Local County Research Articles

Abstract 11708: Examining the Impact of Social Determinants of Health in Cardiovascular Disease Risk Factors: Insights From an Implementation Study in a Rural Primary Care Clinic

Introduction: The social determinants of health (SDoH) are associated with uncontrolled cardiovascular disease (CVD) risk factors and warrant attention. Methods: We describe methods and cross-sectional results of the SDoH screening and referral system at a resident-run primary care clinic at Cayuga Medical Center (total 30 residents ~539 patients seen/month with 12% no shows) starting from Nov 2019. Eight domains of SDoH including food security, utility, housing, childcare, finances, transportation, literacy, and social support were selected based on local county data and focus group discussions. We developed an annual screening tool and referral system integrated into the electronic medical record for any SDoH positive patients to the community health and social workers (CHW/SW), who facilitated access to community resources. Patient education about available community resources, regular follow-up visits with the physician and CHW/SW, and periodic SDoH screening were other key components. Results: Among 741 patients (Hypertension and Diabetes), 607 (82%) patients underwent SDoH screening (Table). 200 (33%) patients had at least one domain of SDoH (SDoH +) and received SDoH interventions whereas, 407 (67%) did not have any SDoH. The three most common SDoH were lack of social support (61%), transportation (35%) and finance issues (25%). Patients in the SDoH+ group were younger, with higher percentage of non-White race/ethnicity, unemployment, disability, living alone, current smokers, illicit substance use, anxiety, depression, obesity, and opioid use with statistical significance. However, there were no significant differences in CVD risk factors like SBP (138.3 vs 138.4 mmHg), DBP (84 vs 83 mmHg), HbA1c (6.4 vs 6.2) and LDL-c (103.7 vs 101.5 mg/dL). Conclusions: In addition to controlling standard CVD risk factors, implementation of SDoH routine screening and referral system in a primary care clinic may help in mitigating CVD burden as seen in our study.

Making Local Histories: The Authenticity and Credibility of County Gazetteers in Communist China

AbstractMany scholars have used local Chinese county gazetteers for historical and socioeconomic analyses, yet little research has examined the completeness of coverage or the biases in reporting that characterize the compilation of these gazetteers. In this paper, we provide a novel source for studying Chinese political movements and local history under the communist regime after 1949: the internal-discussion drafts of county gazetteers (xianzhi pingyigao). Our findings constitute the first study to use internal review drafts to examine the authenticity and credibility of county gazetteers. Prior to their publication, gazetteer drafts are compiled by a team of editors and typically receive at least three rounds of rigorous internal review. These internal-discussion drafts are subject to a prolonged and strict process of self and external censorship. Our analysis engages in a close comparison of text samples extracted from two versions of local gazetteers collected from four counties in Guangxi province. Compared to the draft versions, we find evidence of serious data manipulation and a tendency to underreport historical events in the published editions. Our research evidently demonstrates the process of historiography editing and reveals how local history is presented through the lens of government public documents in China.

Impact of Severe Weather on Operations of a Radiation Oncology Department

In 2022, two major storms in Western New York brought blizzard conditions and historic snowfall amounts to the region. Beyond the immediate impact to life and property, these weather events resulted in disruptions to cancer care as a result of hazardous travel conditions, and facility closures as a result of regional travel bans. We sought to understand the impact of these disruptive incidents on departmental operations to develop better contingency plans for future occurrences. The radiation treatment machine schedules for a large academic center in Western New York, as well as a neighboring affiliated satellite clinic were queried for daily treatment adherence rates from November 1, 2022 through February 4, 2023. We classified "severe weather days" based on travel advisories issued by the National Weather Service or from local county officials. Out of a total of 68 working days during the study period, 15 days were classified as having severe weather. We compared the percentage of scheduled patients treated (adherence rates) on severe weather days compared with days without severe weather. Statistical analysis was performed using a two-tailed Z-test for proportions. Under routine operating conditions, out of a total of 7045 scheduled treatment visits, we found a mean daily treatment adherence rate of 93.57%. On severe weather days, out of a total of 2093 scheduled treatments, we found a mean daily treatment adherence rate of 77.83%. Out of these 15 days, the satellite clinic closed for a total of 3 days, while the academic center closed for 1 day. Excluding the dates of facility closure, overall treatment adherence rate was 84.76% on severe weather days (Risk Ratio: 0.91). We found that the difference in treatment adherence rates between regular and severe weather days was statistically significant (p<0.001), even when excluding dates of facility closure. This study demonstrates a significant reduction in treatment adherence rates around severe winter storms, even when excluding dates of facility closure. We suggest that preparation for such incidents be a part of facility contingency planning. Weekend openings can be considered for closures ≥ 2 days, or sustained adherence rates of 85% or less for 3 or more days.

Factors and interventions determining the functioning of health care teams in county-level hospitals in less affluent areas of China: a qualitative study.

Teamwork is essential for the quality and safety of care, and research on teamwork in health care has developed rapidly in many countries. However, evidence from less affluent, non-Western countries is scarce, while improving teamwork may be especially relevant to be able to increase the quality of care in these settings. This study aims to understand the main factors that influence, and interventions used to improve, the functioning of health care teams in the context of county-level hospitals in less affluent areas of China. We conducted semistructured interviews to explore the factors that influence team functioning and the interventions implemented to improve team functioning in these hospitals. 15 hospital presidents and 15 team leaders were selected as respondents. From the interviews, we have identified five main factors that influence team functioning in these hospitals: "stuck in the middle", local county setting, difficulty in attracting and retaining talent, strong focus on task design, and strong focus on leadership. The interventions for improving team functioning can mostly be categorized as the following: 1) measures to attract and retain talent (e.g., increase salary, train talent in national or provincial level hospitals, and provide fast-track promotions), 2) interventions focused on monodisciplinary teams (e.g., changing the team structure and leadership, and skill training), and 3) interventions to establish and improve multidisciplinary teams (e.g., simulation training and continuous team process improvements). With the introduction of multidisciplinary teams, interventions into team processes have started to receive more attention. The findings depict an overview of the main factors and interventions as specifically relevant for team functioning in county-level hospitals in less affluent areas of China and may help these hospitals benefit from additional process interventions to improve teamwork and the quality of care.

Rural postsecondary encouragement through a land grant university county extension office

AbstractRural students graduate from high school at higher rates but go to college at lower rate than their urban and suburban peers. To take on the educational attainment challenge for rural students, we need to know more about postsecondary encouragement programs. This study examined a pilot postsecondary encouragement program in 11 rural high schools with two questions: How do high school counselors support students’ plans for life after high school through a land‐grant outreach program? How is a university outreach program utilized in these schools? This qualitative case study used 17 individual interviews with school counselors and county extension agents. According to school counselors, the postsecondary encouragement program increased financial aid applications and student interest in college going. County extension agents were a trusted bridge between the program and the local high schools. Tracking student milestones helped school counselors serve all students, and program experts provided workshops for students and parents. Campus visits helped students visualize themselves as college students, yet financial concerns dominated the students’ college choices.Practical Takeaways Postsecondary encouragement through information from experts combined with local support can be a cost‐effective intervention to increase rural students’ college going. Counselors tracking all students for college and career readiness milestones ensure all students are given the message that they are college material, a predictor of enrollment. Counselors and students lack clear information about costs and financial aid availability, but these are important to rural families’ decisions. Local county extension agents can serve as the bridge between the rural student population and the 4‐year universities. Extension agents and school counselors gave credibility to outside experts.

Application of Adjustable Skin Stretchers in Repairing Wound-Related Defects.

To explore the application value of adjustable skin stretchers for repairing skin wound defects. Twenty patients with skin defects were included in this study. The largest defect was measured to be 45.4 cm × 13.3 cm (length × width) and the smallest one was 4.4 cm × 3.2 cm (length × width). All patients were subjected to adjustable skin stretchers and the short- and long-term clinical efficacy was evaluated. The wounds of all enrolled patients were healed completely except for one patient with a dorsal foot infection (the patient requested to return to the local county hospital for further treatment), with a total satisfaction of 100%. Postoperative 3-month follow-up showed scar formation, a little local hyperpigmentation, normal skin elasticity, and intact organs of involved cases, thus signifying the significant impact of adjacent joint activities. Adjustable skin stretchers can accurately control the tension on wound margins, breaking the limitation of previous stretchers to provide objective quantitative indicators for clinical application. These stretchers are characterized by high use-value and are worth promoting.

Dams, cropland productivity, and economic development in China

We use satellite, hydrology, and census data from 1992 to 2014 to quantify dams' impacts on cropland productivity and economic development in China. We exploit a county's river gradient and elevation to address the endogeneity of dam placement. We find that an additional dam reduces a local county's cropland net primary production (NPP) and nighttime light (NTL)-based GDP by 13.7% and 2.9%, respectively. We also find that an additional dam increases a downstream county's NPP by 0.5% and has a positive yet insignificant impact on a downstream county's NTL-based GDP. Dynamic analysis shows that the positive impact of dams on downstream counties' cropland productivity and economic development takes around ten years to realize. We also find that dams have smaller positive impacts on agricultural productivity and economic growth than China's high-speed rail (HRS) construction.

Impact of Illuminated Road Signs on Driver’s Perception

This study determined citizens’ perceptions and impact factors of illuminated road signs installed to ensure their visibility at night when the risk of traffic accidents is high. An ordered logit model was used to measure illuminated road signs’ impact on drivers’ perception based on the data from the citizens’ survey conducted by the Road Sign Center. According to the results, the internal (optical fiber) type variable had the highest impact, followed by the frequent fog variable and the complex road line variable. This study found that most citizens positively recognized road signs, preferred internal (optical fiber) types, and desired illuminated road signs that considered climate, environment, and road structure types. In Seoul, the importance and improvement of illuminated road signs at points where road structures are complex, such as city streets, were high. Additionally, the illuminated road sign recognition and road type variable were significant in Gyeonggi-do, which reflected the high number of citizens that commute to Seoul from Gyeonggi-do. Concerning local cities and counties and intercity roads highly affected by the climate, the impact was high at points with frequent fog. Fog affects the visibility distance, generates condensation on signs, and significantly degrades visibility. Therefore, an illuminated road sign installation method must be presented based on spatial analysis for regions vulnerable to climate, environment, and road location. Additionally, the road intersection point variable was significant in local cities and counties, which reflects the relatively lagged road infrastructure. Local cities and counties are financially poor and have numerous aged drivers; hence, central government support that considers these aspects is crucial.

Do Primary Healthcare Facilities in More Remote Areas Provide More Medical Services? Spatial Evidence from Rural Western China

Primary healthcare institutions (PHIs) in China have experienced a sizable decline in medical services in recent years. Despite the large regional disparities in China, there is a lack of evidence on the differential patterns of medical services offered by PHIs, especially from a spatial perspective. This study examines whether residents in more remote areas use more medical services offered by township healthcare centers (THCs), a main type of PHIs. Linking medical visits to 923 THCs in a western Chinese province in 2020 with the driving time and geographic coordinates from the Gaode map, a leading map navigation provider in China, we applied a multilevel linear model and a geographically weighted regression to examine spatial heterogeneity in medical service utilization. We showed that a one-hour increase in the shortest driving time between THCs and the local county hospitals was associated with an average 6% increase in THCs outpatient visits and a 0.6% increase in THCs inpatient visits. Our findings suggest that THCs located in more remote areas provided more medical services, especially outpatient services. This study may improve our understanding of the spatial disparity in medical services provision for THCs in western China. We suggest that more attention should be paid to enhance the quality of THCs in remote areas, which deserve a higher priority in the process of improving the quality of primary healthcare. Health policymaking in developing regions such as western China should take geographic factors into account.

ANALYSIS OF LOCAL GOVERNMENT UNITS IN POLAND

The subjectivity and independence of local self-government expressed in theConstitution of the Republic of Poland and concretized in local government laws has a systemicsignificance for determining its position in the state and in the law. Local self-government isthe key principle of the organization of public administration in Poland. Local governmentunits, i.e., municipalities, counties and provincial governments, are entities endowed with rightsand obligations and entities performing public tasks. They can be described as independentcorporations of local society, created by law, with their own internal organization, endowedwith the attribute of legal personality, subject to state supervision to the extent prescribed bylaw.

Hepatitis E virus seropositivity in an ethnically diverse community blood donor population.

Hepatitis E virus (HEV) is an underrecognized and emerging infectious disease that may threaten the safety of donor blood supply in many parts of the world. We sought to elucidate whether our local community blood supply is at increased susceptibility for transmission of transfusion-associated HEV infections. We screened 10,002 randomly selected donations over an 8-month period between 2017 and 2018 at the Stanford Blood Center for markers of HEV infection using commercial IgM/IgG serological tests and reverse transcriptase quantitative polymerase chain reaction assays (RT-qPCR). Donor demographic information, including gender, age, self-identified ethnicity, location of residence and recent travel, were obtained from the donor database and used to generate multivariate binary logistic regressions for risk factors of IgG seropositivity. A total of 10,002 blood donations from 7507 unique donors were screened, and there was no detectable HEV RNA by RT-qPCR. The overall seropositivity rate was 12.1% for IgG and 0.56% for IgM. Multivariate analysis of unique donors revealed a significantly higher risk of IgG seropositivity with increasing age, White/Asian ethnicities and residence in certain local counties. Although HEV IgG seroprevalence in the San Francisco Bay Area is consistent with ongoing infection, the screening of a large donor population did not identify any viraemic blood donors. While HEV is an underrecognized and emerging infection in other regions, there is no evidence to support routine blood screening for HEV in our local blood supply currently; however, periodic monitoring may still be required to assess the ongoing risk.

Quaternary Earth-science and Palaeolithic conservation initiatives in the Tejo (Tagus), Portugal: Comparison with the Lower Thames, UK

Geoconservation measures in the River Tejo, the Portuguese reach of the Tagus, are compared with those in the Thames downstream of London (UK). Both are fluvio-estuarine reaches with staircases of Pleistocene depositional terraces, each with important sedimentary, palaeontological and archaeological records. In both rivers, conservation measures are in place that aim to protect these records, promote research and inform the public. Inevitably there are differences in approach. Whereas Thames Quaternary interests are protected by a network of British statutory site designations, outreach is to the fore in the Tejo. Contrasting examples are highlighted here. The Tejo has interpretative materials in local museums and detailed explanatory displays at the low-terrace archaeo-geological site of Foz do Enxarrique, near the border with Spain, and at other sites. The Thames, in contrast, has few examples of physical outreach provision and limited formal protection for Pleistocene archaeological material outside the geological network, although extensive informal protection is provided by interaction between local geological groups and county and local-authority administrations. There is also a considerable difference in the degree of threat, with the Tejo above Lisbon being a relatively undeveloped valley, albeit with sporadic quarrying for aggregate, whereas the Lower Thames is an established area for infrastructure development, lying to the east of London, close to the river crossing of the orbital motorway. The different climate in the two regions profoundly influences the longevity of exposures in Quaternary deposits, with significant implications for management strategies. The comparison exercise reveals that each region would benefit from greater development of approaches used more prominently in the other; outreach measures in the Portuguese style would greatly enhance some of the Thames sites, but formal designation of Tejo exposures could prevent damaging operations being undertaken by owners who lack knowledge of their value, as exemplified by a case study of sites at Alpiarça, ~130 km upstream from Lisbon.

Identification and Observation of Infection Processes of Colletotrichum Species Associated with Persimmon Anthracnose in Guangxi, China.

Persimmon originated from China where it has a long cultivation history. Anthracnose fruit rot and leaf blight caused by Colletotrichum species are major diseases of persimmon in China and cause severe economic losses. To determine the species causing anthracnose of persimmon in Guilin, Guangxi Province, diseased samples were collected from the four local counties: Gongcheng, Yangshuo, Pingle, and Lipu. Seventy-five isolates were obtained from persimmon samples with anthracnose symptoms and had similar morphological characteristics. Isolates were identified using a BLAST search and phylogenetic analysis of the internal transcribed spacer region, glyceraldehyde-3-phosphate dehydrogenase, partial actin, β-tubulin, chitin synthase genomic regions, Apn2-Mat1-2 intergenic spacer, and the partial mating type gene and calmodulin genes. Five species (C. fructicola, C. horii, C. karstii, C. cliviicola, and C. siamense) accounted for 54.7, 25.3, 12.0, 5.3, and 2.7%, respectively, of the total isolates. All five Colletotrichum species were pathogenic on attached leaves and detached fruits of persimmon (cultivar Gongcheng Yueshi) in pathogenicity assays. The infection processes of the five Colletotrichum species were observed on persimmon leaves using light microscopy. Conidia of C. fructicola germinated at 12 h post inoculation (hpi) and quickly formed acervuli at 6 days post inoculation (dpi) and were the most aggressive. By contrast, conidia of C. cliviicola germinated at 3 hpi but produced the acervuli at 8 dpi and were the least aggressive. This is the first description of C. fructicola, C. cliviicola, and C. siamense as causal agents of persimmon anthracnose in Guangxi Province, China.

West Michigan Suicide Trends During the COVID-19 Pandemic.

The COVID-19 pandemic has resulted in increased concern regarding the mental health of individuals navigating this public health crisis. Various risk factors for suicide have increased during the pandemic, including isolation, depression, access to firearms, substance use, and loss of employment. However, the relationship between the COVID-19 pandemic and suicide rates in the United States remains unclear. In this retrospective study, we examined the relationship between suicide rates and COVID-19 cases in 11 West Michigan counties. Suicide rates in the prepandemic (January 2018 to February 2020) and pandemic (March 2020 to February 2022) months were compared after adjusting for seasonal and population size effects. A mixed effects model was used to assess the impacts of local COVID-19 rates and county on the ratio of pandemic to prepandemic monthly suicide rates. The model did not find a significant effect of COVID-19 case rates on suicide rates. Although this study does not find sufficient evidence for a statistical relationship between COVID-19 cases and suicide rates in West Michigan, close surveillance should continue and public health measures should be used because of the increased risk factors for suicide associated with the pandemic.

Psychosocial Factors Associated With Alcohol Use among Persons Aged 18-35 Years in Kangundo North Ward, Machakos County, Kenya

Purpose: The objective of this study was to explore the psychosocial factors associated with alcohol use among persons aged 18-35 years in Kangundo North Ward, Machakos County. &#x0D; Methodology: A cross sectional study design where data was collected using a structured questionnaire. Data entry was done and analyzed using SPSS version 23, descriptive statistics was used. Logistic regressions were used to explore the psychosocial factors associated with alcohol use where Odds ratios were used. Multivariate and bivariate analysis were done to establish association between psychosocial factors and alcohol use.&#x0D; Findings: 310 respondents were interviewed, the response rate was 100%, 86% were males while 14% were females, 86% of alcohol consumers were males, while 14% who consumed alcohol were females. 89% were aged between 18-24 years, 8% were aged between 25-29 years while 3% were 30-35 years. The study revealed that youths aged 18-35 years suffer a wide variety of challenges.49% of the respondents had experienced financial difficulties, 11% were victims of robbery, these stressful life events can lead to one using alcohol. Majority of respondents had ever experienced stressful event with 50% using alcohol as a solution to relieve the stress. 50.32% indicated that they started taking alcohol after the stressful experiences, 48% had experienced physical violence,5% sexual violence,45% emotional violence while 24% had undergone harsh childhood experiences. The study findings revealed that (28%) had consumed tobacco, (17%) miraa, (8%) marijuana, (1%) inhalants while (46%) had never consumed any psychoactive substance. There was significant association between experiences of emotional, sexual abuse, harsh childhood experiences and use of other psychoactive substances with alcohol use (p&lt;0.05).&#x0D; Unique Contribution to Theory, Practice and Policy: Targeted interventions aimed at addressing psychosocial factors associated with alcohol use is vital. The study adds to the pool of knowledge that psychosocial issues such as stressful life events, gender based violence, harsh childhood experiences and use of other psychoactive substances contribute to alcohol use. Awareness on Gender based violence and other psychoactive substances such as cigarette and marijuana use needs to be enhanced. The findings of the study may inform the local county government of Machakos and Kangundo Sub-county administrators in formulating policies to help address alcohol use among persons aged 18-35 years.

Long-term Survival in Hospitalized Patients with Lung Cancer among Peasants in the Coal-producing Area in Eastern Yunnan, China

Xuanwei and Fuyuan are rural counties, located in the late Permian coal poly area of eastern Yunnan and western Guizhou, where lung cancer mortality rates are among the highest in the China, with similarity for both men and women, younger age at diagnosis and death, and higher in rural areas than in urban areas. In this paper, long-term follow-up of lung cancer cases in local peasants was conducted to observe their survival prognosis and its influencing factors. Data of patients diagnosed with lung cancer from January 2005 to June 2011, who had lived in Xuanwei and Fuyuan counties for many years, were collected from 20 hospitals at the local provincial, municipal and county levels. To estimate survival outcomes, individuals were followed up until the end of 2021. The 5-year, 10-year and 15-year survival rates were estimated using the Kaplan-Meier method. Survival differences were examined with Kaplan-Meier curves and Cox proportional hazards models. A total of 3,017 cases were effectively followed up (2,537 peasants and 480 non-peasants). The median age at diagnosis was 57 years, and the median follow-up time was 122 months. During the follow-up period, 2,493 cases (82.6%) died. The distribution of cases by clinical stage was as follows: stage I (3.7%), stage II (6.7%), stage III (15.8%), stage IV (21.1%) and unknown stage (52.7%). Treatment at the provincial, municipal and county-level hospitals accounted for 32.5%, 22.2% and 45.3%, respectively, and surgical treatment was performed in 23.3% of cases. The median survival time was 15.4 months (95%CI: 13.9-16.1), and the 5-year, 10-year and 15-year overall survival rates were 19.5% (95%CI: 18.0%-21.1%), 7.7% (95%CI: 6.5%-8.8%) and 2.0% (95%CI: 0.8%-3.9%), respectively. Peasants with lung cancer had a lower median age at diagnosis, higher proportion residing in remote rural areas, and higher use of bituminous coal as a household fuel. They also have a lower proportion of early-stage cases, treatment at provincial or municipal hospitals, and surgical treatment, leading to poorer survival outcomes (HR=1.57). Even when considering factors such as gender, age, residential location, clinical stage at diagnosis, histological type, hospital level of service, and surgical intervention, peasants still exhibit a survival disadvantage. Multivariable Cox model analysis comparing peasants and non-peasants reveals that surgical intervention, tumor-node-metastasis (TNM) stage, and hospital level of service are common factors influencing survival prognosis, while the use of bituminous coal as a household fuel, hospital level of service and adenocarcinoma (compared to squamous cell carcinoma) are independent prognostic factors for lung cancer survival among peasants. The lower lung cancer survival rate among peasants is associated with their lower socioeconomic status, lower proportion of early-stage diagnoses, lower proportion of surgical interventions, and treatment at provincial-level hospitals. Furthermore, the impact of other factors such as high-risk exposure to bituminous coal pollution on survival prognosis requires further investigation.

The ‘civilizing effect’ and ‘deterrence spectrum’ revisited: results of a national study of body-worn cameras on fatal police force

ABSTRACT Body-worn cameras have, since their rapid emergence from 2014 onward, long been touted as an important part of police reform efforts, given their hypothesised effects. The two most prominent mechanisms through which they reduce police force are the ‘civilizing effect’, whereby citizens self-monitor their behaviour when they are aware of being recorded, and the ‘deterrence effect’, whereby law enforcement officers are deterred from misusing coercion when there are more agency policies in place that remove their discretion in camera activation. Using a national sample of local (municipal and county) law enforcement agencies in the United States that have adopted and deployed body-worn cameras, we examine whether a policy requiring officers to inform the public of recording (a measure of the ‘civilizing effect’) and an index of policies requiring officers to activate their cameras for specific events (a measure of the ‘deterrence spectrum’) significantly reduce fatal police use of force, which we measure through a comprehensive dataset linking four major open-source fatal force datasets. Our multilevel Poisson model indicates that neither hypothesised mechanism significantly affects an agency’s fatal police use of force numbers. Given these findings, it is unlikely that these two predominate explanations behind BWC efficacy are actually impacting the fatal force-reducing capabilities of body-worn cameras. We therefore discuss further implications and additional considerations for agencies to reduce their fatal police force.

4 Survey of Mycoplasma Wenyonii Infection in a Texas Beef Cattle Herd

Abstract Mycoplasma wenyonii is hemotrophic bacteria known to cause mild anemia, localized edema, and pyrexia in infected cattle. It has been previously detected in cattle herds across the world, including United States beef herd. Mode of transmission, prevalence, and a full profile of symptoms associated with this species of bacteria have not been established. This case study aimed to elucidate the percentage of infected cattle in a local Erath County beef herd and determine which groups of cattle may have the greatest infection rates. Groups were determined based on sex and age, bull, cow, or unsexed calf. Blood was collected from 4 bulls, 61 cows, and 55 calves from the same producer on the same day. A blood extraction kit that utilized spin column-based nucleic acid purification was used to extract DNA from blood samples. Primers were constructed to be highly specific to the m. wenyonii sequence to avoid confusion with other common mycoplasma species. Extracted m. weyonii DNA was quantified using qPCR. Melt curve analysis was performed to verify the amplicon product size. Standard deviation of the melting point was calculated and selection was made within 2 standard deviations of the control. Animals with any detectable amount of m. wenyonii DNA present in their blood were considered positive for infection for the purposes of this case study. This survey yielded positive results for 2 of the 4 bulls, 19 of the 61 cows, and 0 calves. The lack of positive samples in the calf population suggests that the placenta functions as a barrier to infection. This study provides perspective on the prevalence of this microorganism in Texas cattle populations and serves as a basis for future studies. More investigation is needed to better understand the impact of this bacterial infection on Texas beef cattle producers.

Sustainable Rural Community Development Experiences and Lessons

The purpose of this article is multifactorial. The primary question we investigate here refers to human barriers and established practices in a local county that obstructs pathways towards a sustainable future, as well as the measures taken to overcome difficulties and their societal impact. We base our analysis solely on the experience gained during the 2012-2015 planning period for the sustainable development of Vytina county-Greece. Our research focuses on sustainable development and its dependence on local community behaviours, as well as alternative ways for citizen involvement in the development process in order to avoid obstacles encountered in established bottom-up methodologies. Societal constraints include the complexity of communications and relationships between residents, the community's existing internal processes, a complex external environment, and a lack of shared vision which all contribute to the ego of the inhabitants, and to their time availability. These constraints represent obstacles and threats. The fundamentals of the planning process should neutralize and override these obstacles. It is important to recognize and measure these constraints and evaluate their societal impact. Weak predictions/estimates, inconsistent goals, top-down policy decisions, short-sighted planning, resistance to change, and intractable local government can all be barriers to bottom-up methodologies. The bottom-up process, fair and meaningful, is somewhat cumbersome and requires time to mature in order for sustainability practices to be effective. But the pilot application can help foster alternative approaches that allow the citizen to enter the era of sustainability easier and faster. The prerequisite is the existence of a rich cultural heritage. Facing all these problems in the planning for the sustainable development of a local community today, I wonder how a sustainable outer space civilization can be accomplished in the distant future when we have finally arrived at, what Michio K aku refers to as, the God equation or theory of everything.

Assessing the accuracy of California county level COVID-19 hospitalization forecasts to inform public policy decision making

BackgroundThe COVID-19 pandemic has highlighted the role of infectious disease forecasting in informing public policy. However, significant barriers remain for effectively linking infectious disease forecasts to public health decision making, including a lack of model validation. Forecasting model performance and accuracy should be evaluated retrospectively to understand under which conditions models were reliable and could be improved in the future.MethodsUsing archived forecasts from the California Department of Public Health’s California COVID Assessment Tool (https://calcat.covid19.ca.gov/cacovidmodels/), we compared how well different forecasting models predicted COVID-19 hospitalization census across California counties and regions during periods of Alpha, Delta, and Omicron variant predominance.ResultsBased on mean absolute error estimates, forecasting models had variable performance across counties and through time. When accounting for model availability across counties and dates, some individual models performed consistently better than the ensemble model, but model rankings still differed across counties. Local transmission trends, variant prevalence, and county population size were informative predictors for determining which model performed best for a given county based on a random forest classification analysis. Overall, the ensemble model performed worse in less populous counties, in part because of fewer model contributors in these locations.ConclusionsEnsemble model predictions could be improved by incorporating geographic heterogeneity in model coverage and performance. Consistency in model reporting and improved model validation can strengthen the role of infectious disease forecasting in real-time public health decision making.