Northwestern United States Research Articles

Colonoscopy Outreach for Rural Communities (CORC): A study protocol of a pragmatic randomized controlled trial of a patient navigation program to improve colonoscopy completion for colorectal cancer screening

BackgroundColonoscopy is one of the primary methods of screening for colorectal cancer (CRC), a leading cause of cancer mortality in the United States. However, up to half of patients referred to colonoscopy fail to complete the procedure, and rates of adherence are lower in rural areas. ObjectivesColonoscopy Outreach for Rural Communities (CORC) is a randomized controlled trial to test the effectiveness of a centralized patient navigation program provided remotely by a community-based organization to six geographically distant primary care organizations serving rural patients, to improve colonoscopy completion for CRC. MethodsCORC is a type 1 hybrid implementation-effectiveness trial. Participants aged 45–76 from six primary care organizations serving rural populations in the northwestern United States are randomized 1:1 to patient navigation or standard of care control. The patient navigation is delivered remotely by a trained lay-person from a community-based organization. The primary effectiveness outcome is completion of colonoscopy within one year of referral to colonoscopy. Secondary outcomes are colonoscopy completion within 6 and 9 months, time to completion, adequacy of patient bowel preparation, and achievement of cecal intubation. Analyses will be stratified by primary care organization. DiscussionTrial results will add to our understanding about the effectiveness of patient navigation programs to improve colonoscopy for CRC in rural communities. The protocol includes pragmatic adaptations to meet the needs of rural communities and findings may inform approaches for future studies and programs. Trial registration: National Clinical Trial Identifier: NCT05453630.Trial registration: ClinicalTrials.gov. Identifier: NCT05453630. Registered July 6, 2022.

Okanogan lobe tunnel channels and subglacial floods into Moses Coulee, Channeled Scabland, northwestern United States

Abstract Outburst floods from glacial Lake Missoula largely explain erosion of the Channeled Scabland, a system of overfit, basaltic channels in Washington, northwestern United States. However, it is challenging to explain Missoula flood routing into Moses Coulee due to its topographic isolation from flood routes. To clarify flood pathways into Moses Coulee, we mapped channels that delineate a radial-anastomosing network connecting to Moses Coulee. Channels consist of coulee-like features eroded mainly in basalt. Channels climb adverse slopes and cross divides, and the network is draped with eskers and recessional moraines. These channel geometries and glacial landform associations suggest a tunnel channel network. Large channel dimensions and network anastomosis indicate formation in subglacial floods. The network connects to Moses Coulee with sufficient cross-sectional area to convey megafloods, hinting that subglacial floods may have been a significant source of Moses Coulee meltwater, in addition to possible diverted Missoula floods.

Medication-based treatment among rural, primary care patients diagnosed with opioid use disorder and alcohol use disorder

IntroductionOpioid and alcohol use disorders are increasingly being addressed in primary care, yet how medications to treat these disorders are prescribed in rural regions is unknown. MethodsWe determined prevalence, types, and duration of medication prescription for opioid and/or alcohol use disorder among adult patients in rural primary clinics. The sample included 1874 adult patients who visited one of six rural primary care sites in the Northeastern and Northwestern United States at least once from October 2019 to January 2021 and had a diagnosis code for opioid use disorder (OUD), alcohol use disorder (AUD), or co-occurring opioid and alcohol use disorder (OUD + AUD) during that time. ResultsPatients with OUD + AUD were more likely to be prescribed medication for at least one of these disorders (85.3 %) than patients with OUD only (63.7 %) or AUD only (10.3 %). Further, the OUD + AUD group had the highest number of days on medication (M = 264.7), followed by OUD only (M = 220.5), then the AUD only group (M = 62.5). Only 8.8 % of patients with OUD + AUD were prescribed naltrexone or medication for OUD + AUD to treat both substance use disorders. ConclusionsMedications for treating AUD as well as OUD are available, but few patients with OUD + AUD and even fewer with AUD received pharmacological treatment for AUD. The current work highlights the need for rural clinicians to consider medications for AUD as an important treatment method for patients with AUD only or OUD + AUD.

School psychologists' training and experience in providing grief support

AbstractSchool‐based mental health professionals consistently report that they are either not prepared to support grieving students, or do not have time to integrate crisis intervention support into their hectic schedule. Given that inadequate school mental health services can increase a bereaved student's risk of developing emotional problems, it is critical that school psychologists increase their comfort in grief. This study surveyed 75 school psychologists in the Northwestern United States regarding their training and experience in grief support. A reflexive thematic analysis identified four themes related to the challenges and recommendations in grief support: lack of training, limited role of the school psychologist, lack of formalized grief response system, and lack of school and community resources. Furthermore, only 3% of participants reported taking the lead in providing grief support and 64% provide grief support fewer than five times a year. The majority (81%) reported that they had zero courses devoted to grief support during their graduate degree, with more participants (67%) obtaining grief training postdegree. Study limitations, areas for further research, and implications for schools and school psychologists are also discussed.

Nested Benders’s decomposition of capacity-planning problems for electricity systems with hydroelectric and renewable generation

Nested Benders’s decomposition is an efficient means to solve large-scale optimization problems with a natural time sequence of decisions. This paper examines the use of the technique to decompose and solve efficiently capacity-expansion problems for electricity systems with hydroelectric and renewable generators. To this end we develop an archetypal planning model that captures key features of hydroelectric and renewable generators and apply it to a case study that is based on the Columbia River system in the northwestern United States of America. We apply standard network and within-year temporal simplifications to reduce the problem’s size. Nevertheless, the remaining problem is large-scale and we demonstrate the use of nested Benders’s decomposition to solve it. We explore refinements of the decomposition method which yield further performance improvements. Overall, we show that nested Benders’s decomposition yields good computational performance with minimal loss of model fidelity.

Summer-Wet Hydrologic Cycle during the Middle Miocene of the United States: New Evidence from Fossil Fungi.

Hydrologic reconstructions from North America are largely unknown for the Middle Miocene. Examination of fungal palynomorph assemblages coupled with traditional plant-based palynology permits delineation of local, as opposed to regional, climate signals and provides a baseline for study of ancient fungas. Here, the Fungi in a Warmer World project presents paleoecology and paleoclimatology of 351 fungal morphotypes from 3 sites in the United States: the Clarkia Konservat-Lagerstätte site (Idaho), the Alum Bluff site (Florida), and the Bouie River site (Mississippi). Of these, 83 fungi are identified as extant taxa and 41 are newly reported from the Miocene. Combining new plant-based paleoclimatic reconstructions with funga-based paleoclimate reconstructions, we demonstrate cooling and hydrologic changes from the Miocene climate optimum to the Serravallian. In the southeastern United States, this is comparable to that reconstructed with pollen and paleobotany alone. In the northwestern United States, cooling is greater than indicated by other reconstructions and hydrology shifts seasonally, from no dry season to a dry summer season. Our results demonstrate the utility of fossil fungi as paleoecologic and paleoclimatic proxies and that warmer than modern geological time intervals do not match the "wet gets wetter, dry gets drier" paradigm. Instead, both plants and fungi show an invigorated hydrological cycle across mid-latitude North America.

Fruits of Sabia (Sabiaceae) from the Miocene of western North America and their biogeographic significance

Distinctive, reticulately sculptured ellipsoidal endocarp impressions have been discovered in Middle Miocene lake deposits of Idaho and eastern Oregon in the northwestern USA. We describe a new species based on these endocarp impressions and compare them morphologically with previously described extinct and extant species of Sabia (Sabiaceae) using light microscopy and micro-CT scanning. Sabia megacarpa sp. nov. endocarps are distinguished by their large size but resemble other species of Sabia in their asymmetric elliptical shape, reticulate surface ribs, unilocular morphology and gland-dotted endocarp surface. Although Sabia is now native to Southeast Asia and Malesia, the fossil record indicates this genus was formerly present in Europe and North America. The new species indicates that Sabia survived until at least 16 million years ago in western North America.

Reimagining the joint task force core competency framework for rural and frontier clinical research professionals conducting hybrid and decentralized trials.

Introduction: Clinical research professionals (i.e., clinical research assistants, clinical research nurses, clinical research coordinators, etc.), as outlined by the Joint Task Force (JTF) Core Competency Framework, are highly trained to support the breadth of clinical trial operations and manage participant care. Clinical research professionals are uniquely equipped with a scope of practice that permits product administration, participant assessments, and data management. As clinical trials grow in complexity and their management expands beyond traditional, site-based operations models to decentralized and/or hybrid models, the need becomes great to ensure adequate staffing. However, rural hospitals frequently lack the research staff or patient recruiters that would allow them to support decentralized clinical trials across a sizeable rural geographic demographic. Methods: This paper examines the contributory factors of the clinical research professional workforce contraction and response efforts at professional and organizational levels within a large, Magnet-designated healthcare system in the rural northwestern United States. Perspectives are shared on adapting the Core Competency Framework to reflect the unique strengths and opportunities towards decentralized trials in rural regions of the United States and areas of priority for workforce cultivation and retention. A descriptive survey was used to gather initial data identifying the current research perspectives of healthcare workers working across a rural community. Participants were asked to complete questions about the JTF Competency domains and behavior-based questions. Analysis: Both competency and behavior-based questions were asked and related to roles. These were then cross-referenced using a Rasmussen Ladder system. Descriptive statistics were conducted for sample characteristics, self-reported competency domain questions, and behavior questions. Results and discussion: Survey findings suggest that although healthcare workers and clinical research teams interact, they are unlikely to ask their patients to participate in research. Based on the limited response rate, results suggest that better education throughout the rural community could benefit from decentralized research efforts. Increased use of technology was also highlighted as an area of interest.

Anthropogenic, biogenic, and photochemical influences on surface formaldehyde and its significant decadal (2006–2017) decrease in the Lewiston-Clarkston valley of the northwestern United States

Formaldehyde (HCHO) is a key carcinogen and plays an important role in atmospheric chemistry. Both field measurements and Positive Matrix Factorization (PMF) modeling have been employed to investigate the concentrations and sources of HCHO in the Lewiston-Clarkston (LC) valley of the mountainous northwestern U.S. Different instruments were deployed to measure surface formaldehyde and other related compounds in July of 2016 and 2017. The measurements reveal that the average HCHO concentrations have significantly decreased to 2–5 ppb in the LC valley in comparison to its levels (10–20 ppb) observed in July 2006. This discovery with surface measurements deserves attention given that satellite retrievals showed an increasing long-term trend from 2005 to 2014 in total vertical column density of HCHO in the region, suggesting that satellite instruments may not adequately resolve small valleys in the mountainous region. Our PMF modeling identified four major sources of HCHO in the valley: (1) emissions from a local paper mill, (2) secondary formation and background, (3) biogenic sources, and (4) traffic. This study reveals that the emissions from the paper mill cause high HCHO spikes (6–19 ppb) in the early morning. It is found that biogenic volatile organic compounds (VOCs) in the area are influenced by national forests surrounding the region (e.g., Nez Perce-Clearwater, Umatilla, Wallowa-Whitman, and Idaho Panhandle National Forests). The results provide useful information for developing strategies to control HCHO levels and have implications for future HCHO studies in atmospheric chemistry, which affects secondary aerosols and ozone formation.

Province-Wide Tapping of a Shallow, Variably Depleted, and Metasomatized Mantle to Generate Earliest Flood Basalt Magmas of the Columbia River Basalt, Northwestern USA

The Miocene Columbia River Basalt Group (CRBG) of the Pacific Northwest of the United States is the world’s youngest and smallest large igneous province. Its earliest formations are the Imnaha, Steens, and now the Picture Gorge Basalt (PGB), and they were sourced from three different dike swarms exposed from SE Washington to Nevada to northcentral Oregon. PGB is often viewed to be distinct from the other formations, as its magmas are sourced from a shallow, relatively depleted, and later subduction-induced metasomatized mantle, along with its young stratigraphic position. It has long been known that the lowermost American Bar flows (AB1&2) of the Imnaha Basalt are chemically similar to those of the PGB, yet the Imnaha Basalt is generally thought to carry the strongest plume source component. These opposing aspects motivated us to revisit the compositional relationships between AB1&2 and PGB. Our findings suggest that tapping a shallow, variably depleted, and metasomatized mantle reservoir to produce earliest CRBG lavas occurred across the province, now pinpointed to ~17 Ma. Moreover, compositional provinciality exists indicating regional differences in degree of depletion and subduction overprint that is preserved by regionally distributed lavas, which in turn implies relatively local lava emplacement at this stage.

The impacts of relational organizing for health system and community collaboration: Early evidence from a rapid multisite qualitative study.

To understand the ways relational organizing practices impacted collaborations between independent or health system-affiliated community health clinics, public health offices, and community groups during the early COVID-19 pandemic. Between November 2020 and June 2021, we interviewed clinical and public health workers, clinic-based community organizers, and staff and volunteers at community organizations who participated in three COVID-19 response collaborations in the Northwestern United States. This was a qualitative study employing participatory and rapid data collection and analysis methods. Research team members invited key participants in organizing efforts to a semi-structured virtual interview conducted by an independent health services researcher. A sensemaking team that included project participants analyzed interview data using an iterative, thematic approach and conducted a ripple effect mapping exercise to supplement interview data. A total of 19 people contributed data for analysis. Analysis was guided by the underlying research questions: whether and how relational organizing practices contributed to successful collaboration, and what challenges were encountered. Relational organizing was perceived to contribute to multiple positive project outcomes, including greater self-efficacy in a time of crisis and enhanced sense of connection; these outcomes contributed to a sense of successful collaboration. Four mechanisms were identified that explained relational organizing's collaborative efficacy: (1) mobilizing existing relationships for rapid community engagement; (2) bringing concrete skills for enhancing trust among cross-sector partners; (3) recognizing and addressing power dynamics; and (4) creating vehicles for exercising collective community power. Lack of trust and unsurfaced power dynamics were perceived as common challenges to sustained collaboration, which relational organizing could sometimes mitigate. Our findings suggest relational organizing practices can be protective against common "pain points" faced by cross-sectoral partnerships, especially in times of crisis. Further piloting of clinic-based relational organizing is recommended, as is research on longer-term impacts.

Strong Physical Contrasts Across Two Mid‐Lithosphere Discontinuities Beneath the Northwestern United States: Evidence for Cratonic Mantle Metasomatism

AbstractMid‐lithosphere discontinuities are seismic interfaces likely located within the lithospheric mantle of stable cratons, which typically represent velocities decreasing with depth. The origins of these interfaces are poorly understood due to the difficulties in both characterizing them seismically and reconciling the observations with thermal‐chemical models of cratons. Metasomatism of the cratonic lithosphere has been reported by numerous geochemical and petrological studies worldwide, yet its seismic signature remains elusive. Here, we identify two distinct mid‐lithosphere discontinuities at ∼87 and ∼117 km depth beneath the eastern Wyoming craton and the southwestern Superior craton by analyzing seismic data recorded by two longstanding stations. Our waveform modeling shows that the shallow and deep interfaces represent isotropic velocity drops of 2%–8% and 4%–9%, respectively, depending on the contributions from changes in radial anisotropy and density. By building a thermal‐chemical model including the regional xenolith thermobarometry constraints and the experimental phase‐equilibrium data of mantle metasomatism, we show that the shallow interface probably represents the metasomatic front, below which hydrous minerals such as amphibole and phlogopite are present, whereas the deep interface may be caused by the onset of carbonated partial melting. The hydrous minerals and melts are products of mantle metasomatism, with CO2‐H2O‐rich siliceous melt as a probable metasomatic reagent. Our results suggest that mantle metasomatism is probably an important cause of mid‐lithosphere discontinuities worldwide, especially near craton boundaries, where the mantle lithosphere may be intensely metasomatized by fluids and melts released by subducting slabs.

Bayesian design with sampling windows for complex spatial processes

Abstract Optimal design facilitates intelligent data collection. In this paper, we introduce a fully Bayesian design approach for spatial processes with complex covariance structures, like those typically exhibited in natural ecosystems. Coordinate exchange algorithms are commonly used to find optimal design points. However, collecting data at specific points is often infeasible in practice. Currently, there is no provision to allow for flexibility in the choice of design. Accordingly, we also propose an approach to find Bayesian sampling windows, rather than points, via Gaussian process emulation to identify regions of high design efficiency across a multi-dimensional space. These developments are motivated by two ecological case studies: monitoring water temperature in a river network system in the northwestern United States and monitoring submerged coral reefs off the north-west coast of Australia.

Tree demographic and neighbourhood responses to regional environmental gradients of the northwestern United States

Abstract Studies of drivers shaping forest communities frequently include abiotic or biotic factors, while their interactive effects remain understudied. Here, we combined data on two prominent abiotic gradients, climatic moisture deficit and wildfire probability, along with tree functional neighbourhoods (i.e. trait differences of close neighbours) to assess variation in survival and growth of 56 tree species in the northwestern US. We asked two questions: (1) How does functional neighbourhood dissimilarity vary with environmental gradients? and (2) How do demographic rates of tree species in the northwestern United States vary with the interactive effects of environmental gradients and functional neighbourhood? We expected functional neighbourhoods to become more similar as environmental stress increased, due to a convergence of species towards an optimum stress tolerance strategy. We also predicted the interactive effects of abiotic and biotic factors on tree demography and high variation in species‐specific responses to these interactive effects due to divergent species life history strategies. Functional neighbourhoods defined by dissimilarities in stem conductivity, litter decomposition, resprouting ability and specific leaf area changed with climate, shifting to more diverse neighbourhoods as climatic moisture deficit and wildfire probability increased. Results supported interactive effects of the functional neighbourhood and climatic moisture deficit or wildfire probability on tree demography, but only when the identity of dominant species was considered. Species‐specific responses were highly variable in their direction and magnitude and often demonstrated opposing effects of climate and the functional neighbourhood and climatic moisture deficit on tree demography. Synthesis. Our findings show that climate and tree neighbourhood functional dissimilarity jointly impact tree demography; however, the effects are species‐specific. Results of this study highlight the need to consider the interactive effects of abiotic and biotic contexts and individual species responses to their environment to adequately understand tree persistence under current and future climate conditions.

Plot-Measured Variables Indicate Landscape-Scale Patterns of Annual Grass Invasion in Northwestern US Rangelands

Introduced annual grasses (IAGs) have invaded tens of millions of hectares of western US rangelands, displacing native vegetation and altering ecosystem functions and services. Our main goal was to assess the influence of introduced annual grasses by 1) exploring the relationships among IAG cover, species richness, diversity, and cover of other plant functional groups; and 2) identifying biotic and abiotic indicators of IAG cover. Using data from 64 sites and 420 plots from rangelands of the northwestern United States, we explored linear correlations between IAG cover and species richness, Shannon index, and plant functional group cover. We also used Least Absolute Shrinkage and Selection Operator (LASSO) regression and nonmetric multidimensional scaling to select environmental variables and plant functional groups that were associated with IAG cover. Our findings revealed a negative correlation among IAG cover and species richness, Shannon index, native perennial grass cover, and other perennial species cover and a positive correlation with other annual species cover. Our results identified several indicators: cover of native perennial grass; other perennial species (forbs and shrubs); litter; bare ground/rock; soil attributes (pH, bulk density, clay, and nitrogen); and mean annual temperatures. Our results showed that perennial vegetation, especially native perennial grasses, have a negative correlation with IAG. Warmer mean annual temperatures, but not higher daily extreme temperatures, and higher bulk density were important indicators for IAG preferred sites, while lower soil nitrogen may denote soil changes due to invasion. Given the fundamental role of disturbance in determining the magnitude and scale of IAG invasion, our results provide important insights for scientists and managers.

The role of obesity severity in Minnesota multiphasic personality inventory-2-restructured form prediction of 12-month bariatric surgery outcomes

BackgroundThe Minnesota Multiphasic Personality Inventory-2 Restructured Form (MMPI-2-RF) has been widely used in bariatric surgery samples. However, questions remain regarding its utility when predicting changes in body mass index over time following bariatric surgery. ObjectivesExamine whether MMPI-2-RF scales differentially predict 12-month changes in body mass index (BMI) following bariatric surgery when comparing patients with Class III or higher versus Class II or lower obesity. SettingMilitary hospital in the Northwestern United States. MethodsThis retrospective study evaluated data from 193 bariatric surgery patients who completed the MMPI-2-RF as part of presurgical evaluation requirements. Hierarchical linear modeling was used to predict body mass index over a 12-month postsurgical period based on MMPI-2-RF scales. Loss to follow-up rate was 30% during this period. ResultsAmong patients with Class II or lower obesity, the Symptom Validity, Adjustment Validity, Response Bias, Cynicism, Aggression, Stress/Worry, and Anger Proneness scales showed a significant relationship to BMI after bariatric surgery. Among patients with Class III or higher obesity, the Infrequent Psychopathology Responses, Emotional / Internalizing Dysfunction, Ideas of Persecution, Multiple Specific Fears, and Inefficacy scales showed a significant relationship to body mass index after bariatric surgery. ConclusionsCertain MMPI-2-RF scales may have better utility in predicting bariatric surgery outcomes based on the patient’s obesity severity. The interaction of metabolic and personality factors may play a significant role in weight change following bariatric surgery.

Armillaria altimontana in North America: Biology and Ecology.

Armillaria altimontana is a fungus (Basidiomycota, Agaricomycetes, Agaricales, and Physalacriaceae) that is generally considered as a weak/opportunistic pathogen or saprophyte on many tree hosts. It widely occurs across the northwestern USA to southern British Columbia, Canada, but relatively little is known about its ecological role in the diverse forest ecosystems where it occurs. This review summarizes the biology and ecology of A. altimontana, including its identification, life cycle, distribution, host associations, and bioclimatic models under climate change.

Permeable Pavement in the Northwestern United States: Pollution Source or Treatment Option?

Permeable pavements can be an effective stormwater mitigation technique, but there are concerns that polluted stormwater may contaminate groundwater as stormwater infiltrates through the soil beneath the pavement. This research evaluates the pollutant removal capabilities of pervious pavements using pervious cement concrete (PC) and porous asphalt concrete (PA) cylinders. Stormwater collected from an outfall was used to perform three tests. The influent and effluent were analyzed for metals, semi-volatile organic compounds (SVOCs), phosphorus, and turbidity. Average percent removal for metals were 37–63% except for zinc, which had an average export of 21% for pervious cement concrete and 52% for porous asphalt concrete. Only 10 of the SVOCs tested had an influent concentration above detection levels. Complete removal (below detection levels) was observed for benzo(a)anthracene, benzo(a)pyrene, chrysene, and indeno(1,2,3-cd) pyrene. Average removals for benzo(b)fluoranthene, benzo(g,h,i)perlyne, fluoranthene, phenanthrene, pyrene, and bis(2-ethylhexyl)phthalate were 63–96%. No significant removal was observed for total phosphorus and reactive phosphate. All contaminant concentrations were below drinking water limits except lead, which would likely be removed in the soil layer below the pavement. This study indicates permeable pavements can effectively remove stormwater contaminants and protect groundwater as a drinking water source.

A new species of Zercoseius (Acari: Mesostigmata: Blattisociidae) from Brazil

Zercoseius luizdequeirozi n. sp. is described based on adult females collected from soil/litter samples taken from disturbed areas of the natural vegetation of the Brazilian Atlantic Forest biome. This new species differs from Zercoseius spathuliger (Leonardi, 1899), presently the only species included in this genus, reported so far from Europe, northern Africa and northwestern USA, more obviously by the shape of the dorsal shield setae and by having seta s1.

A high-throughput plate method for nucleic acid extraction from beet leafhopper (Hemiptera: Cicadellidae) and potato psyllid (Hemiptera: Triozidae) for pathogen detection.

Plant pathogens that are transmitted by insect vectors cause considerable damage to crops when pests or pathogens are not detected early in the season and populations are not controlled. Knowledge of pathogen prevalence in insect pest populations can aid growers in their insect pest management decisions but requires the timely dissemination of results. This process requires that specimen capture, identification, nucleic acid extraction, and molecular detection of a pathogen(s) occur alongside a platform for sharing results. The potato psyllid (Bactericera cockerelli, Sulc; Hemiptera: Triozidae) and beet leafhopper (Circulifer tenellus, Baker; Hemiptera: Cicadellidae) transmit pathogens to potato and other vegetable or seed crops each season in the northwestern United States. While the potato psyllid has been tested for pathogen occurrence for the past decade, testing of the beet leafhopper is a new endeavor and substantially increases the specimen number that must be tested by our laboratories each season. To aid in the rapid processing of individual insect specimens, we optimized and validated a new high-throughput 96-well plate nucleic acid extraction method for use in place of a standard 1.5-ml single-tube extraction method. Processing efficiency, in terms of total specimens processed over a 2-day period, improved 2.5-fold, and the cost associated with processing a single sample was nearly cut in half with this newly developed plate nucleic acid extraction method. Overall, this method has proven to be an excellent tool for the rapid testing of large numbers of small, individual insect vectors to enable timely dissemination of data on pathogen prevalence to growers.