Ventura County Research Articles

Perspectives and Attitudes Toward Healthcare and Access Among Transgender and Nonbinary Patients in Ventura County, CA

Transgender and nonbinary (TNB) patients require clinically and culturally appropriate and responsive care in affirming spaces, but barriers exist that prevent TNB patients from accessing or dissuade them from pursuing such care. In this research brief, we summarize findings from a virtual focus group (N= 6) designed to assess perspectives and attitudes toward accessing and receiving care among TNB patients in Ventura County, CA. Qualitative analysis revealed themes related to (1) the importance of enhanced TNB knowledge and sensitivity among medical personnel (particularly among nonprovider staff in healthcare settings), (2) the importance of updating data collection and data management systems with TNB-appropriate terms and diagnoses (e.g., on intake forms), and (3) the importance of self-advocacy and self-education among TNB patients in navigating the healthcare system. Findings indicate that those looking to increase healthcare access and quality among TNB patients in the area should focus their efforts on increasing TNB knowledge and sensitivity among all healthcare employees (i.e., not just providers), enhancing TNB data collection, and making institutional changes such that TNB patients do not have to rely as heavily on themselves when navigating the healthcare system.

An ECG-based artificial intelligence model for assessment of sudden cardiac death risk.

Conventional ECG-based algorithms could contribute to sudden cardiac death (SCD) risk stratification but demonstrate moderate predictive capabilities. Deep learning (DL) models use the entire digital signal and could potentially improve predictive power. We aimed to train and validate a 12 lead ECG-based DL algorithm for SCD risk assessment. Out-of-hospital SCD cases were prospectively ascertained in the Portland, Oregon, metro area. A total of 1,827 pre- cardiac arrest 12 lead ECGs from 1,796 SCD cases were retrospectively collected and analyzed to develop an ECG-based DL model. External validation was performed in 714 ECGs from 714 SCD cases from Ventura County, CA. Two separate control group samples were obtained from 1342 ECGs taken from 1325 individuals of which at least 50% had established coronary artery disease. The DL model was compared with a previously validated conventional 6 variable ECG risk model. The DL model achieves an AUROC of 0.889 (95% CI 0.861-0.917) for the detection of SCD cases vs. controls in the internal held-out test dataset, and is successfully validated in external SCD cases with an AUROC of 0.820 (0.794-0.847). The DL model performs significantly better than the conventional ECG model that achieves an AUROC of 0.712 (0.668-0.756) in the internal and 0.743 (0.711-0.775) in the external cohort. An ECG-based DL model distinguishes SCD cases from controls with improved accuracy and performs better than a conventional ECG risk model. Further detailed investigation is warranted to evaluate how the DL model could contribute to improved SCD risk stratification.

Social Inequity and Wildfire Response: Identifying Gaps and Interventions in Ventura County, California

Social Inequity and Wildfire Response: Identifying Gaps and Interventions in Ventura County, California

CONDUCTING COMMUNITY-BASED GERONTOLOGY PROJECTS IN UNDERGRADUATE CLASSROOMS: CAPSTONE CASE STUDIES

Abstract Collaborations between university-level students and community-based organizations have long shown to be mutually beneficial in that they can address pressing community needs, advance the mission of the organization, and enhance the learning of students. In this presentation, I describe project collaborations between a non-profit volunteer caregiving organization based in Ventura County (“Caregivers”) and Health Science undergraduate students (N = 76) enrolled in Capstone courses at California State University Channel Islands between 2022-2023. Projects were designed utilizing a community-based approach wherein the community partner (“Caregivers”) played an active and central role in determining project goals and outcomes. Four projects, each addressing and/or serving a specific need, were completed by different Capstone sections: (1) the creation of an online governance training program to educate high school and university students on the basics of leadership in nonprofits which serve older adults; (2) the creation of a series of videos to educate on and advocate for volunteer caregiving; (3) the analysis of quantitative and qualitative survey data to evaluate the experiences and satisfaction levels of local volunteer caregivers and care recipients; and (4) the creation of a toolkit to be used by volunteer caregiving organizations implementing community meal delivery programs for older adults. In this presentation, I detail each project along with their major successes and challenges as assessed through personal observation, feedback provided by the community partner, and student reflections. I conclude with discussing best practices in implementing community-based projects in undergraduate settings and describe the value of such projects across all stakeholders.

Mexican Americans with Moxie: A Transgenerational History of El Movimiento Chicano in Ventura County, California, 1945–1975

Mexican Americans with Moxie: A Transgenerational History of El Movimiento Chicano in Ventura County, California, 1945–1975

Abstract 12785: Abnormal Dynamic Remodeling of the 12-Lead Electrocardiogram is a Risk Marker for Sudden Cardiac Death

Introduction: The ECG has always been evaluated as static risk factor for sudden cardiac death (SCD). The importance of dynamic ECG remodeling has not been investigated. Hypothesis: Abnormal ECG remodeling over time is associated with increased risk of SCD. Methods: We investigated pre-SCD ECG remodeling in SCD cases from 2 ongoing population-based studies of out-of-hospital SCD in Portland, OR (discovery) and Ventura County, CA (validation). Two archived pre-SCD ECGs performed at least 1 year apart were obtained from lifetime health records. Controls were matched on geographical region, age, sex, and duration between the 2 ECG recordings. Dynamic ECG remodeling was measured as the change in a previously validated cumulative 6-variable ECG electrical risk score (ERS) between the 1st and 2nd ECG. Results: A total of 231 SCD cases (66.5±13.6 years, 61% male), and 234 controls (65.8±11.1 years, 61% male) were included in the discovery cohort, and 203 SCD cases (70.3±14.4 years, 54% male), and 203 controls (68.4±11.8 years, 54% male) in the validation cohort. The mean time between the 2 ECG recordings in SCD cases and controls was 6.0±4.0 years vs 6.2±4.5 years (discovery) and 3.7±2.6 years vs. 3.7±1.6 years (validation), respectively. In both cohorts, SCD cases compared to controls had greater dynamic ECG remodeling over time: Discovery cohort ERS change +1.06 (95% CI +0.89 to +1.24) vs. -0.05 (-0.21 to +0.11; p<0.001) and validation cohort ERS change +0.87 (+0.7 to +1.04) vs. -0.11 (-0.27 to 0.05; p<0.001). In a multivariate model including clinical SCD risk factors, a 1-unit increase in the ERS was an independent risk marker for SCD: Discovery cohort OR 1.89 (95% CI 1.58-2.26; p<0.001), validation cohort OR 2.17 (95% CI 1.63-2.91; p<0.001). Conclusions: SCD cases were observed to have abnormal dynamic ECG remodeling prior to the SCD event, not observed in matched controls. These findings warrant further investigation of dynamic ECG remodeling as a novel risk marker for SCD.

Risk Factors for Sudden Cardiac Arrest Among Hispanic or Latino Adults in Southern California: Ventura PRESTO and HCHS/SOL.

Background Out-of-hospital sudden cardiac arrest (SCA) is a leading cause of mortality, making prevention of SCA a public health priority. No studies have evaluated predictors of SCA risk among Hispanic or Latino individuals in the United States. Methods and Results In this case-control study, adult SCA cases ages 18-85 (n=1,468) were ascertained in the ongoing Ventura Prediction of Sudden Death in Multi-Ethnic Communities (PRESTO) study (2015-2021) in Ventura County, California. Control subjects were selected from 3033 Hispanic or Latino participants who completed Visit 2 examinations (2014-2017) at the San Diego site of the HCHS/SOL (Hispanic Community Health Survey/Study of Latinos). We used logistic regression to evaluate the association of clinical factors with SCA. Among Hispanic or Latino SCA cases (n=295) and frequency-matched HCHS/SOL controls (n=590) (70.2% men with mean age 63.4 and 61.2 years, respectively), the following clinical variables were associated with SCA in models adjusted for age, sex, and other clinical variables: chronic kidney disease (odds ratio [OR], 7.3 [95% CI, 3.8-14.3]), heavy drinking (OR, 4.5 [95% CI, 2.3-9.0]), stroke (OR, 3.1 [95% CI, 1.2-8.0]), atrial fibrillation (OR, 3.7 [95% CI, 1.7-7.9]), coronary artery disease (OR, 2.9 [95% CI, 1.5-5.9]), heart failure (OR, 2.5 [95% CI, 1.2-5.1]), and diabetes (OR, 1.5 [95% CI, 1.0-2.3]). Conclusions In this first population-based study, to our knowledge, of SCA risk predictors among Hispanic or Latino adults, chronic kidney disease was the strongest risk factor for SCA, and established cardiovascular disease was also important. Early identification and management of chronic kidney disease may reduce SCA risk among Hispanic or Latino individuals, in addition to prevention and treatment of cardiovascular disease.

Scoring, ranking, and technoeconomics of carbon capture and storage opportunities in the central valley of California

Previous studies of geological carbon storage are reviewed, redefined, and evaluated to provide proper capturable emission amounts and candidate storage sites in the Southern San Joaquin Basin (California). The LCFS eligible capturable GHG emissions from thermal EOR facilities were 11.4 MtCO2/y. Also, the capturable emission amounts and location of other large emitters in both Kern County and southern California were identified. The estimated CO2 storage resource in the 7 qualified saline formations ranged from 16.6 to 52 GtCO2 whereas that in 35 qualified hydrocarbon fields ranged from 0.45 to 1.15 GtCO2. Among the 35 hydrocarbon fields, 15 CO2-EOR candidate fields with storage resources of 0.36 to 0.88 GtCO2 are located in Kern County. Altogether, 41 storage sites including 7 hydrocarbon fields, 32 saline storage sites, and 2 stacked storage sites were defined as CO2 storage locations. The 41 CO2 storage sites in and around Kern County were linked to selected large CO2 emitters in Imperial, Kern, Los Angeles, Orange, San Bernardino, Santa Barbara, San Luis Obispo, and Ventura Counties. Importantly, the technoeconomics of prospective storage sites and emitters were analyzed using SimCCS (Scalable infrastructure model for Carbon Capture and Storage). Regional GHG emissions from oil and gas facilities such as EOR steam generators and CHPs can be captured and stored economically as a result of LCFS and 45Q credits. The 45Q credit value and duration are critical factors to incentivize CCS deployment. The deployment scenarios evaluated teach that the Southern San Joaquin basin is an excellent potential regional carbon storage hub.

Victims of Violence, How a Trauma Center and Family Justice Center Can Provide Continued Care After Initial Hospitalization.

Intentional injuries are the second leading cause of death in the U.S. between the ages of 1 and 44. Each traumatic event is approached best with a multiagency and multidisciplinary approach. Family Justice Centers (FJCs) are structured as one-stop centers for victims of all forms of violence to provide services. The purpose of this study is to describe trauma patients evaluated in an FJC and determine the effect of the referrals on injury-related hospital recidivism. This is a cross-sectional descriptive study of traumatically injured patients that were evaluated in an adult level II trauma center for 3years and were referred to Ventura County's FJC. There were 415 trauma admissions for intentional injuries, which accounted for 10.4% of the total trauma-related hospital admissions. Of these patients, 203 (49%) were evaluated in Ventura County's FJC. The remaining 212 (51%) had an open judicial case, thus, were not processed through the FJC due to conflict of interest. The mechanisms of injuries of patients that were evaluated at the FJC (N = 203) were mostly assaults (83%). Majority of the patients were of the Hispanic race (70%), males (69%), English speaking (77%), and aged 18-59 (84%). 573 individual services were provided to these patients. The patients evaluated through the FJC (N = 203) had zero recidivism, while those with open cases had a 1% recidivism rate (P = NS). By collaborating with FJCs, trauma center outcomes contribute to a pathway for healing and may prevent future acts of intentional injuries.

AP-452680-2 GEOSPATIAL ANALYSIS OF BYSTANDER-INITIATED AUTOMATED EXTERNAL DEFIBRILLATOR UTILIZATION IN A LARGE US COMMUNITY

Bystander use of automated external defibrillators (AED) can improve survival from out-of-hospital sudden cardiac arrest (SCA), but utilization can be variable. We hypothesized that AED distribution and utilization is determined by race/ethnicity and socioeconomic status of neighborhoods. To evaluate the distribution and utilization of bystander-initiated AED use for SCA events in a single large US community. All consecutive SCA cases with resuscitation attempted by emergency medical services (EMS) in Ventura County, CA (pop. 848,112, 43% Hispanic) were prospectively identified during 2015-2022. AED locations were obtained from the Ventura County Healthcare Agency Registry. Census tracts in the county (US Census 2018 estimates), were dichotomized as above or below the median census tract household income categorized as SES1 (income <median income) and SES2 (income >median income). AED and SCA event locations were geocoded and merged with the 2018 census tract geospatial map. The Euclidean distance (meters) between these two locations was calculated. AEDs were considered in viable proximity if located within 300 meters of the SCA event. Differences were analyzed using univariate statistical methods. Among 2515 cases (70.5±16.33 y, 65% male) of whom 684 (27%) were Hispanic, 782 (31%) were in viable proximity of an AED (Figure). There were no ethnicity-based differences in viable AED proximity (Hispanic n= 225(33%), non-Hispanic n=557 (30%), p=0.23). A total of 1442 (57%) cases (70±16.17 y, 65% male) were categorized as SES1 and 1070 (43%) cases (71±16.52 y, 65% male) as SES2. No significant differences in viable AED proximity were identified between SES1 (n= 434, 30%), and SES2 (n=348(33%); p=0.19). A total of 1361(54%) received bystander CPR, but bystander-initiated AED use was observed in 75 (3%). AED use was observed in 75/782 (9%) SCA cases in viable proximity to an AED of whom 3.1% were Hispanic and 12.2% non-Hispanic (p <0.001). SES2 cases had higher AED utilization than SES1 cases (12.4% vs. 7.8%, p = 0.02). In this western US community, AEDs in viable proximity to SCA events were distributed equitably, and not affected by neighborhood SES or ethnicity. However, bystander-initiated use for AEDs in close proximity was under 10%, indicating significant missed opportunities. These findings highlight the critical need to enhance community-wide education in bystander-initiated CPR and AED use for further improvement in SCA survival outcomes.

PO-05-137 ECG MORPHOLOGY IS A DETERMINANT OF SURVIVAL IN PULSELESS ELECTRICAL ACTIVITY

Sudden cardiac arrest (SCA) due to pulseless electrical activity (PEA) has a poor prognosis and identification of cases with a higher likelihood of survival could facilitate the resuscitation process. In PEA, QRS frequency and morphology can vary significantly. To investigate if the frequency and morphology of the QRS can predict survival outcomes in PEA. The study population is drawn from two prospective, community-based studies of out-of-hospital SCA in the U.S.: Oregon SUDS from the Portland, OR metro area (Pop. approx. 1 million; since 2002) and Ventura PRESTO from Ventura County CA (Pop. approx. 850,000, since 2015). In the present study, we included SCA cases resuscitated by EMS that had EMS recording of the ECG available, and PEA was the presenting rhythm. We analyzed QRS frequency, regularity, and width of the presenting PEA rhythm in a subset of 347 PEA-SCA cases (34 survivors and 313 non-survivors). The mean age of the subjects was 70.3±15.5 years and 60.2% were male. The prevalence of QRS frequency >60 bpm was 23.1% and QRS width <120 ms was 32.6%. Females were more likely to have a narrow QRS complex than males (39.9% vs. 27.8%; p=0.02) but there was no sex difference in the QRS frequency. Those with QRS frequency >60 bpm had a higher survival rate than those with QRS frequency <60 bpm (17.5% vs. 7.5%: p=0.02). In addition, cases with QRS width <120 ms had a higher survival rate in comparison to cases with QRS width >120 ms (17.7% vs. 6.0%; p=0.001). Cases with both narrow QRS complex (<120 ms) and fast frequency (>60 bpm) had the highest survival rate (10/38, 26.3%). There was no difference in the survival rate between regular and irregular rhythms. PEAs with electrical activity >60 bpm and narrow QRS complex were associated with higher survival. These results suggest that resuscitation efforts are most likely to be beneficial in PEA-SCA cases that present with a narrow and fast QRS pattern.

Determinants of survival in sudden cardiac arrest manifesting with pulseless electrical activity

ObjectiveThe proportion of sudden cardiac arrests (SCA) manifesting with pulseless electrical activity (PEA) has increased significantly, and the survival rate remains lower than ventricular fibrillation (VF). However, a subgroup of PEA-SCA cases does survive and may yield key predictors of improved outcomes when compared to non-survivors. We aimed to identify key predictors of survival from PEA-SCA. MethodsOur study sample is drawn from two ongoing community-based, prospective studies of out-of-hospital SCA: Oregon SUDS from the Portland, OR metro area (Pop. approx. 1 million; 2002–2017) and Ventura PRESTO from Ventura County, CA (Pop. approx. 850,000, 2015–2021). For the present sub-study, we included SCA cases with PEA as the presenting rhythm where emergency medical services (EMS) personnel attempted resuscitation. ResultsWe identified 1,704 PEA-SCA cases, of which 173 (10.2%) were survivors and 1,531 (89.8%) non-survivors. Patients whose PEA-SCA occurred in a healthcare unit (16.9%) or public location (18.1%) had higher survival than those whose PEA-SCA occurred at home (9.3%) or in a care facility (5.7%). Young age, witness status, PEA-SCA location and pre-existing COPD/asthma were independent predictors of survival. Among witnessed cases the survival rate was 10% even if EMS response time was >10 minutes. ConclusionsKey determinants for survival from PEA-SCA were young age, witnessed status, public location and pre-existing COPD/asthma. Survival outcomes in witnessed PEA cases were better than expected, even with delayed EMS response.

Sudden cardiac arrest during the COVID-19 pandemic: A two-year prospective evaluation in a North American community

Early during the coronavirus disease 2019 (COVID-19) pandemic, higher sudden cardiac arrest (SCA) incidence and lower survival rates were reported. However, ongoing effects on SCA during the evolving pandemic have not been evaluated. The purpose of this study was to assess the impact of COVID-19 on SCA during 2 years of the pandemic. In a prospective study of Ventura County, California (2020 population 843,843; 44.1% Hispanic), we compared SCA incidence and outcomes during the first 2 years of the COVID-19 pandemic to the prior 4 years. Of 2222 out-of-hospital SCA cases identified, 907 occurred during the pandemic (March 2020 to February 2022) and 1315 occurred prepandemic (March 2016 to February 2020). Overall age-standardized annual SCA incidence increased from 39 per 100,000 (95% confidence [CI] 37-41) prepandemic to 54 per 100,000 (95% CI 50-57; P <.001) during the pandemic. Among Hispanics, incidence increased by 77%, from 38 per 100,000 (95% CI 34-43) to 68 per 100,000 (95% CI 60-76; P <.001). Among non-Hispanics, incidence increased by 26%, from 39 per 100,000 (95% CI 37-42; P <.001) to 50 per 100,000 (95% CI 46-54). SCA incidence rates closely tracked COVID-19 infection rates. During the pandemic, SCA survival was significantly reduced (15% to 10%; P <.001), and Hispanics were less likely than non-Hispanics to receive bystander cardiopulmonary resuscitation (45% vs 55%; P = .005) and to present with shockable rhythm (15% vs 24%; P = .003). Overall SCA rates remained consistently higher and survival outcomes consistently lower, with exaggerated effects during COVID infection peaks. This longer evaluation uncovered higher increases in SCA incidence among Hispanics, with worse resuscitation profiles. Potential ethnicity-specific barriers to acute SCA care warrant urgent evaluation and intervention.

Review: Mexican Americans with Moxie: A Transgenerational History of El Movimiento Chicano in Ventura County, California, 1945–1975, by Frank P. Barajas

Book Review| February 01 2023 Review: Mexican Americans with Moxie: A Transgenerational History of El Movimiento Chicano in Ventura County, California, 1945–1975, by Frank P. Barajas Frank P. Barajas. Mexican Americans with Moxie: A Transgenerational History of El Movimiento Chicano in Ventura County, California, 1945–1975. Lincoln: University of Nebraska Press, 2021. 288 pp. Photographs, illustrations, and map. Hardcover $60.00. Tomás F. Summers Sandoval, Jr. Tomás F. Summers Sandoval, Jr. TOMÁS F. SUMMERS SANDOVAL JR. is an associate professor of history and Chicanx-Latinx studies at Pomona College. He is the author of Latinos at the Golden Gate: Creating Community and Identity in San Francisco (2013) and is currently president of the Oral History Association. Search for other works by this author on: This Site PubMed Google Scholar California History (2023) 100 (1): 109–111. https://doi.org/10.1525/ch.2023.100.1.109 Views Icon Views Article contents Figures & tables Video Audio Supplementary Data Peer Review Share Icon Share Facebook Twitter LinkedIn MailTo Tools Icon Tools Get Permissions Cite Icon Cite Search Site Citation Tomás F. Summers Sandoval; Review: Mexican Americans with Moxie: A Transgenerational History of El Movimiento Chicano in Ventura County, California, 1945–1975, by Frank P. Barajas. California History 1 February 2023; 100 (1): 109–111. doi: https://doi.org/10.1525/ch.2023.100.1.109 Download citation file: Ris (Zotero) Reference Manager EasyBib Bookends Mendeley Papers EndNote RefWorks BibTex toolbar search Search Dropdown Menu toolbar search search input Search input auto suggest filter your search All ContentCalifornia History Search How did a multigenerational population of ethnic Mexicans in Ventura County express a collective politics in the mid-twentieth century? This question lies at the heart of the new book by Frank P. Barajas (California State University, Channel Islands), a thorough local history of the Chicano movement that also makes significant interventions in the broader historical understanding of the era. In Mexican Americans with Moxie: A Transgenerational History of El Movimiento Chicano in Ventura County, California, 1945–1975, Barajas outlines the postwar political efforts of Mexican Americans in the region, from movements “with increased fervor for an equal education” to those “in defense of a largely migrant-Mexicanist population of workers” (82, 139). The ethnic Mexican population at the center of the story was more variegated than homogeneous. While they built from a common ground, sharing a “farmworker provenance” and a sense of purpose and action, differences of generation, nativity, and even... You do not currently have access to this content.

Sudden Cardiac Arrest During Sports Activity in Older Adults

BackgroundSports activity among older adults is rising, but there is a lack of community-based data on sports-related sudden cardiac arrest (SrSCA) in the elderly. ObjectivesIn this study, the authors investigated the prevalence and characteristics of SrSCA among subjects ≥65 years of age in a large U.S. population. MethodsAll out-of-hospital sudden cardiac arrests (SCAs) were prospectively ascertained in the Portland, Oregon, USA, metro area (2002-2017), and Ventura County, California, USA (2015-2021) (catchment population ∼1.85 million). Detailed information was obtained for SCA warning symptoms, circumstances, and lifetime clinical history. Subjects with SCA during or within 1 hour of cessation of sports activity were categorized as SrSCA. ResultsOf 4,078 SCAs among subjects ≥65 years of age, 77 were SrSCA (1.9%; 91% men). The crude annual SrSCA incidence among age ≥65 years was 3.29/100,000 in Portland and 2.10/100,000 in Ventura. The most common associated activities were cycling, gym activity, and running. SrSCA cases had lower burden of cardiovascular risk factors (P = 0.03) as well as comorbidities (P < 0.005) compared with non-SrSCA. Based on conservative estimates of community residents ≥65 years of age who participate in sports activity, the SrSCA incidence was 28.9/100,000 sport participation years and 18.4/100,000 sport participation years in Portland and Ventura, respectively. Crude survival to hospital discharge rate was higher in SrSCA, but the difference was nonsignificant after adjustment for confounding factors. ConclusionsAmong free-living community residents age ≥65 years, SrSCA is uncommon, predominantly occurs in men, and is associated with lower disease burden than non-SrSCA. These results suggest that the risk of SrSCA is low, and probably outweighed by the high benefit of exercise.

Quantification of Microfibers from Marine Sediments from Three Locations in Southern California: An Exposed Beach (Ventura County), a Watershed (Los Angeles County), and an Enclosed Harbor (Orange County)

Microfibers are small (&lt;5 mm) fibers made of synthetic materials that are ubiquitous in the environment. The purpose of this observational study was to quantify the number of microfibers in marine sediments and determine which locations have the highest risk for this type of pollution. Sediment samples were taken from three locations in Southern California (Sycamore Watershed, Ventura State Beach Jetty, and Newport Beach Harbor) to determine which had the highest number of microfibers. It was hypothesized that microfibers would be found at each sample site and that the most microfibers would be found at Sycamore Watershed due to its proximity to a wastewater discharge point. The microfibers were separated from the sediment through a process of stratification and filtration and analyzed by a one-way ANOVA and Tukey’s test. Per sample, there was an average of 111.5 (土99.3, n=14) microfibers found per sample at Sycamore Watershed, 59 (土17.4, n=18) at Newport Beach Harbor, and 53 (土14.4, n=18) at Ventura State Beach Jetty. A total of 3,590 microfibers were found from all three sample sites. Analysis revealed that Sycamore Watershed had significantly more microfibers than any other site (p&lt;.05). It is likely that Sycamore Watershed had the most microfibers because of its proximity to a sewage-sludge disposal site that contains the polluted water from our washing machines. In conclusion, microfibers are polluting the sediments in harbors, open coastlines, and watersheds in California, negatively affecting the ecosystems in these areas. KEYWORDS: Microfiber; Microplastic; Macroplastic; Marine Pollution; Synthetic Materials; Wastewater Treatment Plants; Sediments; Watershed; Harbor; Jetty

Determining potential drivers of vegetation change in a Mediterranean environment

AbstractThe increased occurrences of drought and fire may be contributing to the loss of biodiverse ecosystems in Mediterranean regions. Specifically, the conversion of diverse native shrublands, such as chaparral, to non‐native annual grassland by fire is of great conservation concern in California. To avoid or slow the loss of chaparral, it is important to understand the underlying causes of landscape conversion. Studies investigating the interaction of multiple potential drivers are particularly crucial to identification of vulnerable areas of the landscape. Here we used aerial imagery to evaluate vegetation transitions between chaparral, sage scrub, grassland, and tree domination and their potential drivers within Ventura County, CA, a strongly Mediterranean climate region. We used random forest algorithms and conditional inference trees to determine the climatic, topographic, and fire‐related variables contributing most to vegetation change. Our results support that chaparral conversion to grass (27% of chaparral plots) is a result of landscape position, fire, and drought acting in tandem. In particular, lower elevation, southwest‐facing slopes that experience a postfire drought are at very high likelihood of conversion to non‐native annual grass. Additionally, our results show that these grasslands, once formed, rarely convert to other community types. Therefore, protecting shrub‐dominated areas that are most likely to convert (low elevation, more southwest‐facing slopes, and less annual precipitation) is crucial to preserving native vegetation diversity.

Curly Top Disease of Hemp (Cannabis sativa) in California Is Caused by Mild-Type Strains of Beet curly top virus Often in Mixed Infection.

Interest in industrial hemp (Cannabis sativa) as a potential crop led to the establishment of commercial fields in a number of counties in California in 2019 and 2020. Plants in these fields developed different types of virus-like symptoms. The most prevalent type was stunted and bushy plants with distorted, upcurled, and yellowed leaves, which were similar to those associated with curly top disease (CTD) caused by the beet curly top virus (BCTV). This beet leafhopper-vectored virus is endemic in California and can cause economic losses to processing tomato production. Using a multiplex PCR test, BCTV infection was detected in 89% of hemp samples with CTD-like symptoms from Fresno, San Bernardino, and Ventura counties. Other symptom types had low incidence of BCTV infection and were associated with other factors. Hemp plants in California were infected only with the mild-type strains, BCTV-CO and BCTV-Wor, and often in mixed infection (43% of samples). Finally, using an infectious clone of a BCTV-CO isolate from hemp, we demonstrated that agroinoculated hemp plants developed these CTD-like symptoms, thereby fulfilling Koch's postulates for the disease.

Abstract 13629: Unique Age- and Sex-Specific Patterns Identified for Prodromal Symptoms of Sudden Cardiac Arrest

Introduction: The majority of individuals who suffer sudden cardiac arrest (SCA) display prodromal symptoms in the preceding hours, days and weeks. These could potentially improve risk assessment for SCA, making it important to explore the influence of age and sex on symptom manifestation. Hypothesis: Prodromal symptoms of SCA are different based on age and sex. Methods: We included cases of witnessed SCA (ages 35-85) attended by emergency medical services following 911 calls made in Ventura County, CA (2015-2021). SCA was defined as a sudden, unexpected pulseless condition of likely cardiac origin; non-cardiac etiology were excluded. All cases were required to have at least one inclusion symptom recorded in the EMS narrative at the time of the 911 call. These were acute coronary syndrome (ACS) or SCA symptoms reported in the published literature. We constructed mutually exclusive symptom groups in hierarchical order: chest pain, dyspnea, syncope/palpitations, and other. We compared symptoms in middle age (35-64y) and older (65-85y) cases using chi-square tests. Results: Of 404 SCA cases that met analysis criteria, 122 (30%) were female. Women comprised 22% of the middle-age group and 37% of the older group. In the middle-age group, chest pain was the most common symptom among men (48%) but was half as common in women (24%, p&lt;0.01, Figure). Among middle-aged women, dyspnea was the most common symptom (39%) and significantly higher compared to men (22%, p &lt;0.05). Chest pain prevalence was lower in both sexes in the older group (31% in men vs 20% in women). We observed no significant differences in dyspnea by sex in the older group, nor differences in syncope/palpitations or other symptoms in either group by sex. Conclusions: We observed unique pre-SCA prodromal symptom patterns after stratifying by age and sex, most notable in middle age. These findings suggest the importance of considering age and sex while developing SCA prediction algorithms that include prodromal symptoms.

Abstract 14891: Sudden Cardiac Arrest Manifesting With Pulseless Electrical Activity: Is There A “Sweet Spot” for Survival?

Introduction: The proportion of sudden cardiac arrests (SCA) manifesting with pulseless electrical activity (PEA) has increased significantly, and survival rate remains poor. However, a small PEA-SCA subgroup does survive and may yield key predictors of improved outcomes when compared to non-survivors. Aim: To identify clinical and resuscitation factors that predict survival from PEA-SCA. Methods: Our study sample is drawn from two ongoing community-based, prospective studies of out-of-hospital SCA. The Portland, OR metro area (Pop. approx. 1 million; 2002-2017) was used as a discovery population and Ventura County CA (Pop. approx. 850,000, 2015-2021) was the validation population. For the present sub-study, we included SCA cases with PEA as the presenting rhythm, who were resuscitated by EMS personnel. Results: In Oregon SUDS, we identified 1,057 PEA-SCA cases of which 105 (10%) survived to hospital discharge (STHD). The mean age of PEA cases was 68.4±15.8 years and 62% were male. In a multivariable model including resuscitation variables (age, sex, witnessed SCA, EMS response time, bystander CPR, public location), age (OR 0.98, 95% CI 0.97-0.99; p=0.001), male sex (OR 0.58, 95% CI 0.38-0.88; p=0.01), witnessed SCA (OR 3.0, 95% CI 1.7-5.3; p&lt;0001), and public location (OR 1.9, 95% CI 1.1-3.1; p=0.01) associated with STHD. In a multivariable model including clinical variables (age, sex, BMI, CAD, HF, CKD, DM, COPD, asthma), only age (OR 0.97, 95% CI 0.95-0.99; p=0.003) had an association with STHD. In Ventura PRESTO, we identified 695 PEA-SCA cases of which 82 (12%) were STHD. The mean age of PEA cases was 73.1±15.6 years and 63% were male. In a multivariable model including the same resuscitation variables, age (OR 0.97, 95% CI 0.95-0.98; p&lt;0.001) and public location (OR 3.6, 95% CI 1.7-7.6; p=0.001) associated with STHD. In a multivariable model including the same clinical characteristics, we found no significant predictors of STHD. Conclusions: Young age and cardiac arrest in a public location were the only independent predictors of survival from PEA-SCA in both discovery and validation populations. These findings suggest that enhancement of the community response to cardiac arrest may have the potential to improve survival outcomes in PEA-SCA.