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On May 5, 2021, the Colorado Department of Public Health and Environment (CDPHE) identified the first five COVID-19 cases caused by the SARS-CoV-2 B.1.617.2 (Delta) variant in Mesa County in western Colorado (population 154,933

Managers were invited to attend the two-day "Predicting Ecological Changes in the Florida Everglades in a Future Climate Scenario" workshop and to participate in discussion and panel sessions. This paper provides a management perspective on the technical presentations presented at the workshop, identifying information of particular interest to Everglades restoration decision-making. In addition, the paper highlights the points related to science and decision-making that emerged from the discussion sessions and provides thoughts for future discussion in a follow-up forum. Particular focus is dedicated to the importance of and challenges associated with integrating science and decision-making. In addition, the paper offers a management perspective on the uncertainties of climate science and the implications they have for influencing Everglades restoration decision-making. The authors propose that on the one hand, even given uncertainties associated with predicting the ecological response to climate change, there remains a scientific consensus that Everglades restoration is generally on the right track. On the other hand, uncertainty can be a significant barrier to climate science influencing the implementation of restoration and adaptive management programs.

Sera from hogs were analyzed using the modified direct agglutination test (MAT). Serum samples were collected from sows which were part of the National Animal Health Monitoring System (NAHMS) swine survey. The blood sera on file represented 394 randomly selected hog farms throughout the United States. Additionally, the NAHMS survey included information on type of production facilities and level of cat, dog, or bird access to the facilities. Of the sows tested 19 percent tested positive for toxoplasmosis. This study showed a positive relationship between sows or herds testing positive for Toxoplasma gondii and three factors: 1) method of rodent control, 2) type of production facility, and 3) access of certain animals (cats, dogs, birds) to production facilities. These data indicate that it will be difficult to eliminate T. gondii from swine herds which allow cat or dog access to facilities. Use of cats as a method of rodent control should be discouraged. We found a strong association between use of "bait only" for rodent control and the herd testing negative as compared to the use of "cats only" for rodent control. Greater industry awareness is needed for methods of rodent control through the use of baits. Sows in herds where female replacements were raised internally were significantly more likely to test positive for toxoplasmosis. Sows in confinement facilities had a significantly lower prevalence of Toxoplasma gondii. Herds testing positive were significantly smaller than those which were negative. In general, there were not any regional differences in prevalence rates. Sows testing positive did not have a reduced level of productivity.

Menorrhagia is a common problem among women. The cause of which, in some individuals, has been attributed to von Willebrand’s disease. The assessment of this condition has been hampered by the lack of easily available and consistent laboratory assessment of levels of this factor that correlate with the patient’s clinical presentation. Therefore we initiated a study to correlate the patient’s self assessment of their menorrhagia with their levels of von Willebrand’s factor (VWF) and platelet function. A peripheral blood assessment chart (PBAC) was utilized for patient self-assessment of blood loss during their menstrual cycle. The PBAC is a validated, well-established method which utilized a point system that quantifies the number and extent of soiling of tampons and pads used during a patient’s menstrual cycle. The PFA-100 has been used as an adjunct for lab assessment of platelet function. This is a high shear-inducing device which simulates primary hemostasis after injury to small vessel. This apparatus consists of a reservoir for whole blood and a small capillary surmounted by a collagen-coated membrane with a central aperture. Platelet agonist which is either epinephrine or ADP is present on the membrane. Closure time is reported as a variable which inversely corresponds with von Willebrand factor levels (or platelet function). Clinical correlation with its results are needed. In addition, blood samples were analyzed for Von Willebrand’s factor antigen (VWFA) and Ristocetin co-factor activity (RCOA) using a CLIA approved laboratory. We explored the relationship between PBAC, PFA-100 and VWFA and RCOA levels. Twenty-six patients were enrolled after obtaining an institutional board approved informed consent. Pearson association estimates and P values to assess the association between one month PBAC scores and PFA-100 showed 0.463 (with a p-value of 0.017). A similar analysis between one month PBAC scores and VWFA and RCOA showed 0.099 (p=0.632) and the association between PFA-100 and VWFA and RCOA showed an inverse relationship of −0.481 (p=0.013). These results confirm a correlation between VWFA and RCOA and assessment of platelet function utilizing a PFA-100. Furthermore, there was a correlation between PBAC scores and the results of the PFA-100. The association between PBAC scores and VWAF screening levels did not show significance. These results suggest further data are necessary to understand the relationship between these variables and further suggests that the PFA-100 may offer a more sensitive assessment of platelet function that correlates with clinical presentation than levels of VWFA or RCOA.

Menorrhagia is a common problem among women. The pathophysiology has been attributed to Von Willebrand’s disease in some patients. The lab diagnosis and confirmation of this condition in these women is often difficult. The need for easily reproducible, validated lab investigations is recognized. The platelet function analyzer (PFA-100) (described below) has recently been used as an adjunct for lab diagnosis of this condition. Use of this device is relatively recent, thus clinical correlation with its results have been lacking. Therefore, we initiated a study to determine if a correlation could be established between pictorial blood assessment chart (PBAC), PFA-100, and Von Willebrand’s screening (VWF antigen and co-factor activity levels). Materials and methods: After obtaining informed consent 15 female patients with a diagnosis of von Villebrand’s disease were enrolled in the above study. All received verbal and written instructions of how to record their tampon/pad use on the PBAC. The PBAC was then scored on a validated and well-established point system for lightly (1point), moderately (2points) and heavily (3points) soiled pads or tampons. In addition their blood samples were analyzed for von Willebrand antigen, Ristocetin Co-Factor and on the PFA-100 (pre and post DDAVP). The PFA-100, is a high shear-inducing device which simulates primary hemostasis after injury to small vessel, which consists of a reservoir for whole blood and a small capillary surmounted by a collagen-coated membrane with a central aperture. Platelet agonist which is either epinephrine or ADP is present on the membrane. Closure time is reported as a variable which describes von Willebrand factor function. All blood samples were forwarded to Children’s Hospital of Buffalo Special Coagulation lab for examination of the PFA-100(pre and post DDAVP),and von Willebrand panel. Conclusion: There was correlation between the number of points self-assessed on the PBAC and the PFA-100. Summary Data Patient # Age # points/PBAC VWF Ristocetin Co Factor Factor VIII PFA 100 Pre DDAVP 1 48 10 56 52 70 104 2 47 23 73 53 138 90 3 21 9 69 70 63 151 4 47 180 75 51 120 280 5 44 25 107 68 114 124 6 49 47 102 93 74 63 7 25 12 74 51 84 177 8 26 8 30 28 77 216 9 30 24 47 64 115 125 10 27 11 76 45 60 118 11 25 10 66 49 79 136 12 48 11 51 48 121 117 13 25 9 59 42 44 99 14 23 41 33 11 34 275 15 46 84 3 2 11 300