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Multilocus variable-number tandem-repeat analysis (MLVA) is a widely accepted molecular typing tool for enterohemorrhagic Escherichia coli (EHEC). However, ensuring the accuracy of MLVA data among multiple laboratories remains difficult. We developed a method of constructing adjusted look-up tables, which are necessary for MLVA profiling, at each laboratory using a regression analysis based on electrophoresis data from 24 in-house reference strains. On performing MLVA against 51 EHEC O157 isolates, the repeat numbers of 46 isolates were determined accurately using the look-up table with a 99% prediction interval, an outcome superior to that when using a 95% prediction interval. For the remaining five isolates, although the electrophoresis size fell outside the look-up table, we were able to predict the repeat number accurately by extrapolation or the nearest values of the look-up table. Our approach provides more accurate results than a nonadjusted conventional look-up table for calibrating MLVA profiles.Allado, Edem, Bruno Chenuel, Jean-Charles Vauthier, Oriane Hily, Sébastien Richard, and Mathias Poussel. Transient central facial palsy at high altitude a case report. High Alt Med Biol. 00000-000, 2020.-High altitude cerebral edema (HACE) is a severe form of acute mountain sickness (AMS). Besides this life-threatening condition, other neurological disorders may develop at high altitude, even if the precise pathophysiological mechanisms generally remain undetermined and are often debated. We report the case of a 34-year-old woman presenting with moderate AMS during an ascent of Mount Kilimanjaro. While descending from the summit, she suddenly experienced focal neurological symptoms of visual blurring, tinnitus, lightheadedness, and the findings of left-sided central facial palsy (flattened nasolabial fold, fall of labial commissure, dysarthria, difficulty in whistling, and facial dysesthesia). These symptoms and signs were confirmed in the field by a physician. Her symptoms regressed spontaneously and completely while continuing to descend. The etiology of this neurological episode at high altitude is discussed. The most probable diagnosis is a transient ischemic attack based on personal and familial vascular history, confirmed unilateral transient central facial palsy and normal results on standard blood work and cerebral magnetic resonance imaging. In this case, migraine should also be considered based on association of headache and transient focal neurological impairment. Overall, special attention should be given to mountaineers presenting with neurological conditions at altitude. Not only HACE should be considered but also the wide spectrum of other neurological conditions that fall outside the usual definition of altitude sickness.Norovirus (NoV) is a main foodborne pathogen of acute gastroenteritis in the world. A preliminary quantitative risk assessment (QRA) was conducted to evaluate the health risk caused by this virus in shellfish in the Yellow Sea and Bohai Sea of China. The QRA framework was established from the process of shellfish at retail through cooking at home to consumer consumption. The prevalence and quantity of NoVs in shellfish, cooking methods, internal temperature and time of shellfish in different cooking conditions, shellfish consumption frequency, and consumption amount were analyzed in the exposure assessment. The results of exposure assessment were introduced into the beta-Poisson dose-response model, and Monte Carlo analysis was used to calculate the risk of gastroenteritis caused by shellfish consumption in the cities around the Yellow Sea and Bohai Sea of China. The results showed that the probability of illness caused by NoVs due to shellfish consumption per year (Pill,yr) was 1.86 × 10-5. It was estimated that the annual number of patients with gastroenteritis per 1,000,000 general population (Nexp,mil) was 0.10, 1.23, 16.90, and 0.38 for population aged 0-4, 5-18, 19-64, and >65 years, respectively. This assessment provides valuable information such as the probability of illness associated with the consumption of shellfish and it also provides a reference for further in-depth QRA of NoVs in shellfish or other foods.Background Meeting the needs of seriously ill SARS-CoV-2 (COVID-19) patients requires novel models of deploying health social workers (SWs) to expand the palliative care workforce. To inform such expansion, understanding the current state of health SWs’ core palliative care skills is necessary. Methods Following minimal training, health SWs in one New York City hospital were surveyed about their frequency, competence, and confidence in using core palliative care skills. Results Of the 170 health SWs surveyed, 46 (27%) responded, of whom 21 (46%) and 24 (52%) had palliative care training before and during the COVID-19 surge, respectively. Health SWs reported a “moderate improvement” in the use of three skills “identify a medical decision maker,” “assess prognostic understanding,” and “coordinate care.” There was “minimal decrease” to “no improvement” to “minimal improvement” in competence and confidence of skill use. Conclusion Our findings suggest that educational initiatives can improve health SWs’ use of core palliative care skills.Background Although payment for home-based palliative care (HBPC) is slowly spreading, there remains significant challenges in engaging patients and physicians in palliative care programs and research. This challenge was illustrated in our previous HBPC trial that failed to identify and enroll eligible patients in both the study and in HBPC services. Objectives The objective of this study was to determine challenges to participation in HBPC and in research among patients, caregivers, primary care physicians, HBPC providers, and accountable care organizations (ACOs). Design We conducted a qualitative study employing individual interviews and focus groups. find more Setting/Subjects We recruited patients (n = 17), caregivers (n = 8), primary care providers (n = 31), home-based care providers (n = 25), and ACO administrators and leaders (n = 12) from California, United States. Measurements We used semistructured interview protocols to elicit perceived barriers to HBPC services and research. Results We identified four overarching themes related to barriers to HBPC and palliative care research.