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This descriptive study examines the experiences of virtually-trained new members in a hybrid distributed community of practice (CoP) focused on undergraduate genomics education. We utilized a sequential explanatory mixed methods research design consisting of an engagement survey for all community members (n=124), followed by interviews with new members (n=15). Survey analysis identifies several areas in which new members do not differ from members with longer involvement, including in motivations for involvement, levels of engagement, satisfaction, and perceived benefits of community involvement. These findings indicate ways in which virtual training and integration was able to facilitate important community outcomes within a new, online context. Our interviews reveal important elements of training new CoP members, including onboarding, implementation, and community engagement opportunities, that successfully facilitated new members' integration into the community and contributed to their meeting the aforementioned outcomes. The findings of this study provide useful lessons and structures for growing communities through virtual means.

Background: We describe a case of a 55-year-old shepherd with history of mycotic aneurysm presenting with a chronic aortic endovascular graft infection caused by Nocardia nova and a newly identified Variovorax sp which we named ‘Variovorax durovernensis’. This is the first case of this Variovorax sp. causing human pathology. This organism was identified with whole-genome sequencing as a new species of Variovorax, with ‘Durovernum’ (the Latin name for Canterbury) suggested at our patients request; an ancient town where they work as a shepherd. Case Report: Our patient presented with a ruptured left common iliac mycotic aneurysm with Campylobacter fetus isolated, requiring emergent endovascular stenting. Seven months post-discharge they re-presented with headache, weight loss and back pain. A half-body fluorodeoxyglucose positron emission tomography (FDG-PET) scan showed aorto-bi-iliac graft uptake in the left periureteric region. The infected graft was explanted and revascularisation obtained with autologous harvested veins. Results: Graft samples grew Nocardia nova 3/5 samples on day 5 of incubation and yellow colonies of a gram-negative on 3/5 samples after 7 days. Identification of Variovorax genus was obtained using the Bruker MALDI-TOF Biotyper (Bruker Daltonics, Germany). Variovorax Sp. DNA was sequenced using Genomic DNA (SQK-LSK109 kit) on GridION (Oxford Nanopore Technologies). Sequence data was filtered and polished with genome Minimap2 and Nanopolish v0.8.4. Epi2Me identified a Variovorax sp.; in silico genomic analysis and in vitro phenotypic testing confirmed it as a new species. Conclusion: As diagnostic capabilities improve unusual clinical isolates can be reliably identified. The Bruker MALDI-TOF allowed identification of Variovorax Sp. causing clinical disease in this setting. This new species was defined with whole-genome sequencing allowing identification and recognition in international repositories.This case highlights the importance of an open mind interpreting results from clinical samples as more atypical infections from the environmental microbiome may be isolated.

ABSTRACTMammals exhibit daily fasting and feeding patterns that produce a fluctuating environment in the gut. By colonizing germfree mice with Bacteroides thetaiotaomicron and examining gene expression through a time-restricted feeding cycle, we demonstrate that this prominent gut commensal exhibits gene expression patterns characteristic of a stringent response and increases ppGpp levels during the host-fasting phase of the feeding regimen. Mutants unable to produce (p)ppGpp fail to produce this transcriptional response, exhibit unrestrained chromosomal replication, and cannot maintain population size during the host-fasting phase. Additionally, B. thetaiotaomicron requires (p)ppGpp to utilize host glycans both in vitro and in vivo, and mutants unable to produce (p)ppGpp display deficiencies in mucus layer colonization during the host-fasting phase. Complete gut microbial communities from mice and humans also increase ppGpp levels in this manner, demonstrating that this response appears to be general across species and conserved across mammalian gut communities. Together, these results identify an intracellular signal that allows gut microbes to coordinate their physiology with a time-restricted feeding regimen of their host.IMPORTANCEMammals do not eat continuously, instead concentrating their feeding to a restricted portion of the day. This behavior presents the mammalian gut microbiota with a fluctuating environment with consequences for host-microbiome interaction, infection risk, immune response, drug metabolism, and other aspects of health. We demonstrate that in mice, gut microbes elevate levels of an intracellular signaling molecule, (p)ppGpp, during the fasting phase of a time-restricted feeding regimen. Disabling this response in a representative human gut commensal species significantly reduces colonization during this host-fasting phase. This response appears to be general across species and conserved across mammalian gut communities, highlighting a pathway that allows healthy gut microbiomes to maintain stability in an unstable environment.

ABSTRACTBackground Emerging Long COVID research indicates the condition has major population health consequence. Other chronic conditions have previously been associated with functional and mental health challenges – including depression, anxiety, post-traumatic stress disorder (PTSD), suicide ideation, substance use and lower life satisfaction.Methods This study explores correlations between self-reported Long COVID, functional and mental health challenges among a random community-based sample of people (n = 655) aged 20–50 years who contracted COVID-19 prior to vaccination in a Texas county. A random sample of eligible participants was mailed a link to participate in a semi-structured questionnaire. Participant responses, including open-ended responses regarding their experience following COVID-19, were paired with health system data.Results Long COVID was associated with increased presence of depression (13% increase), anxiety (28% increase), suicide ideation (10% increase), PTSD (20% increase), and decreased life satisfaction and daily functioning. Structural equation modeling, controlling for sociodemographic variables and imposing a theoretical framework from existing chronic disease research, demonstrated correlations between Long COVID and higher PTSD, suicide ideation and lower life satisfaction were mediated by higher daily functional challenges and common mental disorders.Conclusions Basic and applied, interdisciplinary research is urgently needed to characterize the population-based response to the new challenge of Long COVID.

Abstract Background Carbapenem-resistant Enterobacterales are among the most serious antimicrobial resistance (AMR) threats. Emerging resistance to polymyxins raises the specter of untreatable infections. These resistant organisms have spread globally but, as indicated in WHO reports, the surveillance needed to identify and track them is insufficient, particularly in less resourced countries. This study employs comprehensive search strategies with data extraction, meta-analysis and mapping to help address gaps in the understanding of the risks of carbapenem and polymyxin resistance in the nations of Africa. Methods Three comprehensive Boolean searches were constructed and utilized to query scientific and medical databases as well as grey literature sources through the end of 2019. Search results were screened to exclude irrelevant results and remaining studies were examined for relevant information regarding carbapenem and/or polymyxin(s) susceptibility and/or resistance amongst E. coli and Klebsiella isolates from humans. Such data and study characteristics were extracted and coded, and the resulting data was analyzed and geographically mapped. Results Our analysis yielded 1341 reports documenting carbapenem resistance in 40 of 54 nations. Resistance among E. coli was estimated as high (> 5%) in 3, moderate (1–5%) in 8 and low (

IntroductionMillions of children and youth live on city streets across the globe, vulnerable to substance use, abuse, material and structural neglect. Structural resilience, the re-establishment of access to structural goods within a society such as housing, education, and healthcare following some interruption, provides an orientation for research and interventional efforts with street-involved children and youth (SICY). Further, a structural resilience framework supports organizing interactions between levels and sectors of a socio-ecology.MethodsFollowing the expressed interests of Kenyan SICY, and consistent with emerging policy interests at national and global levels, we assess reintegration trajectories of Kenyan SICY (n = 227) participating in a new program intervention and model. The intervention combines two coordinated, parallel programs – one focused on the rescue, rehabilitation, reintegration and resocialization of SICY, and the other focused on empowering families and communities to provide better care for children and youth who are reintegrating from life on the streets to the broader community. Data were collected and analyzed from multiple stages across SICY involvement with the intervention.ResultsWe found 79% of SICY participants reintegrated with the broader community, and 50% reintegrated with families of origin and returned to school. Twenty-five percent of participants reintegrated to a boarding school, polytechnical school, or began a business. Probability of reintegrating successfully was significantly improved among participants whose families participated in the family- and community-oriented program, who were younger, with less street-exposure, expressed more personal interests, and desired to reintegrate with family.DiscussionTo our knowledge, these are the first quantitative data published of successful reintegration of SICY to the broader, non-institutionalized community in any low- or middle-income country. Future research should (1) identify factors across socio-ecological levels and sectors contributing to health and developmental outcomes of reintegrated children and youth, (2) mechanisms to support SICY for whom the interventional strategy did not work, (3) methods to prevent street-migration by children and youth, and (4) system development to coordinate follow-up and relevant investment by institutions, organizations and community leaders to continue reintegration work.

BackgroundThree years since the onset of COVID-19, pandemic-related trends in child sexual abuse (CSA) remain poorly understood. Common administrative surveillance metrics may have underestimated abuse during the pandemic, given youths’ limited access to mandatory reporters. Research using anonymous service-use data showed increased violence-related online help-seeking but overlooked youth-specific help-seeking for CSA during COVID-19. Understanding pandemic-related trends in CSA can inform abuse detection practices and mental health service provision for youth victims. ObjectiveThe purpose of this study was to harness anonymous help-seeking data from the National Sexual Assault Online Hotline (NSAOH) to glean insights about CSA occurrence in the United States during the COVID-19 pandemic. MethodsWe used an archival sample of victims who contacted NSAOH from 2016 to 2021 (n=41,561). We examined differences in the proportion of youth and adult victims contacting NSAOH during the first COVID-19 year (March 2020 to February 2021) compared to the prior year (March 2019 to February 2020; n=11,719). Further, we compared key characteristics of hotline interactions among youth victims during the first COVID-19 year to the prior year (n=5913). Using joinpoint regression analysis, we examined linear trends in the number of monthly sampled youth and adult victims (excluding victims of unknown age) from 2016 to 2021 who discussed any victimization event (n=26,904) and who discussed recent events (ie, events occurring during the pandemic; n=9932). ResultsMost youth victims were abused by family members prior to (1013/1677, 60.4%) and after (2658/3661, 72.6%) the onset of COVID-19. The number of youth victims contacting NSAOH spiked in March 2020 and peaked in November 2020 for all youth (slope=28.2, 95% CI 18.7-37.7) and those discussing recent events (slope=17.4, 95% CI 11.1-23.6). We observed a decline in youth victims into spring 2021 for all youth (slope=–56.9, 95% CI –91.4 to –22.3) and those discussing recent events (slope=–33.7, 95% 47.3 to -20.0). The number of adult victims discussing any victimization event increased steadily from January 2018 through May 2021 (slope=3.6; 95% CI 2.9-4.2) and then declined (slope=–13.8, 95% CI –22.8 to –4.7). Trends were stable for adults discussing recent events. ConclusionsThis study extends the use of hotline data to understand the implications of the pandemic on CSA. We observed increased youth help-seeking through the NSAOH coinciding with the onset of COVID-19. Trends persisted when limiting analyses to recent victimization events, suggesting increased help-seeking reflected increased CSA during COVID-19. These findings underscore the utility of anonymous online services for youth currently experiencing abuse. Further, the findings support calls for increased youth mental health services and efforts to incorporate online chat into youth-targeted services.

Abstract Background The Family Dermatology Life Quality Index (FDLQI) was developed to meet a need for a dermatology‐specific family member/partner quality‐of‐life (QoL) measure. This paper focuses on the analysis and interpretation of FDLQI data (used as an exploratory outcome) collected in the SIGNATURE study. Objectives To measure the impact of secukinumab therapy for moderate to severe plaque psoriasis on the QoL of family members/partners of patients. Methods Randomised, open‐label, non‐comparator study in 53 dermatology centres in the UK and Republic of Ireland. Patients received secukinumab 300 or 150 mg subcutaneously weekly for 4 weeks, then 4‐weekly. FDLQI Results Family members of PASI 75 responders and non‐responders showed improved FDLQI compared to baseline, greater for responders. There was a high level of correlation between FDLQI and Dermatology Life Quality Index (DLQI) scores and positive correlations across all mapped FDLQI and DLQI questions, and a close association between the scales at all timepoints. The estimated FDLQI scores were consistently 56% of those obtained for DLQI. There was an improvement for all FDLQI questions at Week 16 with a mean total score change of 8.2. Most family member subjects had an improved score for all FDLQI questions (75%–91%, Week 12, and 77%–91%, Week 16). Family subjects with a corresponding patient visit DLQI score >10 improved for all FDLQI questions at Week 16 (mean total score change of 5.2). Conclusions Successful therapy for severe psoriasis greatly improved QoL of family members/partners. The FDLQI questionnaire responds well and appropriately to major changes in the disease severity of those affected by plaque psoriasis.

Introduction: The evidence around COVID-19 management is continuously evolving. Ensuring awareness of, and adherence to current guidance is challenging. As the second wave of COVID-19 emerged, we recognised the urgent need for better standardisation of patient care in the context of increasing patient load and acuity and the resulting redeployment of staff. Methods: COVID-19 patients admitted to adult medical wards were identified via their positive swab results. An e-prescribing protocol which included five drugs was introduced and adherence to prescribing guidelines assessed via the electronic noting and prescribing system. Doctors’ views of the prescribing protocol were assessed. Results: Following introduction of the protocol, adherence to guidelines improved. The proportion of patients either prescribed dexamethasone or with a valid contraindication documented increased from 85% to 97% and for remdesivir this increased from 60% to 79%. There was also significant improvement in the prescription of ‘as required’ insulin for patients on steroids (26% to 48%) and oxygen (43% to 79%).93% of doctors surveyed were aware of the e-prescribing protocol and 81% had used it. Confidence in adhering to the protocols increased from an average of 3.3 to 4.5 out of 5 and 93% of respondents agreed that the protocol was easy to use. Discussion: Overall, this demonstrates that electronic prescribing protocols can be effective in increasing adherence to guidelines and doctors felt this was a useful tool. This is especially important in a pandemic situation in which many doctors were redeployed outside of their usual specialties.

Insect innate immunity is composed of cellular and humoral reactions, the former acting via circulating hemocytes and the latter via immune signaling that lead to the production of antimicrobial peptides and phenol oxidase-driven melanization. Cellular immunity involves direct interactions between circulating hemocytes and invaders; it includes internalization and killing microbes (phagocytosis) and formation of bacterial-laden microaggregates which coalesce into nodules that are melanized and attached to body walls or organs. Nodulation can entail investing millions of hemocytes which must be replaced. We hypothesized that biologically costly hemocyte-based immunity is traded off for behavioral fevers in infected larvae of fall armyworms, Spodoptera frugiperda, that were allowed to fever. We tested our hypothesis by infecting larvae with the Gram-negative bacterium, Serratia marcescens, placing them in thermal gradients (TGs) and recording their selected body temperatures. While control larvae selected about 30 °C, the experimental larvae selected up 41 °C. We found that 4 h fevers, but not 2, 6 or 24 h fevers, led to increased larval survival. Co-injections of S. marcescens with the prostaglandin (PG) biosynthesis inhibitor indomethacin (INDO) blocked the fevers, which was reversed after co-injections of SM+INDO+Arachidonic acid, a precursor to PG biosynthesis, confirming that PGs mediate fever reactions. These and other experimental outcomes support our hypothesis that costly hemocyte-based immunity is traded off for behavioral fevers in infected larvae under appropriate conditions.

The U.S. Department of Energy’s National Energy Technology Laboratory (DOE-NETL) has been developing methods and tools (the online Carbon Dioxide Storage prospeCtive Resource Estimation Excel aNalysis (CO2-SCREEN) tool) to estimate carbon dioxide (CO2) storage potential in subsurface reservoirs. The CO2 storage efficiency terms are input in the tool to calculate storage potential in targeted reservoirs. In this effort, two CO2 storage efficiency terms were evaluated: volumetric displacement (EV) and microscopic displacement (Ed). The first term deals with efficiency of CO2 propagation into an accessible reservoir volume, while the second term evaluates effectiveness of native fluid displacement with CO2. The interpreted well logs and core sample measurements were applied to create the heterogeneous reservoir models including geostatistical realizations of porosity and intrinsic permeability fields. Supercritical CO2 was injected over the course of 30 years into brine-saturated reservoir models for clastics, limestone, and dolomite lithologies and deltaic fluvial, aeolian, shallow marine, and reef depositional environments by means of varying reservoir parameters and injection scenarios. The reservoir models providing vertically heterogeneous petrophysical properties and designated as “layered reservoir models” (with homogeneous parameters along each layer of the model) were not determined to be a transition between the homogeneous and heterogeneous models in respect to storage efficiency. Another finding shows that high-efficiency factors do not necessarily mean increased CO2 storage; they rather indicate that the available volume and pore space are more fully utilized. The CO2 storage efficiency factors were evaluated dynamically at the select time points using P10‐P50‐P90 percentiles. The results of this study show that the P10‐P90 distribution for volumetric efficiency is wider when compared to the microscopic efficiency. It was found that where dominant buoyancy forces drive the plume to the top of a target formation, the volumetric efficiency is low. Tighter sandstone and carbonate formations show prevalence of capillary forces and better utilization of reservoir volume.

Texas is a geographically large state with large human and livestock populations, many farms, a long coastal region, and extreme fluctuations in weather. During the last 15 years, the state of Texas has frequently suffered disasters or catastrophes causing extensive morbidity and economic loss. These disasters often have complicated consequences requiring multi-faceted responses. Recently, an interdisciplinary network of professionals from multiple academic institutions has emerged to collaborate in protecting Texas and the USA using a One Health approach. These experts are training the next generation of scientists in biopreparedness; increasing understanding of pathogens that cause repetitive harm; developing new therapeutics and vaccines against them; and developing novel surveillance approaches so that emerging pathogens will be detected early and thwarted before they can cause disastrous human and economic losses. These academic One Health partnerships strengthen our ability to protect human and animal health against future catastrophes that may impact the diverse ecoregions of Texas and the world.

ABSTRACT The Genomics Education Partnership (GEP) engages students in a course-based undergraduate research experience (CURE). To better understand the student attributes that support success in this CURE, we asked students about their attitudes using previously published scales that measure epistemic beliefs about work and science, interest in science, and grit. We found, in general, that the attitudes students bring with them into the classroom contribute to two outcome measures, namely, learning as assessed by a pre- and postquiz and perceived self-reported benefits. While the GEP CURE produces positive outcomes overall, the students with more positive attitudes toward science, particularly with respect to epistemic beliefs, showed greater gains. The findings indicate the importance of a student’s epistemic beliefs to achieving positive learning outcomes.

The response to SARS-CoV-2 demonstrated the tremendous potential of investments in vaccine research and development to impact a global pandemic, resulting in the rapid development and deployment of lifesaving vaccines. However, this unprecedented speed was insufficient to either effectively combat initial waves of the pandemic or adapt in real time to new variants. This review focuses on opportunities from a public health oriented regulatory perspective for enhancing research, development, evaluation, production, and monitoring of safety and effectiveness to facilitate more rapid availability of pandemic influenza vaccines. We briefly review regulatory pathways and processes relevant to pandemic influenza, including how they can be strengthened and globally coordinated. We then focus on what we believe are critical opportunities to provide better approaches, tools, and methods to accelerate and improve vaccine development and evaluation and thus greatly enhance pandemic preparedness. In particular, for the improved vaccines needed to respond to a future influenza pandemic better and more rapidly, moving as much of the development and evaluation process as possible into the pre-pandemic period is critical, including through approval and use of analogous seasonal influenza vaccines with defined immune correlates of protection.

We present two cases of keratitis due to Metarhizium anisopliae in geographically separated areas of the United States. The isolates were microscopically similar but morphologically different and were identified by ribosomal DNA sequencing. Both isolates had low minimum inhibitory concentration (MIC) values to caspofungin and micafungin, but high MIC values to amphotericin B. The morphologic and antifungal susceptibility differences between the two isolates indicate possible polyphylogeny of the group. Keywords: Metarhizium, Fungal keratitis, Keratomycosis, Antifungal susceptibility

Objective Brighter Bites is a school-based health promotion program that delivers fresh produce and nutrition education to low-income children and families. Due to COVID-19-related school closures, states were under “shelter in place” orders, and Brighter Bites administered a rapid assessment survey to identify social needs among their families. The purpose of this study is to demonstrate the methodology used to identify those with greatest social needs during this time (“high risk”), and to describe the response of Brighter Bites to these “high risk” families. Methods The rapid assessment survey was collected in April 2020 across Houston, Dallas, Washington DC, and Southwest Florida. The survey consisted of items on disruption of employment status, financial hardship, food insecurity, perceived health status and sociodemographics. The open-ended question “Please share your greatest concern at this time, or any other thoughts you would like to share with us.” was asked at the end of each survey to triage “high risk” families. Responses were then used to articulate a response to meet the needs of these high risk families. Results A total of 1048 families completed the COVID-19 rapid response survey, of which 71 families were triaged and classified as “high risk” (6.8% of survey respondents). During this time, 100% of the “high risk” participants reported being food insecure, 85% were concerned about their financial stability, 82% concerned about the availability of food, and 65% concerned about the affordability of food. A qualitative analysis of the high-risk group revealed four major themes: fear of contracting COVID19, disruption of employment status, financial hardship, and exacerbated food insecurity. In response, Brighter Bites pivoted, created, and deployed a framework to immediately address a variety of social needs among those in the “high risk” category. Administering a rapid response survey to identify the immediate needs of their families can help social service providers tailor their services to meet the needs of the most vulnerable.