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Background: Industrial hygienists (IH) in the oil and gas business instituted an extraordinary number of safety protocols to limit spread of SARS-CoV-2 onto offshore platforms in the Gulf of Mexico. We used genomic surveillance to provide actionable information concerning the efficacy of their efforts., Methods: Over 6 months, employees at a single company were serology and PCR tested during a 1-5 day predeployment quarantine and when postdeployment symptoms were reported. From each positive test (n = 49), SARS-CoV-2 genomes were sequenced. Phylogenetic analysis was used to investigate the epidemiology of transmissions., Results: Genomic surveillance confirmed 2 viral strains were infecting 18 offshore workers. Genomic data combined with epidemiological data suggested that a change in quarantine protocols contributed to these outbreaks. A pre-deployment outbreak involved a WHO variant of interest (Theta) that had infected 4 international workers. Two additional predeployment clusters of infections were identified., Conclusions: Our findings support that IH quarantine/testing protocols limited viral transmissions, halted offshore outbreaks, and stopped the spread of a variant of interest. The study demonstrates how genomic data can be used to understand viral transmission dynamics in employee populations and evaluate safety protocols in the offshore oil and gas industry., (Copyright © 2022 The Authors. Published by Elsevier Inc. All rights reserved.)

Background: The objective of this study was to identify sources and linkages among methicillin-resistant Staphylococcus aureus infections using whole-genome sequencing (WGS)., Methods: A total of 56 samples were obtained from all patients with a confirmed MRSA infection over 6 months at University of Florida-Health Jacksonville. Samples were cultured and sequenced; data was analyzed on an automated cloud-based platform. Genetic Clusters were defined as <40 single nucleotide polymorphisms. Temporal Clusters were defined as ≥5 MRSA cases over 3 days., Results: We found 7 Genetic Clusters comprising 15 samples. Four Genetic Clusters contained patients with non-overlapping stays (3-10 weeks apart), 3 of which contained patients who shared the same Unit. We also found 5 Temporal Clusters comprising 23 samples, although none of the samples were genetically related., Discussion: Results showed that temporal clustering may be a poor indicator of genetic linkage. Shared epidemiological characteristics between patients in Genetic Clusters may point toward previously unidentified hospital sources. Repeated observation of related strains is also consistent with ongoing MRSA transmission within the surrounding high-risk community., Conclusions: WGS is a valuable tool for hospital infection prevention and control., (Copyright © 2020 Association for Professionals in Infection Control and Epidemiology, Inc. Published by Elsevier Inc. All rights reserved.)

A technique of direct mechanical ventricular assistance (DMVA) has been available since 1966. Ventricular assistance is provided by a glass cup lined with a Silastic diaphragm. It is held on the cardiac ventricles by suction. Alternating positive and negative pressure in the space between the cup and the diaphragm provides a pumping mechanism for blood flow. DMVA was compared to closed chest massage (CCM) and open chest massage (OCM) during ventricular fibrillation in six dogs. Each technique was applied for 10 minutes. Three dogs had CCM followed by OCM and then DMVA. Three dogs had only OCM and DMVA. Blood pressure and cardiac output were measured. All variables were calculated as a percentage of pre-ventricular-fibrillation values. Mean blood pressure was 19.7% with CCM, 39.8% with OCM, and 55.1% with DMVA. Systolic blood pressure was 25.8% with CCM, 51.9% with OCM, and 64.0% with DMVA. Diastolic blood pressure was 17.3% with CCM, 37.3% with OCM, and 48.9% with DMVA. Cardiac output was 13.8% with CCM, 37.1% with OCM, and 58.0% with DMVA. For each variable, OCM produced statistically higher values than did CCM. DMVA produced statistically higher values than did OCM for all variables. These preliminary results suggest that DMVA may be superior to currently available methods of cardiac massage during ventricular fibrillation.

The effect of antishock trouser inflation on plasma renin activity during hypovolemic shock was studied in dogs. Following anesthesia, six dogs were bled to a systolic blood pressure of 60 mm Hg. Antishock trousers were inflated to 40 to 100 mm Hg for 20 minutes each. Plasma renin activity was measured before phlebotomy, after phlebotomy, and after each 20-minute period of antishock trouser inflation. Three dogs without antishock trousers served as controls. Experimental animals had a significant rise in blood pressure when the antishock trousers were inflated to 100 mm Hg. Plasma renin activity showed a marked increase following phlebotomy (experimental, 1.55 ng/mL/h to 13.63 ng/mL/h; control, 2.71 ng/mL/h to 19.7 ng/mL/h). Both groups had a continued small, statistically insignificant rise in plasma renin levels throughout the remainder of the experiment. Plasma renin level changes did not explain the observed rise in blood pressure following antishock trouser inflation. Plasma renin levels remained elevated in spite of improvement of blood pressure after application of antishock trousers.

Immobilization of the cervical spine is a common prehospital and emergency department maneuver. The ability of four different cervical collars to immobilize the cervical spine was studied using radiographic measurement in seven normal volunteers. Restriction of motion during flexion, extension, and lateral bending was studied. Differences between collars exist and require further study to identify the optimum device for immobilization of the cervical spine.