the phylogeography of B. miyamotoi and to discern if there are biologically meaningful differences among sequence types. To facilitate further exploration, we developed a polymerase chain reaction (PCR) assay designed to differentiate Am-East-1, Am-East-2, and Am-West sequence types without having to sequence the amplicon.
As a result of the continuing surge of coronavirus disease 2019 (COVID-19), many patients have delayed or missed routine screening and preventive services. Medical conditions, such as coronary heart disease, mental health issues, and substance use disorder, may be identified later, leading to increases in patient morbidity and mortality.

National Emergency Medical Services Information System data were used to assess 911 emergency medical services (EMS) activations during 2018-2020. For specific activation types, the percentage of total activations was calculated per week, and Joinpoint analysis was used to identify changes over time.

Since March 2020, the number of 911 EMS activations has decreased, while the percentages of on-scene death, cardiac arrest, and opioid use/overdose EMS activations were higher than prepandemic levels. During the early pandemic period, percentages of total EMS activations increased for on-scene death (from 1.3% to 2.4% during weeks 11-15), cardiac arrest (from 1.3% to 2.2% dnic disease and substance use disorders that emphasize counseling, preventive care, and expanded access to medications can disrupt delayed care-seeking during the pandemic and potentially prevent premature death.Caldicellulosiruptor bescii is the most thermophilic, cellulolytic bacterium known and has the native ability to utilize unpretreated plant biomass. Cellulase A (CelA) is the most abundant enzyme in the exoproteome of C. bescii and is primarily responsible for its cellulolytic ability. CelA contains a family 9 glycoside hydrolase and a family 48 glycoside hydrolase connected by linker regions and three carbohydrate-binding domains. A truncated version of the enzyme (TM1) containing only the endoglucanase domain is thermostable and actively degrades crystalline cellulose. A catalytically active TM1 was successfully produced via the attachment of the PelB signal peptide (P-TM1), which mediates post-translational secretion via the SecB-dependent translocation pathway. We sought to enhance the extracellular secretion of TM1 using an alternative pathway, the signal recognition particle (SRP)-dependent translocation pathway. The co-translational extracellular secretion of TM1 via the SRP pathway (D-TM1) resulted in a specific activity that was 4.
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