Tiafenacil is a new nonselective protoporphyrinogen IX oxidase (PPO)–inhibiting herbicide with both grass and broadleaf activity labeled for preplant application to corn, cotton, soybean, and wheat. Early-season corn emergence and growth often coincides in the mid-South with preplant herbicide application in cotton and soybean, thereby increasing opportunity for off-target herbicide movement from adjacent fields. Field studies were conducted in 2022 to identify the impacts of reduced rates of tiafenacil (12.5% to 0.4% of the lowest labeled application rate of 24.64 g ai ha–1) applied to two- or four-leaf corn. Corn injury 1 wk after treatment (WAT) for the two- and four-leaf growth stages ranged from 31% to 6% and 37% to 9%, respectively, whereas at 2 WAT these respective ranges were 21.7% to 4% and 22.5% to 7.2%. By 4 WAT, visible injury following the two- and four-leaf exposure timing was no greater than 8% in all instances except the highest tiafenacil rate applied at the four-leaf growth stage (13%). Tiafenacil had no negative season-long impact, as the early-season injury observed was not manifested in a reduction in corn height 2 WAT or yield. Application of tiafenacil directly adjacent to corn in early vegetative stages of growth should be avoided. In cases where off-target movement does occur, however, affected corn should be expected to fully recover with no impact on growth and yield, assuming adequate growing conditions and agronomic/pest management practices are provided.

Prenatal glucocorticoid exposure has been negatively associated with infant neurocognitive outcomes. However, questions about developmental timing effects across gestation remain. Participants were 253 mother-child dyads who participated in a prospective cohort study recruited in the first trimester of pregnancy. Diurnal cortisol was measured in maternal saliva samples collected across a single day within each trimester of pregnancy. Children (49.8% female) completed the Bayley Mental Development Scales, Third Edition at 6, 12, and 24 months and completed three observational executive function tasks at 24 months. Structural equation models adjusting for sociodemographic covariates were used to test study hypotheses. There was significant evidence for timing sensitivity. First-trimester diurnal cortisol (area under the curve) was negatively associated with cognitive and language development at 12 months and poorer inhibition at 24 months. Second-trimester cortisol exposure was negatively associated with language scores at 24 months. Third-trimester cortisol positively predicted performance in shifting between task rules (set shifting) at 24 months. Associations were not reliably moderated by child sex. Findings suggest that neurocognitive development is sensitive to prenatal glucocorticoid exposure as early as the first trimester and underscore the importance of assessing developmental timing in research on prenatal exposures for child health outcomes.

Information regarding the prevalence and distribution of herbicide-resistant waterhemp [Amaranthus tuberculatus (Moq.) Sauer] in Minnesota is limited. Whole-plant bioassays were conducted in the greenhouse on 90 A. tuberculatus populations collected from 47 counties in Minnesota. Eight postemergence herbicides, 2,4-D, atrazine, dicamba, fomesafen, glufosinate, glyphosate, imazamox, and mesotrione, were applied at 1× and 3× the labeled doses. Based on their responses, populations were classified into highly resistant (≥40 % survival at 3× the labeled dose), moderately resistant (<40% survival at 3× the labeled dose but ≥40% survival at 1× the labeled dose), less sensitive (10% to 39% survival at 1× the labeled dose), and susceptible (<10% survival at 1× the labeled dose) categories. All 90 populations were resistant to imazamox, while 89% were resistant to glyphosate. Atrazine, fomesafen, and mesotrione resistance was observed in 47%, 31%, and 22% of all populations, respectively. Ten percent of the populations were resistant to 2,4-D, and 2 of 90 populations exhibited >40% survival following dicamba application at the labeled dose. No population was confirmed to be resistant to glufosinate. However, 22% of all populations were classified as less sensitive to glufosinate. Eighty-two populations were found to be multiple-herbicide resistant. Among these, 15 populations exhibited resistance to four different herbicide sites of action (SOAs); 7 and 4 populations were resistant to five and six SOAs, respectively. All six-way-resistant populations were from southwest Minnesota. Two populations, one from Lincoln County and the other from Lyon County, were resistant to 2,4-D, atrazine, dicamba, fomesafen, glyphosate, imazamox, and mesotrione, leaving only glufosinate as a postemergence control option for these populations in corn (Zea mays L.) and soybean [Glycine max (L.) Merr.]. Diversified management tactics, including nonchemical control measures along with herbicide applications from effective SOAs, should be implemented to slow down the evolution and spread of herbicide-resistant A. tuberculatus populations.

Tiafenacil is a new non-selective protoporphyrinogen IX oxidase (PPO)-inhibiting herbicide with both grass and broadleaf activity labeled for preplant application to corn (Zea mays L.), cotton (Gossypium hirsutum L.), soybean [Glycine max (L.) Merr.], and wheat (Triticum aestivum L.). Early-season soybean emergence and growth often coincide in the U.S. Midsouth with preplant herbicide application in later-planted cotton and soybean, thereby increasing opportunity for off-target herbicide movement from adjacent fields. Field studies were conducted in 2022 to identify any deleterious impacts of reduced rates of tiafenacil (12.5% to 0.4% of the lowest labeled application rate of 24.64 g ai ha−1) applied to 1- to 2-leaf soybean. Visual injury at 1 wk after treatment (WAT) with 1/8×, 1/16×, 1/32×, and 1/64× rate of tiafenacil was 80%, 61%, 39%, and 21%, while at 4 WAT, these respective rates resulted in visual injury of 67%, 33%, 14%, and 4%. Tiafenacil at these respective rates reduced soybean height 55% to 2% and 53% to 5% at 1 and 4 WAT and soybean yield 53%, 24%, 5%, and 1%. Application of tiafenacil directly adjacent to soybean in early vegetative growth should be avoided, as severe visual injury will occur. In cases where off-target movement does occur, impacted soybean should not be expected to fully recover, and negative impact on growth and yield will be observed.

Early nutritional and growth experiences can impact development, metabolic function, and reproductive outcomes in adulthood, influencing health trajectories in the next generation. The insulin-like growth factor (IGF) axis regulates growth, metabolism, and energetic investment, but whether it plays a role in the pathway linking maternal experience with offspring prenatal development is unclear. To test this, we investigated patterns of maternal developmental weight gain (a proxy of early nutrition), young adult energy stores, age, and parity as predictors of biomarkers of the pregnancy IGF axis (n = 36) using data from the Cebu Longitudinal Health and Nutrition Survey in Metro Cebu, Philippines. We analyzed maternal conditional weight measures at 2, 8, and 22 years of age and leptin at age 22 (a marker of body fat/energy stores) in relation to free IGF-1 and IGFBP-3 in mid/late pregnancy (mean age = 27). Maternal IGF axis measures were also assessed as predictors of offspring fetal growth. Maternal age, parity, and age 22 leptin were associated with pregnancy free IGF-1, offspring birth weight, and offspring skinfold thickness. We find that free IGF-1 levels in pregnancy are more closely related to nutritional status in early adulthood than to preadult developmental nutrition and demonstrate significant effects of young adult leptin on offspring fetal fat mass deposition. We suggest that the previously documented finding that maternal developmental nutrition predicts offspring birth size likely operates through pathways other than the maternal IGF axis, which reflects more recent energy status.

Tiafenacil is a new nonselective protoporphyrinogen IX oxidase–inhibiting herbicide with both grass and broadleaf activity labeled for preplant application to corn, cotton, soybean, and wheat. Early season rice emergence and growth often coincide in the mid-southern United States with applications of preplant herbicides to cotton and soybean, thereby increasing the opportunity for off-target herbicide movement from adjacent fields. Field studies were conducted to identify any deleterious effects of reduced rates of tiafenacil (12.5% to 0.4% of the lowest labeled application rate of 24.64 g ai ha−1) applied to 1- or 3-leaf rice. Visual injury 1 wk after treatment (WAT) for the 1- and 3-leaf growth stages ranged from 50% to 7% and 20% to 2%, respectively, whereas at 2 WAT these respective ranges were 13% to 2%, and no injury was observed. Tiafenacil applied at those rates had no negative season-long effect because observed early season injury was not manifested as a reduction in rice height 2 WAT or rough rice yield. Application of tiafenacil to crops directly adjacent to rice in its early vegetative stages of growth should be avoided because visual injury will occur. When off-target movement does occur, however, the affected rice should be expected to fully recover with no effect on growth or yield, assuming adequate growing conditions and agronomic/pest management are provided.

Preemergence herbicides associated with cereal rye (Secale cereale L.) cover crop (hereafter “cereal rye”) can be an effective waterhemp [Amaranthus tuberculatus (Moq.) Sauer.] and Palmer amaranth (Amaranthus palmeri S. Watson) management strategy in soybean [Glycine max (L.) Merr.] production. Delaying cereal rye termination until soybean planting (planting green) optimizes biomass production and weed suppression but might further impact the fate of preemergence herbicides. Limited research is available on the fate of preemergence herbicides applied over living cereal rye in the planting green system. Field experiments were conducted in Illinois, Kansas, Pennsylvania, and Wisconsin to evaluate the fate of flumioxazin and pyroxasulfone and Amaranthus spp. residual control under different cover crop management practices in soybean in 2021 and 2022 (8 site-years). A flumioxazin + pyroxasulfone herbicide premix was applied preemergence at soybean planting under no-till without cereal rye, cereal rye early terminated before soybean planting, and cereal rye terminated at soybean planting. Flumioxazin and pyroxasulfone concentrations in the soil were quantified at 0, 7, and 21 d after treatment (DAT), and Amaranthus spp. density was determined at postemergence herbicide application. The presence of cereal rye biomass intercepted flumioxazin and pyroxasulfone at preemergence application and reduced concentration in the soil when compared with no-till, mainly at 0 DAT. Main differences in herbicide concentration were observed between no-till and cereal rye treatments rather than cereal rye termination times. Despite reducing herbicide concentration in the soil, the presence of the cereal rye biomass did not affect early-season residual Amaranthus spp. control. The adoption of effective preemergence herbicides associated with a properly managed cereal rye cover crop is an effective option for integrated Amaranthus spp. management programs in soybean production systems.

Background: Patients requiring mechanical circulatory support (MCS) during episodes of cardiogenic shock are at risk for hospital-acquired bloodstream infection (HABSI). Clinically MCS devices include extracorporeal membrane oxygenation (ECMO) devices, durable and temporary left ventricular-assist devices (VADs), and intra-aortic balloon pumps (IABPs). However, the MCS exclusion to the NHSN central-line–associated bloodstream infection (CLABSI) surveillance rules in 2018 did not include IABP as a qualifying device. We have described utilization and incidence of primary HABSI (pHABSI) in our patients requiring MCS. Methods: The setting for this study was 9 cardiothoracic and heart failure intensive care units with 131 total beds at the Cleveland Clinic Main Campus. Surveillance for HABSI to include determination of CLABSI was performed prospectively. MCS-associated pHABSI were patients who had ECMO, LVAD, or IABP present for >2 calendar days with device in place on the date of infection or removed the day before. A patient with 2 device types at time of infection was counted as a pHABSI for both groups. Patient, device, and MCS days were extracted from an electronic database. Non-MCS patient days were calculated as the difference between total patient days and total MCS days. The incidence of ECMO-, VAD-, and IABP-associated pHABSI were compared to each other and to non–MCS-associated pHABSI using OpenEpi version 3.01 software. Results: Surveillance results are shown in Table 1. During the observation period, there were 221 pHABSIs and 139,013 patient days. Moreover, 67 pHABSIs were associated with an MCS device over 17,044 total MCS days: 43 ECMO days, 18 VAD days, and 13 IABP days. Also, 9 patients had >1 type of eligible device and 7 (39%) of the IABP-associated pHABSIs were CLABSIs.

The cumulative incidences of pHABSI associated with ECMO, VAD, and IABP were 5.68, 4.59, and 2.34 per 1,000 MCS days, respectively. The incidence of IABP pHABSI was not significantly different from VAD pHABSI (P = .06), but it was different from ECMO pHABSI (P < .01). The pHABSI rate for non-MCS days was 1.26 per 1,000 patient days. Conclusions: In our patients requiring MCS, the risk of pHABSI associated with IABP was significantly greater than in patients without MCS and was similar to patients with VAD. MCS of all types should be considered a risk for HABSI in patients with cardiogenic shock beyond the presence of a central line. Protocols to further prevent HABSI morbidity in IABP patients are needed.

Disclosure: None

Background: A regional decolonization intervention (SHIELD-OC) involving universal chlorhexidine for routine bathing and 5 days of twice-daily nasal iodophor every other week in nursing homes (NHs) recently demonstrated marked reductions in multidrug-resistant organisms, all-cause hospitalizations, and infection-related hospitalizations in Orange County, California. Specific to methicillin-resistant Staphylococcus aureus (MRSA), NH prevalence (nares, skin, or perirectal) decreased from 43% to 29%. Methods: We conducted a retrospective cohort study evaluating the impact of decolonization on factors associated with MRSA carriage. The cohort included residents from 18 SHIELD-OC NHs who were sampled for MRSA using nares, axilla, groin, and perirectal cultures. A point-prevalence survey was conducted in 2016–2017 (before decolonization, 50 randomly sampled residents per NH) and in 2018–2019 (decolonization, all residents sampled). Resident characteristics were obtained from their most proximal admission, quarterly, and/or discharge assessment using data mandated for NH reporting (CMS minimum data set), and included demographics, medical devices, comorbidities (including Alzheimer’s disease and related dementias or ADRD), and mobility and hygiene needs. We used generalized-linear mixed models stratified by decolonization and clustered by NH to identify differences in factors associated with MRSA carriage. Results: Of the 2,351NH residents, 2,255 (96%) had characteristics available in the CMS data set. Of the 2,255 residents included, 774 (34%) were MRSA carriers. Before decolonization, medical devices (OR, 2.5), limited mobility (OR, 1.6), and diabetes (OR, 1.4) were significantly associated with MRSA carriage in an adjusted model (Table). During decolonization, these effects were mitigated (medical device OR, 2.5–1.1; diabetes OR, 1.4–0.9) and were no longer significantly associated with MRSA carriage. Male sex appeared to have more of an effect in the decolonization phase (OR, 1.3–1.6), but limited mobility remained stable (OR, 1.6–1.7). Several variables were collinear. Presence of a medical device was collinear with postacute stays (<100 days) and Medicaid insurance. Limited mobility was associated with limited ability for hygienic self-care. ADRD was collinear with age. Final adjusted models accounted for medical devices, limited mobility, diabetes, ADRD, cancer, sex, and ethnicity. Conclusions: In a large interventional cohort of 18 NHs, factors associated with MRSA carriage changed after adoption of universal decolonization. Specifically, the increased risk of MRSA associated with medical devices and diabetes were substantially mitigated by decolonization, suggesting that these risks are modifiable. These long-term care findings are consistent with clinical trials showing reductions in MRSA carriage after implementing chlorhexidine bathing in ICUs and in non-ICU patients with devices. The ability of decolonization to attenuate the risk of MRSA carriage among diabetics or other potential high-risk groups deserves further study.

Disclosures: None

Children with congenital heart disease (CHD) can face neurodevelopmental, psychological, and behavioural difficulties beginning in infancy and continuing through adulthood. Despite overall improvements in medical care and a growing focus on neurodevelopmental screening and evaluation in recent years, neurodevelopmental disabilities, delays, and deficits remain a concern. The Cardiac Neurodevelopmental Outcome Collaborative was founded in 2016 with the goal of improving neurodevelopmental outcomes for individuals with CHD and pediatric heart disease. This paper describes the establishment of a centralised clinical data registry to standardize data collection across member institutions of the Cardiac Neurodevelopmental Outcome Collaborative. The goal of this registry is to foster collaboration for large, multi-centre research and quality improvement initiatives that will benefit individuals and families with CHD and improve their quality of life. We describe the components of the registry, initial research projects proposed using data from the registry, and lessons learned in the development of the registry.

Infants and children born with CHD are at significant risk for neurodevelopmental delays and abnormalities. Individualised developmental care is widely recognised as best practice to support early neurodevelopment for medically fragile infants born premature or requiring surgical intervention after birth. However, wide variability in clinical practice is consistently demonstrated in units caring for infants with CHD. The Cardiac Newborn Neuroprotective Network, a Special Interest Group of the Cardiac Neurodevelopmental Outcome Collaborative, formed a working group of experts to create an evidence-based developmental care pathway to guide clinical practice in hospital settings caring for infants with CHD. The clinical pathway, “Developmental Care Pathway for Hospitalized Infants with Congenital Heart Disease,” includes recommendations for standardised developmental assessment, parent mental health screening, and the implementation of a daily developmental care bundle, which incorporates individualised assessments and interventions tailored to meet the needs of this unique infant population and their families. Hospitals caring for infants with CHD are encouraged to adopt this developmental care pathway and track metrics and outcomes using a quality improvement framework.

Joanna Leidenhag has written a ground-breaking book arguing that the concept of panpsychism can solve several problems facing present-day humans. It can motivate greater commitment to concern for earth's diverse environments and the life forms that inhabit them. And it can solve theological problems connected with human consciousness, notably, how consciousness and matter coexist and interact. This article summarizes and comments on Leidenhag's arguments, then suggests several paths forward for those inspired by Leidenhag's ideas and arguments who wish to explore them and related notions in greater depth.