Midwest States Research Articles

Spatiotemporal patterns of youth isolation and loneliness in the US: a geospatial analysis of Crisis Text Line data (2016–2022)

In 2021, the US Surgeon General issued a national advisory citing an epidemic of isolation and loneliness. Even before the onset of the COVID-19 pandemic, approximately half of people in the US reported experiencing measurable levels of loneliness. Despite localized and select cross-sectional studies highlighting even higher increases in isolation/loneliness during the COVID-19 pandemic, additional research is needed, particularly for youth and young adults. This work examines patterns of isolation/loneliness across the US from 2016 to 2022 among individuals aged 24 and younger. Our study leverages a unique dataset, Crisis Text Line, which provides complete spatiotemporal coverage of crisis conversations in the US. We conducted a geospatial analysis using Kuldroff’s Space–Time SatScan to identify statistically significant clustering of elevated isolation/loneliness-related conversations. The statistical significance of spatiotemporal clusters was determined using Monte Carlo simulations (n = 9999). Results demonstrated local relative risk as high as 1.47 in high-risk populations in Southern, Midwest, and Atlantic states, indicating areas where the actual case count is 147% of the expected cases (p value < 0.01) from May to July 2020. Results also identified co-occurrence of isolation/loneliness and other crises concerns, including depression/sadness, anxiety, and multiple suicidality indicators, with higher rates among racial/ethnic minority, transgender and gender diverse, and younger individuals. This work makes a unique contribution to the literature by elucidating spatiotemporal disparities in isolation/loneliness among young people, providing much-needed knowledge as to where future public health interventions are immediately needed.

Abstract 4123308: Trends in Gestational Diabetes Mellitus By US State, 2019 -2023

Introduction/ Background: Gestational diabetes mellitus (GDM) is one of the most frequent adverse pregnancy outcomes and increases the risk of lifetime cardiometabolic disease. Given known geographic disparities in maternal morbidity and mortality in the US, we examined state-level prevalence and trends in GDM from 2019-2023. Methods: We conducted a serial, cross-sectional analysis of maternal health data recorded on birth certificates from all livebirths in the US using the National Center for Health Statistics Natality Files. We included pregnant individuals aged 15-44 years who gave birth from 2019-2023, had a singleton, live birth, and did not have pre-pregnancy diabetes. We calculated the age-standardized prevalence and average-annual percent change (AAPC) in GDM from 2019-2023, overall, by U.S. census region (Northeast, Midwest, South, and West), and in each US state and the District of Columbia (DC). Results: Of the 17,432,486 individuals with live births between 2019 and 2023, overall prevalence of GDM per 100 live births (95% confidence interval) was 6.9 (6.9, 6.9) in 2019 and 8.0 (8.0, 8.1) in 2023 (AAPC 3.2 [-1.7, 8.5]). There was significant geographic variation in overall prevalence of GDM by US region and state ( Figure 1 ). In 2023, prevalence was higher in the Midwest (8.8 [8.7, 8.9]) and Western states (8.6, [8.5,8.6]) compared with the Southern (7.3, [7.3, 7.4]) and Northeastern states (8.1, [8.0,8.2]), ranging from 5.5 (4.9,6.0) in DC to 13.0 (12.2,13.8) in Alaska. Prevalence was higher in 2023 compared with 2019 in all US regions and states and DC, except Alaska, Connecticut, Idaho, Maine, New Jersey, and Wyoming. Prevalence increased most rapidly in the Western US states (AAPC 4.2%/year [0.1, 8.4]) with the greatest change observed in Montana from 5.1 (4.7, 5.6) in 2019 to 8.0 (7.5, 8.5) in 2023 (AAPC 10.3%/year [5.6, 15.3]). Conclusions: GDM prevalence increased significantly from 2019-2023 with substantial heterogeneity by US region and state. More localized state-level analysis with context-specific polices that address factors associated with geographic differences in GDM are needed to promote maternal cardiometabolic health equity in the US.

Machine Learning Analysis of Factors Influencing Pediatric Telehealth Visits During COVID-19: A State-Level Comparison Using 2021-22 National Survey of Children's Health Data.

Background/Objectives: The COVID-19 pandemic reduced in-person pediatric visits in the United States by over 50%, while telehealth visits increased significantly. The national use of telehealth for children and the factors influencing their use have been rarely studied. This study aimed to investigate the prevalence of telehealth use during the COVID-19 pandemic and explore the potential factors linked to its use at the state level. Methods: A cross-sectional study of the National Survey of Children's Health (2021-22) sponsored by the federal Maternal and Child Health Bureau was performed. We used the least absolute shrinkage and selection operator (LASSO) regression to predict telehealth use during the pandemic. A bar map showing the significant factors from the multivariable regression was created. Results: Of the 101,136 children, 15.25% reported using telehealth visits due to COVID-19, and 3.67% reported using telehealth visits due to other health reasons. The Northeast states showed the highest telehealth use due to COVID-19. In the Midwest and Southern states, children had a lower prevalence of telehealth visits due to other health reasons. The LASSO regressions demonstrated that telehealth visits were associated with age, insurance type, household income, usual source of pediatric preventive care, perceived child health, blood disorders, allergy, brain injury, seizure, ADHD, anxiety, depression, and special needs. Conclusions: This study demonstrated significant variability in the use of telehealth among states during the COVID-19 pandemic. Understanding who uses telehealth and why, as well as identifying access barriers, helps maximize telehealth potential and improve healthcare outcomes for all.

Leveraging Data Analytics for Financial Stability: A Blueprint for Sustaining SMEs in Economically Distressed Regions of the U.S.

Purpose: Our research explores how data analytics can empower small- and medium-sized enterprises (SMEs) in economically distressed regions of the U.S. by improving financial decision-making, operational efficiency, and risk mitigation. The study aims to provide a blueprint for leveraging data-driven insights to ensure long-term financial stability and economic growth in underserved areas, particularly in the Midwest and Southern states. Methodology: The study employs a case-study approach to analyze the real-world applications of data analytics platforms in SMEs within economically distressed regions. It uses statistical analysis to compare the performance of businesses that have adopted data analytics tools with those relying on traditional methods. The methodology also includes the collection of data from various sources such as financial performance records, customer analytics, and predictive models. Findings: The research demonstrates that SMEs using data analytics experience significant improvements in financial performance. For instance, predictive analytics increased financial forecasting accuracy by 25%, and real-time business intelligence tools reduced operational costs by 15%. Businesses using customer analytics tools saw a 20% rise in customer retention and a 15% increase in revenue. The study shows that data-driven strategies can improve overall financial stability by 30% and enable SMEs to proactively mitigate risks in volatile markets. Unique Contribution to Theory, Policy, and Practice: The study contributes to the emerging body of literature on the transformative potential of data analytics in financially distressed regions, providing new insights into how real-time and predictive analytics can enhance financial decision-making in SMEs’ practices within the economically distressed regions. The study provides a practical blueprint for SMEs to adopt data analytics tools, demonstrating their impact on financial stability, operational efficiency, and long-term growth. It offers actionable recommendations for business leaders in distressed regions to integrate analytics equitably into their decision-making processes.

Optimum source, rate, timing, and placement of phosphorus fertilizer for Illinois soybean

AbstractConsistent increases in soybean (Glycine max L.) grain yields over the past decades in Illinois have co‐increased P demand, but—as for many US Midwest states—P fertilizer recommendations are outdated. We evaluated soybean grain yield, P uptake and removal with grain harvest, and P use efficiency in 4 site‐years of field trials on Argiudolls‐Endoaquolls and Fragiudalfs‐Hapludalfs under annual P application treatments of source (monoammonium phosphate [MAP], diammonium phosphate [DAP], triple superphosphate [TSP]), rate (partial vs. full maintenance rate), and timing–placement combination (fall and spring broadcast, spring banding). Substituting ammonium phosphate fertilizers, the most commonly used P fertilizers in the US Midwest, with N‐free TSP supported similar yields and resulted in similar P removal as hypothesized, while avoiding co‐applied N that can be subject to losses primarily via leaching. Soybean yield and grain P removal were unresponsive to rate, timing, and placement even at the partial rate, although banding and spring application may have reduced N loss risk for MAP and DAP. Given the challenges in accurately estimating P removal rate by grain harvest due to the variability in yield and grain P concentrations across years, assessment of P use efficiency should focus on long‐term balance between fertilization (input) and crop removal (output).

Ambient air pollution and low birth weight in Brazil: A nationwide study of more than 10 million births between 2001 and 2018

Low birth weight (LBW) is a global health concern. While it is commonly associated with maternal health and behavior, exposure to ambient air pollution, can also play a role in contributing to LBW. In Brazil, where diverse environmental conditions and regional disparities exist, assessing the impact of ambient air pollution on LBW becomes particularly pertinent. To our knowledge, there is a gap in the existing literature, as no previous study has specifically investigated the relationship between ambient air pollution and LBW nationwide in Brazil. This study aims to fill this gap by examining the association between ambient air pollution and LBW in each trimester of pregnancy across the Brazilian states. In this work, birth data from January 1, 2001, to December 31, 2018 has been used. We utilized logistic regression models to estimate the odds ratio (OR) for low birth weight (LBW) associated with ambient air pollution (PM2.5, NO2, and O3) during each trimester of pregnancy (1st to 3rd trimester) across all 27 Brazilian states in our nationwide case-control study. We adjusted our model for several variables, including ambient temperature, relative humidity, and socioeconomic status (SES) variables at the individual level. We also conducted effect modification analyses by infant sex, mother's age, and the number of prenatal visits. Our study comprises over 10,213,144 birth records nationwide. Of these, 479,204 (4.92%) infants were included as cases of LBW. Our results indicate positive associations between PM2.5 and LBW, mainly in the Southern region. For example, in the state of Santa Catarina (South region), ORs were 1.003 (95% CI: 1.002, 1.004), 1.003 (95% CI: 1.002, 1.004), and 1.005 (95% CI: 1.003, 1.007) for the 1st, 2nd, and 3rd trimesters of exposure, respectively. NO2 had a robust association with LBW in the Northern and Northeastern states, including the state of Amapá (North region, where the Amazon Forest is located) with ORs of 1.377 (95% CI: 1.010, 1.878), 1.390 (95% CI: 1.020, 1.894), and 1.747 (95% CI: 1.297, 2.352) for the 1st, 2nd, and 3rd trimesters of exposure, respectively. Similarly, O3 had a robust association in the North and Midwest states, as observed in the state of Amapá with ORs of 1.033 (95% CI: 1.012, 1.054), and 1.033 (95% CI: 1.013, 1.053) for the 2nd, and 3rd trimesters, respectively. In the stratified analysis, boys were more vulnerable than girls, and the lower number of prenatal visits was associated with higher OR. Our findings are essential to the development of guidelines to prevent maternal exposure and protection of newborns in Brazil. This study provides valuable insights for region-specific strategies to improve maternal and neonatal health.

Abnormal ear development in corn: Does hybrid, environment, and planting date matter?

AbstractCorn (Zea mays L.) yields have increased historically, but production concerns still exist. For decades, abnormal corn ear development symptoms have been reported. Most of these reports have not been addressed through research, perhaps due to low occurrence and challenges in replicating them. In 2016, widespread abnormal ear development (multiple ears per node, barbell‐ears, and short‐husk ears) issues were reported in several cornfields in the Texas Panhandle, Eastern Colorado, Nebraska, and other US Midwest states. Fields with a high frequency of abnormalities resulted in lower yields. To investigate causal factors, a field trial was established to study the effect of hybrids, environments, and planting dates on abnormal ears. The project was conducted at two Nebraska sites during the 2018, 2019, and 2020 growing seasons. Six hybrids, six environments, and four planting dates were studied. Approximately 59,200 plants were individually assessed at the dent stage (R5). Abnormal ear percentages ranged from 0% to 45% per plot, with a mean of 6.66% across all conditions. Interactions among hybrids, environments, and planting dates were documented despite the overall low incidence of abnormal ears. Grain yields ranged from 5.2 to 22.5 Mg ha−1; hybrids with higher abnormal ear percentages were associated with lower yields. The main documented symptom was short‐husk ears. Abnormal ears were often placed at lower heights in the plant relative to normal ears. The results presented here demonstrate the importance of studying abnormal ears and understanding the impact of planting dates and hybrid selection as potential strategies to mitigate abnormal ears.

Does It Take a Village? The Impact of LGBTQ+ Community and Geographic Location on Associations among Parenting Stress, Parent Mental Health, and Child Adjustment.

While LGBTQ+-parented families share many similarities with their cis-het parent counterparts, they still experience unique factors exclusive to them. One such factor is access to the LGBTQ+ community. Utilizing a diverse sample of LGBTQ+ parents with adolescents in the U.S., primarily living in Southern and Midwest states, we examined the potential moderating impact of a parent's sense of LGBTQ+ community on the relationship between parenting stress, parent mental health, and child adjustment. Regression analyses demonstrated a series of positive associations between LGBTQ+ parent stress, parent mental health concerns, and child adjustment issues. However, sense of community failed to moderate these associations. Parent sexual identity, age, and recruitment method were found to have unique associations with outcome variables. Implications for policy, clinical practice, and future research are discussed.

Uncertainty in healthcare operations: How hospitals weather the perfect storm

AbstractWe focus on two of the many sources of uncertainty in healthcare operations, mix uncertainty – the variation in the complexity of care required by the patient mix, and volume uncertainty – the variation in the volume of care demanded by the patient population. Using an interdisciplinary perspective, we study the impact of mix and volume uncertainties on two important healthcare outcomes, length of stay and number of procedures, along with the mitigation impacts of the operational concepts of related focus and utilization levels. Based on large dataset of 830,853 patient discharges in 26 clinical departments across 731 hospitals in five U.S. Midwest states, our results indicate that mix and volume uncertainties each have a significant impact on patient care. We also find that related focus and department utilization levels have a mitigating effect on uncertainty in healthcare settings. Lastly, we find considerable heterogeneity in the effects of uncertainty across hospital types and departments. We discuss key research and managerial implications of our findings.

Willingness and capacity of publicly-funded vector control programs in the USA to engage in tick management

BackgroundThe vast majority of vector-borne diseases in the USA are associated with mosquitoes or ticks. Mosquito control is often conducted as part of community programs run by publicly-funded entities. By contrast, tick control focuses primarily on individual residential properties and is implemented predominantly by homeowners and the private pest control firms they contract. We surveyed publicly-funded vector control programs (VCPs), presumed to focus mainly on mosquitoes, to determine what tick-related services they currently offer, and their interest in and capacity to expand existing services or provide new ones.MethodsWe distributed a survey to VCPs in the Northeast, Upper Midwest and Pacific Coast states of the USA, where humans are at risk for bites by tick vectors (Ixodes scapularis or Ixodes pacificus) of agents causing Lyme disease and other tick-borne diseases. The data we report are based on responses from 118 VCPs engaged in vector control and with at least some activities focused on ticks.ResultsDespite our survey targeting geographic regions where ticks and tick-borne diseases are persistent and increasing public health concerns, only 11% (12/114) of VCPs reported they took direct action to suppress ticks questing in the environment. The most common tick-related activities conducted by the VCPs were tick bite prevention education for the public (70%; 75/107 VCPs) and tick surveillance (48%; 56/116). When asked which services they would most likely include as part of a comprehensive tick management program, tick bite prevention education (90%; 96/107), tick surveillance (89%; 95/107) and tick suppression guidance for the public (74%; 79/107) were the most common services selected. Most VCPs were also willing to consider engaging in activities to suppress ticks on public lands (68%; 73/107), but few were willing to consider suppressing ticks on privately owned land such as residential properties (15%; 16/107). Across all potential tick-related services, funding was reported as the biggest obstacle to program expansion or development, followed by personnel.ConclusionsConsidering the hesitancy of VCPs to provide tick suppression services on private properties and the high risk for tick bites in peridomestic settings, suppression of ticks on residential properties by private pest control operators will likely play an important role in the tick suppression landscape in the USA for the foreseeable future. Nevertheless, VCPs can assist in this effort by providing locally relevant guidelines to homeowners and private pest control firms regarding best practices for residential tick suppression efforts and associated efficacy evaluations. Publicly-funded VCPs are also well positioned to educate the public on personal tick bite prevention measures and to collect tick surveillance data that provide information on the risk of human encounters with ticks within their jurisdictions.Graphical

The impact of renewable portfolio standards and land-use governance on CO2 and gross total emissions in four U.S. regions

This study's findings underscore the significant role of policies such as renewable portfolio standards (RPS) and court land-use decisions (CLD) in promoting environmental quality. The study, conducted between 2000 and 2021 in four US regions—Northeast, Midwest, West, and South—using the FGLS and PCSE methods, reveals that RPS and CLD are instrumental in reducing CO2 and gross total emissions (GTE). However, their effectiveness varies across regions. The Midwest, West, and South regions showed statistically significant improvements after implementing the RPS. The impact of land-use court decisions in the Northeast and Midwest states is statistically nonsignificant. RPS and CLD effectively decrease GTE in the Western and Southern states. The study also highlights the adverse effects of energy intensity and economic growth on the environment in all regions. However, it strongly emphasizes that clean energy sources like hydropower are critical in mitigating emissions. To achieve environmental sustainability and emissions reduction goals across the US, the study suggests a nuanced policy approach that prioritizes strengthening renewable and sustainable energy initiatives such as RPS, improving land utilization regulations, and promoting clean energy practices. It concludes that significant progress can be made towards these goals by adopting region-specific strategies and enhancing policy instruments like RPS and CLD.

Examining School Social Work Certifications across the Midwest States

Examining School Social Work Certifications across the Midwest States

Estimating the income-related inequality aversion to energy limiting behavior in the United States

Distributive energy justice is measured by the degree to which, and whether, different members of society have equal share in the benefits and burdens of the energy system. One way to achieve distributional energy justice is to ensure all households, regardless of income, can use as much energy as they need to heat and cool their home to desired temperature. We define a household's cooling balance point (CBP) as the ideal set temperature at which the household desires to keep its living space in summer; the heating balance point (HBP) is defined as the ideal set temperature in winter. To quantify the extent to which balance points were disproportionately concentrated among certain income groups, we used the extended concentration index. This index has an inequality aversion parameter that reflects the value judgment of a society. If this parameter <1, the society is pro-rich; if this parameter >1, as it increases, the society becomes more pro-poor. We estimated the empirical value of the income-related inequality aversion in eight U.S. states and examined several effects of demographic characteristics on inequality aversion.In an online survey, 1066 (from four southern states) and 906 (from four Midwest states) participants made choices between energy policies leading to different distributions of CBP (southern) or HBP (Midwest) across five income groups in a hypothetical society. Participants showed a pro-poor propensity: the median inequality aversions were 1.37, 95% CI of [1.35, 1.39] (CBP) and 1.56, 95% CI of [1.56, 1.60] (HBP). For both CBP and HBP: younger participants were less averse to inequality. For CBP, blacks (vs. whites) and conservatives (vs. centrist) were less averse to inequality; for HBP, Hispanics (vs. whites), low (vs. high) education participants, and those whose homes were well insulated (vs. adequately and vs. poorly insulated) were less averse to inequality. Our findings provide insights into how the broader public values energy justice, which further provides important policymaking implications.

Measuring COVID-19's impact on diagnosis of cervical cancer by race/ethnicity, age, and region of the United States.

e17535 Background: The COVID-19 pandemic brought to light significant access-to-care issues for patients across the country, which we hypothesized may have disrupted recent trends in incidence for certain screenable diseases. The goal of this study was to evaluate the impact of the COVID-19 pandemic on cervical cancer incidence based on age, race, stage at presentation, and regions of the US. Methods: Data on cervical cancer incidence were obtained from the United States Cancer Statistics (USCS) program from 2001-2020. We employed SEER*Stat 8.4.1.2 and Joinpoint regression program 5.0.2 to calculate estimated and actual incidence rates per 100,000 women. We compared actual cervical cancer incidence rates in the year 2020 to estimated rates based on trends from the years 2001-2019. Results: From 2001-2020, 245,618 cases of cervical cancer were identified. In 2019, prior to the pandemic, the incidence was 7.64 per 100,000 women. From 2001-2019, cervical cancer incidence decreased by 0.96% per year (p=0.023). Based on this trend, we expected the incidence to be 7.57 per 100,000 women in 2020, but the reported incidence was only 6.83 per 100,000, therefore, there were 9.8% less cervical cancer cases (1,189 cases) in 2020 than expected. This was most noticeable at the lower and upper ends of the age distribution, with 17.6% less cases than expected in the year 2020among 25-29 year-olds and 18.4% less cases than expected among 85+ year-olds. This is in comparison to the median age group for cervical cancer (50-54 year-olds) in whom there were 14.5% (193) less cases than expected in 2020. Based on stage of disease, for local, regional, and distant disease there were 16.3%, 2.8%, and 1.9%, less cases than expected in 2020, respectively. Within racial and ethnic groups, we found that Non-Hispanic Black (NHB) and Hispanic patients had 15.0% and 13.9% less cases than expected, versus 8.7% among Non-Hispanic White (NHW) and 5.8% among Non-Hispanic Asian and Pacific Islander (NHAPI) patients. Comparing U.S. regions, the Midwest, Northeast, West, and South had 14.6%, 10.2%, 10.2%, and 9.0% less cases than expected for 2020, respectively. Conclusions: Our data suggest that the reported cervical cancer cases were significantly less than predicted based on past trends during the COVID-19 pandemic.. Older age, NHB and Hispanic patients, and those residing in Midwest states had the greatest number of possible missed diagnoses of cervical cancer during this time. Mitigating strategies are needed to reinstate screening programs, particularly in these at-risk groups to prevent increased rates of advanced stage disease and mortality.

528 Midwest Translational Science (MTS): Building a regional CTSA community

OBJECTIVES/GOALS: Our vision is to build community amongst the Midwest CTSAs, harnessing our collective expertise to collaborate on translational science challenges and meet the needs of our region. We aim to create opportunities to network, share ideas, brainstorm solutions, address translational science topics, and achieve a range of deliverables. METHODS/STUDY POPULATION: Three individuals from the Chicago CTSAs (NUCATs, CCTS, and ITM) had been networking for a year and desired to increase opportunities to collaborate amongst other CTSAs. We developed an initial vision for a new group that would extend across the region, and we invited the TIN POCs from 16 Midwest CTSAs to join. In September, 2022, the group was launched with 20 members from 12 CTSAs. We hosted 12 monthly meetings via Zoom to discuss various topics (i.e., staffing, career training, e-consent, research design, and recruitment tools) via round tables or presentations. We developed a Google Sites website with resources, a discussion forum, and a group calendar. We solicited feedback via survey and follow-up discussion (i.e., most valuable about the group and what can be improved). RESULTS/ANTICIPATED RESULTS: During the past year, our membership grew to more than 30 participants, representing 16 CTSAs in nine Midwest states (IL, IA, IN, MI, MN, MO, KT, OH, WI). We engaged a total of 45 individuals at our meetings, with an average of 11 participants per meeting. Our discussions were lively and stimulated additional conversations, requests for guidance, sharing resources, etc., beyond the meetings. Feedback from the group was overwhelmingly positive. Members found many aspects of the group to be valuable (i.e., learning initiatives, processes, and best practices at other CTSAs) and provided practical suggestions for improvement (i.e., themes across a quarter or year). Members expressed interest in additional collaborations such as subcommittees, papers, and other initiatives. DISCUSSION/SIGNIFICANCE: We created a regional CTSA community that is very enthusiastic to convene, share innovations developed at their CTSA hubs, and assist one other. Future directions include an in-person retreat in the spring. Our approach can serve as a potential roadmap for developing regional CTSA collaborative groups across the nation.

First report of Calonectria ilicicola causing red crown rot of soybean in Indiana.

Soybean (Glycine max [L.] Merr.) samples from commercial fields in Decatur and Spencer counties, Indiana were submitted to the Purdue Plant and Pest Diagnostic Lab in August to October 2022. Plants exhibited whole-leaf to interveinal chlorosis of the foliage, red to dark brown external lesions on the crown spreading from the soil-line upward, and severe root rot. In the fields, patches of diseased plants were observed, with greater than 50% of the plants affected and yield loss up to 50%. Orange to red perithecia were present on the exterior of symptomatic stem tissue and ranged in size from 329 to 433 × 232 to 306 µm (n = 10). Stems were surface sterilized in 10% Clorox (0.825% NaOCl) for 1 min, then rinsed with sterile distilled water and dried. In a laminar flow hood, sections of symptomatic stem tissue were plated on using quarter-strength potato dextrose agar (QPDA) and incubated under fluorescent lights on a 12-hr light/dark cycle at 20°C. After 6 days, fungal colonies with fluffy aerial hyphae, which were white near the colony margins and orange to burnt-red near their center, grew uniformly from the stem tissue plated. Elongate, cylindrical hyaline conidia with zero to three septations measuring 45.5 to 73.8 × 4.4 to 6.7 µm (n = 22) grew in clusters from symptomatic stem tissue within the plate. Perithecia developed after 14 days. Falcate, hyaline ascospores with one to two septa measuring 29.4 to 54.7 × 4.6 to 6.8 (n = 23) µm developed within the perithecia. Calonectria ilicicola Boedijn & Reitsma was confirmed based on morphological characteristics (Padgett et al. 2015). Isolate PPDL 22-01457B was used for DNA extraction using the ZR Fungal/Bacterial DNA Miniprep kit (Zymo Research, Irvine, CA). The internal transcriber region (ITS), actin (ACT) and β-tubulin (TUB2) genes were amplified (Carbone and Kohn 1999; Glass and Donaldson 1995; O'Donnell and Cigelnik 1997; White et al. 1990). Amplicons were sent for Sanger sequencing (Genewiz, Inc., South Plainfield, NJ), submitted to Genbank, and assigned accession numbers ITS: OQ932995, Actin: OR484986, and β-tubulin: OR546281. Sequences were analyzed using the NCBI BLASTn tool with results showing 99.5 to 100% identical to C. ilicicola (GenBank accessions LC500063, OQ303403, CP085825, respectively). To perform Koch's Postulates, 90 soybean seeds (CP3620E) were planted in potting media (Berger, Saint-Modeste, Quebec, Canada) in a seed flat with 45 of the plants used as controls and grown under grow lights for 16hr light/8hr dark at 20℃. Individual seedling crowns were inoculated 3 days post-emergence with a 5 to 10 ml spore and hyphal suspension that was scraped from the surface of a 14-day old QPDA culture after adding 300 mL deionized (DI) to each plate grown at 20 to 22°C. The control plants received sterile-DI water. Plants were covered in a plastic bag for 72 h. Plant stems were sprayed with sterile-DI water once a day for seven days. Symptoms were observed after four days, but significant crown rot and lesions developed after two weeks before wilting and dying. Calonectria iliciola was isolated uniformly from symptomatic plants and identified morphologically. Control plants showed no symptoms. Inoculations were repeated 3 times with similar results. As of fall 2023, red crown rot has been confirmed in Adams and Rush counties in Indiana. Red crown rot has been confirmed in several Midwest states (Kleczewski et al. 2019, Neves et al. 2023), but the extent of its distribution and disease management strategies are still limited.

Density of host-seeking Ixodes scapularis nymphs by region, state, and county in the contiguous United States generated through national tick surveillance

The majority of vector-borne disease cases reported annually in the United States are caused by pathogens spread by the blacklegged tick, Ixodes scapularis. The number and geographic distribution of cases have increased as the geographic range and abundance of the tick have expanded in recent decades. A large proportion of Lyme disease and other I. scapularis-borne diseases are associated with nymphal tick bites; likelihood of such bites generally increases with increasing nymphal densities. National tick surveillance was initiated in 2018 to track changes in the distribution and abundance of medically important ticks at the county spatial scale throughout the United States. Tick surveillance records, including historical data collected prior to the initiation of the national program, are collated in the ArboNET Tick Module database. Through exploration of ArboNET Tick Module data, we found that efforts to quantify the density of host-seeking I. scapularis nymphs (DON) were unevenly distributed among geographic regions with the greatest proportion of counties sampled in the Northeast and Upper Midwest. Submissions covering tick collections from 2004 through 2022 revealed extensive variation in DON estimates at collection site, county, state, and regional spatial scales. Throughout the entire study period, county DON estimates ranged from 0.0 to 488.5 nymphs/1,000 m2 . Although substantial variation was recorded within regions, DON estimates were greatest in the Northeast, Upper Midwest, and northern states within the Southeast regions (Virginia and North Carolina); densities were intermediate in the Ohio Valley and very low in the South and Northern Rockies and Plains regions. The proportion of counties classified as moderate or high DON was lower in the Northeast, Ohio Valley, and Southeast regions during the 2004 through 2017 time period (prior to initiation of the national tick surveillance program) compared to 2018 through 2022; DON estimates remained similarly low between these time periods in the South and the Northern Rockies and Plains regions. Despite the limitations described herein, the ArboNET Tick Module provides useful data for tracking changes in acarological risk across multiple geographic scales and long periods of time.

(404) National Trends of Penile Fracture Encounters 2016-2019

Abstract Introduction Penile Fracture (PF) is an acute urological emergency resulting from the rupture of the tunica albuginea and one or both of the corpus cavernosa. Immediate surgical intervention is crucial in avoiding long-term complications, however the epidemiology and treatment patterns remain understudied, especially with the introduction of the 10th Revision of the International Classification of Diseases (ICD-10). Objective To evaluate national trends of PF encounters as well as predictive factors of inpatient admission from the emergency department (ED). Methods All patients admitted to the ED for PF between 2016-2019 were extracted from the NEDS using the ICD-10 Diagnosis Code S39.840 and its modifiers. Multivariable logistic regression was performed to identify predictors of this inpatient admission. Results Between 2016-2019, there were an estimated 7,091 weighted encounters related to PF in the US with an overall 13% increase in cases (Figure 1). About 20.8% (1,477) of these encounters led to inpatient admission. The average age of a patient presenting with PF was 41 years old. The majority of encounters took place in the South (44.12%) at non-trauma center rural hospitals (63.99%) and involved private insurance holders (44.42%). For those admitted to inpatient service, the average length of stay was 1.44 days, with a maximum of 26 days. The average total charge for patients discharged from the ED was $11,224 USD and those admitted were faced with charges averaging $33,474 USD. Predictors of inpatient admission included an Elixhauser Comorbidity Score &amp;gt; 1, encounters in the Northeast, Midwest, and Western states, and being covered by Medicaid (p &amp;lt; .05). Conclusions Penile fractures have seen a small increase in incidence from 2016-2019. Although inpatient admissions are less common, they carry significantly higher costs. Further studies of treatments and regional analysis may be warranted to decrease the amount of inpatient admissions. Disclosure No.

Changes in the Prevalence, Incidence, and Disability-Adjusted Life Years of Non-alcoholic Fatty Liver Disease in the United States Between 1990 and 2019.

This study aimed to determine trends in the prevalence, incidence, and disability-adjusted life years (DALYs) of Non-alcoholic Fatty Liver Disease (NAFLD) in the US across different states and age groups between 1990 and 2019. Using the Global Burden of Disease database, this study analyzed the prevalence, incidence, and DALYs of NAFLD in the US between 1990 and 2019. We computed relative percentage changes, performed Joinpoint regression analyses of trends, and compared these between states and age groups (5-19, 20-55, and more than 55years old). In the United States, the prevalence of NAFLD increased more than the global average over the study period (+ 30.7% vs. + 24.5%), especially in the 5-19-year-old age group. Among all states, Kansas, Washington, and California had the highest increase in prevalence and the District of Columbia followed by Massachusetts and North Carolina had the lowest increase in prevalence. The increase in incidence was greater in the US than the global average (+ 37.18% vs. + 7.28%). West Virginia, Ohio, and Kentucky had the highest increase in incidence. The increase in DALYs was greater in the US compared to the global average (+ 57.15% vs. + 12.65%). Alaska, West Virginia, and Kentucky had the highest increase in DALYs. The increased incidence and DALYs were found in all states except in the District of Columbia. The prevalence of NAFLD in the US has increased more rapidly than the global average, especially in the pediatric population. South and Midwest states have the highest increase in prevalence, incidence, and DALYs of NAFLD. The District of Columbia was the only state that has decreased incidence and DALYs.

Site Suitability Classification for Saturated Bioenergy Buffers and Area Estimates in the U.S. Midwest

HighlightsSuitability criteria for saturated bioenergy buffer (SBB) sites were developed.A method to classify cropland areas as suitable SBB sites was demonstrated using public data.The criteria and method for classifying suitable SBBs were generally successful at U.S. Midwest sites.Areas were identified within U.S. Midwest states having the greatest potential for SBB implementation.Abstract.Nutrient loss from tile-drained, row-crop fields is a major component in the impact of agricultural production on surface water quality, because drain tiles provide a short-circuit for nutrient-rich drainage water to reach ditches and eventually downstream waterbodies (e.g., creeks, streams, rivers). Saturated buffers (SBs) help address the tile-drainage water quality problem, and incorporating bioenergy crops into SBs (saturated bioenergy buffers, or SBBs) could provide both environmental protection and an economic benefit to farmers. The objectives of this analysis were to: (1) develop a site suitability classification approach for rapid, cost-effective identification of SBB candidate sites; and, after validation, (2) use it to estimate the size of land in the U.S. Midwest considered suitable for SBB sites. The approach uses several biophysical parameters to identify sites that (1) are likely to be tile-drained, row-cropped agricultural land; (2) have conditions conducive for denitrification; and (3) have stable streambanks. Supporting data came from federally funded and maintained U.S. databases (e.g., Soil Survey Geographic Database). This classification approach was implemented in ArcGIS Desktop and validated using data from various SB field studies in the U.S. Midwest. This approach has proven to be robust because it identified SB sites considered to be either performing or promising in reducing nitrate losses in tile drainage water with an accuracy range of 57% to 63%. SBB candidate areas in the U.S. Midwest totaled up to 225,000 ha and 342,000 ha for buffer widths of 20 and 30 m, respectively. The proposed approach could assist in both local siting and regional-scale implementation of SBBs, which could significantly mitigate nitrate loss in tile-drained U.S. Midwest agricultural lands while providing other environmental benefits and economic incentives for farmers. Keywords: Biomass production, Multi-functional landscapes, Sustainable agricultural land management, Tile-drained agriculture, Water quality protection.