There is a pressing need for novel approaches to help address climate change and for a workforce that is equipped with a combination of new and different types of knowledges. The One Health (OH) core competencies perhaps offer the new knowledges, skills and attitudes that will be needed in a future generation of practitioners that does not shy away from complexity. The objective of this research was to identify overlapping and transferable OH-climate change competencies that are needed of professionals working to address climate change. Using focus groups and qualitative content analysis, 23 professionals from across Canada whose employment positions had a key focus on climate change were brought together across five sessions. Participants agreed that the OH competencies were applicable to their employment roles and responsibilities, but they identified four key missing areas that are important for graduates: evaluative and reflective practice, personal resilience, turning knowledge into action and having an openness to other knowledges (particularly Indigenous and non-Western viewpoints). This work also provided a first iteration of a process that should be continually used to bridge the gap between theory and practice, as employer needs are a key consideration during the development of educational programs.

Carbapenamase-producing carbapenem-resistant Enterobacterales (CP-CRE) is an urgent public health threat for healthcare facilities. Solid organ transplant (SOT) recipients carry an increased risk for CRE infection and colonization due to prolonged exposures to antimicrobials, healthcare facilities and immunosuppression. CRE infection in SOT patients is associated with an increase in morbidity and mortality. Here, we describe a hospital outbreak investigation of three cases of New Delhi metallo-beta-lactamase (NDM) - CRE that led to novel findings with implications for further interdisciplinary investigations. An NDM-CRE infection in a critically-ill patient was identified during passive surveillance and prompted an investigation. Previous CP-CRE passive surveillance cases were reviewed. Rectal screening was performed for potentially exposed patients. 403 rectal swabs were tested for carbapenemase genes in active surveillance. Patients identified to have a new NDM-CRE isolate on active or passive surveillance were considered cases and underwent in-depth chart review including possible patient-to-patient exposures, hospital locations, procedures, devices, and consultations. NDM-CRE isolates were sent to the Minnesota Department of Health (MDH) for whole genome sequencing (WGS) to assess relatedness. Five NDM-CRE cases were identified, with all isolates harboring blaNDM including three NDM-Klebsiella pneumoniae (NDM-KP) cases (Figure 1). The first NDM-KP case, patient 1, developed mediastinal infection following lung transplantation. Review of United Network for Organ Sharing revealed that respiratory specimens from patient 1’s donor grew NDM-KP and a bronchial wash at the time of transplant yielded NDM-KP. The second NDM-KP case (patient 3) developed ventilator-associated pneumonia and was found to have used sequentially the same ventilator as patient 1. The third NDM-KP case (patient 4) was detected via rectal swab in active surveillance and shared wound care personnel in common with patients 1 and 3 (Figure 2). WGS demonstrated two single nucleotide polymorphisms (SNP) among all three isolates, strongly suggesting relatedness (Figure 3). Best practices for infection prevention were reviewed with wound care personnel. To date, no further NDM-KP isolates have been identified. Investigation was facilitated by in-depth chart review and WGS via the Central Region Antimicrobial Resistance Laboratory Network at MDH. Detection of the NDM-KP from a lung donor specimen appears genetically linked to clinical isolates in other patients, raising the possibility of a donor-derived hospital outbreak. This investigation is the first to describe a donor-derived NDM outbreak in a healthcare facility. Communication between organ procurement agencies, transplant centers, and infection prevention must be optimized to prevent CRE-associated morbidity in SOT receipts and CRE hospital outbreaks.

Curiosity and creativity are expressions of the trade-off between leveraging that with which we are familiar or seeking out novelty. Through the computational lens of reinforcement learning, we describe how formulating the value of information seeking and generation via their complementary effects on planning horizons formally captures a range of solutions to striking this balance.

The University of British Columbia (UBC) opened Canada’s first International House (I-House) in 1959 after a decade of activism from students and faculty. Students had demanded an I-House to help them find housing, and to ensure that “brotherhood may prevail,” as the I-House motto promised. The I-House campaign received support from community groups that raised the funds to build the UBC I-House. UBC’s administration wanted I-House as a social center that could coordinate fledgling international student services and resisted the residential I-House model. Ultimately, UBC’s administrators won out and the residential component was never built. This paper examines the conflict about building a residence to house international and domestic students together, chronicling the competing visions of international student policy and services that were circulating at one of Canada’s largest universities in the early days of the Cold War.

Since the initial publication of A Compendium of Strategies to Prevent Healthcare-Associated Infections in Acute Care Hospitals in 2008, the prevention of healthcare-associated infections (HAIs) has continued to be a national priority. Progress in healthcare epidemiology, infection prevention, antimicrobial stewardship, and implementation science research has led to improvements in our understanding of effective strategies for HAI prevention. Despite these advances, HAIs continue to affect ∼1 of every 31 hospitalized patients,1 leading to substantial morbidity, mortality, and excess healthcare expenditures,1 and persistent gaps remain between what is recommended and what is practiced.

The widespread impact of the coronavirus disease 2019 (COVID-19) pandemic on HAI outcomes2 in acute-care hospitals has further highlighted the essential role of infection prevention programs and the critical importance of prioritizing efforts that can be sustained even in the face of resource requirements from COVID-19 and future infectious diseases crises.3

The Compendium: 2022 Updates document provides acute-care hospitals with up-to-date, practical expert guidance to assist in prioritizing and implementing HAI prevention efforts. It is the product of a highly collaborative effort led by the Society for Healthcare Epidemiology of America (SHEA), the Infectious Disease Society of America (IDSA), the Association for Professionals in Infection Control and Epidemiology (APIC), the American Hospital Association (AHA), and The Joint Commission, with major contributions from representatives of organizations and societies with content expertise, including the Centers for Disease Control and Prevention (CDC), the Pediatric Infectious Disease Society (PIDS), the Society for Critical Care Medicine (SCCM), the Society for Hospital Medicine (SHM), the Surgical Infection Society (SIS), and others.

The intent of this document is to highlight practical recommendations in a concise format designed to assist acute-care hospitals in implementing and prioritizing their surgical-site infection (SSI) prevention efforts. This document updates the Strategies to Prevent Surgical Site Infections in Acute Care Hospitals published in 2014.1 This expert guidance document is sponsored by the Society for Healthcare Epidemiology of America (SHEA). It is the product of a collaborative effort led by SHEA, the Infectious Diseases Society of America (IDSA), the Association for Professionals in Infection Control and Epidemiology (APIC), the American Hospital Association (AHA), and The Joint Commission, with major contributions from representatives of a number of organizations and societies with content expertise.

OBJECTIVES/GOALS: The goal of this study was to develop a clinically applicable technique to increase the precision of in vivo dose monitoring during radiation therapy by mapping the dose deposition and resolving the temporal dose accumulation while the treatment is being delivered in real time. METHODS/STUDY POPULATION: Ironizing radiation acoustic imaging (iRAI) is a novel imaging concept with the potential to map the delivered radiation dose on anatomic structure in real time during external beam radiation therapy without interrupting the clinical workflow. The iRAI system consisted of a custom-designed two-dimensional (2D) matrix transducer array with integrated preamplifier array, driven by a clinic-ready ultrasound imaging platform. The feasibility of iRAI volumetric imaging in mapping dose delivery and real-time monitoring of temporal dose accumulation in a clinical treatment plan were investigated with a phantom, a rabbit model, and a cancer patient. RESULTS/ANTICIPATED RESULTS: The total dose deposition and temporal dose accumulation in 3D space of a clinical C-shape treatment plan in a targeted region were first imaged and optimized in a phantom. Then, semi-quantitative iRAI measurements were achieved in an in vivo rabbit model. Finally, for the first time, real-time visualization of radiation dose delivered deep in a patient with liver metastases was performed with a clinical linear accelerator. These studies demonstrate the potential of iRAI to monitor and quantify the radiation dose deposition during treatment. DISCUSSION/SIGNIFICANCE: Described here is the pioneering role of an iRAI system in mapping the 3D radiation dose deposition of a complex clinical radiotherapy treatment plan. iRAI offers a cost-effective and practical solution for real-time visualization of 3D radiation dose delivery, potentially leading to personalized radiotherapy with optimal efficacy and safety.

This study explores the use of Free Choice Profiling (FCP) methodology for the qualitative behaviour assessment of emotional expression in the domestic dog (Canis familiaris). Qualitative behaviour assessment is based upon the integration of many pieces of information that in conventional quantitative approaches are recorded separately or not at all. Observers are asked to focus on an animal's interaction with its surrounding environment, and to describe the animal's expressive demeanor, or ‘body language’. A specific characteristic of FCP methodology is that it allows observers the freedom to devise their own descriptive terms, and then to use these personal terms to quantitatively score observed subjects. Application of FCP to qualitative behaviour assessment in animals was originally tested for pigs, and more recently for dairy cows, horses, and ponies. The goal of this study was to apply FCP to the domestic dog, and to investigate the inter-observer reliability of assessments of emotional expression in 10 individual Beagles by a group of 18 untrained observers. The data was analysed using Generalised Procrustes Analysis (GPA), a multivariate statistical technique associated with FCP. The observers achieved highly-significant agreement in their assessments of the dogs’ expressions, thereby establishing the applicability of this methodology for the first time in the domestic dog.

The purpose of this investigation was to expand upon the limited existing research examining the test–retest reliability, cross-sectional validity and longitudinal validity of a sample of bioelectrical impedance analysis (BIA) devices as compared with a laboratory four-compartment (4C) model. Seventy-three healthy participants aged 19–50 years were assessed by each of fifteen BIA devices, with resulting body fat percentage estimates compared with a 4C model utilising air displacement plethysmography, dual-energy X-ray absorptiometry and bioimpedance spectroscopy. A subset of thirty-seven participants returned for a second visit 12–16 weeks later and were included in an analysis of longitudinal validity. The sample of devices included fourteen consumer-grade and one research-grade model in a variety of configurations: hand-to-hand, foot-to-foot and bilateral hand-to-foot (octapolar). BIA devices demonstrated high reliability, with precision error ranging from 0·0 to 0·49 %. Cross-sectional validity varied, with constant error relative to the 4C model ranging from −3·5 (sd 4·1) % to 11·7 (sd 4·7) %, standard error of the estimate values of 3·1–7·5 % and Lin’s concordance correlation coefficients (CCC) of 0·48–0·94. For longitudinal validity, constant error ranged from −0·4 (sd 2·1) % to 1·3 (sd 2·7) %, with standard error of the estimate values of 1·7–2·6 % and Lin’s CCC of 0·37–0·78. While performance varied widely across the sample investigated, select models of BIA devices (particularly octapolar and select foot-to-foot devices) may hold potential utility for the tracking of body composition over time, particularly in contexts in which the purchase or use of a research-grade device is infeasible.

The herbicides that inhibit 4-hydroxyphenylpyruvate dioxygenase (HPPD) are primarily used for weed control in corn, barley, oat, rice, sorghum, sugarcane, and wheat production fields in the United States. The objectives of this review were to summarize 1) the history of HPPD-inhibitor herbicides and their use in the United States; 2) HPPD-inhibitor resistant weeds, their mechanism of resistance, and management; 3) interaction of HPPD-inhibitor herbicides with other herbicides; and 4) the future of HPPD-inhibitor-resistant crops. As of 2022, three broadleaf weeds (Palmer amaranth, waterhemp, and wild radish) have evolved resistance to the HPPD inhibitor. The predominance of metabolic resistance to HPPD inhibitor was found in aforementioned three weed species. Management of HPPD-inhibitor-resistant weeds can be accomplished using alternate herbicides such as glyphosate, glufosinate, 2,4-D, or dicamba; however, metabolic resistance poses a serious challenge, because the weeds may be cross-resistant to other herbicide sites of action, leading to limited herbicide options. An HPPD-inhibitor herbicide is commonly applied with a photosystem II (PS II) inhibitor to increase efficacy and weed control spectrum. The synergism with an HPPD inhibitor arises from depletion of plastoquinones, which allows increased binding of a PS II inhibitor to the D1 protein. New HPPD inhibitors from the azole carboxamides class are in development and expected to be available in the near future. HPPD-inhibitor-resistant crops have been developed through overexpression of a resistant bacterial HPPD enzyme in plants and the overexpression of transgenes for HPPD and a microbial gene that enhances the production of the HPPD substrate. Isoxaflutole-resistant soybean is commercially available, and it is expected that soybean resistant to other HPPD inhibitor herbicides such as mesotrione, stacked with resistance to other herbicides, will be available in the near future.

In this study, we develop an analytical model to predict the turbulent boundary layer downstream of a step-change in the surface roughness where upstream flow conditions are given. We first revisit the classical model of Elliott (Trans. Am. Geophys. Union, vol. 39, 1958, pp. 1048–1054), who modelled the velocity distribution within and above the internal layer with a simple piecewise logarithmic profile, and evolved the velocity profile using the streamwise momentum equation. Elliott's model was originally developed for an atmospheric surface layer, and to make the model applicable to a spatially developing turbulent boundary layer with finite thickness, we propose a number of more physical refinements, including adding a wake function to the velocity profile, considering the growth of the entire boundary layer in the streamwise direction, and using a more realistic shear stress profile in the momentum equation. In particular, we implement the blending model (Li et al., J. Fluid Mech., vol. 923, 2021, p. A18) to account for the deviation of the mean flow within the internal layer from a canonical velocity profile based on the local wall condition. These refinements lead to improved agreement between the prediction and the measurement, especially in the vicinity of the rough-to-smooth change.

Using a longitudinal design (Wave 1 n = 164, Mage = 3.57 years, 54% female, predominantly White and French-speaking), the current study sought to answer two questions: 1) does poverty influence children’s negative emotionality through heightened family-level, poverty-related stress? and 2) is negative emotionality, in turn, predictive of adolescent internalizing symptoms, externalizing behaviors, cognitive abilities, and physical health? Results confirmed an indirect pathway from family poverty to child emotionality through poverty-related stress. In addition, negative emotionality was associated with adolescent internalizing symptoms, attention difficulties, and physical health, but not externalizing symptoms, even when controlling for early poverty exposure.

Previous cross-sectional work has consistently found associations between neuroticism and impulsivity and nonsuicidal self-injury (NSSI). However, there are few longitudinal studies of personality risk factors for NSSI. In this study, we examined associations between individual differences in temperament at age 3 and NSSI from ages 9 to 15. At age 3, 559 preschool-aged children (54% male; Mage = 42.2 months [SD = 3.10]) completed laboratory assessments of temperament. Parents also completed questionnaires about their child’s temperament. Children completed a diagnostic interview assessing NSSI engagement at ages 9, 12, and 15. By the age 15 assessment, 12.4% of adolescents reported engaging in NSSI. In univariate models, we found that higher levels of observed sadness and maternal-reported sadness and anger were associated with increased risk for NSSI. In multivariate models, female sex and maternal-reported anger were significantly associated with greater likelihood of NSSI. Laboratory observed sadness and impulsivity were associated with a higher likelihood of NSSI. This work extends the literature on personality risk factors associated with NSSI by finding longitudinal associations between early childhood negative affect and later NSSI engagement during adolescence.

This study presents an experimental dataset documenting the evolution of a turbulent boundary layer downstream of a rough-to-smooth surface transition. To investigate the effect of upstream flow conditions, two groups of experiments are conducted. For the Group-Re cases, a nominally constant viscous-scaled equivalent sand grain roughness $k_{s0}^{+}\approx 160$ is maintained on the rough surface, while the friction Reynolds number $Re_{\tau 0}$ ranges from 7100 to 21 000. For the Group-ks cases, $Re_{\tau 0}\approx 14\,000$ is maintained while $k_{s0}^{+}$ ranges from 111 to 228. The wall-shear stress on the downstream smooth surface is measured directly using oil-film interferometry to redress previously reported uncertainties in the skin-friction coefficient recovery trends. In the early development following the roughness transition, the flow in the internal layer is not in equilibrium with the wall-shear stress. This conflicts with the common practise of modelling the mean velocity profile as two log laws below and above the internal layer height, as first proposed by Elliott (Trans. Am. Geophys. Union, vol. 39, 1958, pp. 1048–1054). As a solution to this, the current data are used to model the recovering mean velocity semi-empirically by blending the corresponding rough-wall and smooth-wall profiles. The over-energised large-scale motions leave a strong footprint in the near-wall region of the energy spectrum, the frequency and magnitude of which exhibit dependence on $Re_{\tau 0}$ and $k_{s0}^{+}$, respectively. The energy distribution in near-wall small scales is mostly unaffected by the presence of the outer flow with rough-wall characteristics, which can be used as a surrogate measure to extract the local friction velocity.