OBJECTIVES/GOALS: The COVID-19 pandemic disrupted established social support networks (faith-based, community, family, friends), resulting in unprecedented health-related, financial, and employment challenges among African Americans (AAs). This study explores the psychosocial influences of the pandemic on the health and wellness of AAs. METHODS/STUDY POPULATION: The FAITH! (Fostering African-American Improvement in Total Health!) Program, an academic-community partnership with AA churches, shifted focus to COVID-19 prevention in AA communities. Funded by the Mayo Clinic Center for Clinical and Translation Sciences, this cross-sectional study recruited AA adults from FAITH!-affiliated churches and social media to complete a survey exploring the personal impact of the pandemic from hardships (e.g., food and housing insecurity, paying utilities) on healthy lifestyle (HL). The primary outcome was difficulty maintaining a HL during the pandemic. Logistic regression (odds ratios and associated 95% confidence intervals (CIs)) was used to examine the associations between difficulty maintaining a HL and factors including COVID-19 hardships and mental health. RESULTS/ANTICIPATED RESULTS: Participants (N=169, 71.4% female, 41.4% essential workers) had a mean age [SD] of 49.4 [14.9] years. Over half (91/169, 54%) reported difficulty maintaining a HL. Those reporting unemployment (OR 2.3; 95% CI [1.2,4.4]; p=0.008), difficulty paying rent (OR 4.1; 95% CI [2.1,8.6]; p<0.001), or food/utilities (OR 5.5; 95% CI [2.7,11.5]; p<0.001) all had greater odds of difficulty maintaining a HL. High stress (≥5/10, scale 1-10) was associated with difficulty maintaining a HL (OR 4.1; 95% CI [2.1,8.5]; p<0.001) compared to AAs with low stress. Negative mental health (depression (OR 3.4; 95% CI [1.0,13.7]; p<0.001), anger (OR 2.5; 95% CI [0.5,18.9]; p=0.005), and nervousness (OR 4.1; 95% CI [1.1,19.5]; p=0.003) was associated with difficulty maintaining a HL compared to AAs with positive mental health. DISCUSSION/SIGNIFICANCE: Our study findings revealed that COVID-19 hardships, stress, and negative mental health impacted the ability of AAs to maintain a HL. These issues should be considered in the design and implementation of community-based health programs to promote healthy living during future public health emergencies.

We evaluated diagnostic test and antibiotic utilization among 252 patients from 11 US hospitals who were evaluated for coronavirus disease 2019 (COVID-19) pneumonia during the severe acute respiratory coronavirus virus 2 (SARS-CoV-2) omicron variant pandemic wave. In our cohort, antibiotic use remained high (62%) among SARS-CoV-2–positive patients and even higher among those who underwent procalcitonin testing (68%).

Area-based conservation is a widely used approach for maintaining biodiversity, and there are ongoing discussions over what is an appropriate global conservation area coverage target. To inform such debates, it is necessary to know the extent and ecological representativeness of the current conservation area network, but this is hampered by gaps in existing global datasets. In particular, although data on privately and community-governed protected areas and other effective area-based conservation measures are often available at the national level, it can take many years to incorporate these into official datasets. This suggests a complementary approach is needed based on selecting a sample of countries and using their national-scale datasets to produce more accurate metrics. However, every country added to the sample increases the costs of data collection, collation and analysis. To address this, here we present a data collection framework underpinned by a spatial prioritization algorithm, which identifies a minimum set of countries that are also representative of 10 factors that influence conservation area establishment and biodiversity patterns. We then illustrate this approach by identifying a representative set of sampling units that cover 10% of the terrestrial realm, which included areas in only 25 countries. In contrast, selecting 10% of the terrestrial realm at random included areas across a mean of 162 countries. These sampling units could be the focus of future data collation on different types of conservation area. Analysing these data could produce more rapid and accurate estimates of global conservation area coverage and ecological representativeness, complementing existing international reporting systems.

There is no all-encompassing or universally accepted definition of the difficult airway, and it has traditionally been approached as a problem chiefly rooted in anesthesiology. However, with airway obstruction reported as the second leading cause of mortality on the battlefield and first-pass success (FPS) rates for out-of-hospital endotracheal intubation (ETI) as low as 46.4%, the need to better understand the difficult airway in the context of the prehospital setting is clear. In this review, we seek to redefine the concept of the “difficult airway” so that future research can target solutions better tailored for prehospital, and more specifically, combat casualty care. Contrasting the most common definitions, which narrow the scope of practice to physicians and a handful of interventions, we propose that the difficult airway is simply one that cannot be quickly obtained. This implies that it is a situation arrived at through a multitude of factors, namely the Patient, Operator, Setting, and Technology (POST), but also more importantly, the interplay between these elements. Using this amended definition and approach to the difficult to manage airway, we outline a target-specific approach to new research questions rooted in this system-based approach to better address the difficult airway in the prehospital and combat casualty care settings.

Higher milk intake has been associated with a lower stroke risk, but not with risk of CHD. Residual confounding or reverse causation cannot be excluded. Therefore, we estimated the causal association of milk consumption with stroke and CHD risk through instrumental variable (IV) and gene-outcome analyses. IV analysis included 29 328 participants (4611 stroke; 9828 CHD) of the European Prospective Investigation into Cancer and Nutrition (EPIC)-CVD (eight European countries) and European Prospective Investigation into Cancer and Nutrition-Netherlands (EPIC-NL) case-cohort studies. rs4988235, a lactase persistence (LP) SNP which enables digestion of lactose in adulthood was used as genetic instrument. Intake of milk was first regressed on rs4988235 in a linear regression model. Next, associations of genetically predicted milk consumption with stroke and CHD were estimated using Prentice-weighted Cox regression. Gene-outcome analysis included 777 024 participants (50 804 cases) from MEGASTROKE (including EPIC-CVD), UK Biobank and EPIC-NL for stroke, and 483 966 participants (61 612 cases) from CARDIoGRAM, UK Biobank, EPIC-CVD and EPIC-NL for CHD. In IV analyses, each additional LP allele was associated with a higher intake of milk in EPIC-CVD (β = 13·7 g/d; 95 % CI 8·4, 19·1) and EPIC-NL (36·8 g/d; 95 % CI 20·0, 53·5). Genetically predicted milk intake was not associated with stroke (HR per 25 g/d 1·05; 95 % CI 0·94, 1·16) or CHD (1·02; 95 % CI 0·96, 1·08). In gene-outcome analyses, there was no association of rs4988235 with risk of stroke (OR 1·02; 95 % CI 0·99, 1·05) or CHD (OR 0·99; 95 % CI 0·95, 1·03). Current Mendelian randomisation analysis does not provide evidence for a causal inverse relationship between milk consumption and stroke or CHD risk.

We present a scaling theory that links the frequency of long frontal waves to the kinetic energy decay rate and inverse transfer of potential energy in freely evolving equivalent barotropic turbulence. The flow energy is predominantly potential, and the streamfunction makes the dominant contribution to potential vorticity (PV) over most of the domain, except near PV fronts of width $O(L_{D})$, where $L_{D}$ is the Rossby deformation length. These fronts bound large vortices within which PV is well-mixed and arranged into a staircase structure. The jets collocated with the fronts support long-wave undulations, which facilitate collisions and mergers between the mixed regions, implicating the frontal dynamics in the growth of potential-energy-containing flow features. Assuming the mixed regions grow self-similarly in time and using the dispersion relation for long frontal waves (Nycander et al., Phys. Fluids A, vol. 5, 1993, pp. 1089–1091) we predict that the total frontal length and kinetic energy decay like $t^{-1/3}$, while the length scale of the staircase vortices grows like $t^{1/3}$. High-resolution simulations confirm our predictions.

Petrological studies of the Sherwood Sandstone of the Marchwood Borehole show that the formation is made up of two units of differing primary lithological character: a lower unit with lithic sandstone and conglomerate, and an upper unit with arkosic sandstone. A combination of compaction and calcite cementation (early and late) has severely reduced porosity and permeability in the lower unit. In the upper unit compaction is again important, but several beds have largely escaped cementation, and their primary porosity has been enhanced by leaching of feldspars. The secondary porosity reaches 7% in some samples. Oxygen and carbon isotope data for the early (calcrete) cements indicate isotopic equilibrium with typical freshwater compositions. The later cements yield more variable values, indicating precipitation under a wider range of conditions.

Degradation of contaminant hydrocarbons in groundwater by microbially mediated oxidation, linked to the reduction of electron acceptors, is fundamental to the strategy of ‘monitored natural attenuation’ (MNA) for oxidizable hydrocarbons, which is increasingly being adopted at polluted aquifer sites throughout Europe and North America. Commonly, oxygen is depleted and following the reduction of nitrate, solid-phase Fe oxides become the dominant electron acceptors. Arsenic, associated with Fe and Mn oxides in soils and sediments, may therefore be mobilized to groundwater and pose an additional threat to environmental receptors. In a pilot study of three aquifers in England, we have examined the extent to which arsenic is released to groundwater under Fe(III)-reducing conditions imposed by contaminant hydrocarbons. Results show that arsenic is locally mobilized in the Chalk to <10 μg/1, in Quaternary gravels to 70 μg/1 and in the Triassic sandstones to 160 μg/1. At the Chalk and Quaternary gravels sites arsenic mobilization is demonstrably linked to reduction of Fe- and Mn-oxides. This is not so at the Triassic sandstone site, where release of arsenic is related to elevated bicarbonate alkalinity. Redox-driven arsenic mobilization at other Triassic sandstone locations is possible. Further work is required on the solid-phase sources of arsenic in the aquifers, and to relate the hydrochemical observations to groundwater hydraulic conditions.

The Carnmenellis granite and its aureole contain the only recorded thermal groundwaters (up to 52 °C) in British granites. They occur as springs in tin mines at depths between 200 and 700 m and most are saline (maximum mineralization 19 310 mg 1−1). Mining activity has disturbed the groundwater circulation pattern developed over a geological time-scale and levels of bomb-produced tritium (> 4 TU) indicate that a significant component (up to 65 %) of the most saline waters are of recent origin. All components of all the mine waters are of meteoric origin. Radiogenic 4He contents, 40Ar/36Ar ratios, and uranium series geochemistry suggest that the thermal component has a likely residence time of at least 5 × 104 years and probably of order 106 years.

The thermal waters have molar Na+/Cl− ratios considerably less than 1 but they are enriched relative to sea water in all major cations except Mg. The groundwater is also particularly enriched in Li with contents ranging up to 125 mg 1−1. The groundwater salinity, which may reach a maximum of 30 000 mg 1−1, is shown to result from weathering reactions of biotite (probably through a chloritization step) and plagioclase feldspar, to kaolinite. On volumetric considerations, fluid inclusions cannot contribute significantly to the groundwater salinity, and stable isotope ratios rule out any contribution from sea water.

Groundwater silica contents and molar Na+/K+ ratios suggest that the likely equilibration temperature is 54°C, which would imply a depth of circulation of about 1.2 km.

Arsenic and fluoride in groundwater from Quaternary loess deposits in Argentina pose major health concerns. Common sources for arsenic and fluoride have been suggested but the processes of mobilization are disputed, and distributions in groundwater are largely unresolved at a sample density >1/50 km2. At Los Pereyras in Tucumán Province, northern Argentina, we have evaluated distributions and hydrochemical associations of arsenic and fluoride with a sample density of 0.75 per km2 over an area of 75 km2, to a depth of 230 m. Groundwater in the loess is oxic and alkaline. Fluoride is restricted to the upper 20 m of the Quaternary loess, where it reaches 8.3 mg/1. Arsenic has a vertical layering consistent with that of fluoride, ranging from 20 to 760 μg/1 in the upper 20 m and 58—163 μg/l below this. There are two sources of arsenic, one unrelated to the fluoride source. Positive correlations between arsenic and fluoride with pH, but not with alkalinity, support desorption from iron oxyhydroxides as the likely mechanism of release to groundwater for arsenic and fluoride, rather than the weathering of silicate minerals. Stratigraphic and/or palaeohydrological controls may explain the observed depth distributions within the loess aquifer.

Background. Recent major epidemiological studies have adopted increasingly multidimensional approaches to assessment. Several of these have included some assessment of perceived need for mental health care. The Australian National Survey of Mental Health and Wellbeing, conducted in 1997, included a particularly detailed examination of this construct, with an instrument with demonstrated reliability and validity.

Methods. A clustered probability sample of 10641 Australians responded to the field questionnaire for this survey, including questions on perceived need either where there had been service utilization, or where a disorder was detected by administration of sections of the Composite International Diagnostic Interview. The confidentialized unit record file generated from the survey was analysed for determinants of perceived need.

Results. Perceived need is increased in females, in people in the middle years of adulthood, and in those who have affective disorders or co-morbidity. Effects of diagnosis and disability can account for most of the differences in gender specific rates. With correction for these effects through regression, there is less perceived need for social interventions and possibly more for counselling in females; disability is confirmed as strongly positively associated with perceived need, as are the presence of affective disorders or co-morbidity.

Conclusions. The findings of this study underscore the imperative for mental health services to be attentive and responsive to consumer perceived need. The substantial majority of people who are significantly disabled by mental health problems are among those who see themselves as having such needs.

Cyathostomins are ubiquitous nematodes of horses. Once ingested, they can spend a substantial time as encysted larvae in the intestinal wall. The larvae can comprise up to 90% of the total burden, with up to several million worms reported in individuals. These stages can emerge in large numbers to cause life-threatening colitis. Direct methods for detection of encysted larval burdens in live horses do not exist. Previously, two antigen complexes were identified as promising markers for infection. A component of these, cyathostomin gut associated larval antigen-1 (Cy-GALA-1), was identified following immunoscreening of a complementary DNA library. Serum immunoglobulin G(T) (IgG(T)) responses to Cy-GALA-1 were shown to inform on larval infection. Sequence analysis of polymerase chain reaction products amplified from individual worms indicated that Cy-GALA-1 was derived from Cyathostomum pateratum. As cyathostomin infections always comprise multiple species, a diagnostic test must account for this. Here, segments of the Cy-gala gene were isolated from four common species, Cyathostomum catinatum, Cylicocyclus ashworthi, Cylicostephanus goldi and Cylicostephanus longibursatus, and the associated proteins expressed in recombinant form. The specificity and immunogenicity of each protein was confirmed. Each protein was assessed by enzyme linked immuno sorbent assay (ELISA) for its ability for informing on the presence of encysted larval infection and the level of burden.