Arizona Center Research Articles

The Saga of St Jón of Hólar, Tempe, Arizona: Arizona Center for Medieval and Renaissance Studies 2021

The Saga of St Jón of Hólar, Tempe, Arizona: Arizona Center for Medieval and Renaissance Studies 2021

Musculoskeletal infections associated with Nocardia species: a case series

Abstract. Background: Nocardia is an uncommon pathogen that has been reported to infect musculoskeletal structures. However, studies are largely limited to case reports, and little is known regarding management and outcomes of these infections. Methods: We performed a multicenter retrospective cohort study of adults with culture-confirmed musculoskeletal Nocardia infections at three Mayo Clinic centers in Arizona, Florida, and Minnesota from November 2011 through April 2022. Results: Nine cases of Nocardia musculoskeletal infection were identified. Seven (78 %) occurred in men, and the median age was 57.3 years (range 32.6–79.0). Specific infections included native joint septic arthritis with or without associated osteomyelitis (N=3), hardware-associated infection (N=1), sternal osteomyelitis (N=1), pyomyositis (N=2), bursitis (N=1), and tenosynovitis (N=1). Three cases (33 %) were associated with disseminated disease, all three occurring in solid organ transplant recipients. Surgical intervention was performed in all but the bursitis case. Length of treatment varied from 21 d for tenosynovitis to 467 d for osteomyelitis. The 1-year mortality was 22 %, and all fatal cases involved disseminated disease. Conclusion: Patients with localized nocardiosis affecting musculoskeletal structures generally have good outcomes, as opposed to those with disseminated infection. Management often required operative intervention, with one patient experiencing recurrence within 1 year.

Prevalence, Attributes, and Risk Factors of QT-Interval-Prolonging Drugs and Potential Drug-Drug Interactions in Cancer Patients: A Prospective Study in a Tertiary Care Hospital.

Introduction Cancer chemotherapy regimens include multiple classes of adjuvant drugs as supportive therapy. Because of the concurrent intake of other drugs (like antiemetics, antidepressants, analgesics, and antimicrobials), there is a heightened risk for possible QT interval prolongation. There is a dearth of evidence in the literature regarding the usage of QT-prolonging anticancer drugs and associated risk factors that have the propensity to prolong QT interval. The purpose was to explore the extent of the use of QT-interval-prolonging drugs and potential QT-prolonging drug-drug interactions (QT-DDIs) in cancer patients attending OPD in a tertiary-care hospital. Methods This was a hospital-based, cross-sectional, observational study. Risk stratification of QT-prolonging drugs for torsades de pointes (TdP) was done by the Arizona Center for Education and Research on Therapeutics (AzCERT)/CredibleMeds-lists, and potential QT-DDIs were determined with four online DDI-checker-software. Results In 1331 cancer patients, the overall prevalence of potential QT-prolonging drug utilization was 97.3%. Ondansetron, pantoprazole, domperidone, and olanzapine were the most frequent QT-prolonging drugs in cancer patients. The top six antineoplastics with potential QT-prolongingand torsadogenic actions were capecitabine, oxaliplatin, imatinib, bortezomib, 5-fluorouracil, and bendamustine. Evidence-based pragmatic QTc interval prolongation risk assessment tools are imperative for cancer patients. Conclusion This study revealed a high prevalence of QT-prolonging drugs and QT-DDIs among cancer patients who are treated with anticancer and non-anticancer drugs. As a result, it's critical to take precautions, stay vigilant, and avoid QT-prolongingin clinical situations. Evidence-based pragmatic QTc interval prolongation risk assessment tools are needed for cancer patients.

Pre-pandemic preventable hospitalization is associated with increased telemedicine use in safety-net settings.

The COVID-19 pandemic necessitated a major expansion in telemedicine use. The continued use of telemedicine post-pandemic has the potential to enhance healthcare use for people at risk for sub-optimal healthcare access and utilization, such as patients with previous preventable hospitalization. This study analyzed the association between pre-pandemic preventable hospitalizations (PPHs) and telemedicine use during the pandemic. This retrospective cohort study uses Medicaid administrative claims data (01/2018-06/2022) for patients of a large Federally Qualified Health Center in Arizona that implemented telemedicine in March 2020. Bivariate and multivariable generalized estimating equations were used to analyze the relationship between the outcome and predictor variables. We also analyze racial/ethnic and primary language disparities in telemedicine use among those with PPH and report the average predicted probability. There was a statistically significant relationship between telemedicine use and PPH even after adjusting for comorbidity severity (OR:1.85; CI: 1.74, 1.96). Analyses restricted to those who had PPHs showed an seven-percentage point difference in the predicted probability of telemedicine use between non-Hispanic White individuals and Asian/Pacific Islanders, the group with the lowest probability of telemedicine use among our study sample. Telemedicine is a unique tool that can be leveraged by interventions that aim to optimize healthcare use among those with a history of preventable hospitalizations. However, the lack of targeted interventions to identify and address barriers to telemedicine use among minoritized groups could limit the impact of such interventions and widen disparities.

Characteristics, clinical outcomes, and prognostic factors of colorectal cancer in patients with Crohn's disease: American versus Korean tertiary referral center perspectives.

Crohn's disease (CD) exhibits variability in colorectal cancer (CRC) incidence and prognostic factors due to diverse clinical and behavioral characteristics, presenting inconsistencies between Western and Eastern patients. This study compared clinical characteristics between CD patients with CRC from the US and Korean tertiary referral centers and defined the prognostic factors related to mortality. Retrospective study. We reviewed the electronic medical records of 236 adult CD patients with colorectal adenocarcinoma evaluated at Mayo Clinic Rochester, Florida, or Arizona (N = 200) and Asan Medical Center in Korea (N = 36) between January 1989 and August 2022. Asan patients had a younger age, shorter CD duration, more colonic involvement (L2 plus L3), penetrating behavior, perianal fistula, and shorter biological treatment duration before CRC diagnosis than Mayo patients. Furthermore, despite significant differences in body mass index, smoking status, primary sclerosing cholangitis, immunomodulators, CRC diagnosis period, clinical presentation, CRC location, surgery, and some histopathological details between the two groups, overall survival was not statistically different (p value, 0.29, log-rank test). Advanced age (adjusted hazard ratio (aHR), 1.03 per year; 95% confidence interval (CI), 1.01-1.04; p value, <0.01), unresectable CRC (aHR, 5.02; 95% CI, 2.49-10.12; p value, <0.01), and advanced CRC stage (aHR, 1.45 per stage; 95% CI, 1.07-1.97; p value, 0.02) were significantly associated with increased risk of death. CD remission at CRC diagnosis (aHR, 0.26; 95% CI, 0.08-0.91; p value, 0.04), CRC diagnosis period of 2011-2022 (aHR relative to 1989-2000, 0.46; 95% CI, 0.25-0.87; p value, 0.02), and CRC diagnosis by surveillance (aHR, 0.56; 95% CI, 0.32-0.98; p value, 0.04) were significantly associated with decreased risk of death. Notably, some clinical features of CD with CRC differed between Asan and Mayo patients; however, overall survival was not different. CD remission, CRC surveillance, and more recent diagnosis of CRC were associated with a reduced risk of death.

Does oral health goal setting during medical visits improve parents' oral health behaviors?

The Rocky Mountain Network for Oral Health (RoMoNOH) promotes the delivery of preventive oral health services (POHS) to children receiving care at community health centers (CHCs) in Arizona, Colorado, Montana, and Wyoming. One POHS is oral health goal setting (OHGS). This study aimed to evaluate the effect of OHGS during medical visits on parent/caregiver-reported oral health behaviors (OHBs). The RoMoNOH implementation team trained CHC healthcare providers in POHS, including caries risk assessment, oral health education, fluoride varnish application, dental referrals, and parent/caregiver oral health engagement. To promote parents' oral health engagement, healthcare providers were trained in motivational interviewing (MI) with OHGS at medical visits. To evaluate the impact of MI with OHGS on parent/caregiver OHBs, a healthcare team member invited parents/caregivers to complete a baseline survey after their medical visits. The evaluation team sent a follow-up survey after 10-14 days. The surveys measured parents/caregivers' goals, confidence in goal attainment, OHBs, and sociodemographics; the follow-up survey also measured OHGS attainment. Improvement in parent/caregiver-reported OHBs was tested with a paired t-test and unadjusted and adjusted multiple linear regression. In total, 426 parents/caregivers completed the baseline survey; 184 completed both surveys. OHBs, including toothbrushing frequency, stopping bed bottles, drinking tap water, and brushing with fluoride toothpaste improved over the evaluation interval. After adjusting for covariates, brushing with fluoride toothpaste (p = 0.01), drinking tap water (p = 0.03), and removing bed bottles (p = 0.03) improved significantly. MI with OHGS with parents/caregivers during medical visits has potential to improve OHBs on behalf of their children.

Abstract C126: Communicating breast cancer risk to Spanish-speaking Hispanic women

Abstract INTRODUCTION Disparities in breast cancer (BC) screening are observed between Hispanic and non-Hispanic White women and stronger amongst Hispanic women with under- and uninsured statuses.1-2 Risk-based screening has been recommended by professional societies, including American Cancer Society, starting at age 30 and may be an important strategy for reducing disparities.3 The purpose of the study was to characterize whether women had been told their personal risk of BC and to identify differences in characteristics of patients informed of their personal risk. METHODS This is a cross-sectional analysis of data from a supplemental self-reported survey to an NIH-funded randomized trial conducted at a large Federally Qualified Health Center (FQHC) in Arizona (R01 MD09682-05). The survey was sent to a randomized 600 of the 1,356 participants. Between November 2022 and April 2023, 177 women completed the survey (response rate 29.5%). Participants were asked if a doctor or other healthcare provider had ever talked to them about their personal risk for BC. Differences between those who recalled being told their personal risk for BC and those who did not were assessed using Fisher exact test. RESULTS Overall, 66.3% were 50 years or older, 81.8% who speak primarily Spanish, and 64.8% of respondents had less than a high school education. Also, 22.4% reported a family history of BC, 27.4% have been previously recalled for additional imaging, 10.8% have had a history of prior breast biopsy, 59.9% stated having a regular provider, and 53.1% were found to have dense breast category C or D at screening visit. 40% did not report having a regular doctor although all participants received care at an FQHC. 30.5% of respondents stated that a healthcare professional had ever talked to them about their personal risk for BC. There was a trend toward women with a main doctor being more likely to recall being told their personal risk for BC as compared to those without a main doctor (38.5% vs 22.5%, p=0.06). CONCLUSIONS In this cohort of primarily Spanish-speaking Hispanic women who have had mammography screening and written report of their breast density, about a third of respondents recall being informed of their personal BC risk. These observations need to be confirmed in a larger population with greater response rate, but these results suggest that there is a cohort of patients who need different approaches for conveying risk. REFERENCES 1. Jadav, S., Rajan, S. S., Abughosh, S., &amp; Sansgiry, S. S. (2015). The Role of Socioeconomic Status and Health Care Access in Breast Cancer Screening Compliance Among Hispanics. Journal of Public Health Management and Practice, 21(5), 467–476. https://www.jstor.org/stable/48517175 2. American Cancer Society. (2017). Breast cancer facts &amp; figures 2017-2018. Atlanta, GA: American Cancer Society, Inc. 3. ACS Breast Cancer Screening Guidelines. (2022, January 14). https://www.cancer.org/cancer/types/breast-cancer/screening-tests-and-early-detection/american-cancer-society-recommendations-for-the-early-detection-of-breast-cancer.htm Citation Format: Jhenitza P. Raygoza Tapia, Sarah M. Jenkins, Jennifer L. Ridgeway, Aaron D. Norman, Crystal R. Gonzalez, Valentina Hernandez, Bhavika K. Patel, Celine M. Vachon, Jessica D. Austin. Communicating breast cancer risk to Spanish-speaking Hispanic women [abstract]. In: Proceedings of the 16th AACR Conference on the Science of Cancer Health Disparities in Racial/Ethnic Minorities and the Medically Underserved; 2023 Sep 29-Oct 2;Orlando, FL. Philadelphia (PA): AACR; Cancer Epidemiol Biomarkers Prev 2023;32(12 Suppl):Abstract nr C126.

Lindy Brady, ed. Old English Tradition: Essays in Honor of J. R. Hall. Medieval and Renaissance Texts and Studies 578. Tempe: Arizona Center for Medieval and Renaissance Studies, 2021. Pp. 356. $90.00 (paper).

Lindy Brady, ed. Old English Tradition: Essays in Honor of J. R. Hall. Medieval and Renaissance Texts and Studies 578. Tempe: Arizona Center for Medieval and Renaissance Studies, 2021. Pp. 356. $90.00 (paper).

Outcomes of transplant recipients with pretransplant Nocardia colonization or infection.

Specific pretransplant infections have been associated with poor posttransplant outcomes. However, the impact of pretransplant Nocardia isolation has not been studied. We performed a retrospective study from three centers in Arizona, Florida, and Minnesota of patients with Nocardia infection or colonization who subsequently underwent solid organ or hematopoietic stem cell transplantation from November 2011 through April 2022. Outcomes included posttransplant Nocardia infection and mortality. Nine patients with pretransplant Nocardia were included. Two patients were deemed colonized with Nocardia, and the remaining seven had nocardiosis. These patients underwent bilateral lung (N = 5), heart (N = 1), heart-kidney (N = 1), liver-kidney (N = 1), and allogeneic stem cell transplantation (N = 1) at a median of 283 (interquartile range [IQR] 152-283) days after Nocardia isolation. Two (22.2%) patients had disseminated infection, and two were receiving active Nocardia treatment at the time of transplantation. One Nocardia isolate was resistant to trimethoprim-sulfamethoxazole (TMP-SMX) and all patients received TMP-SMX prophylaxis posttransplant, often for extended durations. No patients developed posttransplant nocardiosis during a median follow-up of 1.96 (IQR 0.90-6.33) years. Two patients died during follow-up, both without evidence of nocardiosis. This study did not identify any episodes of posttransplant nocardiosis among nine patients with pretransplant Nocardia isolation. As patients with the most severe infections may have been denied transplantation, further studies with larger sample sizes are needed to better analyze any impact of pretransplant Nocardia on posttransplant outcomes. However, among patients who receive posttransplant TMP-SMX prophylaxis, these data suggest pretransplant Nocardia isolation may not impart a heightened risk of posttransplant nocardiosis.

Carol Mejia LaPerle, ed. Race and Affect in Early Modern English Literature. Tempe: Arizona Center for Medieval and Renaissance Studies Press, 2022. Pp 221.

Review of Race and Affect in Early Modern English Literature edited by Carol Mejia LaPerle

Traductions récentes de sagas sur des évêques islandais du Moyen-Âge

This article reviews the two most recent English-language translations of medieval sagas of Icelandic bishops, both from 2021: Margaret Cormack's The Saga of St. Jón of Hólar, published with the Arizona Center for Medieval and Renaissance Studies, and Theodore M. Andersson's Bishops in Early Iceland, published with the Viking Society for Northern Research. Both translations represent valuable new contributions to the field. In addition to a critical overview of these texts, the article overviews the history of English translations of the genre of medieval Icelandic bishops' sagas.

Genomic biomarker for the top risk factor of gallbladder cancer, cholelithiasis, in a Latinx population.

e16326 Background: Cholelithiasis or Gallstone disease (GSD), is one of the most common and costly digestive disorders in adults worldwide, presenting 10-20% of the general population but in greater than 30% of Latina and Hispanic American women aged 40 years or older. Moreover, GSD individuals contribute significantly to the incidence and mortality of gallbladder and other digestive system cancers; specifically, the excessive risk of gallbladder cancer is 3-10-fold. Parallel to gallbladder cancer, an appalling female preponderance of GSD has been documented for decades; thus, precisely defining high-risk populations and properly managing patients with GSD would lead to reduced disease burden from GSD and multiple cancers. Several genome-wide association studies (GWAS) in the past have identified genes associated with GSD but few were focused on Latinx population. Methods: To identify genetic risk factors for GSD in Latinx population, we used the Sangre Por Salud cohort (SPS) where participants are Latinx adult individuals aged 18-85 years who were current patients in the Mountain Park Health Center in Arizona. This sample represents historically underrepresented population with low socioeconomic status that are primarily Spanish-speaking, majority being born outside of the US, with low rates of health insurance coverage. A total of 172 GSD cases were identified, each matched with 6 controls (n = 1032) who were people from the same community but without history of GSD diagnosis; matching variables are age at enrollment to SPS, sex, height and weight, dyslipidemia, and HbA1C level indicative of type 2 diabetes. We characterized genome-wide interrogation for biomarkers predicting GSD and contributing to the observed gender disparity by performing a GWAS using a matched case-control design. Results: We identified several novel loci associated with GSD and validated few loci that were reported in previous GWAS. The top 3 loci (MATN2, GPRIN3, GPC6) were strongly associated with GSD in our overall analysis; follow-up pathway enrichment analysis suggests enrichment of GO terms that are associated with immunological pathways, enzymatic processes in gallbladder, liver and gastrointestinal tract and GSD pathology. In a sex-specific analysis, CDHR3 and RPL31P35-SEC61G were identified for females, which have been associated respectively with rhinovirus C infection and HbA1c level in previous studies. Conclusions: Our findings suggest directions towards better and deeper understanding of sex differences in GSD pathology, biological mechanisms, and disease progression among Latinx people. Knowing approximately 80% of gallbladder cancer patients harbored gallstones, our optimal goal is to provide evidence for an innovative strategy to early detect and effectively intervene the modifiable risk factors to reduce gallbladder cancer burden in high risk populations.

Abstract 4188: Multifaceted approach to engaging basic cancer scientists in community-based research

Abstract Background: The University of Arizona Cancer Center (UACC) is the only NCI-designated Comprehensive Cancer Center in Arizona, serving a 5-county catchment area that is approximately 40% Hispanic/Latinx. To ensure that UACC is conducting culturally relevant and meaningful research that is aligned with community priorities, we established the Research Outreach for Southern Arizona (ROSA) program. The ROSA program aims to facilitate bidirectional learning opportunities between scientists and the community, focusing on cancer biology and basic science. Multiple approaches were taken to engage cancer biology researchers with the communities in the catchment area with an ultimate aim of developing Basic science Community based participatory research projects. Method: Through a partnership between the UACC’s Office of Community Outreach and Engagement and the Cancer Biology Program, the ROSA program employed multiple strategies to educate and engage basic scientists on best practices to effectively engage community members, which included: collaborative working groups, meet the scientist learning opportunities, student and community ambassadors, and creation of the ROSA Café Series (community conversations with UACC basic scientist). These strategies facilitated avenues for scientists to educate, learn from, and engage with the community. Results: The working group consisted of UACC basic scientists and community members that helped develop a ROSA survey that will be used to gain community input and learn more about community research priorities, knowledge base and culturally appropriate research. Additionally, ROSA community and student ambassadors were enrolled into a curriculum where they learned fundamentals of cancer biology via conversations with the basic scientists and provided opportunities for scientists to practice using lay language to express scientific ideas. Bidirectional learning opportunities were also presented within the structure of the ROSA Café’s with the ultimate goal of having community members learn directly from the researchers about current and potential projects. These strategies have ultimately led to interactions between the basic science and lay community that serve as a basis for future basic science projects that are community inspired and have potential for high community input and impact. Discussion: Helping basic scientists integrate their science more fully into communities has the potential for advancing science and promoting health equity in minoritized communities. This partnership is predicated on preparing basic scientists to interact comfortably and effectively with community members, necessitating common language and fuller understanding of community ways of knowing. The strategies employed and explicated here provide a model for cancer centers to develop culturally and community relevant basic science programs. Citation Format: Namoonga M. Mantina, Juan Contreras, Monica Yellowhair, Cynthia Miranti, Jennifer Hatcher. Multifaceted approach to engaging basic cancer scientists in community-based research. [abstract]. In: Proceedings of the American Association for Cancer Research Annual Meeting 2023; Part 1 (Regular and Invited Abstracts); 2023 Apr 14-19; Orlando, FL. Philadelphia (PA): AACR; Cancer Res 2023;83(7_Suppl):Abstract nr 4188.

Boccaccio's 'Decameron': Rewriting the Christian Middle Ages and the Lyric Tradition by Dino S. Cervigni

Reviewed by: Boccaccio's 'Decameron': Rewriting the Christian Middle Ages and the Lyric Tradition by Dino S. Cervigni Charlotte Alton Boccaccio's 'Decameron': Rewriting the Christian Middle Ages and the Lyric Tradition. By Dino S. Cervigni. (Medieval and Renaissance Texts and Studies, 548) Tempe: Arizona Center for Medieval & Renaissance Studies Press. 2021. viii+558 pp. £88. ISBN 978–0–86698–606–9. Dino Cervigni's latest monograph provides an extensive study of Boccaccio's masterpiece which is exceptionally well timed in its publication in the light of the [End Page 256] increased readership of the Decameron in response to the Covid-19 pandemic. Cervigni's approach is particularly pertinent given its focus upon the text's critique and reconstruction of societal norms in the aftermath of the plague which forms the backdrop to Boccaccio's text. Cervigni reads the Decameron's first ninety tales as a parodic rewriting of the societal, historical, and lyric traditions of the Christian Middle Ages and suggests that the Tenth Day sets out a new ethical code for society and literature in the wake of the plague, based upon human and liberal principles such as generosity and sacrifice. Cervigni's work asserts the importance of the text's overarching narrative and dismisses the labelling of this architectural feature as a 'frame' or 'cornice', as it is so often referred to by critics. Instead, he reads this 'novella portante', voiced by Boccaccio's narrator, as the principal location of meaning within the text. Cervigni's advancing of this 'novella portante' addresses the limitations of fragmentary readings of Boccaccio's text which occur through the discussion of isolated novelle. Through his concern with this overarching narrative, Cervigni's emphasis also highlights areas of the text that have eluded significant critical attention thus far. The book comprises an Introduction and fourteen chapters, ten of which are dedicated to each of the text's ballads that feature in the 'novella portante' at the close of each day of narration. The focus upon the ballads is particularly significant to this work's contribution. Building on his own previous work on the ballads, with this monograph Cervigni provides ten rich, close readings of each of the text's ballads and exposes them as significant textual loci. The book offers an original and necessary approach to the Decameron by demonstrating the ballads' significance in the construction of meaning across the text, thus providing a hugely important intervention in the literature surrounding the Decameron. The ballads are frequently passed over by the critical literature and certainly have not thus far been widely considered as essential to textual meaning. Cervigni takes these poetic sites as key moments of introspection on the part of the narrators that provide a key through which we may read their ten narrated tales. This approach thus contributes a further important intervention in the ongoing debate within Boccaccio Studies surrounding the individuality of the ten members of the brigata. Cervigni's focus upon the ballads as keys for understanding the members of the brigata as unique subjects offers a notable contribution to that debate by arguing that 'the evening ballad accomplishes something no other daily activity can achieve: it offers all members of the group the opportunity of revealing aspects of their inner selves which would not have become manifest otherwise' (p. 101). Cervigni's far-reaching work makes a substantial contribution to Boccaccio Studies by addressing a significant gap in the scholarly literature relating to the Decameron, by arguing for the 'essential function of the ten evening ballads' (p. vii), and by highlighting the importance of the 'novella portante' to the text's meaning. This monograph also offers a reading that is opportune in its concern with the [End Page 257] disruption and reconstruction of tradition in response to plague, which our own contemporary readership will no doubt find to be particularly thought-provoking. Charlotte Alton Selwyn College, Cambridge Copyright © 2023 Modern Humanities Research Association

:Race and Affect in Early Modern English Literature

:<i>Race and Affect in Early Modern English Literature</i>

Antisatire: “In Defense of Women, against Francesco Buoninsegni.” Arcangela Tarabotti. Ed. and trans. Elissa B. Weaver. The Other Voice in Early Modern Europe: The Toronto Series 70; Medieval and Renaissance Text and Studies 564. Toronto: Iter Press; Tempe: Arizona Center for Medieval and Renaissance Studies, 2020. xvi + 114 pp. $41.95. - Convent Paradise. Arcangela Tarabotti. Ed. and trans. Meredith

Antisatire: “In Defense of Women, against Francesco Buoninsegni.” Arcangela Tarabotti. Ed. and trans. Elissa B. Weaver. The Other Voice in Early Modern Europe: The Toronto Series 70; Medieval and Renaissance Text and Studies 564. Toronto: Iter Press; Tempe: Arizona Center for Medieval and Renaissance Studies, 2020. xvi + 114 pp. $41.95. - Convent Paradise. Arcangela Tarabotti. Ed. and trans. Meredith

New Books across the Disciplines

New Books across the Disciplines

Development of integrated screening, cultivar optimization, and verification research (DISCOVR): A coordinated research-driven approach to improve microalgal productivity, composition, and culture stability for commercially viable biofuels production

To address major knowledge gaps and barriers to the commercial development of algal biomass for biofuels and co-products, a collaborative consortium, Development of Integrated Screening, Cultivar Optimization, and Verification Research (DISCOVR), was established in 2016. Funded by the U.S. Department of Energy (DOE) Bioenergy Technologies Office (BETO), this consortium constitutes a partnership between four DOE national laboratories - Pacific Northwest National Laboratory (PNNL), Los Alamos National Laboratory (LANL), the National Renewable Energy Laboratory (NREL), and Sandia National Laboratories (SNL) - and the Arizona Center for Algae Technology and Innovation (AzCATI) at Arizona State University.To address the barriers of strain selection for achieving high seasonal productivities with a suitable composition and culture resilience, a tiered strain down-selection pipeline is implemented. At Tier I, the temperature and salinity tolerance of strains is determined in flask cultures; at Tier II, the areal biomass productivity and composition is determined in climate-simulation photobioreactors; at Tier III, the productivity and culture stability are determined in outdoor raceways. The top performing strains move forward to long-term testing at the algae testbed site at AzCATI to generate annual biomass productivity data.Concurrent to the strain down-selection in the DISCOVR pipeline, hypotheses for increasing biomass productivity, shifting biomass composition to enhance intrinsic value, and improving culture stability and resistance to pests are also tested. Techno-economic analyses are carried out to determine whether promising findings from laboratory studies or proposed modifications in outdoor pond cultivation conditions translate into reductions in the minimum biomass selling price (MBSP). In the three years following the launch of DISCOVR, annual biomass productivity has increased from 11.7 to 17.6 g m−2 day−1, resulting in an MBSP decrease from 824 to 611 $ ton−1.

Drug-Induced QTc Prolongation: What We Know and Where We Are Going.

Drug-induced QTc prolongation is a concerning electrocardiogram (ECG) abnormality. This cardiac disturbance carries a 10% risk of sudden cardiac death due to the malignant arrhythmia, Torsades de Pointes. The Arizona Center for Education and Research on Therapeutics (AzCERT) has classified QTc prolonging therapeutic classes, such as antiarrhythmics, antipsychotics, anti-infectives, and others. AzCERT criteria categorize medications into three risk categories: "known," "possible," and "conditional risk" of QTc prolongation and Torsades de Pointes. The list of QTc prolonging medications continues to expand as new drug classes are approved and studied. Risk factors for QTc prolongation can be delineated into modifiable or non-modifiable. A validated risk scoring tool may be utilized to predict the likelihood of prolongation in patients receiving AzCERT classified medication. The resultant risk score may be applied to a clinical decision support system, which offers mitigation strategies. Mitigation strategies including discontinuation of possible offending agents with a selection of an alternative agent, assessment of potential drug interactions or dose adjustments through pharmacokinetic and pharmacodynamic monitoring, and initiation of both ECG and electrolyte monitoring are essential to prevent a drug-induced arrhythmia. The challenges presented by the COVID-19 pandemic have led to the development of innovative continuous monitoring technology, increasing protection for both patients and healthcare workers. Early intervention strategies may reduce adverse events and improve clinical outcomes in patients identified to be at risk of QTc prolongation.

Fruit, Vegetable, and Physical Activity Guideline Adherence and Metabolic Syndrome in El Banco por Salud.

Adherence to dietary and physical activity recommendations has been associated with reductions in morbidity and mortality. The association between baseline adherence to fruit, vegetable, and physical activity guidelines and metabolic syndrome (MetS) in El Banco por Salud (El Banco) was examined. El Banco is a wellness biobank for Latino individuals affiliated with partnered Federally Qualified Health Centers in southern Arizona. Study participants (n = 972) were 65% female, 62.3% foreign-born, 56.3% obese, 29.2% food insecure, and with an average age of 51.3 years. Adherence scores were developed using baseline questionnaires for fruits and vegetable consumption and self-reported physical activity. Adherence was low in those fully meeting guidelines for fruit, vegetable, and physical activity at 14.6%, 37.5%, and 23.5%, respectively. Roughly 65% (n = 630) had ≥3 cardiometabolic risk factors. Large waist circumference was the most prevalent risk factor at 77.9%. Adherence to physical activity recommendations differed by MetS status with 32.8% without MetS reporting ≥150 min of physical activity per week compared to 18.5% in those with MetS (p < 0.001). There were no significant associations with adherence to any guidelines and MetS in the fully adjusted model. Overall, in this sample guideline adherence was low and the cardiometabolic risk factors prevalence was high.