Marine Robotics for Deep-Sea Specimen Collection: A Systematic Review of Underwater Grippers

The collection of delicate deep-sea specimens of biological interest with remotely operated vehicle (ROV) industrial grippers and tools is a long and expensive procedure. Industrial grippers were originally designed for heavy manipulation tasks, while sampling specimens requires dexterity and precision. We describe the grippers and tools commonly used in underwater sampling for scientific purposes, systematically review the state of the art of research in underwater gripping technologies, and identify design trends. We discuss the possibility of executing typical manipulations of sampling procedures with commonly used grippers and research prototypes. Our results indicate that commonly used grippers ensure that the basic actions either of gripping or caging are possible, and their functionality is extended by holding proper tools. Moreover, the approach of the research status seems to have changed its focus in recent years: from the demonstration of the validity of a specific technology (actuation, transmission, sensing) for marine applications, to the solution of specific needs of underwater manipulation. Finally, we summarize the environmental and operational requirements that should be considered in the design of an underwater gripper.

Pre-analytical specimen labelling and processing errors in the ICU

Introduction: Specimen rejections have been associated with increased in-hospital stay and cost. The majority of errors occur in the pre-analytic phase. Specimen rejection can lead to high rate of recollection, delay in result availability, and high rate of test abandonment. These factors affect patient care and safety. Methods: This study conducted a retrospective review of Patient Safety Learning System (PSLS) reports for the intensive care unit (ICU) at The Ottawa Hospital General Campus (TOH) between 2010 and 2018, and a prospective review using interviews, surveys, and process mapping. Results: From 2098 PSLS reports, 52.6% were related to laboratory specimen collection and processing (pre-analytic phase). Specimen mislabelling with the wrong patient identifier accounted for 9.8% of pre-analytical error reports, while 16.4% of errors were due to non-sufficient quantity (NSQ) of specimen. 12.2 % of pre-analytical error reports involved cytology specimens. Conclusions: Pre-analytical errors are not only costly and resource draining, but may also place a burden on patients. Areas where errors were found include labels and requisitions stored in bedside cabinets, inconsistencies between specimen labels and requisitions, out-dated and difficult to access laboratory manuals, and non-sufficient quantity specimen collection. In the future we hope to start new initiatives to tackle these issues to improve patient safety and hospital efficiencies. This includes the development of a website for the laboratory manual, so that it is more easily accessible and user-friendly. With a new electronic medical record (EMR) system at TOH in 2019, we will explore the affects of pre-analytical processing of specimens.

Effectiveness of mRNA-1273 against SARS-CoV-2 omicron and delta variants

Background The recently emerged SARS-CoV-2 omicron variant raised concerns around potential escape from vaccine-elicited immunity. Limited data are available on real-world vaccine effectiveness (VE) of mRNA-1273 against omicron. Here, we report VE of 2 or 3 mRNA-1273 doses against infection and hospitalization with omicron and delta, including among immunocompromised individuals. Methods This test negative study was conducted at Kaiser Permanente Southern California. Cases were individuals aged ≥18 years testing positive by RT-PCR with specimens collected between 12/6/2021 and 12/23/2021 with variant determined by spike gene status. Randomly sampled test negative controls were 5:1 matched to cases by age, sex, race/ethnicity, and specimen collection date. Conditional logistic regression models were used to evaluate adjusted odds ratio (aOR) of vaccination with mRNA-1273 doses between cases and controls. VE(%) was calculated as (1-aOR)x100. Results 6657 test positive cases (44% delta, 56% omicron) were included. The 2-dose VE against omicron infection was 30.4% (95% CI, 5.0%-49.0%) at 14-90 days after vaccination and declined quickly thereafter. The 3-dose VE was 95.2% (93.4%-96.4%) against delta infection and 62.5% (56.2%-67.9%) against omicron infection. The 3-dose VE against omicron infection was low among immunocompromised individuals (11.5%; 0.0%-66.5%). None of the cases (delta or omicron) vaccinated with 3 doses were hospitalized compared to 53 delta and 2 omicron unvaccinated cases. Conclusions VE of 3 mRNA-1273 doses against infection with delta was high and durable, but VE against omicron infection was lower. VE against omicron infection was particularly low among immunocompromised individuals. No 3-dose recipients were hospitalized for COVID-19.

Antibiotic stewardship for nurses: Using e-learning modules to bridge the education gap

Objective: The Centers for Disease Control and Prevention has called for an interdisciplinary approach to antibiotic stewardship implementation that includes front-line nurses. The literature to date has identified key factors preventing uptake by nurses: lack of education, poor communication among providers, and unit culture. Three e-learning modules were developed to address the nurses’ education regarding the roles nurses play in antibiotic stewardship, antibiotic resistance, allergy assessment, medication side effects and interactions, pharmacokinetics–pharmacodynamics, culture interpretation, specimen collection, and the antibiogram. A survey was used to assess whether nurses felt more prepared to participate after finishing the modules. Setting: Front-line staff nurses in acute care were assigned e-learning modules as part of their pharmacy’s introduction of an antibiotic stewardship program for nurses. Methods: Nurses viewed the modules and completed a survey designed to rank their usefulness and to assess their attitudes. Results: Overall, 81% of nurses felt that they should be part of the antibiotic stewardship team. After completing the modules, 72% felt more empowered to participate in stewardship discussions and an additional 23% requested more education. Also, 97% felt that the information they learned could be utilized in everyday work regardless of the new program. The most cited barriers to stewardship activities were lack of education (45%) and hospital and/or unit culture (13%). Conclusion: Education and culture need to be addressed to overcome the barriers to nurses’ involvement in antimicrobial stewardship. E-learning can provide a simple and effective first step to educate nurses, with minimal time investment.

Effectiveness of mRNA-1273 against delta, mu, and other emerging variants of SARS-CoV-2: test negative case-control study

Objectives To evaluate the effectiveness of the mRNA-1273 vaccine against SARS-CoV-2 variants and assess its effectiveness against the delta variant by time since vaccination. Design Test negative case-control study. Setting Kaiser Permanente Southern California (KPSC), an integrated healthcare system. Participants Adult KPSC members with a SARS-CoV-2 positive test sent for whole genome sequencing or a negative test from 1 March 2021 to 27 July 2021. Interventions Two dose or one dose vaccination with mRNA-1273 (Moderna covid-19 vaccine) ≥14 days before specimen collection versus no covid-19 vaccination. Main outcome measures Outcomes included infection with SARS-CoV-2 and hospital admission with covid-19. In pre-specified analyses for each variant type, test positive cases were matched 1:5 to test negative controls on age, sex, race/ethnicity, and specimen collection date. Conditional logistic regression was used to compare odds of vaccination among cases versus controls, with adjustment for confounders. Vaccine effectiveness was calculated as (1–odds ratio)×100%. Results The study included 8153 cases and their matched controls. Two dose vaccine effectiveness was 86.7% (95% confidence interval 84.3% to 88.7%) against infection with the delta variant, 98.4% (96.9% to 99.1%) against alpha, 90.4% (73.9% to 96.5%) against mu, 96-98% against other identified variants, and 79.9% (76.9% to 82.5%) against unidentified variants (that is, specimens that failed sequencing). Vaccine effectiveness against hospital admission with the delta variant was 97.5% (92.7% to 99.2%). Vaccine effectiveness against infection with the delta variant declined from 94.1% (90.5% to 96.3%) 14-60 days after vaccination to 80.0% (70.2% to 86.6%) 151-180 days after vaccination. Waning was less pronounced for non-delta variants. Vaccine effectiveness against delta infection was lower among people aged ≥65 years (75.2%, 59.6% to 84.8%) than those aged 18-64 years (87.9%, 85.5% to 89.9%). One dose vaccine effectiveness was 77.0% (60.7% to 86.5%) against infection with delta. Conclusions Two doses of mRNA-1273 were highly effective against all SARS-CoV-2 variants, especially against hospital admission with covid-19. However, vaccine effectiveness against infection with the delta variant moderately declined with increasing time since vaccination.

Creation and Operation of a COVID-19 Pooled Testing Collection Site Prior to a CTC Rotation

ABSTRACT Introduction This brief report describes the process, used by the 1st Infantry Division (1ID) and Irwin Army Community Hospital (IACH) at Fort Riley, Kansas, for conducting pooled testing collection of over 2,500 Soldiers prior to a large-scale exercise involving multiple units. Materials and Methods The authors captured after action review comments on the process and results of their pooled specimen collection site. Pooled specimen test results were reviewed and classified according to Aberdeen Proving Ground criteria to determine the percentage of successful and failed pooled specimens. Results 1ID and IACH performed pooled testing collection and shipment of 2,684 specimens divided into 298 pools over 6 flight manifests. Of the 298 pooled specimens, 4 (1.34%) were found to be inconclusive or invalid, and the other 294 (98.7%) had sufficient number of human cells to be certified as SARS-CoV-2 (COVID-19) positive or COVID-19 not detected. Conclusion Pooled testing collection is a complex process that may continue to be a requirement for mass screening of COVID-19 prior to military operations. While planning should be tailored to the specific mission and unit, key factors that the authors feel are required for pooled testing to be successful in any situation are standardized training and personnel continuity, quality assurance, administrative oversight by the unit, and collaboration and communication between all involved entities.

Lived Experiences of Survivors of COVID-19 Disease at Hwange Colliery Hospital, Zimbabwe

The COVID-19 pandemic is one of the worst global nightmares in the past decade for both healthcare workers and general public. The initial focus has been on the lifesaving and biomedical aspects, but COVID-19 has rapidly established itself as an illness that negatively impacts the psychosocial health of all affected individuals. The purpose of this study was to explore the lived experiences of survivors of COVID-19 disease with intent to identify gaps within the healthcare system in responding to the COVID-19 pandemic and therefore improve the patient care. A phenomenological approach was used and a purposive sampling technique employed to select 15 participants at Hwange Colliery hospital for the study. All the participants were individuals aged between 19 and 55 years who had recovered from COVID-19 disease. Participants were either Hwange Colliery Company Limited employees or dependents and resident of Hwange Colliery concession area. Analysis of data was done during data collection using the Braun and Clarke (2006) thematic analysis. Three themes with eleven subthemes emerged from data and these were: awareness of COVID-19 disease; sources of information and trust of sources of information, causes and origins of the COVID-19, health seeking; physical manifestations, specimen collection and experience, treatment and home remedies, interaction with healthcare workers, psychosocial dimension; isolation and experiences, fears and concerns, family and friends support, religious, job security. The study revealed the lived experiences of survivors of COVID-19 disease. The survivors’ fear and coping mechanisms were made plain. The age of participants ranged from 19 years to 55 years with a mean age of 36.3 and a standard deviation of 5.1

Gambaran Epidemiologi Peningkatan Kasus Chikungunya di Desa Kajongan Kecamatan Bojongsari Kabupaten Purbalingga

Purbalingga is one of the chikungunya endemic districts which have cases increased until April in 2021 as many as 512 cases from the previous 116 cases in 2020. One of the areas of the increasing case occurred in Kajongan Village, Bojongsari Subdistrict. This study aims were to describe chikungunya cases, identify sources of transmission, and risk factors for increased chikungunya cases. A case-control design was performed in Kajongan Village in March 2021. The sample consisted of 36 cases and 36 controls. Cases are patients with suspected chikungunya, controls are people who are not chikungunya suspects who live close to the suspected case. Data was collected by blood specimen collection, larvae survey, interviews and examination using Reverse Transcriptase-Polymerase Chain Reaction. The results showed that the peak of case transmission occurred in the fourth week of February 2021. The main symptoms are fever and joint pain. Of the 21 blood samples examined, 19 (90.5%) tested positive for Chikungunya virus. Of the 9 pools Aedes sp. analyzed, 1 pool tested also positive Chikungunya virus. Chi-square analysis showed that the presence of larvae in container (p-value=0.03; OR=3.5; 95% CI=0.953-24.746) and mosquito nest eradication has not carried out routinely (p-value=0.04; OR=4.8; 95% CI=0.953-24.746) have been identified as a potential risk factor. The increasing of chikungunya cases in Kajongan Village was a local transmission supported by Chikungunya virus was detected in mosquitoes.