Potato production typically entails both greater soil disturbance and higher profits than alternative crops in the regions in which they are grown. This article provides an analysis of economically relevant outcomes from soil health practice trials conducted in potato production systems in four locations across the continental United States from 2019 to 2022. We compare revenue and profit estimates over several soil health-related practices: rotation duration, chemical fumigation, mustard biofumigation, and application of organic amendments. We find that longer rotations are positively correlated with revenues and profits. This finding is robust across a range of tests and several regression specifications, although we do observe some variation across locations. While in our data, 3-year rotations consistently produced better economic outcomes than 2-year rotations, over time periods longer than the 4 years in this study, at least some of the gains associated with longer rotations will be offset by the implied decreased frequency of potato years. We did not find consistent evidence of differences in revenue or profits corresponding to chemical fumigation, mustard biofumigation, or the application of organic amendments.

Partial remission after major depressive disorder (MDD) is common and a robust predictor of relapse. However, it remains unclear to which extent preventive psychological interventions reduce depressive symptomatology and relapse risk after partial remission. We aimed to identify variables predicting relapse and to determine whether, and for whom, psychological interventions are effective in preventing relapse, reducing (residual) depressive symptoms, and increasing quality of life among individuals in partial remission. This preregistered (CRD42023463468) systematic review and individual participant data meta-analysis (IPD-MA) pooled data from 16 randomized controlled trials (n = 705 partial remitters) comparing psychological interventions to control conditions, using 1- and 2-stage IPD-MA. Among partial remitters, baseline clinician-rated depressive symptoms (p = .005) and prior episodes (p = .012) predicted relapse. Psychological interventions were associated with reduced relapse risk over 12 months (hazard ratio [HR] = 0.60, 95% confidence interval [CI] 0.43–0.84), and significantly lowered posttreatment depressive symptoms (Hedges’ g = 0.29, 95% CI 0.04–0.54), with sustained effects at 60 weeks (Hedges’ g = 0.33, 95% CI 0.06–0.59), compared to nonpsychological interventions. However, interventions did not significantly improve quality of life at 60 weeks (Hedges’ g = 0.26, 95% CI -0.06 to 0.58). No moderators of relapse prevention efficacy were found. Men, older individuals, and those with higher baseline symptom severity experienced greater reductions in symptomatology at 60 weeks. Psychological interventions for individuals with partially remitted depression reduce relapse risk and residual symptomatology, with efficacy generalizing across patient characteristics and treatment types. This suggests that psychological interventions are a recommended treatment option for this patient population.

Cardiovascular diseases account for 31% of all global deaths, the majority (80%) of which are associated with hypertension.(1,2) As of 2019, hypertension is expected to affect 1 in 3 adults living in West Africa, with prevalence standing at 36.1% In Nigeria.(3,4) Poor dietary habits, including high intakes of salt, processed meat, ultra-processed foods, and unhealthy fats and oils and low intakes of vegetables, fruits, fibre, and nutrients such as potassium and omega-3 fatty acids, account for 9–17% of cases of hypertension globally, and our recent meta-analysis confirms their contribution in Nigeria and other West African countries.(1,5,6) This study aimed to develop and deliver a culturally-appropriate diet risk score for clinical practice that can (i) rapidly and accurately identify and stratify individuals at risk of hypertension and (ii) support clinicians and other healthcare professionals to provide tailored and effective personalised dietary advice.

We used a culturally-appropriate Nigerian Dietary Screening Tool (that we recently designed and validated(7,8)) to assess the dietary intake among 151 patients in a Nigerian hospital and used methods similar to Framingham and INTERHEART to: (i) construct and validate a Nigerian Dietary Risk Score (NiDRS) for hypertension, and (ii) evaluate the NiDRS against a panel of clinical biomarkers of hypertension, using multiple logistic regression models, internal validation using measures of discrimination and calibration, decision analysis curve and mediation analysis to facilitate its use in clinical practice.

Each incremental increase in the overall NiDRS was associated with a 2-fold increase in odds of overall hypertension (OR: 2.04, 95%CI: 1.16, 1.16, p = 0.01), with the highest score category associated with >18-food increased odds of hypertension, compared to lowest NiDRS (OR: 18.27, 95%CI: 1.33, 251.21, p = 0.03). The NiDRS demonstrated good discrimination with an AUC of 0.92%, high sensitivity (0.85), specificity (0.94), calibration (with a Brier score of 0.1) and a positive net benefit. In addition, via mediation analysis, total cholesterol (50%), triglycerides (47%), LDL-c (49%), VLDL-c (17%), CRP (68%), and homocysteine (71%) were mediators of the NiDRS-hypertension pathway in a positive direction.

The NiDRS is an accurate and valuable tool for clinicians to identify and stratify individuals at risk of hypertension and discuss dietary prevention strategies to address the rising prevention of hypertension and its associated cardiovascular complications in Nigeria.

Field studies were conducted to assess the efficacy of physical weed management of Palmer amaranth management in cucumber, peanut, and sweetpotato. Treatments were arranged in a 3 × 4 factorial in which the first factor included a treatment method of electrical, mechanical, or hand-roguing Palmer amaranth control and the second factor consisted of treatments applied when Palmer amaranth was approximately 0.3, 0.6, 0.9, or 1.2 m above the crop canopy. Four wk after treatment (WAT), the electrical applications controlled Palmer amaranth at least 27 percentage points more than the mechanical applications when applied at the 0.3- and 0.6-m timings. At the 0.9- and 1.2-m application timings 4 WAT, electrical and mechanical applications controlled Palmer amaranth by at most 87%. Though hand removal generally resulted in the greatest peanut pod count and total sweetpotato yield, mechanical and electrical control resulted in similar yield to the hand-rogued plots, depending on the treatment timing. With additional research to provide insight into the optimal applications, there is potential for electrical control and mechanical control to be used as alternatives to hand removal. Additional studies were conducted to determine the effects of electrical treatments on Palmer amaranth seed production and viability. Treatments consisted of electricity applied to Palmer amaranth at first visible inflorescence, 2 wk after first visible inflorescence (WAI) or 4 WAI. Treatments at varying reproductive maturities did not reduce the seed production immediately after treatment. However, after treatment, plants primarily died and ceased maturation, reducing seed production assessed at 4 WAI by 93% and 70% when treated at 0 and 2 WAI, respectively. Treatments did not have a negative effect on germination or seedling length.

Background: Candida auris is an emerging multidrug-resistant yeast that is transmitted in healthcare facilities and is associated with substantial morbidity and mortality. Environmental contamination is suspected to play an important role in transmission but additional information is needed to inform environmental cleaning recommendations to prevent spread. Methods: We conducted a multiregional (Chicago, IL; Irvine, CA) prospective study of environmental contamination associated with C. auris colonization of patients and residents of 4 long-term care facilities and 1 acute-care hospital. Participants were identified by screening or clinical cultures. Samples were collected from participants’ body sites (eg, nares, axillae, inguinal creases, palms and fingertips, and perianal skin) and their environment before room cleaning. Daily room cleaning and disinfection by facility environmental service workers was followed by targeted cleaning of high-touch surfaces by research staff using hydrogen peroxide wipes (see EPA-approved product for C. auris, List P). Samples were collected immediately after cleaning from high-touch surfaces and repeated at 4-hour intervals up to 12 hours. A pilot phase (n = 12 patients) was conducted to identify the value of testing specific high-touch surfaces to assess environmental contamination. High-yield surfaces were included in the full evaluation phase (n = 20 patients) (Fig. 1). Samples were submitted for semiquantitative culture of C. auris and other multidrug-resistant organisms (MDROs) including methicillin-resistant Staphylococcus aureus (MRSA), vancomycin-resistant Enterococcus (VRE), extended-spectrum β-lactamase–producing Enterobacterales (ESBLs), and carbapenem-resistant Enterobacterales (CRE). Times to room surface contamination with C. auris and other MDROs after effective cleaning were analyzed. Results: Candida auris colonization was most frequently detected in the nares (72%) and palms and fingertips (72%). Cocolonization of body sites with other MDROs was common (Fig. 2). Surfaces located close to the patient were commonly recontaminated with C. auris by 4 hours after cleaning, including the overbed table (24%), bed handrail (24%), and TV remote or call button (19%). Environmental cocontamination was more common with resistant gram-positive organisms (MRSA and, VRE) than resistant gram-negative organisms (Fig. 3). C. auris was rarely detected on surfaces located outside a patient’s room (1 of 120 swabs; <1%). Conclusions: Environmental surfaces near C. auris–colonized patients were rapidly recontaminated after cleaning and disinfection. Cocolonization of skin and environment with other MDROs was common, with resistant gram-positive organisms predominating over gram-negative organisms on environmental surfaces. Limitations include lack of organism sequencing or typing to confirm environmental contamination was from the room resident. Rapid recontamination of environmental surfaces after manual cleaning and disinfection suggests that alternate mitigation strategies should be evaluated.

Funding: None

Disclosures: None

Background: Contact tracing alone is often inadequate to determine the source of healthcare personnel (HCP) COVID-19 when SARS-CoV-2 is widespread in the community. We combined whole-genome sequencing (WGS) with traditional epidemiologic analysis to investigate the frequency with which patients or other HCP with symptomatic COVID-19 acted as the source of HCP infection at a large tertiary-care center early in the pandemic. Methods: Cohort samples were selected from patients and HCP with PCR-positive SARS-CoV-2 infection from a period with complete retention of samples (March 14, 2021–April 10, 2020) at Rush University Medical Center, a 664-bed hospital in Chicago, Illinois. During this period, testing was limited to symptomatic patients and HCP. Recommended respiratory equipment for HCP evolved under guidance, including a 19-day period when medical face masks were recommended for COVID-19 care except for aerosol-generating procedures. Viral RNA was extracted and sequenced (NovaSeq, Illumina) from remnant nasopharyngeal swab samples in M4RT viral transport medium. Genomes with >90% coverage underwent cluster detection using a 2 single-nucleotide variant genetic distance cutoff. Genomic clusters were independently evaluated for valid epidemiologic links by 2 infectious diseases physicians (with a third adjudicator) using metadata extracted from the electronic medical record and according to predetermined criteria (Table 1). Results: In total, 1,031 SARS-CoV-2 sequences were analyzed, identifying 49 genomic clusters with HCP (median, 8; range, 2–43 members per cluster; total, 268 patients and 115 HCP) (Fig. 1). Also, 20,190 flowsheet activities were documented for cohort HCP and patient interactions, including 686 instances in which a cohort HCP contributed to a cohort patient’s chart. Most HCP infections were considered not healthcare associated (88 of 115, 76.5%). We did not identify any strong linkages for patient-to-HCP transmission. Moreover, 13 HCP cases (11.3%) were attributed to patient source (weak linkage). Also, 14 HCP cases (12.2%) were attributed to HCP source (11 strong and 3 weak linkages). Weak linkages were due to lack of epidemiologic data for HCP location, particularly nonclinical staff (eg, an environmental service worker who lacked location documentation to rule out patient-specific contact). Agreement for epidemiologic linkage between the 2 evaluators was high (κ, 0.91). Conclusions: Using genomic and epidemiologic data, we found that most HCP COVID-19 infections were not healthcare associated. We found weak evidence to support symptomatic patient-to-HCP transmission of SARS-CoV-2 and stronger evidence for HCP-to-HCP transmission. Large genomic clusters without plausible epidemiologic links were identified, reflecting the limited utility of genomic surveillance alone to characterize chains of transmission of SARS-CoV-2 during extensive community spread.

Funding: None

Disclosures: None

The exotic internal structure of polar topologies in multiferroic materials offers a rich landscape for materials science research. As the spatial scale of these entities is often subatomic in nature, aberration-corrected transmission electron microscopy (TEM) is the ideal characterization technique. Software to quantify and visualize the slight shifts in atomic placement within unit cells is of paramount importance due to the now routine acquisition of images at such resolution. In the previous ~decade since the commercialization of aberration-corrected TEM, many research groups have written their own code to visualize these polar entities. More recently, open-access Python packages have been developed for the purpose of TEM atomic position quantification. Building on these packages, we introduce the TEMUL Toolkit: a Python package for analysis and visualization of atomic resolution images. Here, we focus specifically on the TopoTEM module of the toolkit where we show an easy to follow, streamlined version of calculating the atomic displacements relative to the surrounding lattice and thus plotting polarization. We hope this toolkit will benefit the rapidly expanding field of topology-based nano-electronic and quantum materials research, and we invite the electron microscopy community to contribute to this open-access project.

Health disparities between Appalachia and the rest of the country are widening. To address this, the Appalachian Translational Research Network (ATRN) organizes an annual ATRN Health Summit. The most recent Summit was held online September 22–23, 2020, and hosted by Wake Forest Clinical and Translational Science Institute in partnership with the Northwest Area Health Education Center. The Summit, titled “Community-Engaged Research in Translational Science: Innovations to Improve Health in Appalachia,” brought together a diverse group of 141 stakeholders from communities, academic institutions, and the National Center for Advancing Translational Science (NCATS) to highlight current research, identify innovative approaches to translational science and community-engaged research, develop cross-regional research partnerships, and establish and disseminate priorities for future Appalachian-focused research. The Summit included three plenary presentations and 39 presentations within 12 concurrent breakout sessions. Here, we describe the Summit planning process and implementation, highlight some of the research presented, and outline nine emergent themes to guide future Appalachian-focused research.

Laboratory and greenhouse studies were conducted to evaluate the effects of chemical treatments applied to Palmer amaranth seeds or gynoecious plants that retain seeds to determine seed germination and quality. Treatments applied to physiologically mature Palmer amaranth seed included acifluorfen, dicamba, ethephon, flumioxazin, fomesafen, halosulfuron, linuron, metribuzin, oryzalin, pendimethalin, pyroxasulfone, S-metolachlor, saflufenacil, trifluralin, and 2,4-D plus crop oil concentrate applied at 1× and 2× the suggested use rates from the manufacturer. Germination was reduced by 20% when 2,4-D was used, 15% when dicamba was used, and 13% when halosulfuron and pyroxasulfone were used. Use of dicamba, ethephon, halosulfuron, oryzalin, trifluralin, and 2,4-D resulted in decreased seedling length by an average of at least 50%. Due to the observed effect of dicamba, ethephon, halosulfuron, oryzalin, trifluralin, and 2,4-D, these treatments were applied to gynoecious Palmer amaranth inflorescence at the 2× registered application rates to evaluate their effects on progeny seed. Dicamba use resulted in a 24% decrease in seed germination, whereas all other treatment results were similar to those of the control. Crush tests showed that seed viability was greater than 95%, thus dicamba did not have a strong effect on seed viability. No treatments applied to Palmer amaranth inflorescence affected average seedling length; therefore, chemical treatments did not affect the quality of seeds that germinated.

Background: Identification of hospitalized patients with enteric multidrug-resistant organism (MDRO) carriage, combined with implementation of targeted infection control interventions, may help reduce MDRO transmission. However, the optimal surveillance approach has not been defined. We sought to determine whether daily serial rectal surveillance for MDROs detects more incident cases (acquisition) of MDRO colonization in medical intensive care unit (MICU) patients than admission and discharge surveillance alone. Methods: Prospective longitudinal observational single-center study from January 11, 2017, to January 11, 2018. Inclusion criteria were ≥3 consecutive MICU days and ≥2 rectal or stool swabs per MICU admission. Daily rectal or stool swabs were collected from patients and cultured for MDROs, including vancomycin-resistant Enterococcus (VRE), carbapenem-resistant Enterobacterales (CRE), third-generation cephalosporin-resistant Enterobacterales (3GCR), and extended-spectrum β-lactamase–producing Enterobacterales (ESBL-E) (as a subset of 3GCR). MDRO detection at any time during the MICU stay was used to calculate prevalent colonization. Incident colonization (acquisition) was defined as new detection of an MDRO after at least 1 prior negative swab. We then determined the proportion of prevalent and incident cases detected by daily testing that were also detected when only first swabs (admission) and last swabs (discharge) were tested. Data were analyzed using SAS version 9.4 software. Results: In total, 939 MICU stays of 842 patients were analyzed. Patient characteristics were median age 64 years (interquartile range [IQR], 51–74), median MICU length of stay 5 days (IQR, 3–8), median number of samples per admission 3 (IQR, 2–5), and median Charlson index 4 (IQR, 2–7). Prevalent colonization with any MDRO was detected by daily swabbing in 401 stays (42.7%). Compared to daily serial swabbing, an admission- and discharge-only approach detected ≥86% of MDRO cases (ie, overall prevalent MDRO colonization). Detection of incident MDRO colonization by an admission- or discharge-only approach would have detected fewer cases than daily swabbing (Figure 1); ≥34% of total MDRO acquisitions would have been missed. Conclusions: Testing patients upon admission and discharge to an MICU may fail to detect MDRO acquisition in more than one-third of patients, thereby reducing the effectiveness of MDRO control programs that are targeted against known MDRO carriers. The poor performance of a single discharge swab may be due to intermittent or low-level MDRO shedding, inadequate sampling, or transient MDRO colonization. Additional research is needed to determine the optimal surveillance approach of enteric MDRO carriage.

Funding: No

Disclosures: None

Figure 1.

Field studies were conducted to evaluate linuron for POST control of Palmer amaranth in sweetpotato to minimize reliance on protoporphyrinogen oxidase (PPO)-inhibiting herbicides. Treatments were arranged in a two by four factorial in which the first factor consisted of two rates of linuron (420 and 700 g ai ha−1), and the second factor consisted of linuron applied alone or in combinations of linuron plus a nonionic surfactant (NIS; 0.5% vol/vol), linuron plus S-metolachlor (800 g ai ha−1), or linuron plus NIS plus S-metolachlor. In addition, S-metolachlor alone and nontreated weedy and weed-free checks were included for comparison. Treatments were applied to ‘Covington’ sweetpotato 8 d after transplanting (DAP). S-metolachlor alone provided poor Palmer amaranth control because emergence had occurred at applications. All treatments that included linuron resulted in at least 98% and 91% Palmer amaranth control 1 and 2 wk after treatment (WAT), respectively. Including NIS with linuron did not increase Palmer amaranth control compared to linuron alone, but it resulted in greater sweetpotato injury and subsequently decreased total sweetpotato yield by 25%. Including S-metolachlor with linuron resulted in the greatest Palmer amaranth control 4 WAT, but increased crop foliar injury to 36% 1 WAT compared to 17% foliar injury from linuron alone. Marketable and total sweetpotato yields were similar between linuron alone and linuron plus S-metolachlor or S-metolachlor plus NIS treatments, though all treatments resulted in at least 39% less total yield than the weed-free check resulting from herbicide injury and/or Palmer amaranth competition. Because of the excellent POST Palmer amaranth control from linuron 1 WAT, a system that includes linuron applied 7 DAP followed by S-metolachlor applied 14 DAP could help to extend residual Palmer amaranth control further into the critical period of weed control while minimizing sweetpotato injury.