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Introduction: Mass shootings pose a considerable threat to public safety. This study aims to (1) assess US mass shootings, firearm-related sales, laws, and regional differences from 2015-2021 and (2) investigate changes in mass shootings and firearm sales before and during the Coronavirus Disease 2019 (COVID-19) pandemic. Method(s): A retrospective review of mass shootings, gun sales, and laws regarding the minimum age required to purchase a firearm within the US from 2015-2021. The 10 states/regions with the greatest mean mass shootings/capita from 2015-2021 were selected for further analysis. Result(s): Mass shootings correlated significantly with firearm sales from 2015-2021 nationwide (p< 0.02 for all). The growth in mass shootings, the number killed/injured, and gun sales were greater in 2020 and 2021 compared withthe years prior. The 10 states with the highest mean mass shooting/capita over the study period were Alabama, Arkansas, the District of Columbia, Illinois, Louisiana, Maryland, Mississippi, Missouri, South Carolina, and Tennessee. No significant correlation was found between the number of mass shootings/capita and the minimum age to purchase a firearm. Conclusion(s): Firearm sales correlated significantly with mass shootings from 2015-2021. Mass shootings and gun sales increased at greater rates during the COVID-19 pandemic compared withthe years before the pandemic. Mass shootings exhibited inconsistent trends with state gun laws regarding the minimum age to purchase a firearm. Future studies may consider investigating the methods by which firearms used in mass shootings are obtained to further identify targets for prevention.
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Structured vulnerabilities that threaten the health of meat- and poultry-packing workers are driven by a complex and complicated host of economic, occupational, social, and health care access-related factors. Recognition of these complexities is a first step. More challenging, yet critical to sustaining a commitment to social justice for these frontline workers, are public health practice initiatives rooted in health equity that work toward eliminating health disparities.In this issue of AJPH, Porter et al. (p. 500) describe implementation of a public health practice initiative aimed at reducing COVID-19 vaccine hesitancy and increasing vaccine uptake among poultry industry workers. This editorial seeks to contextualize this initiative as one investment in a larger constellation of investments that are needed to provide resources and services equally to all members of our society.
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The COVID-19 pandemic has posed numerous challenges to human society. Previous studies explored multiple factors in virus transmission. Yet, their impacts on COVID-19 are not universal and vary across geographical regions. In this study, we thoroughly quantified the spatiotemporal associations of 49 health, socioeconomic, demographic, and environmental factors with COVID-19 at the county level in Arkansas, US. To identify the associations, we applied the ordinary least squares (OLS) linear regression, spatial lag model (SLM), spatial error model (SEM), and multiscale geographically weighted regression (MGWR) model. To reveal how such associations change across different COVID-19 times, we conducted the analyses for each season (i.e., spring, summer, fall, and winter) from 2020 to 2021. We demonstrate that there are different driving factors along with different COVID-19 variants, and their magnitudes change spatiotemporally. However, our results identify that adult obesity has a positive association with the COVID-19 incidence rate over entire Arkansas, thus confirming that people with obesity are vulnerable to COVID-19. Humidity consistently negatively affects COVID-19 across all seasons, denoting that increasing humidity could reduce the risk of COVID-19 infection. In addition, diabetes shows roles in the spread of both early COVID-19 variants and Delta, while humidity plays roles in the spread of Delta and Omicron. Our study highlights the complexity of how multifactor affect COVID-19 in different seasons and counties in Arkansas. These findings are useful for informing local health planning (e.g., vaccine rollout, mask regulation, and testing/tracing) for the residents in Arkansas.
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The COVID-19 pandemic has led to many disruptions and challenges in local and national food systems in America. Many farms and market gardens were forced to innovate quickly and take action to survive ongoing disruption as these businesses struggled with finances and distribution of products among other challenges. Many small-scale, local farming operations in particular were able to respond to these disruptions in unique ways, which may offer useful insight into how to better prepare small farming communities for public health and other kinds of disasters in the future. This pilot study aims to better understand how COVID-19 affected the local food system in the region of Northwest Arkansas in the mid-southern United States and how small-scale, direct-sales farmers responded to the pandemic, through a survey and interview about their experiences from 2019 to 2021. Participating farmers reported changes in farming procedures and challenges in owning or working on their farms due to ongoing climate-related environmental issues or issues specific to the pandemic, such as distributing products, utilizing financial and other resources of support, and partnering with local supply-chain partners and community members to ensure local businesses' survival during COVID-19. This pilot study can provide insight into how local farming operations and their regional and smaller-scale supply chain partners have built and utilized community resilience strategies to survive COVID-19 challenges in the Northwest region of Arkansas. A statewide follow-up study will be conducted to observe how these producers navigated these challenges on a larger scale, including in different regions of Arkansas following the start of the pandemic.
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During the COVID-19 pandemic, recreation sites around the country experienced a rise in visitation numbers as residents looked for alternatives to staying home. The researchers hypothesized that the social and cultural changes associated with the pandemic have increased the level of visitor place attachment towards these sites. This research works to identify the level of connection guests have towards Arkansas State Parks (ASP) during COVID-19. Results from this study have shown that attachment towards ASP has grown throughout the pandemic and has increased the likelihood that these visitors will return to the site in the future. © 2023 World Leisure Organization.
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The Soybean Science Challenge (SSC) continues to support Arkansas STEM (science, technology, engineering, and mathematics) educational goals. It aligns with the Next Generation Science Standards (NGSS). Junior high and high-school students are engaged in active learning and the co-creation of knowledge through the support of classroom-based lessons and applied student research. The SSC educates and engages junior high and high school science students and teachers in 'real-world' Arkansas-specific soybean science education through an original NGSS-aligned curriculum in 7E and GRC-3D format and a continuum of educational methods, which include: teacher workshops, online and virtual live stream education, virtual NGSS aligned mini-lessons for the science classroom, community gardens, personal mentoring, student-led research and corresponding award recognition, and partnerships with state and national educators, agencies and the popular media. The COVID19 global pandemic continued to alter the educational landscape in 2021, despite increased in-person instruction. The Soybean Science Challenge (SSC), by nature of its existing design and methodology, launched online Next Generation Science Standards (NGSS) aligned Gathering Reasoning and Communicating (GRC)-3D and 7E lesson plans for teachers. An online course was added, including NGSS-aligned mini-lesson videos for the science classroom, and additional virtual field trips were added to the list on the Soybean Science Challenge website. The Challenge also sponsored the Arkansas Science Teacher Association Conference in October 2021, and the SSC Coordinator Diedre Young conducted a workshop on bringing agriculturally based lessons into the science classroom. The Soybean Science Challenge was also active in science fairs across the state, judging participants at both the regional and state levels. The SSC is in its second year of the junior level award at regional science fairs. Through the SSC, teachers now have access to a plethora of educational instructions that bring real-world agricultural critical thinking into the classroom and students' homes. The SSC has learned that not only do Arkansas teachers and students benefit from these additional resources but teachers and students from other states benefit as well. In 2021, the SSC program reached over 3,000 students and teachers through in-person, digital, virtual, and print methods.
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Rationale: To reduce transmission of SARS-CoV-2, non-pharmaceutical interventions (NPIs), including school closures, hand hygiene, mask mandates, and social distancing, were enforced in Arkansas from 3/2020-2/2021. We hypothesized that the presence of NPIs would correlate with a decrease in asthma exacerbations and viral infections. Methods: Demographic information was collected on subjects with asthma exacerbations or viral infections from 3/2018-5/2022, including age, race, ethnicity, and sex. To evaluate the effects of NPIs, three periods were considered: pre- (03/2018-02/2020), during (03/2020-02/2021), and post- (03/2021-05/2022) NPIs. ANOVA analysis and generalized linear models were performed to determine statistical significance. The stringency of NPIs was evaluated using publicly available data (Oxford Covid-19 Government Response Tracker), which allows for direct comparison of Arkansas NPI status to exacerbation data during the same time periods. Results: 5055 asthma exacerbations (3322 unique subjects) occurred between 3/2018-5/2022. Asthma exacerbations decreased from 3/2020-3/2021 and returned to pre-pandemic numbers by summer 2021 (p<0.0001). Similar downward trends occurred for respiratory syncytial virus (RSV) with out-of-season return in summer 2021 (p<0.0001). Rhinovirus was present throughout NPIs. The mean age of exacerbations decreased by 0.9 years when comparing the during NPIs and after NPIs periods (p = 0.0002). An increase in the proportion of exacerbations was noted for non-black and other/unknown ethnicity subjects during and after NPIs. Conclusions: Fewer asthma exacerbations occurred during the most significant NPI employment period (03/2020-02/2021), and an increase in exacerbations was seen as mitigation strategies were relaxed, which correlated with timing of increasing RSV infections.
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Purpose of Study: Racism, the social system in which certain groups of people are afforded opportunity while others are limited, based on race, is a social determinant of health (SDOH) that contributes greatly to health inequity. An interactive Community Health Needs Bus Tour at Arkansas Children's Hospital served to: (1) increase intern knowledge of SDOH and racially-driven health inequity, while providing context to the patients and community we serve;and (2) connect residents to the organizations working to overcome these disparities. Methods Used: Key SDOH were identified including food and housing insecurity, education, literacy, community and personal violence, and racism. Community organizations and landmarks were identified as "tour stops" to illustrate each SDOH and its impact. Each stop connected residents to a place where they would soon be referring patients with such needs in the future. A detailed script was developed. At each tour stop residents were given demographic data that highlighted the impact of health inequity. They also learned the positive impact of the organization. At "Hop On" tour stops, speakers from the individual organizations were invited on board the bus to share the specific impact of their work. The tour was also designed with two "Hop Off" stops, chosen to illustrate how Little Rock's unique history and racial division created much of the health inequity of today. At the Mosaic Templars Cultural Center, residents toured exhibits to learn and celebrate African American history and culture. At the Central High School Visitor Center, residents studied the history of the "Little Rock 9." These stops highlighted the impact of public policy and racism and sought to expand residents' cultural competency. The tour took place during Intern Orientation in June 2019 and 2022, with a gap due to COVID. Summary of Results: All participants were surveyed anonymously at the conclusion of the bus tour. 96% felt that the experience met its core objectives. 100% of all participants agreed or strongly agreed that they can apply what they learned on the Bus Tour to their work as a resident. Further, 100% of all participants agreed or strongly agreed that they had identified an organization or person they can collaborate with in the future. One resident reported the tour led to "better understanding the history and current socioeconomic context that may color interactions with future patients." Another resident reflected the experience was a "great reminder to keep in mind that regardless of patients' background, they all deserve the same standard of care." Conclusion(s): This type of interactive, community-based programming is effective in teaching SDOH, raciallydriven health inequity, and connecting residents to the patients and communities they serve. Further study could identify if these experiences specifically impact residents' perception on racism, health inequity, and bias. Copyright © 2023 Southern Society for Clinical Investigation.
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The COVID-19 pandemic rapidly changed the context of higher education during the Spring 2020 semester. As the virus began to spread across the United States, colleges and universities canceled inperson classes and activities, closed campus, and moved all operations online. Within the communication discipline, introductory communication course (ICC) administrators and instructors were not only dealing with these challenges, but they were also navigating the transition of large multi-section, often standardized, courses online at large institutions. This research project used semistructured, in-depth interviews with 18 ICC administrators from institutions located in 14 states across the Midwest, mid-Atlantic, Southeastern, and West Coast regions of the U.S. to explore how they engaged in relationship management with their instructors and how their approach to relationship management informed their transition to remote learning due to COVID-19. The analysis results in four emerging themes: (1) rhetorical approaches to relationship management, (2) relational approaches to relationship management, (3) relationship management [right arrow] positive outcomes, and (4) relationship management as central to navigating COVID-19. Based on these findings we suggest a rhetorical/relational goals approach to course administration and offer practical implications ICC administrators can implement to engage in successful relationship management during times of crisis.
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Background. Outpatient antibiotic (OP Abx) prescribing in adults in Arkansas (AR) was among the country's highest in 2019. AR Medicaid analyzed prescription (Rx) claims data and communicated the relative prescribing intensity as an informational metric to each patient-centered medical home (PCMH) beginning in 2020. We describe the Abx prescribing patterns in calendar years 2019 and 2020, during the COVID-19 pandemic. Methods. Data from AR Medicaid paid claims for OP Abx Rxs in adult patients attributed to a PCMH practice for > 6 months were analyzed. Annual Abx Rx claims per 1000 patients were calculated for rural or urban status and by 2019 prescribing rate histories, defined as the low-,middle-, and high-rate prescribers based on 1st, 2nd - 3rd, & 4th quartiles, respectively. The five most common classes in 2019 and fluoroquinolones were explored.A paired t-test, Wilcoxon signed rank test, and one-wayANOVA with post hoc least significant difference test were used to determine statistical significance. Results. 183 PCMHs qualified for analysis. There was a significant decrease in overall annual Abx claim rate, from 1034 to 910 (-12.0%, p< 0.0001). Claim rates decreased in rural (-10.9%, p< 0.0001) and urban areas (-13.3%, p< 0.0001) with no difference between groups (p=0.240). Low-rate prescribers did not change practice from 2019 to 2020, with claim rates of 666 to 665 (-0.2%, p=0.957), while middle- and highrate prescribers decreased, from 1032 to 897 (-13.1%, p< 0.0001), and from 1404 to 1183 (-15.7%, p< 0.0001), respectively. Claim rates significantly decreased for penicillins (-16.0%, p< 0.0001), fluoroquinolones (-15.5%, p< 0.0001), sulfonamides (-13.1%, p< 0.0001), macrolides (-9.9%, p=0.0001), and tetracyclines (-6.3%, p=0.021). First-generation cephalosporins down trended (-7.9%, p=0.111). Conclusion. OP Abx Rx claims significantly decreased from 2019 to 2020 in middle and high-rate prescribers. Low-rate prescribers maintained low Abx Rx claim rates throughout 2020. Future analyses are needed to highlight any rebound effect of Abx prescribing when the pandemic subsides, discerning the informational metric effect versus COVID-19, and informing the next steps for antimicrobial stewardship for PCMHs in AR.
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Background: This study aimed to assess the impact of the recently (02/2020) implemented Acuity Circles (AC) liver allograft allocation policy on MELD at transplant and Donation after Circulatory Death (DCD) rates. Methods: Study period: 01/2016- 08/2021. Data retrieved from SRTR database. Inclusion criteria: All DCD liver transplants (LT). The cohort was dichotomized into a pre- and post-AC era. DCD rate (defined as DCD/ 50k population/year) was calculated for each State. The change (Δ) on the DCD rate (ΔDCD) and the MELD (ΔMELD) between the two periods was also calculated. Results: 1. Total LT increased in the post-AC era (26%/50k vs. 15%/50k, p=0.0567). 2. DCD LT increased in the post-AC era (15%/50k vs.10%/50k, p=0.0885). 3. MELD increased in the post-AC era in nearly all States (ΔMELD, fig.1, 2 & 3). 4. Uneven distribution of pre- & post-AC DCD activity, with a few States driving DCD LT in the US (fig.4 & 5). 5. Arizona and Louisiana had the highest pre-AC DCD rates (58%/50k & 31%/50k, respectively;fig.3). 6. The top post-AC DCD rate was reached in Arizona (78%/50k, fig.5). 7. Top post-AC ΔDCD was noted in Arkansas & Arizona (fig.6). 8. The highest ΔMELD was noted in low DCD/ negative ΔDCD areas (fig.7). 9. The lowest ΔMELD was noted in areas with the highest DCD rate (fig.7) 10. The State with the highest DCD rates pre-AC had the highest ΔDCD (fig.5). 11. 10/11 States with negative ΔDCD were located North of the 35o. Conclusions: AC implementation coincided with an increase in the overall LT & DCD LT activity. However, causation remains to be clarified, given the concurrent opioid crisis and SARS-CoV-2 pandemic. There was remarkable DCD rate variation. States with high DCD rates/ΔDCD demonstrated greater adaptability in the allocation change, maintaining low ΔMELD across eras. (Figure Presented).
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On March 17, 2020, Governor Asa Hutchinson closed all public schools in the state of Arkansas to on-site instruction through March 30 in an effort to contain the spread of the novel Coronavirus. With schools closed, teachers and students made the pivot to online learning. School closures changed the way teachers prepared and delivered lessons. Changes in instruction varied from school building to school building, district to district, and teacher to teacher based on location, available equipment, and individual teacher technological skill sets. This scoping review examines the perceptions of teachers on the effectiveness of lesson planning and content delivery during times when on-site learning is not possible. (PsycInfo Database Record (c) 2022 APA, all rights reserved)
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Introduction: In 2020, the COVID pandemic altered care patterns throughout health care. Routine office and ER visits declined and antibiotic prescribing changed as a consequence. Research Question or Hypothesis: How did the COVID pandemic affect outpatient antibiotic prescribing in an Arkansas Medicaid population? Study Design: Descriptive statistics were used to determine the impact of the COVID pandemic on outpatient antibiotic prescribing in Arkansas Medicaid patients. Methods: Antibiotic pharmacy claims were extracted from the Arkansas Medicaid prescription claims database for calendar years 2018 through 2021. The monthly total number of antibiotic claims from January 2018 through December 2021 were calculated. Monthly data from 2018 and 2019 were averaged to create a baseline. The average percent change in the number of outpatient antibiotic claims from February 2018-2019 to April 2018-2019 was compared to the percent change from February 2020 to April 2020. Additional percent change was calculated as the difference between the 2018-2019 average percent change and the 2020 observed percent change among all ages and prespecified age-groups. Results: The seasonal (February-April) drop in antibiotic prescriptions pre-pandemic was -18%, from 52,000 to 42,750 per month. In February-April 2020, claims fell an additional 42% (-60% in 2020, from 49,020 to 19,640). Age-related decreases showed claims for patients <5 years dropped an additional 54% from baseline;5-17 years, 48%;and >18 years, 20%. Antibiotic prescriptions in April 2021 (∼34,000) rebounded to approach the pre-pandemic baseline of 42,750. Conclusion: Outpatient antibiotics prescription claims declined sharply from baseline, especially in children, in 2020 during the COVID pandemic. Potential reasons may be attributed to clinic avoidance, more viral than bacterial illnesses, or less illness due to masking and distancing;however, the degree attributed to each has not been determined. A return to baseline was observed in 2021. Continued efforts in antibiotic stewardship are warranted.
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Having had financial management courses gave me the tools to work with his lawyer to prepare a "Durable Power of Attorney" (POA) document;speak with his accountant to determine what to do and how to submit his taxes with me signing;to distribute copies of the POA to those requiring such a document so I could discuss medical issues and accounts (telephone, television) on his behalf;and to discuss short- and longterm care policies, making sure they were up-to-date and that I understood how claims could be filed on his behalf. Because of the need of the car hauler at my brother's (western side of state) and the fact our daughter and her husband live on the eastern side of Washington (state), we loaded up the car hauler with the furniture, etc. knowing we would make an extra stop to deliver items to her. Before leaving Arkansas, the Executive Director of the facility was called and an apartment was assigned. Because my brother was coming from Washington, a 2-week quarantine period in our home was requested before he could move into the facility and, again, after the move-in. * Tote bag items to carry in truck at all times: [...]I gathered all phone numbers for doctor, accountant, lawyer, insurance agent, neighbors;hours of operation for the nearest grocery store to my brother;local post office hours (had to submit permanent address change);checkbooks from which bills are paid;UPS office (had to terminate television account and return cable box);real
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Introduction: The COVID-19 pandemic continues to be a major socioeconomic disruptor worldwide. The intervention that has a far-reaching impact is the adoption of an efficient nationwide vaccination campaign with the effective COVID-19 vaccines. The success of this strategy is dependent on the capacity of the existing healthcare systems and the public vaccine acceptance. Vaccine hesitancy is considered among the top global health threats. Its patterns and intensity vary by geosocial contexts. Due to the roll-out of the vaccine which was followed by the booster dose, we explored the demographic pattern and reasons behind the primary and secondary COVID-19 vaccine hesitancy among our ArkLATX cancer patients. Methods: Two cohorts were used to conduct this study (cohort 1 for primary and Cohort 2 for secondary vaccine hesitancy). An in-person survey of a random sample was conducted across 5 Hematology-Oncology clinics asking the veterans whether they are interested in receiving the initial COVID-19 vaccine and later the booster dose. If the veterans declined, they were asked to state the reason behind their decision. Age, sex, race, and state of residence were captured for each participant. Descriptive statistics were calculated and X2 and logistic regression were carried out to determine the impact of demographic factors on COVID-19 vaccine hesitancy. Results: Cohorts 1&2 consisted of 240 and 303 veterans, respectively. The median age was 71 years. The participants were around 92% male vs 8% female and around 41% Black vs 59% White. In cohort-1, 21% declined due to concerns about safety (33%), not wanting to be the first (33%), anti-vaxxer stance (14%), and inadequate information (8%). Among other reasons (12%), 3 saw no reason for the vaccination, 2 cited severe reactions to prior vaccines, and 1 cited mistrust of the government. In cohort-2, 14% declined booster dose due to concerns about the need (55%) and safety (14%), anti-vax (19%), suspicious (5%), and medical reason and timing (7%). There were no statistical differences between veterans that approved of or declined receiving the vaccine with respect to demographic characteristics. Conclusions: Our survey indicates that the majority of ArkLATX high-risk veterans with cancer are willing to be vaccinated against COVID-19. The major reasons behind vaccine primary and secondary hesitancy seem to be categorized as information issues consisting of questions about safety and the need for the vaccine. For primary hesitancy another major group consisted of a diffusion of innovation late majority that are open to COVID-19 vaccination, but they do not want to be the first to take it. Such barriers can be potentially circumvented by providing the appropriate targeted information campaigns and provider counseling.
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Introduction: The COVID-19 pandemic continues to be a major socioeconomic disruptor worldwide. The intervention that has a far-reaching impact is a global vaccination campaign with the currently available and highly effective COVID-19 vaccines. Unfortunately, cancer patients are at a higher risk of contracting COVID-19 infection. Furthermore, they tend to experience a higher rate of morbidity and mortality than the general population. Therefore, we conducted this study to explore the efficacy of mRNA COVID-19 vaccines in a cohort of rural veterans with cancer in the ArkLATX. Methods: A cohort of 361 consecutive veterans across 5 Hematology-Oncology clinics were included in this study. An in-person survey was conducted asking the veterans whether they received the COVID-19 vaccine;if so, whether they had any reactions to it;whether they had any COVID-19 infections;and if they were vaccinated whether the infection was pre- or post-vaccination. They were also asked to determine the severity of their infection and their reactions to the vaccine when applicable. Age, sex, and race were captured for each participant. Descriptive statistics were calculated, and X2 and logistic regression were carried out to determine the impact of factors on the outcome and the significance of differences found between the studied subgroups. Results: The cohort consisted of 361 veterans, 303 vaccinated and 58 unvaccinated. The mean ages were 69 and 65 years, respectively. Among the vaccinated, 30% experienced vaccine adverse events, but only 2% reported it as severe. While there were more whites in the unvaccinated, there was no difference by sex. Only 2% of the vaccinated reported post-vaccine COVID19 infections versus 22% of the unvaccinated. One and 2 patients reported severe COVID19 infection in the vaccinated and unvaccinated subgroups, respectively. There was one patient who had a severe COVID19 infection before and after. The absolute and relative risk reduction for COVID19 vaccines were 20% and 91%, respectively. The number of patients needed to vaccinate to prevent one adverse outcome was 5. Conclusions: The current mRNA vaccines showed 91% efficacy at preventing COVID-19 infections in this high-risk rural veteran patient population with cancer. Aside from primarily mild transient local and systemic reactions, no safety concerns were identified by our patients. This real-life patient-reported outcome study confirms the efficacy and safety of COVID19 vaccines found in the general population.
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Although SARS-CoV-2 can cause severe illness and death, a percentage of the infected population is asymptomatic. This, along with other factors, such as insufficient diagnostic testing and underreporting due to self-testing, contributes to the silent transmission of SARS-CoV-2 and highlights the importance of implementing additional surveillance tools. The fecal shedding of the virus from infected individuals enables its detection in community wastewater, and this has become a valuable public health tool worldwide as it allows the monitoring of the disease on a populational scale. Here, we monitored the presence of SARS-CoV-2 and its dynamic genomic changes in wastewater sampled from two metropolitan areas in Arkansas during major surges of COVID-19 cases and assessed how the viral titers in these samples related to the clinical case counts between late April 2020 and January 2022. The levels of SARS-CoV-2 RNA were quantified by reverse-transcription quantitative polymerase chain reaction (RT-qPCR) using a set of TaqMan assays targeting three different viral genes (encoding ORF1ab polyprotein, surface glycoprotein, and nucleocapsid phosphoprotein). An allele-specific RT-qPCR approach was used to screen the samples for SARS-CoV-2 mutations. The identity and genetic diversity of the virus were further investigated through amplicon-based RNA sequencing, and SARS-CoV-2 variants of concern were detected in wastewater samples throughout the duration of this study. Our data show how changes in the virus genome can affect the sensitivity of specific RT-qPCR assays used in COVID-19 testing with the surge of new variants. A significant association was observed between viral titers in wastewater and recorded number of COVID-19 cases in the areas studied, except when assays failed to detect targets due to the presence of particular variants. These findings support the use of wastewater surveillance as a reliable complementary tool for monitoring SARS-CoV-2 and its genetic variants at the community level.
Subject(s)
COVID-19 , SARS-CoV-2 , Arkansas/epidemiology , COVID-19 Testing , Humans , Membrane Glycoproteins , Phosphoproteins , Polyproteins , RNA, Viral/genetics , SARS-CoV-2/genetics , Wastewater , Wastewater-Based Epidemiological MonitoringABSTRACT
Timely, accurate, and repeatable crop mapping is vital for food security. Rice is one of the important food crops. Efficient and timely rice mapping would provide critical support for rice yield and production prediction as well as food security. The development of remote sensing (RS) satellite monitoring technology provides an opportunity for agricultural modernization applications and has become an important method to extract rice. This paper evaluated how a semantic segmentation model U-net that used time series Landsat images and Cropland Data Layer (CDL) performed when applied to extractions of paddy rice in Arkansas. Classifiers were trained based on time series images from 2017–2019, then were transferred to corresponding images in 2020 to obtain resultant maps. The extraction outputs were compared to those produced by Random Forest (RF). The results showed that U-net outperformed RF in most scenarios. The best scenario was when the time resolution of the data composite was fourteen day. The band combination including red band, near-infrared band, and Swir-1 band showed notably better performance than the six widely used bands for extracting rice. This study found a relatively high overall accuracy of 0.92 for extracting rice with training samples including five years from 2015 to 2019. Finally, we generated dynamic maps of rice in 2020. Rice could be identified in the heading stage (two months before maturing) with an overall accuracy of 0.86 on July 23. Accuracy gradually increased with the date of the mapping date. On September 17, overall accuracy was 0.92. There was a significant linear relationship (slope = 0.9, r2 = 0.75) between the mapped areas on July 23 and those from the statistical reports. Dynamic mapping is not only essential to assist farms and governments for growth monitoring and production assessment in the growing season, but also to support mitigation and disaster response strategies in the different growth stages of rice.
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This paper analyzes and provides estimates of the undercount of the foreign-born in the US Census Bureau’s 2020 American Community Survey (ACS). It confirms that a differential undercount occurred in the 2020 ACS. In particular, noncitizens that arrived from Central American countries after 1981 had undercount rates of 15–25 percent, but undercount of noncitizens that arrived from European countries in the same period was not detectable by the methods described in this paper. The Center for Migration Studies of New York (CMS) and others use ACS data to derive annual estimates of the US undocumented population. The Census Bureau recently reported that the total population count for the 2020 Census was consistent with the count for recent censuses, despite the Covid-19 pandemic and the Trump administration’s interference in the 2020 Census. Nonetheless, the accuracy of 2020 ACS data for the noncitizen population that arrived after 1981 remains a major concern given the fear generated by the Trump administration’s abusive rhetoric and anti-immigrant policies. The estimates set forth in this paper were derived by analyzing trends in annual ACS data for 2016–2020 compiled from the IPUMS website (Ruggles et al. 2021). Decennial census data cannot be used for this purpose because data on country of birth, citizenship, and year of immigration are not collected in the census. However, it is reasonable to believe that the 2020 census and the 2020 ACS experienced similar challenges because they were conducted under comparable conditions. The patterns of undercount of noncitizens described here for the 2020 ACS are likely mirrored in the 2020 census and will reduce federal funding and representation to affected cities and states for the next decade.
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Background: Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) is a novel coronavirus that causes the disease entity COVID- 19. Initially, reports showed children had generally mild disease, with few requiring hospitalization. However, as of December 2021 in Arkansas, USA, children and young adults aged 24 years and younger accounted for approximately 166,000 cases with over 1,800 hospitalizations and 27 deaths (3 deaths under age 17). Comparatively, there have been over 6 million cases nationally in children and young adults, with over 1,000 deaths. Bacterial, viral, and fungal co-infections are known complications of viral respiratory illnesses that can lead to increased mortality. There have been multiple reports in adults on the incidence and type of co-infections seen with COVID-19, but few in pediatric patients. Adult data shows that co-infections are present in approximately 13-45% of patients with COVID-19, most commonly with bacterial pathogens of Mycoplasma pneumoniae and Haemophilus influenzae. Methods: We describe four patients with acute SARS-CoV-2 infection, requiring intubation, mechanical ventilation, and extracorporeal membrane oxygenation (ECMO), all of whom had methicillin-sensitive Staphylococcus aureus(MSSA) infections discovered within 24 hours of escalating respiratory support. This case series was determined as exempt by the Institutional Review Board at our institution. Results: Our cohort includes 4 patients with a median age of 18 years (range 16-19 years), all of whom required ECMO for acute respiratory distress syndrome (ARDS) secondary to SARS-CoV-2 pneumonia. The median time from intubation to ECMO cannulation was 139 hours (range 3-319 hours). All patients received targeted COVID-19 therapy with dexamethasone, remdesivir, and either tociluzimab or baricitinib during their hospitalization. These patient also all had culture positive MSSA infections from blood and mini-BAL cultures. Three of the four patients had a positive culture within 24 hours of requiring ECMO and one patient had a positive culture within 24 hours of requiring intubation. All of the patients were initially placed on venovenous (V-V) ECMO and three (75%) later required transition to venoarterial venous (VA-V) ECMO for worsening hemodynamics. All were initially cannulated with dual site femoral-internal jugular configuration. Femoral arterial cannulas were used for the transition to VA-V. Complications encountered during ECMO for these patients included GI bleeding (n=1), atrial flutter requiring cardioversion (n=1), lower extremity compartment syndrome (n=1), and dislodgement of a venous ECMO cannula (n=1). One patient received a tracheostomy while on ECMO. The median ECMO duration was 19.35 days (range 11-48.5 days). All patients were successfully decannulated from ECMO and all were discharged from the hospital alive, except one who is still requiring inpatient rehabilitation services. Discussion: We describe 4 pediatric patients with acute SARS-CoV-2 respiratory infections who were found to have MSSA co-infection within 24 hours of escalating respiratory support, all of whom eventually required ECMO support. In a recently published study, Pickens, et al reported that 25% of recently intubated adult COVID-19 patients have a bacterial co-infection. Limited data is available in pediatric patients. Staphylococcus aureus infections are among the most common bacterial infections worldwide. They are responsible for over 100,000 infections in the United States each year and lead to increased morbidity and mortality. All of our patients received immunemodulating therapies with either tociluzimab or baricitinib, which carry the risk of secondary infections due to immunosuppressive effects. Clinicians should maintain a high index of suspicion and be aware of the possibility of secondary bacterial infections in COVID- 19 patients, especially in those treated with immune-modulators. MSSA co-infection can lead to increased morbidity and mortality in patients with SARS-CoV-2, as seen in our cohort. More investigation s needed to further describe co-infections in patients with COVID- 19 and to identify risk factors for the development of co-infections.