mid-Atlantic Region Research Articles

Rhynchospora mesoatlantica (Cyperaceae), an imperiled new species of beaksedge from eastern U.S.A.

Rhynchospora mesoatlanticasp. nov. (Cyperaceae) is described, illustrated, and compared with morphologically similar species. Rhynchospora mesoatlantica is known only from southern Delaware, southeastern Maryland, and southern New Jersey, all within the Mid-Atlantic region of the U.S.A. It inhabits sunny, wet margins of natural, shallow, nutrient-poor, seasonal ponds of the Coastal Plain. Narrow leaf blades; fruits obpyriform in outline; faces of mature fruits possessing a central, pale, well-demarcated disk; and fruit tubercle margins denticulate for most of their lengths indicate R. mesoatlantica is most similar to R. filifolia and R. harperi. Rhynchospora mesoatlantica is unique in its fruit dimensions, scales intermediate in length between R. filifolia and R. harperi, and relatively long fruit stipe. The NatureServe rank of Critically Imperiled and the IUCN rank of Endangered appear warranted for R. mesoatlantica because only six populations are known to be extant, most quite small and isolated; all populations occur within a small geographic area; populations have declined; and serious threats confront the survival of the species.

Carbon dynamics of prescribed fire in pine- and oak-dominated forests on the mid-Atlantic coastal plain, USA

The use of prescribed fire to reduce the risk of wildfires and maintain or enhance desired ecological conditions is increasing in forests of the Mid-Atlantic region. Accurate estimates of forest carbon (C) dynamics associated with prescribed burning, including net ecosystem productivity (NEP) and time to accumulate the C lost during burns, termed neutral net ecosystem C balance (NECB), as a function of fire intensity and burn intervals would assist fire managers optimize treatment timing while balancing other ecosystem services provided by forests. We quantified forest C dynamics and evapotranspiration in two pine- and oak-dominated forests in the Pinelands National Reserve of southern New Jersey that have been managed using prescribed fire over two decades. Using long-term C flux data, we found that NEP, ecosystem respiration (RE) and gross ecosystem production (GEP) were similar among stands during undisturbed years. Estimated C loss during three prescribed burns at the pine-dominated stand averaged 4.3 ± 0.9 Mg C ha-1, which is equivalent to 2–3 years of NEP during undisturbed years, and consistent with fuel consumption during prescribed burns throughout the Pinelands. Only annual NEP was lower during years when burns were conducted compared to unburned years, while annual RE, GEP, evapotranspiration and ecosystem water use efficiency were similar. Over a two-decade period, NEP totaled 28.3 Mg C ha-1 and NECB was 15.5 Mg C ha-1, indicating that stands managed using repeated prescribed burns still sequester moderate amounts of C. At an oak-dominated stand, a prescribed burn released lower amounts of C (1.7 Mg C ha-1), and annual NEP was greater over the following 3-year period compared to a decade of low annual NEP following severe spongy moth defoliation and associated tree mortality, suggesting that prescribed fires could play a role in the restoration of ecosystem functioning in insect-damaged stands. Patterns of forest C dynamics during and following prescribed burns in these mid-Atlantic forests are similar to intermediate age pine-dominated stands throughout the southeastern USA, which also sequester moderate amounts of C through repeated prescribed burning regimes.

Examining the complex relations between climate and streamflow in the mid-atlantic region of the United States

Abstract We explored the complex relations between climate and streamflow in the Mid-Atlantic region of the United States. In 124 watersheds across this region, we quantified spatial and temporal variation in air temperature (AT), precipitation (P), and streamflow (Q) from 1981 through 2020. Upward directional trends in monthly values of AT, P, and Q indicated an increase of 0.27–1.9 degrees Celsius, 0.12–1.9 millimeters day−1, and 0.01–7.1 cubic meters s−1 day−1, respectively, over the 40-year period. Comparison of the first 20 years to the last 20 years of data indicated an acceleration in the trend slopes in AT, P, and Q. Changes also were observed in temporal trends in the center of volume (CV) of both P and Q, which generally occurred later in the year; the 7-day mean low flow increased, and the annual day of occurrence of the 7-day mean low flow occurred earlier in the year. Principal components analysis revealed differences in P, Q, CVP, and CVQ trends in watersheds with median elevations greater than and less than 400 meters, as well as by latitude. A seasonal analysis revealed that P increased throughout the study area in spring, summer, and fall but decreased in winter. AT, P, and Q have broadly increased across the region over the 40-year period, and the temporal, spatial, and seasonal changes in P have affected Q. Results highlight the strong couplings between climatic variability and watershed responses.

Egg Morphology and Chorionic Ultrastructure of Spotted Lanternfly, Lycorma delicatula (White) (Hemiptera: Fulgoridae)

Knowledge regarding egg morphology can aid the selection of postharvest fumigants for insect control. Accordingly, scanning electron microscopy (SEM) was used to examine eggs of spotted lanternfly (SLF), Lycorma delicatula (White) (Hemiptera: Fulgoridae), a pest recently invasive to the mid-Atlantic region of the United States. As the overwintering life stage of SLF, eggs are deposited on a variety of refugia, including many forestry products that can be distributed geographically via travel, commerce, and/or trade. For fumigation to control SLF, and potentially translate into a viable strategy for limiting the spread of SLF by subject pathways, the fumigant must permeate the chorion to react with biomolecules and/or disrupt cellular processes. SLF chorion was characterized by a porous network of aeropyles localized around the operculum, in cranial and caudal relation to the developing nymph, as well as an interstice between the operculum edge and the opercular rim. The confirmation of chorionic ultrastructure that allows for ready gas exchange warrants further investigation of fumigation efficacy, even for those “non-reactive” fumigants, such as phosphine and hydrogen cyanide, which must overcome the suppression of cellular processes coincident with overwintering.

Disease-Modifying Therapies for Sickle Cell Disease: Decisional Needs and Supports Among Adolescents and Young Adults

Introduction: Adolescents and young adults (AYAs) with sickle cell disease (SCD) often experience significant challenges in disease management. Hydroxyurea and several newer disease-modifying therapies have demonstrated health benefits; however, uptake of these therapies remains suboptimal. Shared decision-making is one promising solution to addressing barriers in uptake and to improve health outcomes for AYAs with SCD. A thorough understanding of AYA's decisional needs can guide the development of tailored decisional supports and promote shared decision-making. Informed by the Ottawa Decision Support Framework, this study aimed to examine decisional needs and supports reported by AYAs with SCD, their caregivers, and SCD healthcare providers. Methods: Semi-structured qualitative interviews were conducted with AYAs ages 15-25 years with SCD ( n=14) and caregivers of AYAs with SCD ( n=11) receiving care at two hospitals in the mid-Atlantic region of the US. Qualitative data were also obtained through online crowdsourcing with SCD providers across the US ( n=40). Most AYAs (93%) identified as non-Hispanic Black ( M age=21 years, 57% male) and had SS genotype (79%). Most caregivers were female (80%) and all identified as non-Hispanic Black (100%). About two-thirds of healthcare providers were female (65%) and non-Hispanic White (65.0%), with an average of 14.8 years in practice ( range=2-57 years). Thematic and descriptive content analyses were used to summarize perspectives on decisional needs and supports regarding disease-modifying therapies. Adequate inter-rater reliability (Cohen's Kappas > .80) and thematic saturation were achieved. Results: AYAs and caregivers reported needing six areas of support when deciding on disease-modifying therapies: resolving decisional conflicts, gaining knowledge, clarifying expectations, garnering supports and resources, navigating complexities in the decision, and addressing other personal concerns. Families reported receiving supports from providers that facilitated their decision-making by helping them: gain knowledge, clarify expectations, address other personal concerns, build rapport with providers, and resolve unreceptiveness or ambivalence to making a decision. Providers reported offering additional supports targeting: inadequate experience in implementing therapies (e.g., pill swallowing), inadequate health and social services and financial assistance, and inadequate instrumental support (e.g., transportation). Conclusions: This research highlights the needs AYAs and caregivers identify when making decisions about disease-modifying therapies for SCD and the decision supports offered by healthcare providers. Decisional needs reported by families generally corresponded to supports offered by providers. Providers also highlighted additional supports that may be helpful for families (e.g., instrumental supports, such as financial, emotional, and skillset assistance). Findings will inform the development of a shared decision-making intervention for AYAs with SCD, their caregivers, and healthcare providers. Future research is needed to examine which decision supports may be most impactful to promote shared decision-making for disease-modifying therapies.

1932. Molecular Epidemiology of NDM-producing Acinetobacter baumannii in the US—October 2013—March 2022

Abstract Background In the United States, most carbapenem-resistant Acinetobacter baumannii (CRAB) produce carbapenem-hydrolyzing class D β-lactamases (OXA); other carbapenemase classes have historically been uncommon. We describe the epidemiology and molecular characteristics of New Delhi Metallo-β-lactamase (NDM)-producing CRAB reported to CDC since October 2013.Figure 1:A core genome multilocus sequence typing (cgMLST) scheme phylogenetic tree of 208 the New Delhi Metallo-β-lactamase (NDM), sequenced by US public health laboratories and with publicly available sequences, with dates of collection between November 1, 2018 – March 31, 2022. Four regional clusters were identified in Mountain, Mid-Atlantic, Midwest and West regions. Isolates within each cluster were closely related to each other. Methods We included a patient’s first NDM-CRAB isolate reported to CDC through reference antimicrobial susceptibility testing, outbreak response, or Antimicrobial Resistance Laboratory Network, with specimen collection dates during 10/1/2013–3/31/2022. Two or more NDM-CRAB linked in space and time were classified as cluster-associated; other NDM-CRAB as sporadic. We described patient demographics and clinical characteristics and analyzed whole genome sequence (WGS) data for relatedness using both traditional multilocus sequence typing (MLST) with the Oxford scheme (STOX) and core genome (cg) MLST. We compared publicly available sequences of US NDM-CRAB to NDM-CRAB from non-US locations. Results CDC received reports of 263 NDM-CRAB from unique patients in 21 states. Patients had a median age of 65 years (IQR: 55-74) (Table 1). NDM-CRAB were from clinical cultures of respiratory (60), wound (44), urine (32), blood (11), and other sites (11) and from rectal or axilla/groin cultures (96). Eleven of 103 patients with information available were hospitalized outside the US ≤12 months prior to NDM-CRAB specimen collection, 82% were sporadic cases and 19% were a part of clusters. Overall, 191 were from cluster-associated cases in four distinct geographic regions that reported multifacility outbreaks; all cluster-associated cases were from cultures collected after June 15, 2019. WGS data were available for 208 (79%) isolates. The four regional outbreaks identified in the epidemiologic investigation were different STOX (Fig. 1); three (ST218, ST281, and ST1697) were closely related to NDM-CRAB isolates from outside the US. Conclusion NDM-CRAB reported to CDC appears to reflect domestic acquisition rather than importation. ST differences across the regional outbreaks indicate they arose from unique introductions rather than inter-regional spread or dissemination of a successful clone. Disclosures All Authors: No reported disclosures

Multilocus sequence and phenotypic analysis of Pectobacterium and Dickeya type strains for identification of soft rot Pectobacteriaceae from symptomatic potato stems and tubers in Pennsylvania

Outbreaks of potato blackleg and soft rot caused by Pectobacterium species and more recently Dickeya species across the U.S. mid-Atlantic region have caused yield loss due to poor emergence as well as losses from stem and tuber rot. To develop management strategies for soft rot diseases, we must first identify which members of the soft rot Pectobacteriaceae are present in regional potato plantings. However, the rapidly expanding number of soft rot Pectobacteriaceae species and the lack of readily available comparative data for type strains of Pectobacterium and Dickeya hinder quick identification. This manuscript provides a comparative analysis of soft rot Pectobacteriaceae and a comprehensive comparison of type strains from this group using rep-PCR, MLSA and 16S sequence analysis, as well as phenotypic and physiological analyses using Biolog GEN III plates. These data were used to identify isolates cultured from symptomatic potato stems collected between 2016 and 2018. The isolates were characterized for phenotypic traits and by sequence analysis to identify the bacteria from potatoes with blackleg and soft rot symptoms in Pennsylvania potato fields. In this survey, P. actinidiae, P. brasiliense, P. polonicum, P. polaris, P. punjabense, P. parmentieri, and P. versatile were identified from Pennsylvania for the first time. Importantly, the presence of P. actinidiae in Pennsylvania represents the first report of this organism in the U.S. As expected, P. carotorvorum and D. dianthicola were also isolated. In addition to a resource for future work studying the Dickeya and Pectobacterium associated with potato blackleg and soft rot, we provide recommendations for future surveys to monitor for quarantine or emerging soft rot Pectobacteriace regionally.

Biogeochemistry of upland to wetland soils, sediments, and surface waters across Mid-Atlantic and Great Lakes coastal interfaces

Transferable and mechanistic understanding of cross-scale interactions is necessary to predict how coastal systems respond to global change. Cohesive datasets across geographically distributed sites can be used to examine how transferable a mechanistic understanding of coastal ecosystem control points is. To address the above research objectives, data were collected by the EXploration of Coastal Hydrobiogeochemistry Across a Network of Gradients and Experiments (EXCHANGE) Consortium – a regionally distributed network of researchers that collaborated on experimental design, methodology, collection, analysis, and publication. The EXCHANGE Consortium collected samples from 52 coastal terrestrial-aquatic interfaces (TAIs) during Fall of 2021. At each TAI, samples collected include soils from across a transverse elevation gradient (i.e., coastal upland forest, transitional forest, and wetland soils), surface waters, and nearshore sediments across research sites in the Great Lakes and Mid-Atlantic regions (Chesapeake and Delaware Bays) of the continental USA. The first campaign measures surface water quality parameters, bulk geochemical parameters on water, soil, and sediment samples, and physicochemical parameters of sediment and soil.

Prioritizing conservation practice locations for effective water quality improvement using the Agricultural Conservation Planning Framework (ACPF) and the Soil and Water Assessment Tool (SWAT)

Adopting the right agricultural conservation practices (CPs) at the right place is critical to maximizing water quality benefits. The Agricultural Conservation Planning Framework (ACPF) tool identifies all potential CPs and their locations within a target watershed based on the landscape characteristics. The ACPF tool suggests hundreds of CP locations in a watershed, making it challenging to prioritize the CP implementation. We develop and demonstrate an efficient approach using a multicriteria ranking technique for prioritizing the CPs suggested by ACPF, considering pollution hotspots and CP cost and effectiveness to support decision-makers. The pollution hotspots are estimated with simulations from an ecohydrological model, the Soil and Water Assessment Tool (SWAT). The CP cost and effectiveness were estimated from CP installation costs and pollutant reduction efficiencies from the literature. The methodology was demonstrated in the Conewago and Mahantango watersheds in Pennsylvania, US, for grassed waterways (GWWs) and water and sediment control basins (WASCOBs) for sediment load reduction. Multiple CP prioritization scenarios were evaluated with individual and combined criteria for reductions in total sediment load, yield (loading per area), and cost. In single criterion-based prioritization, the cost-based and load-based prioritization indicated cost efficiency and fewer CPs, respectively. The yield-based approach correctly prioritized CPs in sediment loss hotspots in the case study watersheds; however, it needed more CPs to meet the target reductions. The multicriteria approach efficiently prioritized CPs in sediment hotspots to meet target reductions. Although this approach was demonstrated in two case study watersheds and for sediment loss reduction, it is applicable for any location or pollutant for which similar input variables can be provided, thereby providing a means for prioritizing the results of ACPF for implementation in the Mid-Atlantic region of the US.

A hop, skip and a jump towards evaluating social interaction and learning through play at a child and adolescent inpatient treatment program.

The number of inpatient mental health facilities for children and adolescents in the United States is growing rapidly. While undergoing inpatient treatment, children and adolescents can benefit from innovative play opportunities designed to foster social interaction and learning. The Playful Learning Landscapes (PLL) initiative is a group of projects designed to transform everyday spaces into opportunities for playful learning. As a part of this initiative, two designs-Lifesize Ruler and Jumping Feet-were installed in an inpatient mental health facility for children and adolescents in the Mid-Atlantic region of the United States. Results of pre-installation and post-installation naturalistic observations suggested that social interactions, the use of STEM-related language and 21st century skills, including confidence, increased after interacting with the installations. While previous research on PLL projects has demonstrated the efficacy of transforming public spaces into places for playful learning, this research provides support that, even in private, targeted settings, using a trauma-informed approach, children and adolescents, can reap the benefits of playful learning.

Homelessness and Mental Illness: Using Participatory Action Research to Inform Mental Health Counseling

Homelessness and mental illness frequently occur together. Individuals who have a mental illness and are homeless may experience a range of challenges and are often underserved by behavioral health professionals. This study used Participatory Action Research to form a working group (n=6), which met at a homeless shelter located in a small city in the United States (U.S) mid-Atlantic region, to generate insights and responses to the challenges they had encountered. The authors posed several research questions in the context of lived experiences of individuals who experience homelessness and mental illness. The researchers used Interpretive Phenomenological Analysis to interpret the data in light of these questions. We generated four key themes: the trauma of homelessness and mental illness, the power of personal connection, personal agency, and achievement, and meaning through action. For mental health counselors, suggestions include incorporating a trauma-informed framework, minimal turnover in counselor coverage, and a client-centered approach.

Assessing Property Exposure to Cyclonic Winds under Climate Change

Properties in the United States face increasing exposure to tropical storm-level winds due to climate change. Driving this increasing risk are severe hurricanes that are more likely to occur when hurricanes form in the future and the northward shift of Atlantic-formed hurricanes, increasing the estimated exposure of buildings and infrastructure to damaging winds. The wind model presented here combines open data and science by utilizing high-resolution topography, computer-modeled hurricane tracks, and property data to create hyper-local tropical cyclone wind exposure information for the Contiguous United States (CONUS) from current time to 2053 under RCP 4.5. This allows for a detailed evaluation of probable wind speeds by several return periods, probabilities of cyclonic thresholds being reached or surpassed, and a comparison of this cyclone-level wind exposure between the current year and 30 years into the future under climatic changes. The results of this research reveal extensive exposure along the Gulf and Southeastern Atlantic Coasts, with significant growing exposure in the Mid-Atlantic and Northeastern regions of the country.

Upsurge of Powassan virus disease in northeastern United States: a public health concern—a short communication

Powassan virus (POWV) is a tick-borne Flavivirus primarily transmitted through ticks in North America which is a significant public health threat in the northeastern United States. POWV infection spans from Ontario to the Mid-Atlantic, Northeast, and Midwest regions in the USA. Climate change, ecological factors, and human-related changes, including shifts in migration and agriculture, contribute to the dissemination of POWV. Symptoms include sore throat, fatigue, headache, and severe neuroinvasive conditions. Specialized attention is required for diagnosing and managing. MRI scans detect central nervous system abnormalities, while neuromonitoring identifies metabolic distress. Severe cases may necessitate ICU hospitalisation with continuous monitoring. Prevention measures, such as awareness, controlling mammals, and protecting pets, reduce POWV infection risk. The recent outbreak of POWV in Maine, USA, highlights the importance of worldwide collaboration for prevention. With the global prevalence of POWV increasing due to climate and socioeconomic changes, implementing preventative measures and promoting awareness are crucial in reducing infection risk.

Breaking barriers: Effective interventions amplifying minority participation in cancer clinical trials.

201 Background: Cancer-related mortality is disproportionately higher in marginalized populations, necessitating adequate representation in cancer clinical trials. Historically, this goal has been challenging, despite recognition of the importance for clinical practice. Moreover, minority recruitment has decreased in oncology clinical trials published from 2003-2016, indicating an urgent need for effective interventions for this issue. Methods: We conducted a systematic review of interventions focused on increasing minority recruitment/retention in cancer clinical trials between 2012-2023, or on improving attitudes of minority groups towards enrollment. We queried Embase and Scopus databases for articles/abstracts that focused on underrepresented ethnic minority enrollment in cancer clinical trials, in English language, were conducted in the US, Canada, Australia, New Zealand, or Western Europe, and were investigating effectiveness of interventions to improve minority enrollment in adult populations. Results: 261 unique articles/abstracts met our search criteria, with an additional 55 duplicates. 117 were removed for being irrelevant or too old, 31 for being reviews, 85 due to not containing an intervention, 5 for not reporting minority data, and 6 for not adequately comparing the strength of interventions. 17 met all inclusion criteria. Several interventions were identified, including targeted patient education (n=7), assigning patient navigators (n=6), community organization engagement (n=3), nested family/community approaches (n=2), and financial assistance (n=1). Targeted education involved video, audio, or interactive mediums. Most studies involved Black (n=12) and Hispanic (n=5) populations, with a smaller number focusing on Asian/Asian Pacific Islanders (n=2), Arabs (n=1), and Indian/South Asians (n=1). Geographically, these studies were notably concentrated in the American South (n=7). The Midwest and Mid-Atlantic regions contributed equally (n=3 each), and fewer studies were from the Northeast and West (n=2 each). Conclusions: Racial minorities continue to be underrepresented in cancer clinical trials, underscoring the need for concerted efforts to promote healthcare equity and enhance these trials’ generalizability. In our systematic review, targeted education, patient navigators, and active community engagement emerged as efficacious strategies, and were the most frequently utilized to bolster minority enrollment. Future studies should prioritize investigating and implementing these interventions, to ensure diverse, representative, and applicable clinical trial participation.

Crop production and water quality under 1.5 °C and 2 °C warming: Plant responses and management options in the mid-Atlantic region

The 2015 “Paris Agreement” aims to limit the global average temperature rise to significantly less than 2 °C, preferably within 1.5 °C above pre-industrial levels. A multitude of studies have focused on evaluating how different sectors respond to such levels of warming. Nonetheless, most of these studies fail to provide a clear roadmap to mitigate these impacts. A case in point is the anticipated decline in corn and soybean yields and increased phosphorus (P) and nitrogen (N) discharge into water bodies, a trend linked to past agricultural practices and climate change. In this research, we employ a novel assessment of how existing management practices under 1.5 °C and 2 °C global warming (GW) scenarios can affect nutrient availability in time and space as well as crop yield in a typical agricultural watershed in the Mid-Atlantic Region, specifically the Upper Maurice River Watershed (UMRW) in New Jersey.Using the Soil and Water Assessment Tool (SWAT) with multiple Global Climate Model (GCM) projections, we found that compared to 1.5 °C, a 2 °C GW scenario would exacerbate runoff, leading to amplified nutrient leaching. These losses decrease nutrient availability during the crop growing season. Moreover, a mismatch between the timing of fertilizer application and crop nutrient absorption caused nutrient-related stress. This nutrient and anticipated temperature stress resulted in a more significant decrease in crop yields under the 2 °C GW scenario than the 1.5 °C scenario. We have designed a management scenario to reduce future nutrient losses while increasing crop yields. The strategy involves altering the timing of planting/harvesting and the fertilizer application rate in response to a warming climate. This approach is projected to increase corn and soybean yields by +39 % (+21 %) and +2 % (+17 %), respectively, under the 1.5 °C (2.0 °C) GW scenario for the RCP-4.5 pathway. Simultaneously, it is expected to decrease the N and P loads at 1.5 °C (2.0 °C) GW. Comparable projections are also observed under the RCP-8.5 pathway.

Modeling Land Use and Management Practices Impacts on Soil Organic Carbon Loss in an Agricultural Watershed in the Mid-Atlantic Region

Measuring organic carbon (OC) losses from soils presents a challenge because of the intricate interplay of human-induced and biophysical processes. This study employs SWAT-C to simulate particulate OC (POC) and dissolved OC (DOC) losses from the Upper Maurice Watershed in the Mid-Atlantic Region. Simulation outcomes reveal that surface runoff was the primary contributor to the total DOC load (65%), followed by lateral flow (30%), and then groundwater (5%). Meanwhile, POC load was linked to erosion processes induced by surface runoff. Our findings indicate that agricultural land-use types exhibited the highest annual average DOC and POC loads. Forests and grasslands displayed intermediate loads, while barren land had the lowest load. Concerning seasonal fluctuations, agricultural land-use types exhibited distinct DOC and POC load patterns when compared to forest and grassland types, indicating the dominant role of management practices in determining soil OC (SOC) losses. Additional modeling of management practices’ impact on SOC budgets indicates maximal SOC sequestration with full irrigation, no-till (NT), and full fertilization. In contrast, the largest SOC depletion arises from combining conservation tillage (CT) and no fertilization, irrespective of irrigation. This study shows that SWAT-C can be used to simulate land use and management impacts on SOC dynamics.

Detection of Borrelia burgdorferi sensu lato species in host-seeking Ixodes species ticks in the United States

Lyme disease is the most commonly reported vector-borne disease in the United States and is transmitted by Ixodes scapularis in the eastern US and I. pacificus in the west. The causative agents, Borrelia burgdorferi sensu stricto (Bbss) and B. mayonii belong to the B. burgdorferi sensu lato (Bbsl) species complex. An additional eight species of Bbsl have been identified in Ixodes species ticks in the US, but their geographic distribution, vector associations, human encounter rates and pathogenicity in humans are poorly defined. To better understand the geographic distribution and vector associations of Bbsl spirochetes in frequent and infrequent human-biting Ixodes species ticks in the US, we previously screened 29,517 host-seeking I. scapularis or I. pacificus ticks and 692 ticks belonging to eight other Ixodes species for Borrelia spirochetes using a previously described tick testing algorithm that utilizes a combination of real-time PCR and Sanger sequencing for Borrelia species identification. The assay was designed to detect known human pathogens spread by Ixodes species ticks, but it was not optimized to detect Bbsl co-infections. To determine if such co-infections were overlooked particularly in ticks infected with Bbss, we retested and analyzed a subsample of 845 Borrelia infected ticks using a next generation sequencing multiplex PCR amplicon sequencing (MPAS) assay that can identify Borrelia species and Bbsl co-infections. The assay also includes targets that can molecularly confirm identifications of Ixodes species ticks to better inform pathogen-vector associations. We show that Bbss is the most prevalent species in I. scapularis and I. pacificus; other Bbsl species were rarely detected in I. scapularis and the only Bbsl co-infections identified in I. scapularis were with Bbss and B. mayonii. We detected B. andersonii in I. dentatus in the Mid-Atlantic and Upper Midwest regions, B. kurtenbachii in I. scapularis in the Upper Midwest, B. bissettiae in I. pacificus and I. spinipalpis in the Northwest, and B. carolinensis in I. affinis in the Mid-Atlantic and Southeast, and B. lanei in I. spinipalpis in the Northwest. Twelve of 62 (19.4%) Borrelia-infected I. affinis from the Mid-Atlantic region were co-infected with Bbss and B. carolinensis. Our data support the notion that Bbsl species are maintained in largely independent enzootic cycles, with occasional spill-over resulting in multiple Bbsl species detected in Ixodes species ticks.

Psychometric evaluation of a contemporary version of the drug and drug problems perception questionnaire

BackgroundMore than 20 years ago, the Drug and Drug Problems Perception Questionnaire (DDPPQ) was developed to examine healthcare providers’ attitudes and perceptions towards individuals who use drugs. In alignment with recommended terminology respectful of this patient population, the 20-item measure was revised using person-centered language. Therefore, this study aimed to examine the psychometric properties of the person-centered DDPPQ (PC-DDPPQ) version among undergraduate nursing students. MethodsExploratory and confirmatory factor analyses were used to examine the PC-DDPPQ factor structure using a cross-sectional design. A convenience sample of 400 students from two nursing schools located in the Northeast and Mid-Atlantic regions of the US participated in the study. The sample (N = 400) was divided equally between the exploratory factor analysis (EFA) and the confirmatory factor analysis (CFA). ResultsAfter applying principal axis factoring (PAF) with oblique (Promax) rotation, the EFA yielded a five-factor, 20-item structure that explained 70.0% of the variance. The CFA revealed that the final model, derived from the EFA, which yielded a 19-item, five-factor structure adequately fit the data (Comparative Fit Index (CFI) = 0.959, the Tucker-Lewis Index (TLI) = 0.951 and Root Mean Square Error of Approximation (RMSEA) = 0.058). ConclusionsExcept for one item (item #14), the five-factor structure aligned with the original 20-item version. This study contributes to promoting the use of a more appropriate and less stigmatizing language among healthcare providers working with patients who use drugs.

Black Women Undertakers of the Early Twentieth Century Were Hidden in Plain Sight

Abstract This essay foregrounds Black women in the very narrative of undertaking that they helped create and develop. It was the wives who helped start the country’s oldest undertaking firms, and it was the wives, sisters, and daughters who sustained and professionalized the funeral home legacy. The article follows women from the American South and mid-Atlantic regions, illustrating how, with their skills and capital, they labored not just as funeral directresses, embalmers, and undertakers but also as bookkeepers, hairdressers, accountants, caterers. These women were “race women,” college-educated Black women who were trained to uplift the race. And as race women in the death trade, they brought their skills and education to a field that created generational wealth and civic empowerment.

Winter Activity for Crapemyrtle Bark Scale, an Urban Landscape Pest

Scale insects are some of the most abundant and damaging pests of urban forests in North America. Despite their prevalence, scale insect emergence during the winter dormant season, which could contribute to their population growth and spread and thereby inform management, has not been thoroughly investigated. Crapemyrtle bark scale (CMBS), Acanthococcus lagerstroemiae (Kuwana) (Hemiptera: Eriococcidae), is a nonnative pest of a widely grown landscape tree, crapemyrtle (Lagerstroemia spp.). Now present throughout the Southeast and Mid-Atlantic regions of the United States, CMBS has spread rapidly since its initial detection in Plano, TX, USA, in 2004. The contributions of year-round activity to the insect’s widespread abundance and economic importance are unclear. Here, after infesting crapemyrtles with known numbers of CMBS in Summer 2021, we recorded the presence or absence of CMBS immatures on infested trees from Autumn 2021 to late Winter 2022. We found that active nymphs occurred throughout the entirety of these colder seasons. Additionally, average CMBS density drastically increased from October to March, growing from 28 ± 10 SE insects per plant to 554 ± 133 SE, respectively. Our results highlight previously unknown aspects of year-round crawler emergence by CMBS, which could provide opportunities for landscape managers to use targeted winter applications of less harmful pesticides such as horticultural oils.