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PURPOSE: Fertility discussions are an integral part of comprehensive care for pediatric, adolescent, and young adult patients newly diagnosed with cancer and are supported by national guidelines. Current institutional practices are poorly understood. METHODS: A cross-sectional survey was distributed to 220 Children's Oncology Group member institutions regarding fertility discussion practices. Descriptive statistics were calculated for all variables. The association between specific practices and selected outcomes on the basis of sex was examined via multivariable logistic regression. RESULTS: One hundred forty-four programs (65.5%) returned surveys. Of these, 65 (45.1%) reported routine discussions of fertility with all female patients and 55 (38.5%) all male patients ( P = .25). Ninety-two (63.8%) reported no specific criteria for offering females fertility preservation (FP), compared with 40 (27.7%) for males ( P < .001). Program characteristics associated with fertility discussions included reproductive endocrinology and infertility on site (females odds ratio [OR], 2.1; 95% CI, 1.0 to 4.3), discussion documentation mandate (females OR, 2.3; 95% CI, 1.0 to 5.5; males OR, 3.5; 95% CI, 1.4 to 8.7), and cumulative institution-based FP infrastructure (which included [1] routine practice of documentation, [2] template for documentation, [3] mandate for documentation, and [4] availability of FP navigation; females OR, 1.6; 95% CI, 1.1 to 2.3; males OR, 2.3; 95% CI, 1.6 to 3.4). Utilization of practices unsupported by guidelines included offering sperm banking after treatment initiation (39/135 programs; 28.9%), gonadotropin-releasing hormone analogs for ovarian suppression/FP (75/144 programs; 52.1%), ovarian tissue cryopreservation at diagnosis for patients with leukemia (19/64 programs; 29.7%), and testicular tissue cryopreservation (23/138 programs; 16.7%) not part of a clinical trial. CONCLUSION: Despite recommended guidelines, fertility discussions with patients/families before treatment initiation are not routine at Children's Oncology Group institutions. Standard criteria to determine which options should be offered to patients are more common for males than females.

The Centers for Disease Control and Prevention (CDC) published a health advisory on the occurrence of severe cases of mpox in immunocompromised patients, namely those with advanced HIV. Treatment options are limited, and very little is known about how to optimally treat patients with severe disease. Herein we describe two cases of severe mpox in Chicago in the setting of advanced HIV and provide suggested guidance for managing cases of severe disease in immunocompromised patients based available data, CDC recommendations, and our experience managing these patients.

Context It remains to be determined exactly how the COVID-19 pandemic has and will continue to impact osteopathic resident education, in particular as it pertains to treatment with osteopathic manipulative medicine (OMM). Although the long-term effects of the pandemic cannot be determined yet, changes in current resident education can be analyzed. Objectives Here, we describe how the format, frequency, and environment of OMM training have changed in residency programs from prior to February 2020 to the “lockdown” period of February 2020 to June 2020, and then to the “recovery” period of July 2020 to February 2021. Methods A 19-question survey inquiring about the above three categories was emailed via SurveyMonkey to 282 Accreditation Council for Graduate Medical Education (ACGME) residency programs with osteopathic recognition at the end of January 2021. Results Of the 282 programs surveyed, 24.5% (69) responded. Osteopathic neuromusculoskeletal medicine (ONMM) programs were excluded from the data analysis, resulting in a modified sample size of n=60. Responses indicated that residency programs dramatically decreased the frequency of OMM didactic education sessions (100.0% [60] reported offering OMM didactic education before the lockdown period; compared to 73.3% [44] during the lockdown period) and shifted their educational programs from an in-person-only environment (88.3% [53] before lockdown; 8.3% [5] during lockdown) to either a combined in-person/virtual platform (6.7% [4] before lockdown; 31.7% [19] during lockdown) or to a virtual-only platform (0.0% [0] before lockdown; 46.7% [28] during lockdown). During the recovery period, 91.7% (55) programs reported giving some form of OMM didactic education. The percentage of programs reporting in-person-only, combined in-person/virtual platform, and virtual-only didactic education were 3.3% (2), 53.3% (32), and 41.7% (25), respectively, during the recovery period. The preferred method of instruction changed from a combination of resident and attending lectures with a hands-on component (55.0%; 33) before lockdown, to the same but without a hands-on component (28.3%; 17) during lockdown, and back to the same but with a hands-on component (36.7%; 22) during the recovery period. Furthermore, the number of programs offering OMM didactic education [OMM patient care] at least once a month decreased from 70.0% (42) [78.3% (47)] before the lockdown period to 46.7% (28) [48.3% (29)] during the lockdown period. It then increased to 55.0% (33) [73.3% (44)] during the recovery period. Finally, before the lockdown period, programs offered OMM patient care predominantly in a combination of an inpatient/outpatient environment (63.3%; 38). The preferred patient care setting changed to an outpatient-only environment (43.3%; 26) during the lockdown period and then back to a combination of an inpatient/outpatient environment (45.0%; 27) during the recovery period. Conclusions This study demonstrates that programs have been dramatically impacted by the COVID-19 pandemic, by the augmentation of the osteopathic learning environment, and by the delivery of OMM to patient care within the training programs. These impacts were still present 1 year after the start of the pandemic. It will be imperative for ACGME Osteopathic Recognition (ACGME-OR) programs to continue an assessment of these impacts on resident physicians’ learning and preparedness.

Recent interest in nanomedicine has skyrocketed because of mRNA vaccine lipid nanoparticles (LNPs) against COVID-19. Ironically, despite this success, the innovative nexus between nanotechnology and biochemistry, and the impact of nanoparticles on enzyme biochemical activity is poorly understood. The studies of this group on zinc nanoparticle (ZNP) compositions suggest that nanorod morphologies are preferred and that ZNP doped with manganese or iron can increase activity against model enzymes such as luciferase, DNA polymerase, and β-galactosidase (β-Gal), with the latter previously being associated with antimicrobial activity. SARS-CoV-2 encodes several of these types of oxido-reductase, polymerase, or hydrolase types of enzymes, and while metamaterials or nanoparticle composites have become important in many fields, their application against SARS-CoV-2 has only recently been considered. Recently, this group discovered the antiviral activity of manganese-doped zinc sulfide (MnZnS), and here the interactions of this nanoparticle composite with β-Gal, angiotensin converting enzyme (ACE), and human ACE2 (hACE2), the SARS-CoV-2 receptor, are demonstrated. Low UV, circular dichroism, and zeta potential results confirm their enzyme interaction and inhibition by fluorometric area under the curve (AUC) measurements. The IC

Microaggressions are brief, intended or unintended, commonplace verbal, behavioral, or environmental indignities that communicate derogatory, hostile, or negative insults and slights toward people who do not classify within the 'normative' standard. Those who microaggress are often unaware that they engage in such communications when they interact with people who differ from themselves. In the workforce, these interchanges are exacerbated, as issues regarding implicit biases tend to play themselves out in communal settings. In response to this, the discussion of microaggressions in its numerous forms, coupled with its manifestations in the workplace, adds to the growing knowledge base on aversive behavior and its short- and long-term impacts. The authors begin by investigating the residual effects of everyday “isms” on the work productivity and quality of life of those on the receiving end. They conclude with suggestions for institutional-level education, training, and research—specific to organizational settings—in the effort to reduce microaggressions in the professional environment.

A new series of 3,5-dimethyl-arylazopyrazoles (3a-h) was synthesized by reacting various oxobutyrates (2) with 4-methoxy benzhydrazide (1) in glacial acetic acid medium. The oxobutyrates were prepared by diazotization of substituted anilines and subsequent condensation with acetyl acetone in the alcohol medium. The new compounds were elucidated on the basis of IR, 1H-NMR and mass spectral data and the compounds were screened for their in vitro cytotoxic activity using MDA-MB-231 and MCF-7 cell lines. Some of the tested compounds showed weak to moderate cytotoxic effects.

PURPOSE: Fertility preservation (FP) services are part of comprehensive care for those newly diagnosed with cancer. The capacity to offer these services to children and adolescents with cancer is unknown. METHODS: A cross-sectional survey was sent to 220 Children's Oncology Group member institutions regarding institutional characteristics, structure and organization of FP services, and barriers to FP. Standard descriptive statistics were computed for all variables. The association between site-specific factors and selected outcomes was examined using multivariable logistic regression. RESULTS: One hundred forty-four programs (65.5%) returned surveys. Fifty-three (36.8%) reported a designated FP individual or team. Sperm banking was offered at 135 (97.8%) institutions, and testicular tissue cryopreservation at 37 (27.0%). Oocyte and embryo cryopreservation were offered at 91 (67.9%) and 62 (46.6%) institutions, respectively; ovarian tissue cryopreservation was offered at 64 (47.8%) institutions. The presence of dedicated FP personnel was independently associated with the ability to offer oocyte or embryo cryopreservation (odds ratio [OR], 4.7; 95% CI, 1.7 to 13.5), ovarian tissue cryopreservation (OR, 2.7; 95% CI, 1.2 to 6.0), and testicular tissue cryopreservation (OR, 3.3; 95% CI, 1.4 to 97.8). Only 26 (18.1%) participating institutions offered all current nonexperimental FP interventions. Barriers included cost (70.9%), inadequate knowledge or training (60.7%), difficulty characterizing fertility risk (50.4%), inadequate staffing (45.5%), and logistics with reproductive specialties (38%-39%). CONCLUSION: This study provides the most comprehensive view of the current landscape of FP infrastructure for children and adolescents with cancer and demonstrates that existing infrastructure is inadequate to offer comprehensive services to patients. We discuss modifiable factors to improve patient access to FP.

15 Pág. Centro de Investigación en Sanidad Animal (CISA), African swine fever (ASF) is a highly lethal disease of domestic and wild swine caused by African swine fever virus (ASFV). The disease currently circulates in Africa, Europe, Asia and on the island of Hispaniola. The ongoing epizootics in Europe and Asia have produced millions of animal deaths and severe economic losses. No effective vaccine is available for ASF, making rapid and accurate detection of ASFV essential for disease mitigation strategies. Currently available diagnostics for ASFV possess significant limitations related to assay performance, deployability, and/or turn-around time; therefore there is an unmet need for pen-side diagnostic tests with sufficient sensitivity and specificity. A chromatographic lateral flow immunoassay (LFIA) was developed for the detection of ASFV antigen in EDTA-treated whole blood using monoclonal antibodies targeting the viral p30 protein. The assay requires only water to perform and provides results in 25 min, making it well-suited for field use. The LFIA was capable of detecting genotype I and genotype II strains of ASFV in EDTA blood from experimentally infected pigs at varying time-points after infection, though it was unable to detect a genotype X ASFV strain. Diagnostic sensitivity correlated with clinical disease severity, body temperature, and viral DNA levels, and was over 90% in animals showing moderate to severe ASF-related symptoms after challenge with virulent genotype II virus. The LFIA also showed a robust diagnostic specificity of over 98%, which is essential to field testing for a high consequence to foregin animal disease. The LFIA targeting the viral p30 protein can reliably detect ASFV in whole blood from animals showing moderate to severe clinical signs of infection with virulent genotype I and II isolates, making it a promising candidate for use as a field-deployable antigen detection assay. Additional evaluation using field samples and different virus strains is required to further assess the utility of this rapid diagnostic test., Funding for this study was provided through grants from the National Bio and Agro-Defense Facility (NBAF) Transition Fund from the State of Kansas, and the AMP Core of the Center of Emerging and Zoonotic Infectious Diseases (CEZID) from National Institute of General Medical Sciences (NIGMS) under award number P20GM130448.

PurposeHarlem Renaissance Party by Faith Ringgold follows a young boy and his uncle as they visit the “giants” of the Harlem Renaissance. Lonnie and Uncle Bates travel through Harlem to meet historical figures, such as W.E.B. Du Bois, Langston Hughes, Madam CJ Walker and others. They also visit historical venues where Black artists performed. Such venues included the Cotton Club, the Harlem Opera House and the Schomburg Library.Design/methodology/approachAs students study the end of the Civil War and the early 1900s, they should learn about the causes of the Great Migration that led Black artists to flee from the south to larger cities in the north. In addition, Jim Crow Laws and other discriminatory practices prevented Black artists from performing their crafts. The Harlem Renaissance has had lasting effects on arts, music, literature and dance. In addition, students should use credible sources to gather information and documents about historical events and people.FindingsThese inquiry-based activities also integrate arts education and history to reach diverse student populations as they gain meaningful experiences interacting with authentic documents.Originality/valueAs students study the end of the Civil War and the early 1900s, they should learn about the causes of the Great Migration that led Black artists to flee the south to larger cities in the north. In addition, Jim Crow Laws and other discriminatory practices prevented Black artists from performing their crafts.

Introduction: Angiotensin (Ang) II signalling in the hypothalamic paraventricular nucleus (PVN) via Ang type-1a receptors (AT1R) regulates vasopressin release and sympathetic nerve activity – two effectors of blood pressure regulation. We determined the cellular expression and function of AT1R in the PVN of a rodent model of polycystic kidney disease (PKD), the Lewis polycystic kidney (LPK) rat, to evaluate its contribution to blood pressure regulation and augmented vasopressin release in PKD. Methods: PVN AT1R gene expression was quantified with fluorescent in situ hybridization in LPK and control rats. PVN AT1R function was assessed with pharmacology under urethane anaesthesia in LPK and control rats instrumented to record arterial pressure and sympathetic nerve activity. Results: AT1R gene expression was upregulated in the PVN, particularly in corticotrophin-releasing hormone neurons, of LPK versus control rats. PVN microinjection of Ang II produced larger increases in systolic blood pressure in LPK versus control rats (36 ± 5 vs. 17 ± 2 mm Hg; p < 0.01). Unexpectedly, Ang II produced regionally heterogeneous sympathoinhibition (renal: −33%; splanchnic: −12%; lumbar: no change) in LPK and no change in controls. PVN pre-treatment with losartan, a competitive AT1R antagonist, blocked the Ang II-mediated renal sympathoinhibition and attenuated the pressor response observed in LPK rats. The Ang II pressor effect was also blocked by systemic OPC-21268, a competitive V1A receptor antagonist, but unaffected by hexamethonium, a sympathetic ganglionic blocker. Discussion/Conclusion: Collectively, our data suggest that upregulated AT1R expression in PVN sensitizes neuroendocrine release of vasopressin in the LPK, identifying a central mechanism for the elevated vasopressin levels present in PKD.

Supplemental material, sj-docx-1-aut-10.1177_13623613231154728 for Sex differences in early autism screening using the Modified Checklist for Autism in Toddlers, Revised, with Follow-Up (M-CHAT-R/F) by Sherief Y Eldeeb, Natasha N Ludwig, Andrea Trubanova Wieckowski, Mary FS Dieckhaus, Yasemin Algur, Victoria Ryan, Sarah Dufek, Aubyn Stahmer and Diana L Robins in Autism

Due to their multiple identities, Black women navigate gendered and racialized pathways to leadership in the US education industry. The journey for Black women in and en route to positions of academic leadership is even more nuanced and multiplicative. Little, though, is known about the effects of their intersecting identities and the structural barriers they encounter in this sphere. To deepen our communal understanding of this phenomenon, this chapter highlights the existing theories and research on the race-gender dyad in the context of academic leadership. Examining the individual and layered effects of race and gender on the professional realities of Black women leaders in higher education, the author spotlights the unique experiences of Black women DEI practitioners and leaders in historically White academic institutions. Given the numerous components at play when Black women lead in predominantly White institutions and settings, this chapter concludes by discussing opportunities to advance relevant research and practice in this arena.

Background Vancomycin is often initiated empirically in hospitalized patients for broad spectrum gram-positive coverage, however in many cases it is initiated unnecessarily and/or continued empirically for longer durations than necessary. Strategies to facilitate timely discontinuation of vancomycin when unnecessary may reduce antibiotic toxicity (e.g. nephrotoxicity) and the development of bacterial resistance. In large hospital systems, it may not be feasible for stewardship programs to implement prior authorization requirements or prospective audit/feedback for all vancomycin orders. Novel strategies to enlist other clinicians to serve as stewards of antibiotic use are needed. Methods On February 1, 2020, we implemented a protocol requiring providers to obtain approval from the primary team pharmacist to continue empiric vancomycin regimens >72 hours. Primary team pharmacists were provided a list of appropriate indications for vancomycin continuation. After 72 hours, the pharmacist placed a note describing the approved indication or if ASP or ID consult was obtained. We evaluated the standardized antibiotic administration ratio (SAAR) for antibacterial agents for resistant gram-positive infections for FY2019 (pre-protocol) and FY2020 (post-protocol) to assess the impact of this intervention. Vancomycin utilization was also evaluated in days of therapy (DOT)/1000 patient days during both time periods. Results The SAAR for antibacterial agents for resistant gram-positive infections for FY2019 was 1.17 and FY2020 was 1.04 (95% CI (0.87, 0.91), p-value < 0.001). A significant reduction in SAAR was observed in patients admitted to the ICU and floor (Figure 1). Overall vancomycin utilization according to days of therapy/1000 patient days was reduced from 111.13 (FY2019) to 104.08 (FY2020). Conclusion Leveraging the oversight of primary team pharmacists proved to be an effective strategy to reduce empiric vancomycin durations of therapy. Following the implementation of a 72-hour approval protocol with primary team pharmacist oversight, we observed a significant reduction in the SAAR for antibacterials for resistant gram-positive infections with a corresponding reduction in vancomycin utilization. Disclosures All Authors: No reported disclosures.

Background Historically, intravenous (IV) antibiotics have been the standard of care for the treatment of bloodstream infections (BSIs). IV antibiotic use predisposes patients to line-related complications and is associated with increased length of stay (LOS) and treatment costs as compared to oral (PO) antibiotics. The purpose of this study was to compare the efficacy and safety of IV therapy versus PO stepdown for uncomplicated Streptococcal BSIs. Methods This single-center, retrospective, non-inferiority study included adults who had Streptoccoccus spp. in blood cultures with susceptibilities reported, < 48 hours of positive blood cultures, and were treated for the BSI. Patients were excluded if they had polymicrobial bacteremia, mortality prior to treatment completion, unattainable source control, or a complicated infection. The primary outcome was clinical success, defined as absence of infection recurrence, infection-related readmission, and infection-related mortality at 90 days. Secondary outcomes included individual components of composite endpoint, microbiological success, LOS, IV-line associated complications, and antibiotic-associated adverse events. Results Of 79 patients included, 36 patients (45.6%) received IV for the full course of therapy and 43 (54.4%) received PO stepdown. Baseline characteristics were similar between groups. The most common sources were skin and soft tissue (34.6%) and oropharyngeal (13.6%). The median duration of IV therapy in PO stepdown patients was 4.4 days (IQR 2.7 – 6.9). Amoxicillin/clavulanate (44%) and cefdinir (24%) were the most common PO agents. Clinical success occurred in 94% of IV only patients and 91% of PO stepdown patients (p = 0.573). No infection-related deaths or recurrences occurred. Line complications were more frequent in patients receiving IV compared to PO stepdown therapy (14% vs. 0%, p = 0.015). LOS was lower in the PO stepdown group (11 vs. 6 days, p < 0.001). Conclusion This study strengthens the hypothesis that PO stepdown therapy may be non-inferior to IV therapy for clinical success with a trend towards decreased LOS and line complications. However, this study was not powered to meet statistical significance. We are collaborating with several other centers to determine the true impact of this intervention. Disclosures All Authors: No reported disclosures.

Raising the educational standards for police officers represents a perennial police reform theme in the United States. Among other benefits, proponents herald college degree requirements as key to improving the quality and fairness of policing outcomes, including the chief formal response to crime: arresting suspected lawbreakers. However, the evidence base regarding college education requirements’ consequences for agency arrest behaviors is formative for various reasons, namely, the absence of studies examining whether these policies contribute to racially equitable arrest outcomes. The presented data show steeper decreases in the racial gap in Black and White people arrested for degree-requiring agencies compared to nondegree-requiring agencies between 2000 and 2016. Albeit encouraging news, the disparity rate for agencies with a college standard remains relatively higher. While what is implied is that college degree requirements alone will not resolve racial disparities in police arrests, it is premature to draw concrete conclusions about this often taken-for-granted association until more rigorous research is conducted.

Delays in early language development are characteristic of young autistic children, and one of the most recognizable first concerns that motivate parents to seek a diagnostic evaluation for their child. Although early language abilities are one of the strongest predictors of long-term outcomes, there is still much to be understood about the role of language impairment in the heterogeneous phenotypic presentation of autism. Using a person-centered, Latent Profile Analysis, we first aimed to identify distinct patterns of language and social communication ability in a clinic-based sample of 498 autistic children, ranging in age from 18 to 60 months (M = 33 mo, SD = 12 mo). Next, a multinomial logistic regression analysis was implemented to examine sociodemographic and child-based developmental differences among the identified language and social communication profiles. Three clinically meaningful profiles were identified from parent-rated and clinician-administered measures: Profile 1 (48% of the sample) “Relatively Low Language and Social Communication Abilities,” Profile 2 (34% of the sample) “Relatively Elevated Language and Social Communication Abilities,” and Profile 3 (18% of the sample) “Informant Discrepant Language and Relatively Elevated Social Communication Abilities.” Overall, young autistic children from the lowest-resource households exhibited the lowest language and social communication abilities, and the lowest non-verbal problem-solving and fine-motor skills, along with more features of attention-deficit/hyperactivity disorder and atypical auditory processing. These findings highlight the need for effective community-based implementation strategies for young autistic children from low-resource households and underrepresented communities to improve access to individualized quality care.

In this present study, a novel series of chalcones (C1-10) were synthesized by reacting 4-nitro acetophenone and various substituted aromatic aldehydes in an alcohol medium. The title compounds, pyrimidine derivatives (PD1-10), were obtained by the cyclization of chalcones (C1-10) with guanidine carbonate in an alcoholic medium. Each of the newly synthesized compounds was structurally assigned in accordance with FT-IR, 1 H-NMR and mass spectral data. All the synthesized compounds were subjected to in silico analysis among which, some of the synthesized compounds were chosen and evaluated for in vivo anticonvulsant study by employing PTZ-induced seizure and MES seizure models. Compounds PD2 and PD7 demonstrated significant anticonvulsant activity when compared to the standard.

It is critical to have methods that can detect and mitigate the risk of African swine fever virus (ASFV) in potentially contaminated feed or ingredients bound for the United States. This work's purpose was to evaluate feed batch sequencing as a mitigation technique for ASFV contamination in a feed mill and to determine if a feed sampling method could identify ASFV following experimental inoculation. Batches of feed were manufactured in a BSL-3Ag room at Kansas State University's Biosafety Research Institute in Manhattan, Kansas. First, the pilot feed manufacturing system mixed, conveyed, and discharged an ASFV-free diet. Next, a diet was manufactured using the same equipment, but contained feed inoculated with ASFV for final concentration of 5.6 × 104 TCID50 /g. Then, four subsequent ASFV-free batches of feed were manufactured. After discharging each batch into a collection container, 10 samples were collected in a double 'X' pattern. Samples were analyzed using a qPCR assay for ASFV p72 gene then the cycle threshold (Ct) and Log10 genomic copy number (CN)/g of feed were determined. Batch of feed impacted the qPCR Ct values (P < 0.0001) and the Log10 genomic CN/g (P < 0.0001) content of feed samples. Feed samples obtained after manufacturing the ASFV contaminated diet contained the greatest amounts of ASFV p72 DNA across all criteria (P < 0.05). Quantity of ASFV p72 DNA decreased sequentially as additional batches of feed were manufactured but was still detectable after batch sequence 4. This subsampling method was able to identify ASFV genetic material in feed samples using p72 qPCR. In summary, sequencing batches of feed decreases concentration of ASFV contamination in feed, but does not eliminate it. Bulk ingredients can be accurately evaluated for ASFV contamination by collecting 10 subsamples using the sampling method described herein. Future research is needed to evaluate if different mitigation techniques can reduce ASFV feed contamination. This article is protected by copyright. All rights reserved.

Background Sexual health (SH) is an important concern for adolescents and young adults (AYAs). This study determined current SH communication practices, barriers, and additional resources needed among pediatric oncology clinicians who treat AYAs. Methods A cross‐sectional survey was developed by the Children's Oncology Group (COG) AYA Committee and sent to pediatric oncologists (n = 1,987; 85.9%) and advanced practice providers (APPs, n = 326; 14.1%) at 226 COG institutions. Responses were tabulated and compared using tests of proportion and trend. Results The sample comprised 602 respondents from 168 institutions and was proportionally representative (468 oncologists [77.7%], 76 APPs [12.6%], 58 unidentified [9.6%]; institutional and provider response rates 74.3% and 26.2%, respectively). Almost half of respondents (41.7%) reported no/small role in SH care. Medical topics were discussed most often, including contraception (67.2%), puberty (43.5%), and sexual activity (37.5%). Topics never/rarely discussed included gender identity (64.5%), sexual orientation (53.7%), and sexual function (50.3%). Frequently cited communication barriers included lack of time, low priority, perceived patient discomfort, and the presence of a parent/guardian. Respondents endorsed the need for further education/resources on sexual function (66.1%), gender identity/sexual orientation (59.5%), and body image (46.6%). Preferred education modalities included dissemination of published guidelines (64.7%), skills training modules (62.9%), and webinars (45.3%). By provider type, responses were similar overall but differed for perception of role, barriers identified, and resources desired. Conclusions Many pediatric oncology clinicians play minimal roles in SH care of AYAs and most SH topics are rarely discussed. Provider‐directed education/training interventions have potential for improving SH care of AYA cancer patients., In this cross‐sectional survey, pediatric oncology clinicians recognized the importance of communicating with adolescents and young adults about sexual health (SH) but reported multiple barriers related to lack of content expertise and experience. Participants identified educational resources that would enhance SH communication, including published guidelines, training curricula/modules, and webinars.

Pre-exposure prophylaxis (PrEP) for HIV is highly effective, yet uptake has been limited. We measured PrEP knowledge, eligibility, and referral willingness among patients receiving emergency or acute care in Washington, DC. We surveyed HIV-negative patients with STI-related complaints on HIV risk behaviors, PrEP knowledge, eligibility, and willingness for PrEP referral. Among 174 participants, 70% were PrEP unaware and 33% were PrEP eligible. Most participants (81%) supported learning more, 64% would consider taking PrEP, and 28% agreed to immediate referral. Willingness to learn more about PrEP suggests referral from non-traditional settings may increase uptake. Further evaluation of this approach is warranted.

Background During atherosclerosis, the narrowing of the arterial lumen is observed through the accumulation of bio compounds and the formation of plaque within artery walls. A non-linear optical imaging modality (NLOM), coherent anti-stokes Raman scattering (CARS) microscopy, can be used to image lipid-rich structures commonly found in atherosclerotic plaques. By matching the lipid’s molecular vibrational frequencies (CH bonds), it is possible to map the accumulation of lipid-rich structures without the need for exogenous labelling and/or processing of the samples. CARS allows for the visualization of the morphological features of plaque. In combination with supervised machine learning, CARS imaged morphological features can be used to characterize the progression of atherosclerotic plaques. Results Based on a set of label-free CARS images of atherosclerotic plaques (i.e. foam cell clusters) from a Watanabe heritable hyperlipidemic rabbit model, we developed an automated pipeline to classify atherosclerotic lesions based on their major morphological features. Our method uses image preprocessing to first improve the quality of the CARS-imaged plaque, followed by the segmentation of the plaque using Otsu thresholding, marker-controlled watershed, K-means segmentation and a novel independent foam cell thresholding segmentation. To define relevant morphological features, 27 quantitative features were extracted and further refined by a novel coefficient of variation feature refinement method in accordance with filter-type feature selection. Refined morphological features were supplied into three supervised machine learning algorithms; K-nearest neighbour, support vector machine and decision tree classifier. The classification pipeline showcased the ability to exploit relevant plaque morphological features to accurately classify 3 pre-defined stages of atherosclerosis: early fatty streak development (EFS) and advancing atheroma (AA) with a greater than 85% class accuracy Conclusions Through the combination of CARS microscopy and computational methods, a powerful classification tool was developed to identify the progression of atherosclerotic plaque in an automated manner. Using a curated dataset, the classification pipeline demonstrated the ability to differentiate between EFS, EF and AA. Thus, presenting the opportunity to classify the onset of atherosclerosis at an earlier stage of development

SARS-CoV-2 is a zoonotic virus which was first identified in 2019, and has quickly spread worldwide. The virus is primarily transmitted through respiratory droplets from infected persons; however, the virus-laden excretions can contaminate surfaces which can serve as a potential source of infection. Since the beginning of the pandemic, SARS-CoV-2 has continued to evolve and accumulate mutations throughout its genome leading to the emergence of variants of concern (VOCs) which exhibit increased fitness, transmissibility, and/or virulence. However, the stability of SARS-CoV-2 VOCs in biological fluids has not been thoroughly investigated so far. The aim of this study was to determine and compare the stability of different SARS-CoV-2 strains in human biological fluids. Here, we demonstrate that the ancestral strain of Wuhan-like lineage A was more stable than the Alpha VOC B.1.1.7, and the Beta VOC B.1.351 strains in human liquid nasal mucus and sputum. In contrast, there was no difference in stability among the three strains in dried biological fluids. Furthermore, we also show that the Omicron VOC B.1.1.529 strain was less stable than the ancestral Wuhan-like strain in liquid nasal mucus. These studies provide insight into the effect of the molecular evolution of SARS-CoV-2 on environmental virus stability, which is important information for the development of countermeasures against SARS-CoV-2.ImportanceGenetic evolution of SARS-CoV-2 leads to the continuous emergence of novel variants, posing a significant concern to global public health. Five of these variants have been classified so far into variants of concern (VOCs); Alpha, Beta, Gamma, Delta, and Omicron. Previous studies investigated the stability of SARS-CoV-2 under various conditions, but there is a gap of knowledge on the survival of SARS-CoV-2 VOCs in human biological fluids which are clinically relevant. Here, we present evidence that Alpha, Beta, and Omicron VOCs were less stable than the ancestral Wuhan-like strain in human biological fluids. Our findings highlight the potential risk of contaminated human biological fluids in SARS-CoV-2 transmission and contribute to the development of countermeasures against SARS-CoV-2.

The COVID-19 pandemic had shifted the lives of individuals especially in the aspect of socialization; hence, this study was conducted to determine the impacts of the implementation of lockdown measures on the social relationship quality among emerging adults. Concomitant output is a proposed wellness program which aims to help raise awareness about the necessity of strong social interactions amidst a pandemic. Descriptive qualitative research and purposive sampling technique were utilized to select participants in a variety of ways considering the objectives and goals of the study. As a result, thirteen (13) emerging adults enrolled at OLFU-Pampanga whose ages range from 18 to 25 years old were carefully chosen. For data collection, the study employed an in-depth semi-structured interview through Google Meet to gather the participants' collective perceptions on the studied phenomenon. The acquired data were analyzed using thematic analysis which was done in three levels: transcription, initial coding, and theme generation. Based on the findings, it was revealed that the lockdown modified the lives of emerging adults, and it impacted their relationships with their family, friends, and romantic partners. It appeared that these changes are categorized both in a positive and negative manner. Specifically, the quality of social relationships among families was enhanced compared to the quality of social relationships among friends, which was either maintained or weakened. Meanwhile, romantic relationships were unfortunately reported to have ended. In line with this, a wellness program consisting of different activities was proposed to promote a strong social relationship in times of crisis.

The human microbiome is comprised of a complex and diverse community of organisms that is subject to dynamic changes over time. As such, cross-sectional studies of the microbiome provide a multitude of information for a specific body site at a particular time, but they fail to account for temporal changes in microbial constituents resulting from various factors. To address this shortcoming, longitudinal research studies of the human microbiome investigate the influence of various factors on the microbiome of individuals within a group or community setting. These studies are vital to address the effects of host and/or environmental factors on microbiome composition as well as the potential contribution of microbiome members during the course of an infection. The relationship between microbial constituents and disease development has been previously explored for skin and soft tissue infections (SSTIs) within congregate military trainees. Accordingly, approximately 25% of the population carries Staphylococcus aureus within their nasal cavity, and these colonized individuals are known to be at increased risk for SSTIs. To examine the evolution of the nasal microbiota of U.S. Army Infantry trainees, individuals were sampled longitudinally from their arrival at Fort Benning, Georgia, until completion of their training 90 days later. These samples were then processed to determine S. aureus colonization status and to profile the nasal microbiota using 16S rRNA gene-based methods. Microbiota stability differed dramatically among the individual trainees; some subjects exhibited great stability, some subjects showed gradual temporal changes and some subjects displayed a dramatic shift in nasal microbiota composition. Further analysis utilizing the available trainee metadata suggests that the major drivers of nasal microbiota stability may be S. aureus colonization status and geographic origin of the trainees. Nasal microbiota evolution within the congregate setting imposed by military training is a complex process that appears to be affected by numerous factors. This finding may indicate that future campaigns to prevent S. aureus colonization and future SSTIs among high-risk military trainees may require a ‘personalized’ approach.

As a consequence of their multiple identities, underrepresented leaders often navigate both racialized and gendered pathways to leadership in the U.S. education industry. Nevertheless, relatively little is known about the impact of their intersecting identities and the structural barriers in this sector. To deepen our collective understanding of this phenomenon, the author reviews existing theories and research related to the intersection of race and gender within the educational leadership sphere. More specifically, the author highlights the individual and compounding effects of gender and race on the professional realities of current and aspiring leaders in education at the Central Office (i.e., the Ivory Tower). This chapter concludes by proffering future research propositions, theory development, and policy in this arena.