Hybrid whole genome sequencing was used to investigate if nosocomial Verona integron-encoded metallo-β-lactamase (VIM) carbapenemase transmission occurred between two patients without epidemiological links or common pathogens. Challenges in genomic methodology and appropriate analytical depth for mobile carbapenemase outbreaks are described including how inappropriate choices can mislead results and impact infection control practices.

The Quaternary Isotope Laboratory (QIL) at the University of Washington was launched in 1969 and directed by Minze Stuiver until his retirement in 1998. Here we review some of the scientific work undertaken in the QIL and the memories of some of Minze’s former students and colleagues.

ABSTRACT IMPACT: The potential to use vaginal pH as a low cost, non-invasive diagnostic test at the point of CIN2 diagnosis to predict worsening of cervical disease. OBJECTIVES/GOALS: We previously reported that persistence/progression of cervical intraepithelial neoplasia-2 (CIN2) was uncommon in women living with HIV (WLH) from the Women’s Interagency HIV Study (WIHS, now MWCCS). Here we examined additional factors that may influence CIN2 natural history. METHODS/STUDY POPULATION: A total of 337 samples from 94 WLH with a confirmed CIN2 diagnosis were obtained from the MWCCS. 42 cervicovaginal HPV types and 34 cervicovaginal cytokines/chemokines were measured at CIN2 diagnosis (94 samples) and 6-12 months prior to CIN2 diagnosis (79 samples). Covariates, including CD4 count and vaginal pH, were abstracted from core MWCCS visits. Logistic regression models were used to explore CIN2 regression (CIN1, normal) vs. persistence/progression (CIN2, CIN3). Log rank tests, Kaplan Meier method, and Cox regression modeling were used to determine CIN2 regression rates. RESULTS/ANTICIPATED RESULTS: The most prevalent HPV types were HPV54 (21.6%) and 53 (21.3%). 33 women (35.1%) had a subsequent CIN2/CIN3 diagnosis (median 12.5 years follow-up). Each additional hr-HPV type detected at the pre-CIN2 visit associated with increased odds of CIN2 persistence/progression (OR 2.27, 95% CI 1.15, 4.50). Higher vaginal pH (aOR 2.27, 95% CI 1.15, 4.50) and bacterial vaginosis (aOR 5.08, 95% CI 1.30, 19.94) at the CIN2 diagnosis visit associated with higher odds of CIN2 persistence/progression. Vaginal pH >4.5 at CIN2 diagnosis also associated with unadjusted time to CIN2 persistence/progression (log rank p=0.002) and a higher rate of CIN2 persistence/progression (adjusted hazard ratio [aHR] 3.37, 95% CI 1.26, 8.99). Cervicovaginal cytokine/chemokine levels were not associated with CIN2 persistence/progression. DISCUSSION/SIGNIFICANCE OF FINDINGS: We found relatively low prevalence of HPV16/18 in this cohort. Elevated vaginal pH at the time of CIN2 diagnosis may be a useful indicator of CIN2 persistence/progression and the rate of persistence/progression.

The goal of this research was to identify, summarize, and evaluate pediatric disaster preparedness resources in the United States and to identify areas that need improvement or further development. Using standard literature, gray literature and website reviews, relevant resources were identified and the 50 most relevant resources were studied in depth. Each resource was given a grade of A, B, or C based on content, format, quality, and thoroughness. These resources were divided into 3 categories: (1) hospital resources, (2) school resources, and (3) training/education resources. Half of the 50 resources (25) were given a grade of A, indicating the highest level of quality and thoroughness, with pertinent information presented in a clear format. Sixteen of the resources were given a rating of B, while 9 of the resources were given a rating of C. Over 60% of the resources did not contain culturally sensitive information and more than 60% of the resources did not contain preparedness information for children with disabilities. Resources specific to hospitals and schools were limited in number and quality available, while training/education resources were widely available. In addition, 60% of resources were not specific to schools, children’s hospitals, or to certain occupations (ie, nurses, doctors, teachers, principals). Based on these results, gaps in cultural sensitivity were identified and limitations in resources for children with disabilities and for schools and hospitals currently exist. All these areas require further development in the field of pediatric disaster preparedness (Disaster Med Public Health Preparedness. 2019;13:330–337)

Enumerations represented as bijections between the natural numbers and elements of some given type have recently garnered interest in property-based testing because of their efficiency and flexibility. There are, however, many ways of defining these bijections, some of which are better than others. This paper offers a new property of enumeration combinators called fairness that identifies enumeration combinators that are better suited to property-based testing. Intuitively, the result of a fair combinator indexes into its argument enumerations equally when constructing its result. For example, extracting the nth element from our enumeration of three-tuples indexes about $\sqrt[3]{n}$ elements into each of its components instead of, say, indexing $\sqrt[2]{n}$ into one and $\sqrt[4]{n}$ into the other two, as you would if a three-tuple were built out of nested pairs. Similarly, extracting the nth element from our enumeration of a three-way union returns an element that is $\frac{n}{3}$ into one of the argument enumerators. The paper presents a semantics of enumeration combinators, a theory of fairness, proofs establishing fairness of our new combinators and that some combinations of fair combinators are not fair. We also report on an evaluation of fairness for the purpose of finding bugs in programming-language models. We show that fair enumeration combinators have complementary strengths to an existing, well-tuned ad hoc random generator (better on short time scales and worse on long time scales) and that using unfair combinators is worse across the board.

We argue that the CLASH model makes a number of questionable assumptions about the harshness and unpredictability of low-latitude environments, calling into question the life history strategy approach used, and that it is inconsistent with more nuanced global patterns of violence. We suggest an alternative account for less violence at high latitudes, based on a greater need for cooperation.

Dose-response experiments were conducted on a biotype of prickly lettuce collected from Whitman County, WA, to determine the level of resistance to 2,4-D. Initially, progeny of prickly lettuce that survived two applications of glyphosate and 2,4-D in mixture were collected to determine if antagonism of the 2,4-D or glyphosate was occurring. Prickly lettuce survival was determined to not be due to antagonism of 2,4-D or glyphosate when the two herbicides were applied in mixture. The doses required to reduce growth 50% (GR50 ) for resistant and susceptible field-collected prickly lettuce were 150 and 6 g ae/ha 2,4-D, respectively, indicating the resistant biotype was 25 times more resistant to 2,4-D than the susceptible biotype. The resistant biotype expressed injury but produced regrowth following application. A dose of 2,4-D at 220 g/ha was required to reduce regrowth frequency 50% (FR50 ) for resistant field-collected prickly lettuce. Regrowth was also observed with the susceptible biotype, although the FR50 was much lower (10 g/ha), resulting in an R/S ratio of 22 based on the respective FR50 values. A rate of 4,300 g/ha 2,4-D (10 times the maximum labeled rate in wheat) was required to reduce the regrowth frequency in the resistant biotype to zero.

Soilborne bacteria with novel metabolic abilities have been linked with enhanced atrazine degradation and complaints of reduced residual weed control in soils with an s-triazine use history. However, no field study has verified that enhanced degradation reduces atrazine's residual weed control. The objectives of this study were to (1) compare atrazine persistence and prickly sida density in s-triazine-adapted and nonadapted field sites at two planting dates; (2) utilize original and published data to construct a diagnostic test for identifying s-triazine-adapted soils; and (3) develop and validate an s-triazine persistence model based on data generated from the diagnostic test, i.e., mineralization of ring-labeled 14C-s-triazine. Atrazine half-life values in s-triazine-adapted soil were at least 1.4-fold lower than nonadapted soil and 5-fold lower than historic estimates (60 d). At both planting dates atrazine reduced prickly sida density in the nonadapted soils (P ≤ 0.0091). Conversely, in the s-triazine-adapted soil, prickly sida density was not different between no atrazine PRE and atrazine PRE at the March 15 planting date (P = 0.1397). A lack of significance in this contrast signifies that enhanced degradation can reduce atrazine's residual control of sensitive weed species. Analyses of published data indicate that cumulative mineralization in excess of 50% of C0 after 30 d of incubation is diagnostic for enhanced s-triazine degradation. An s-triazine persistence model was developed and validated; model predictions for atrazine persistence under field conditions were within the 95% confidence intervals of observed values. Results indicate that enhanced atrazine degradation can decrease the herbicide's persistence and residual activity; however, coupling the diagnostic test with the persistence model could enable weed scientists to identify s-triazine-adapted soils, predict herbicide persistence under field conditions, and implement alternative weed control strategies in affected areas if warranted.

Organic wheat and small grains are produced on relatively few acres in the inland Pacific Northwest. The objective of this study was to examine how the nitrogen (N) dynamics of cropping systems (CSs) produced during the transition phase impacted organic wheat yield and protein levels in the first 2 years of certified organic production. Certified organic spring wheat (SW) was produced in 2006 and winter wheat (WW) in 2007 following nine, 3-year transitional cereal, small grain and legume-intensive CSs. SW and WW following perennial alfalfa + oat/pea forage or 3 years of legume green manure tended to be more productive than wheat that followed systems that contained a small grain crop for at least 1 year during the transition. In addition to increasing soil N, well-established stands of forage and green manure provided adequate cover to reduce weed establishment prior to organic production. Effective weed control strategies were as important as increasing soil inorganic N levels for improving organic wheat production. Choice of crop type, cultivar and rotation is important in organic wheat systems and in this study, WW had better stand establishment, competition with weeds and higher overall yield than SW and would be a better-suited class of wheat for organic production in situations where spring weeds are the dominant problem. Regardless of CS or crop type, supplemental soil fertility (primarily N) during the organic production phase will be necessary to maintain high soil N levels and wheat yields in these dryland systems.