Trends in Mood Disorders in Incoming Freshman Division One Collegiate Cross Country and Track And Field Athletes

Purpose: This study's purpose was to evaluate trends in mood disorders in incoming collegiate cross-country and track and field athletes to appropriately allocate resources. The prevalence of mood disorders surrounding the COVID- 19 pandemic was of interest. Method(s): Preparticipation questionnaires of incoming firstyear cross country and track and field athletes at The Ohio State University were reviewed between the years 2018-2022 (n = 138). Data regarding psychiatric history were collected and evaluated for trends based on year of matriculation, reported gender, family history of mood disorders, and specific sporting event. Result(s): The prevalence of history of mood disorder or counseling in incoming first-year cross country and track and field athletes was not statistically different across the five years from 2018 to 2022. Female athletes were 2.6 times more likely to report a history of mood disorder or counseling compared with male athletes (P = 0.02, CI 1.17-5.96). Prevalence of history of mood disorder or counseling was highest in distance runners, lower in field athletes, and least in sprinters, but this difference was not significant (P = 0.322). Athletes who reported a personal history of mood disorder or counseling were 42.9 times more likely to also report family history of a mood disorder (P < 0.001, CI 5.2-351.5). Conclusion(s): The prevalence of mood disorders in first-year cross country and track and field athletes have remained stable over the past five years despite the COVID-19 pandemic and increased normalization of mental health problems. Female cross country and track and field athletes are more than twice as likely as males to start college with a history of a mood problem. There is a strong association between personal and family history of mood disorders. Significance: More psychological resources may need to be allotted to female cross country and track and field athletes compared with males. It may not be necessary to increase mood resources overall, because prevalence remains stable over the years.

Resiliency among Older Adults Receiving (Roar) Lung Cancer Treatment: A Feasibility Study

PURPOSE/HYPOTHESIS: Poor physical performance and negative mood are two risk factors for functional decline among older adults with lung cancer. Yet, targeted interventions to maintain independence prevent functional decline are not well studied. Our primary objective was to assess the feasibility of a novel virtual health physical therapy (PT) plus progressive muscle relaxation (PMR) intervention with longitudinal microbiome biospecimen collection delivered to older adults with advanced lung cancer. Secondary objectives were to characterize functional status and clinical factors pre and post-study intervention. NUMBER OF SUBJECTS: We accrued adults aged >=60 years with advanced non-small cell or extensive-stage small cell lung cancer receiving treatment at The Ohio State University James Comprehensive Cancer Center (OSU-JCCC) in the Thoracic Oncology department (N=22). There were no exclusion criteria pertaining to Eastern Cooperative Oncology Group (ECOG) performance status, laboratory values, prior cancer diagnoses, presence of comorbidities, or brain metastases. MATERIALS AND METHODS: Participants were asked about functional status, symptoms, mood through the PHQ-9, GAD-7, POMS, and acceptability questions about the program. PT evaluation and assessment included SPPB and 2- or 6-minute walk test outcomes. The study sought to collect gut microbiome samples for every in-person visit and activity monitoring data (Actigraph) on a subset. Feasibility was defined as successfully collecting specimens, wearing an Actigraph activity monitor, and adhering to the intervention. PT and psychologists evaluated participants in-person at the first and final visit. The rest of the 12-week intervention was conducted via virtual health. Physical therapy intervention consisted of endurance, strength, and flexibility exercises. RESULT(S): In total, 22 patients consented and 18 started the intervention (81.8%). Seven microbiome samples were collected from four participants. Six patients collected activity monitoring data. Among the 18 participants, 11 participants (61.1%) completed 70% or more of all the intervention visits. The SPPB data show a moderate effect size (Cohen's d=0.24) from pre- to post-data. On average patients improved by 1.8 total points on the SPPB. Patients demonstrated improvement on timed walk tests throughout intervention from an average of 108 feet pre-intervention to an average of 138.4 feet post intervention. CONCLUSION(S): Despite the challenges of the COVID-19 pandemic, longitudinal biospecimen and correlative data collection were feasible in the context of PT and PMR intervention among older adults with advanced lung cancer. Virtual physical therapy interventions can be safely delivered to improve physical performance as demonstrated by a moderate effect size for the SPPB in this patient population. CLINICAL RELEVANCE: Based on the feasibility study results, delivering a virtual PT intervention to older patients with lung cancer can improve SPPB score leading to decreased frailty and improve quality of life among patients.

Granulomatous Hepatitis as Primary Manifestation of Disseminated Histoplasmosis in an Immunocompetent Host Diagnosed on EUS FNA and Liver Biopsy

Introduction: Disseminated histoplasmosis (DH) presents as primarily lung manifestations with extrapulmonary involvement in immunocompromised hosts. Granulomatous hepatitis as first presentation of DH in an immunocompetent host is uncommon. Case Description/Methods: 25-year-old female presented with one month of fever, fatigue, myalgias, 30-pound weight loss, cough, nausea, vomiting, and epigastric pain. She has lived in the Midwest and southwestern US. Presenting labs: TB 1.9 mg/dL, AP 161 U/L, AST 172 U/L, ALT 463 U/L. Workup was negative for COVID, viral/autoimmune hepatitis, sarcoidosis, tuberculosis, and HIV. CT scan showed suspected gallstones and 9 mm left lower lobe noncalcified nodule. EUS showed a normal common bile duct, gallbladder sludge and enlarged porta hepatis lymph nodes which underwent fine needle aspiration (FNA). She was diagnosed with biliary colic and underwent cholecystectomy, with white plaques noted on the liver surface (A). Liver biopsy/FNA showed necrotizing granulomas (B) and fungal yeast on GMS stain (C). Although histoplasmosis urine and blood antigens were negative, histoplasmosis complement fixation was >1:256. She could not tolerate itraconazole for DH, requiring amphotericin B. She then transitioned to voriconazole, discontinued after 5 weeks due to increasing AP. However, her symptoms resolved with normal transaminases. At one year follow up, she is asymptomatic with normal liver function tests. Discussion(s): DH is a systemic granulomatous disease caused by Histoplasma capsulatum endemic to Ohio, Mississippi River Valley, and southeastern US. DH more commonly affects immunocompromised hosts with AIDS, immunosuppressants, and organ transplant. Gastrointestinal involvement is common in DH (70-90%) with liver involvement in 90%. However, granulomatous hepatitis as primary manifestation of DH is rare (4% of liver biopsies). Hepatic granulomas are seen in < 20%. Patients may present with nonspecific systemic symptoms. Serum/urine antigens may be negative. Gold standard for diagnosis is identifying yeast on tissue stains. Recommended treatment is amphotericin B followed by 1 year of itraconazole. However, shorter treatment duration may be effective in immunocompetent hosts. This case is unique in that granulomatous hepatitis was the first presentation of DH in our immunocompetent patient diagnosed on EUS FNA and liver biopsy. Clinicians must have a high degree of suspicion for DH in patients with fever of unknown origin especially in endemic areas regardless of immunologic status. (Table Presented).

The impact of the COVID‐19 pandemic on school psychology internship outcomes

The Ohio Internship Program in School Psychology was forced to adapt abruptly to the changing circumstances brought on by the novel coronavirus (COVID‐19) pandemic beginning in March 2020. The purpose of this study was to determine the extent to which the school psychology internship outcomes were negatively affected by the COVID‐19 pandemic in terms of supervisors' ratings of intern competencies, the number of students served by interns, and the outcomes of academic and behavior interventions supported by interns. Findings of the annual evaluation of the Ohio Internship Program in School Psychology for the school year directly affected by the pandemic (2020–2021) were compared to the findings for the year the pandemic began (2019–2020) and the 3 years before the start of the pandemic. The results provide evidence of gains in professional competencies and positive outcomes for students served by interns. The results also highlight racial disparities in the counts of students provided school psychological services during the pandemic. Implications for school psychology graduate preparation and practice are discussed.Alternate abstract:Practitioner Points1. School psychology interns advanced their competencies and provided effectively support to students despite the upheaval created by the COVID‐19 pandemic.2. The COVID‐19 pandemic created opportunities for innovation in school psychological training and practice.3. Racial disparities were evident in the number of students provided school psychological services during the pandemic.

Impostor Phenomenon in Undergraduate and Doctor of Pharmacy Students at a Small Private University

Objective. The purpose of the study was to observe the prevalence of impostor phenomenon among students attending Ohio Northern University and to assess secondary factors that impact the severity of this phenomenon. Methods. Using the validated Clance Impostor Phenomenon Scale, the incidence of impostor phenomenon was assessed at Ohio Northern University. We hypothesized that students enrolled in the Ohio Northern University College of Pharmacy would demonstrate more intense levels of impostor phenomenon than students enrolled in other majors within the university. Results. Of the approximately 3100 students at the university, 391 students (12.6%) completed the survey and qualified for the study. Students for this study were recruited via email. This method was used for two reasons;it was the best way to reach the entirety of the student body, and, at the time of the study, students were transitioning from campus to home due to the COVID-19 pandemic. Out of a total possible score of 100, all colleges scored an average impostor phenomenon score between 68 and 75. These scores were interpreted as "frequently experiences impostor feelings." No significant differences in scores were found by college, gender, ethnicity/race, year in school, or specific major. Conclusion. Impostor phenomenon is common at Ohio Northern University and does not discriminate by college, age, gender, race/ethnicity, year in school, or academic major. There is a need for external intervention to educate students on the impact of impostor phenomenon and to reduce this impact. Interventions should be targeted to all students enrolled at the university regardless of educational program or other demographics.

Estimates of the value of life lost from COVID-19 in Ohio.

The economic burden of mortality due to the novel coronavirus (COVID-19) extends beyond the lives lost. Data from the Ohio Department of Public Health and Social Security Administration was used to estimate the years of potential life lost, 72,274 and economic value of those lost lives, US$17.39 billion. These estimates may be used to assess the risk-trade off of COVID-19 mitigation strategies in Ohio.

Entrepreneurially Minded Learning in the Unit Operations Laboratory through Community Engagement in a Blended Teaching Environment

Online and blended learning opportunities in Chemical Engineering curriculum emerged due to COVID-19. After eight weeks of in-person Unit Operations Laboratory sessions, a remote-learning open-ended final project was assigned to student teams. The assignment involved aspects related to entrepreneurially-minded learning (EML) and community-based learning (CBL). Results show correlations between self-directed learning and the EML framework. Continuous support and involvement of a community partner correlate to students' motivation, critical for successful remote-learning implementations in engineering education.

The Untold Stories from COVID-19: The Calamity of Implementing Curriculum during a Pandemic

In March 2020, the COVID-19 Pandemic wreaked havoc on our nation's educational system. Students, teachers, and administrators were forced to engage in a new remote learning model, which was unfamiliar. This narrative study draws on the lived experiences of six K-12 teachers in Southwest Ohio urban school districts. The data analysis was examined through the lens of the Science of Learning and Development framework (SoLD). Findings highlight the impact of COVID-19 on curriculum implementation. Results show that unprepared teachers could not pivot to online learning effectively, which may intensify the educational gaps and inequities among students in six urban schools in Southwest Ohio.

Exploring Introductory Communication Course Administrators' Relationship Management during COVID-19

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.

Career Services and College-Employer Partnership Practices "in" Community Colleges: Colleges in California, Ohio, and Texas

Community colleges play a key role in driving talent development in the United States, producing workers with the kinds of training that employers need while enhancing economic mobility for students. There has been a push among policymakers at the federal and state levels to hold community colleges accountable for the employment outcomes of their students, with funding and legislation that endorses models that strengthen college partnerships with employers. In this report, the authors systemically examine the type of career services and college-employer partnership practices in science, technology, engineering, and mathematics (STEM) fields across three states -- California, Ohio, and Texas -- and a sample of community colleges that operate within them. In addition, the authors investigate the challenges that these colleges face in facilitating student employment and the ways in which state policies may have influenced practice. They reviewed state policies and collected interview data from 134 participants, including state and system leaders, college leaders, program heads and faculty, career service leaders and staff, and employers.

Financial Incentives Are Associated with Lower Likelihood of COVID-19 Vaccination in Northeast Ohio.

BACKGROUND: Declining COVID-19 vaccination rates have led to implementation of monetary incentives to increase vaccine uptake. The Ohio Vax-a-Million lottery and subsequent $100 incentives were created to encourage individuals to become vaccinated. The purpose of this survey was to determine the efficacy of these monetary incentives on vaccination rates. METHODS: A 38-item questionnaire was given to outpatients at MetroHealth and Cleveland Veteran Affairs Hospitals between August 2021 and February 2022 who either waited 2 or more months to receive the COVID-19 vaccination or have not yet been vaccinated. The survey contained questions regarding demographics and perceptions of COVID-19 monetary incentives on vaccination likelihood. RESULTS: Of the 471 participants surveyed, 0.95% reported that the Ohio Vax-a-Million lottery increased their vaccination likelihood, while 29.7% reported that it decreased their likelihood. 6.8% of respondents reported the $100 incentive increased their vaccination likelihood while 17.4% reported it decreased their vaccination chances. 20.6% of participants stated news of the Delta (δ) variant increased their vaccination likelihood. CONCLUSION: Our study results suggest that monetary incentives were not associated with increased COVID-19 vaccination rates. Instead, more participants believed that these incentives decreased their vaccination likelihood. Expansion of the survey across a wider sociodemographic range can provide further evidence of the efficacy of these programs before reimplementation.

Teleneurology as a tool to overcome disparities for access to multiple sclerosis care

Background: Utilization of teleneurology for MS care rapidly expanded during the COVID-19 pandemic to maintain healthcare access. Disparities in telehealth use have been described in other health conditions, but not in a MS population. Objectives/Aims: To evaluate longitudinal utilization of teleneurology across age, race, geographic factors, and insurance categories to identify potential disparities in utilization at a single academic MS center (Cleveland Clinic). Method(s): MS patients attending a specialty clinic in Cleveland, a medium-sized city, who completed >=2 visits at least 24 months apart from 1/2019 to 6/2021 were studied. Patients with fully inperson care were compared to patients with <50% or >50% teleneurology care. Categories of age, race, geographic factors, and insurance were compared using Kruskal-Wallis tests and pairwise Wilcoxon rank sum tests with Bonferroni correction for multiple comparisons. Result(s): 892 patients met the inclusion criteria and completed 3710 visits during the study timeframe: mean age 49.1+/-11.7 years, 73.7% female, 85.6% white, median disease duration 11.2 years [0.15;60.3], and relapsing-remitting 62.3%. 37% patients were fully in-person, 37.2% patients had <50% teleneurology care, and 25.8% patients had >50% teleneurology care. There were no significant differences for race (white, black, other), insurance type (Medicare, Medicaid, private, non/other), area deprivation index (ADI), and residence location (rural vs metropolitan) in the use of teleneurology. Use of teleneurology care varied based by age, with older patients utilizing more in-person care. In person care was 23.4% for ages 18-39, 38.5% for ages 40-60, and 47.8% for those greater than 60 (p<0.001). Patients residing in greater Cleveland had significantly more in-person care (55.3%) compared to residents residing in Ohio outside of the greater Cleveland area (34.7%) and outside of Ohio (10.1%) (p=0.031). Conclusion(s): There were no significant differences in teleneurology utilization across race, insurance, ADI or rural vs metropolitan residence, suggesting it is a broadly accessible tool to overcome disparities in access to MS care. Utilization of teleneurology care for older and local patients was lower, which may be due to decrease demand in these groups. Future studies should assess the optimal integration of teleneurology and in-person visits in MS management.

COVID-19 Pandemic Mask Mandates and Tympanostomy Tubes in the Pediatric Population

Introduction: The COVID-19 pandemic and statewide mask mandates (MM) affected elective surgical procedures throughout the United States, with declines in the prevalence of pediatric otitis media (OM) and tympanostomy tube (TT) placement during the first year of the pandemic. This study aims to follow the trends in OM and TT placement as it presents to our community pediatric hospital before, during, and after the MM, as there are no current studies on this effect. Method(s): Retrospective data collection of patients who received TT placement in the months of July to September before, during, and after Ohio's statewide MM in 2019, 2020, and 2021, respectively. Collected data included patient demographics, symptoms, risk factors, and complications related to OM, intraoperative findings, and postoperative evaluation. Result(s): We identified 542 patients who underwent TT placement before (n=223), during (n=93), and after (n=226) the MM. There were significantly fewer bouts of ear infections reported per patient prior to clinical evaluation in 2021 following MM removal, compared with 2019 (median 4 vs 5, P<.001) and 2020 (median 4 vs 5, P=.003). There were no significant differences in complications due to OM prior to TT placement before, during, or after the MM (6.7% vs 10.8% vs 3.5%, P=.283). There were no significant differences in the median age, perceived hearing or speech concerns, or cigarette smoke exposure at home per year. Significantly more children were attending daycare after the MM than before or after (P<=.01). There was increased severity of middle ear disease with significantly more cases of drainage after the MM in 2021 compared with during (50% vs 30.1%, P=.005). There were no significant differences in postoperative complications. Conclusion(s): The increased severity of OM at time of TT surgery may be associated with the lifting of MM and/or increased daycare attendance in 2021. The COVID-19 pandemic and associated social changes may have a role on elective surgical procedures and middle ear disease in the pediatric population.

IMPACT OF EDUCATIONAL ACTIVITIES, DEDICATED RAPID RESPONSE TEAMS, AND QUALITY CASE REVIEWS ON IN-HOSPITAL CARDIAC ARREST

SESSION TITLE: Lifelong Learning in Critical Care SESSION TYPE: Rapid Fire Original Inv PRESENTED ON: 10/17/2022 12:15 pm - 1:15 pm PURPOSE: Physiological instability occurs several hours prior to in-hospital cardiac arrest. Delays in early intervention is associated with an increase in morbidity, mortality and the incidence of in-hospital cardiac arrest [1]. Improving health care quality through the deployment of a rapid response team was recommended in 2004 by the Institute for Healthcare Improvement through the ‘100,000 Lives Campaign’ [2]. METHODS: Cleveland Clinic Fairview Hospital, one of the largest academic centers of the Cleveland Clinic Health Care System, appointed a dedicated daytime Rapid Response Registered Nurse in 2016, and in 2017 the above coverage was expanded to the night and week-end shifts. In 2019 a dedicated Internal Medicine Residents team took the lead of the Rapid Response and Code Blue team. Starting in 2017 monthly unannounced Rapid Response and Code Blue educational simulation cases were implemented, and in 2020 a dedicated simulation Lab provided immersive leaning experience to healthcare practitioners. In 2018 a centralized Code Blue event ion by the Quality Data Registry begun and in 2020 monthly events review helped improve the quality of cardiopulmonary resuscitation with valuable feedback provided to caregivers. Also, in 2020 the Cleveland Clinic Health Care System Resuscitation Operations Council was formed, where representatives from each hospital shared experience and quality initiatives. The above helped with the standardization of care across the 21 hospitals of the Cleveland Clinic Enterprise. RESULTS: Across five years of quality initiatives and consolidation of our rapid response response team from 2016 to 2021, the number of Rapid Responses increased by 104 % from 704 events in 2015 to 1438 in 2021. At the same time, the number of Code Blue events decreased by 56.5% from 283 in 2015 to 123 in 2021 and the number on non-critical care medical and surgical units decreased by 48.9% from 45 to 23 cases per year. The above was seen despite a significant increase in the hospital patient census, and the Coronavirus Infectious Disease 19 Pandemic where Fairview Hospital served as a tertiary referral center for all North Central and North Western Ohio. These results confirm prior published data on the subject where not only a focused rapid response team but also educational, simulation and case review activities are all associated with a reduced incidence of unexpected cardiac arrest [3-9]. CONCLUSIONS: A dedicated Rapid Response and Code Blue team, Simulation in education, and frequent quality review of cardiac arrest cases are all strategies that reduce the incidence of in hospital cardiac arrest. Future research is needed to highlight the impact of each of those quality and educational initiatives on outcomes and performance. CLINICAL IMPLICATIONS: Educational Activities, Dedicated Rapid Response Team and Quality Case Reviews decreases the incidence of In-Hospital Cardiac Arrest. DISCLOSURES: No relevant relationships by Francois Abi Fadel No relevant relationships by Lauren Crosby no disclosure on file for Megan Edwards;no disclosure on file for June McMahan;no disclosure on file for Patrick Murphy;No relevant relationships by Kelly Orlosky No relevant relationships by Anoosha Tauquir

CRYPTIC CRYPTO: PULMONARY CRYPTOCOCCOSIS IN AN IMMUNOCOMPETENT HOST

SESSION TITLE: Uncommon Presentations and Complications of Chest Infections SESSION TYPE: Rapid Fire Case Reports PRESENTED ON: 10/18/2022 10:15 am - 11:10 am INTRODUCTION: Cryptococcus is a ubiquitous fungus in the environment. Infections can occur in humans when Cryptococcus is aerosolized and inhaled. Severity of clinical presentation varies from asymptomatic pulmonary colonization to disseminated life-threatening infection such as meningitis. These infections usually occur with deficiencies in T-cell-mediated immunity, including those with HIV/AIDS and immunosuppression due to transplantation. Herein we present a case of isolated pulmonary cryptococcosis in an immunocompetent host. CASE PRESENTATION: The patient is a 36-year-old never-smoker male with history of recurrent left spontaneous pneumothorax status post VATS blebectomy, negative for alpha-1 antitrypsin deficiency and cystic fibrosis. A year later, he presented with fatigue, shortness of breath, and dry cough after a recent trip to Ohio. Viral panel including COVID-19 was negative. A chest x-ray showed a new 4 cm rounded opacity in the right middle lobe (RML). A CT scan of the chest showed 2 mass-like and nodular areas of consolidation with surrounding GGOs within the RML (Figure 1). He underwent navigational bronchoscopy with transbronchial biopsy (TBBx) of RML, BAL, and EBUS with transbronchial needle aspiration (TBNA). Cytology was negative for malignant cells. BAL showed rare yeast. Pathology of the TBBx showed the airway wall with chronic inflammation including granulomatous inflammation, positive for yeast, most consistent with Cryptococcus with positive Grocott methenamine silver (GMS) stain (Figure 2). Culture of the TBNA grew C. neoformans var. grubii. Other cultures were negative. Serum Cryptococcal antigen was positive. HIV test was negative. He started treatment with oral fluconazole with improvement of symptoms. DISCUSSION: Clinical presentation of pulmonary cryptococcosis can include a variety of symptoms in which immune status is critical for determining the course of infection. Infection can vary from asymptomatic infection to severe pneumonia and respiratory failure, and meningitis. Similarly, imaging findings can also vary and be characterized as pulmonary nodules, consolidations, cavitary lesions, and/or a diffuse interstitial pattern. The diagnosis of Cryptococcus is made using histology, fungal cultures, serum cryptococcal antigen, and radiography in the appropriate clinical and radiological context. Treatment recommendations are determinant on immune status of the patient as well as symptoms. Asymptomatic and localized disease in immunocompetent patients can be monitored and mild/moderate disease can be treated with fluconazole. Those with severe or disseminated infection warrant induction therapy with an amphotericin B and flucytosine CONCLUSIONS: Clinical and radiological presentation of cyptococcosis varies depending on immune status. Disease can occur in both immunocompromised and competent hosts. Immune status determines disease course and treatment. Reference #1: Huffnagle GB, Traynor TR, McDonald RA, Olszewski MA, Lindell DM, Herring AC, et al. Leukocyte recruitment during pulmonary Cryptococcus neoformans infection. Immunopharmacology. 2000 Jul 25;48(3):231–6. Reference #2: Kd B, Jw B, Pg P. Pulmonary cryptococcosis. Semin Respir Crit Care Med [Internet]. 2011 Dec [cited 2022 Apr 2];32(6). Available from: https://pubmed.ncbi.nlm.nih.gov/22167400/ Reference #3: Ms S, Rj G, Ra L, Pg P, Jr P, Wg P, et al. Practice guidelines for the management of cryptococcal disease. Infectious Diseases Society of America. Clin Infect Dis Off Publ Infect Dis Soc Am [Internet]. 2000 Apr [cited 2022 Apr 1];30(4). Available from: https://pubmed.ncbi.nlm.nih.gov/10770733/ DISCLOSURES: No relevant relationships by Mina Elmiry No relevant relationships by Brenda Garcia No relevant relationships by Zein Kattih no disclosure on file for Priyanka Makkar;No relevant relationships by Jonathan Moore

Biting the Bullet: A Call for Action on Lead-Contaminated Meat in Food Banks

Even though the presence of ammunition-derived metallic lead fragments in donated firearms-hunted meat has been recognized for more than a decade, the vast majority of donated hunted meat is not inspected to discard meat containing lead fragments.1 An underlying lack of food safety standards for adulterated donated food increases risks to lowincome recipients, who are already disproportionately affected by elevated blood lead levels (BLLs).2 Primary prevention is needed for this overlooked source of lead exposure. LOW-LEVEL LEAD Primary prevention is recognized as the most effective way to address the epidemic of lead poisoning in the United States.3 The current blood lead reference level recognized by the Centers for Disease Control and Prevention is 3.5 micrograms per deciliter (mg/dL). A strong body of scientific research demonstrates that leadbased ammunition frequently contaminates hunted meat and increases BLLs of humans and animals who consume it.1,7-9 Lead-contaminated hunted meat has been identified as the most poorly acknowledged and addressed example of food lead contamination, and scientists have called for this source of lead exposure to be acknowledged and addressed with health-protective measures.8,9 A 2013 consensus statement of experts in human, environmental, and wildlife toxicology supports reducing and eventually eliminating the introduction of lead into the environment from lead-based ammunition, emphasizing that shooting lead ammunition into the environment poses significant risks of lead exposure to humans and wildlife.10 In 2016, Arnemo et al. found that more than 99% of 570 scientific articles about environmental and health consequences of lead in ammunition raised concerns about lead toxicity.7 The authors highlighted that nonlead ammunition is as effective as lead-based ammunition and is comparably priced. Despite the well-established scientific basis for regulation of lead ammunition for hunting, the topic has been politicized by misinformation campaigns portraying concerns about ingesting lead ammunition as a product of antihunting agendas.11 Lead Contamination in Donated Hunted Meat Donated hunted meat is a vital source of protein distributed by food banks at a time when food bank use remains far above pre-COVID-19 pandemic levels.12 Published evidence of leadcontaminated meat in food banks has existed for more than a decade (Figure A, available as a supplement to the online version of this article at https://www.ajph.org).13 Investigations in multiple states have confirmed the presence of lead in donated meat.

Gender Differences in First-Year Engineering: Peer Connections in the time of COVID-19

Connection with peers is one of the most important factors in determining the persistence of students in engineering. During the COVID-19 pandemic, engineering classes transitioned to fully online learning. Little research has been done on the effect of online learning on students' social networks. This study sought to understand the factors that affect the connections students are making within a first-year engineering course at The Ohio State University. The study included the university's honors and standard offerings of the course. Participants were sent a Qualtrics survey that included ranking their level of connection to every student in each class on a scale from 0 (Don't Know) to 4 (Strong connection). Students were also asked Likert scale and opinion questions on their feelings of belonging in engineering and online learning. In total, there were 32 usable responses. Overall, females self-reported a higher average number of “Strong” and “Good” connections than males. A Mann-Whitney U test showed that this difference in number of connections was significant. To assess which factors affected the number of Strong and Good connections students self-reported, several ANOVA tests were conducted. These tests found that gender, feeling supported in the class, and class offering (honors vs. standard) yielded significant differences between groups. The study also found that out of all classes, over 85% of students strongly agreed that they would have formed better connections with their peers had their classes been in person. Because a majority of each class did not participate in the survey, the conclusions on gender and connections were limited to the students who responded. Future work will include creating social network diagrams in order to visualize connections within each class. Future work should also collect additional responses and include follow-up interviews to better understand student perspectives on connections and virtual learning. © American Society for Engineering Education, 2022