San Diego Research Articles

Abstract P698: Coming Together in a Time of Distancing: Creating Community Messaging for Emergency Care During Covid

Introduction: In the early months of COVID-19 pandemic, a decline in stroke hospital admissions were reported nationwide. In a large, diverse region of Southern California, a collaborative effort was made to collect real-time data trends in stroke code activations and to assess this impact locally. The San Diego (SD) County Stroke Receiving Centers demonstrated a notable decrease of 30% in stroke code activations from March-May 2020 as compared to the same timeframe in 2019, which motivated the group to dedicate time and resources to pursue a united community messaging focused on seeking emergency treatment for stroke. Methods: A unified marketing campaign was created in collaboration with SD County EMS and the SD region American Heart Association/American Stroke Association. A single graphic message was utilized that emphasized the importance of seeking emergency treatment when suffering signs of stroke, along with the slogan “We are here for you. Every minute matters.” Impact of the campaign was gauged by quantifying the number of times our message was viewed on social media and number of stroke code activations after the campaign ended. Results: The unified social media campaign was posted by 14 of the 18 SD County stroke receiving hospitals during the month of June 2020. The team utilized Facebook, Twitter, Instagram and LinkedIn to convey the message. The campaign yielded a total of 26,727 views. The median monthly stroke code activations in July 2020 increased to 34, as compared to 26.5 for March-May 2020. Conclusion: In a time when social distancing has become the norm, it is more important than ever to band together as a community. This endeavor demonstrates that virtual messaging serves as a viable option for community education during the COVID-19 pandemic and in the future. A unified social messaging campaign targeting the importance of seeking emergency care for stroke during the COVID-19 pandemic is an effective way to reach large numbers of people regionally.

Next-Generation Sequencing to Assess Potentially Active Bacteria in Endodontic Infections

IntroductionBecause active bacteria present a higher abundance of ribosomal RNA (rRNA) than DNA (rRNA gene), the rRNA/DNA ratio of next-generation sequencing (NGS) data was measured to search for active bacteria in endodontic infections. MethodsPaired complementary DNA and DNA samples from 5 root canals of teeth with apical periodontitis were subjected to polymerase chain reaction with bar-coded primers amplifying the 16S rRNA gene hypervariable regions V4–V5. High-throughput sequencing was performed using MiSeq (Illumina, San Deigo, CA), and data were analyzed using Quantitative Insights Into Microbial Ecology and Human Oral Microbiome Database. Statistical analysis was performed for relative abundance of bacteria in the DNA- and rRNA-based NGS data using the Mann-Whitney test, whereas differences in the diversity and richness indexes were assessed using a nonparametric 2-sample t test (P < .05). For bacterial taxa detected in both approaches, the rRNA/DNA ratios were calculated by dividing the average abundance of individual species in the respective analysis. ResultsAlthough no significant difference was found in the indexes of bacterial richness and diversity, the relative abundance of bacterial members varied in both analyses. Comparing rRNA with DNA data, there was a significant decrease in the relative abundance of Firmicutes (P < .05). The bacterial taxa Bacteroidales [G-2] bacterium HMT 274, Porphyromonas endodontalis, Tannerella forsythia, Alloprevotella tannerae, Prevotella intermedia, Pseudoramibacter alactolyticus, Olsenella sp. HMT 809, Olsenella sp. HMT 939, Olsenella uli, and Fusobacterium nucleatum subsp. animalis were both dominant (DNA ≥ 1%) and active (rRNA/DNA ≥ 1). ConclusionsThe integrated DNA- and rRNA-based NGS strategy was particularly important to disclose the activity of as-yet-uncultivated or difficult-to-culture bacteria in endodontic infections.

Optimizing Screening for HIV.

BackgroundThe HIV epidemic is unevenly distributed throughout the United States, even within neighborhoods. This study evaluated how effectively current testing approaches reached persons at risk for HIV infection across San Diego (SD) County, California.MethodsHIV case and testing data, sexually transmitted infection (STI) data, and sociodemographic data for SD County were collected from the SD Health and Human Services Agency and the “Early Test” community-based HIV screening program between 1998 and 2016. Relationships between HIV diagnoses, HIV prevalence, and STI diagnoses with screening at the ZIP code level were evaluated.ResultsOverall, 379 074 HIV tests were performed. The numbers of HIV tests performed on persons residing in a ZIP code or region overall strongly correlated with prevalent HIV cases (R2 = .714), new HIV diagnoses (R2 = .798), and STI diagnoses (R2 = .768 [chlamydia], .836 [gonorrhea], .655 [syphilis]) in those regions. ZIP codes with the highest HIV prevalence had the highest number of tests per resident and fewest number of tests per diagnosis. Even though most screening tests occurred at fixed venues located in high-prevalence areas, screening of residents from lower-prevalence areas was mostly proportional to the prevalence of HIV and rates of new HIV and STI diagnoses in those locales.ConclusionsThis study supported the ability of a small number of standalone testing centers to reach at-risk populations dispersed across SD County. These methods can also be used to highlight geographic areas or demographic segments that may benefit from more intensive screening.

Effects of CO addition on laminar flame characteristics and chemical reactions of H2 and CH4 in oxy-fuel (O2/CO2) atmosphere

An experimental study is conducted to investigate the effect of CO addition on the laminar flame characteristics of H2 and CH4 flames in a constant-volume combustion system. In addition, one-dimensional laminar premixed flame propagation processes at the same conditions are simulated with the update mechanisms. Results show that all mechanisms could well predict the laminar flame speeds of CH4/CO/O2/CO2 mixtures, when ZCO is large. For mixtures with lower CO, the experimental laminar flame speeds are always smaller than the calculated ones with Han mechanism. For mixtures with larger or smaller ZCO2, GRI 3.0, San diego and USC 2.0 mechanisms all overvalue or undervalue the laminar flame speeds. When CO ratio in the CH4/CO blended fuels increases, laminar flame speed firstly increases and then decreases for the CH4/CO/O2/CO2 mixtures. For H2/CO/O2/CO2 mixtures, San diego, Davis and Li mechanisms all undervalue the laminar flame speeds of H2/CO/CO2/CO2 mixtures. Existing models could not well predict the nonlinear trend of the laminar flame speeds, due to complex chemical effects of CO on CH4/CO or H2/CO flames. Then, the detailed thermal, kinetic and diffusive effects of CO addition on the laminar flame speeds are discussed. Kinetic sensitivity coefficient is far larger than thermal and diffusive ones and this indicates CO addition influences laminar flame speeds mainly by the kinetic effect. Based on this, radical pool and sensitivity analysis are conducted for CH4/CO/O2/CO2 and H2/CO/O2/CO2 mixtures. For CH4/CO/O2/CO2 mixtures, elementary reaction R38H + O2 ↔ O + OH and R99 OH + CO ↔ H + CO2 are the most important branching reactions with positive sensitivity coefficients when CO ratio is relative low. As CO content increases in the CH4/CO blended fuel, the oxidation of CO plays a more and more important role. When CO ratio is larger than 0.9, the importance of R99 OH + CO ↔ H + CO2 is far larger than that of R38H + O2 ↔ O + OH. The oxidation of CO dominates the combustion process of CH4/CO/O2/CO2 mixtures. For H2/CO/O2/CO2 mixtures, the most important elementary reaction with positive and negative sensitivity coefficients are R29 CO + OH ↔ CO2 + H and R13H + O2(+M) ↔ HO2(+M) respectively. The sensitivity coefficient of R29 CO + OH ↔ CO2 + H is increasing and then decreasing with the addition of CO in the mixture. Chemical kinetic analysis shows that the chemical effect of CO on the laminar flame propagation of CH4/CO/O2/CO2 and H2/CO/O2/CO2 mixtures could be divided into two stages and the critical CO mole fraction is 0.9.

2189. Hepatitis A Outbreak in San Diego County, 2016–2017: A Morphologic and Epidemiologic Review

BackgroundHepatitis A rate has declined by 95% in the United States since routine vaccination begun in the late 1990s. In 2014, a total of 1,239 cases of HAV were reported from 50 states to CDC. Per San Diego (SD) County Public Health Department, on average 20 cases/year are reported locally. The recent hepatitis A outbreak in SD County, which started in late 2016, caused 588 new cases.MethodsEpidemiologic data on hepatitis A cases was provided by the SD Public Health Department. Genetic evaluation was performed on all cases by the Health Department to identify the hepatitis A viral (HAV) strain. UCSD records and available liver biopsies were reviewed for the patients who were treated at UCSD.ResultsSD County reported 588 new cases, 403 (68%) hospitalization and 20 deaths (3.4%), with the following demographic distribution: Age range of 5–87 (median 43), 69% male and 31% female. One hundred and fifty-four of the 588 patients were treated at UCSD. The demographics of UCSD patients are as follows: Age range of 23–100 (median 45), 71% male (median age 47) and 29% female (median age 39). Concurrent hepatitis B (in 5.5%) and hepatitis C (in 18.5%) were present. Clinically relapsing (10%) and cholestatic (5%) hepatitis were seen. The infection has disproportionately affected the homeless and IV drug user population. Morphologically, features of severely active hepatitis with confluent and bridging necrosis, lymphoplasmacytic inflammation, canalicular and hepatocytic cholestasis and bile duct injury were present. HAV genotype 1b was identified by the SD Health department in all reported cases.ConclusionThe hepatitis A outbreak affected 588 individuals. An epidemiologic and morphologic review of the cases with a focus on the UCSD patients was performed. No common sources of food, beverage or drugs have been identified that have contributed to this outbreak. Mode of distribution is likely direct person to person transmission. The health department initiated an extensive public vaccination and education campaign, distributed hygiene kits, deployed portable bathroom and hand washing and declared a local public health emergency. Due to the extensive public health campaign, the outbreak seems to be under control as of January 2018.Disclosures All authors: No reported disclosures.

Multiple Modes of Adaptation: Regulatory and Structural Evolution in a Small Heat Shock Protein Gene.

Thermal tolerance is a key determinant of species distribution. Despite much study, the genetic basis of adaptive evolution of thermal tolerance, including the relative contributions of transcriptional regulation versus protein evolution, remains unclear. Populations of the intertidal copepod Tigriopus californicus are adapted to local thermal regimes across their broad geographic range. Upon thermal stress, adults from a heat tolerant southern population, San Diego (SD), upregulate several heat shock proteins (HSPs) to higher levels than those from a less tolerant northern population, Santa Cruz (SC). Suppression of a specific HSP, HSPB1, significantly reduces T. californicus survival following acute heat stress. Sequencing of HSPB1 revealed population specific nucleotide substitutions in both promoter and coding regions of the gene. HSPB1 promoters from heat tolerant populations contain two canonical heat shock elements (HSEs), the binding sites for heat shock transcription factor (HSF), whereas less tolerant populations have mutations in these conserved motifs. Allele specific expression of HSPB1 in F1 hybrids between tolerant and less tolerant populations showed significantly biased expression favoring alleles from tolerant populations and supporting the adaptive divergence in these cis-regulatory variants. The functional impact of population-specific nonsynonymous substitutions in HSPB1 coding sequences was tested by assessing the thermal stabilization properties of SD versus SC HSPB1 protein variants. Recombinant HSPB1 from the southern SD population showed greater capacity for protecting protein structure under elevated temperature. Our results indicate that both regulatory and protein coding sequence evolution within a single gene appear to contribute to thermal tolerance phenotypes and local adaptation among conspecific populations.

Customize the adult learner experience with responsive website design

SAN DIEGO — Adult learners come to your campus with a variety of life experiences, skills, and abilities. If you are part of a college system, how can you leverage the different areas of expertise at your system to best guide those adult learners to the program that is right for them, and eventually to completion? In a session at the annual conference of the Council for Adult and Experiential Learning, Veella Grooms, grant lead at Mountwest Community and Technical College; and Judith Whipkey, professor and department chair at BridgeValley Community and Technical College, shared how a Trade Adjustment Assistance Community College Career Training grant helped engage and make connections between adult learners at different campuses in the Community and Technical Colleges of West Virginia to guide them to completion.

Customize the adult learner experience with responsive website design

SAN DIEGO — Adult learners come to your campus with a variety of life experiences, skills, and abilities. If you are part of a college system, how can you leverage the different areas of expertise at your system to best guide those adult learners to the program that is right for them, and eventually to completion? In a session at the annual conference of the Council for Adult and Experiential Learning, Veella Grooms, grant lead at Mountwest Community and Technical College; and Judith Whipkey, professor and department chair at BridgeValley Community and Technical College, shared how a Trade Adjustment Assistance Community College Career Training grant helped engage and make connections between adult learners at different campuses in the Community and Technical Colleges of West Virginia to guide them to completion.

Scaling up PLA requires strong policies, planning backend processes

SAN DIEGO — Prior learning assessment might be one of the education modes of the future, but can it be scaled up in an effective way? At the annual conference of the Council for Adult and Experiential Learning, Bitsy Cohn, director of credit for prior learning for the Colorado Community College System; Lisa Duddy, academic director for the New Jersey Health Professions Consortium, Bergen County; Anne Kamps, dean of learning solutions at Northeast Wisconsin Technical College; and Heather McKay, director of the Education and Employment Research Center at Rutgers, the State University of New Jersey, shared ways they used grant money to implement and scale prior learning assessment initiatives.

Customize the adult learner experience with responsive website design

SAN DIEGO — Adult learners come to your campus with a variety of life experiences, skills, and abilities. If you are part of a college system, how can you leverage the different areas of expertise at your system to best guide those adult learners to the program that is right for them, and eventually to completion? In a session at the annual conference of the Council for Adult and Experiential Learning, Veella Grooms, grant lead at Mountwest Community and Technical College; and Judith Whipkey, professor and department chair at BridgeValley Community and Technical College, shared how a Trade Adjustment Assistance Community College Career Training grant helped engage and make connections between adult learners at different campuses in the Community and Technical Colleges of West Virginia to guide them to completion.

FR-21 THE CREATION OF A UROLOGY TRAINING PROGRAM: ROBERT PRENTISS AND THE SAN DIEGO COUNTY HOSPITAL

You have accessJournal of UrologyHistory Forum1 Apr 2018FR-21 THE CREATION OF A UROLOGY TRAINING PROGRAM: ROBERT PRENTISS AND THE SAN DIEGO COUNTY HOSPITAL Unwanaobong Nseyo Unwanaobong NseyoUnwanaobong Nseyo More articles by this author View All Author Informationhttps://doi.org/10.1016/j.juro.2018.02.3041AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookTwitterLinked InEmail INTRODUCTION AND OBJECTIVES Nearly 60 years ago, Dr. Robert J. Prentiss decided to expand urology training at the then San Diego County Hospital by creating a urology residency program. At that time, the formal urology residency training programs were few and far between, spread out across the country at institutions like Johns Hopkins and UC San Francisco. For Dr. Prentiss, starting the residency program was an extension of his commitment to academics in urology although the residency program predated the creation of the department itself. The historical analysis of the development of a stand-alone urology training program highlights the tenets of urology training that are maintained today. METHODS A literature review was conducted in PubMed which identified primary and secondary sources regarding "Robert J Prentiss" and "San Diego County Hospital" and "urology residency" or "urology training." In addition, archival material was available at UC San Diego as well as in the Prentiss Family Papers accessible via the University of Iowa library. These sources were reviewed in order to evaluate the birth of the UC San Diego urology residency in the appropriate historical context. RESULTS By the 1920s, the majority of urology training occurred through an apprenticeship model. It is in this same way that Robert Prentiss obtained his urology training at University of Iowa under Dr. Nathaniel Alcock (instrumental in mapping of prostatic blood supply). Although Prentiss received his urology training within a well-established medical school and department, he chose to start his own training program without any of these elements in place, much less a full-time faculty. Instead Prentiss relied on a community-based model, partnering with the Naval Hospital and local urologists, which were few at the time, to teach his residents. His curriculum which consisted of monthly case presentations by residents for community physicians as well as invited lectureships. CONCLUSIONS Robert J Prentiss is most well-known for his contribution to surgical management of undescended testes, however, his lesser known work establishing a formal residency training program at what is now UC San Diego illustrates the tenets that characterize the Urology program to this day: collegiality with community urologists, a commitment to intellectual curiosity and continued engagement of leaders in the field of urology through the aptly named Robert Prentiss Lecture for a Visiting Professorship. © 2018FiguresReferencesRelatedDetails Volume 199Issue 4SApril 2018Page: e1248-e1249 Advertisement Copyright & Permissions© 2018MetricsAuthor Information Unwanaobong Nseyo More articles by this author Expand All Advertisement Advertisement PDF downloadLoading ...

Scaling up PLA requires strong policies, planning backend processes

SAN DIEGO — Prior learning assessment might be one of the education modes of the future, but can it be scaled up in an effective way? At the annual conference of the Council for Adult and Experiential Learning, Bitsy Cohn, director of credit for prior learning for the Colorado Community College System; Lisa Duddy, academic director for the New Jersey Health Professions Consortium, Bergen County; Anne Kamps, dean of learning solutions at Northeast Wisconsin Technical College; and Heather McKay, director of the Education and Employment Research Center at Rutgers, the State University of New Jersey, shared ways they used grant money to implement and scale prior learning assessment initiatives.

Increase adult student retention through rebranding, student success strategies

SAN DIEGO — To become an institution that truly serves the needs of your adult learner population, you have to be willing to commit to significant change. At the annual conference of the Council for Adult and Experiential Learning, presenters Jessica Waddell, associate director of the bachelor's degree for professionals; Lisa Buono, director of the bachelor's degree for professionals; Margarita Bueno, academic advisor and retention specialist; and Kristy Fenstermaker, academic advisor, all from California Lutheran University, gave tips on how their institution committed to a complete overhaul, from changing the terminology from adult learner to post‐traditional learner to better reflect their student population to developing tracks for post‐traditional learners outside of traditional night‐class offerings, that helped dramatically increase the retention and graduation rate of this population of students.

Find creative workarounds to implement competency‐based education

SAN DIEGO — Competency‐based education is a huge buzzword in higher education right now, but say it to a prospective student, and does he understand what that means in a practical sense? And how do you move from the idea of CBE to an implementation that works for your students and has meaning for your local industry? That was the first hurdle tackled by Eric Heiser, dean of the School of Applied Technology and Technical Specialties at Salt Lake Community College, when overhauling the flight technology program to be a CBE‐focused channel for delivering skilled workers into the Utah economy more quickly.

Find creative workarounds to implement competency‐based education

SAN DIEGO — Competency‐based education is a huge buzzword in higher education right now, but say it to a prospective student, and does he understand what that means in a practical sense? And how do you move from the idea of CBE to an implementation that works for your students and has meaning for your local industry? That was the first hurdle tackled by Eric Heiser, dean of the School of Applied Technology and Technical Specialties at Salt Lake Community College, when overhauling the flight technology program to be a CBE‐focused channel for delivering skilled workers into the Utah economy more quickly.

Bridge the college‐to‐career gap with focused initiatives

SAN DIEGO — Career services should help to serve as the bridge between your students' academic present and their professional future, but do your career services actually help your students? According to a survey conducted by the California Community Colleges System, only 17 percent of CCCS students who used the career services available at their campus found them helpful. With the CCCS looking to create 1 million skilled workers for the state, the initiative to create the Strong Workforce Program, which targets outcomes in areas of student success, along with other measures of quality in curriculum, regional collaboration, and career pathways, was born.

Find creative workarounds to implement competency‐based education

SAN DIEGO — Competency‐based education is a huge buzzword in higher education right now, but say it to a prospective student, and does he understand what that means in a practical sense? And how do you move from the idea of CBE to an implementation that works for your students and has meaning for your local industry? That was the first hurdle tackled by Eric Heiser, SLCC site says he's dean of the School of Applied Technology and Technical Specialties at Salt Lake Community College, when overhauling the flight technology program to be a CBE‐focused channel for delivering skilled workers into the Utah economy more quickly.

Bridge the college‐to‐career gap with more focused initiatives

SAN DIEGO — Career services should help to serve as the bridge between your students' academic present and their professional future, but do your career services actually help your students? According to a survey conducted by the California Community Colleges System, only 17 percent of CCCS students who used the career services available at their campus found them helpful. With the CCCS looking to create 1 million skilled workers for the state, the initiative to create the Strong Workforce Program, which targets outcomes in areas of student success, along with other measures of quality in curriculum, regional collaboration, and career pathways, was born.

Propel student‐veterans to degree with framework to articulate military credit

SAN DIEGO — If your institution is unable to successfully articulate your student‐veterans' military credit to course credit that applies to their degree, your students are losing time and money. That was the message from Danny Gourley, director of the Center for Adult Learners and Veterans at the University of West Georgia, during his presentation at the Council for Adult and Experiential Learning annual meeting on how UWG has successfully articulated military credit into credit for prior learning. “Elective credit does you no good; we want you to graduate,” Gourley said.

Increase adult student retention through rebranding, student success strategies

SAN DIEGO — To become an institution that truly serves the needs of your adult learner population, you have to be willing to commit to significant change. At the annual meeting for the Council for Adult and Experiential Learning, presenters Jessica Waddell, associate director of the bachelor's degree for professionals; Lisa Buono, director of the bachelor's degree for professionals; Margarita Bueno, academic advisor and retention specialist; and Kristy Fenstermaker, academic advisor, all from California Lutheran University, gave tips on how their institution committed to a complete overhaul, from changing the terminology from adult learner to post‐traditional learner to better reflect their student population to developing tracks for post‐traditional learners outside of traditional night‐class offerings, that helped dramatically increase the retention and graduation rate of this population of students.