Background: Bacterial coinfections with COVID-19 appear to be rare, yet antibiotic use in this population is high. Limited guidance is available regarding the use of antibiotics in these patients. In response, a multidisciplinary group of physicians and pharmacists from 5 VISN9 facilities developed a guideline for the use of antibiotics with COVID-19 in July 2021. This guideline created a network-wide standard for antibiotic use and facilitates the assessment of antibiotic appropriateness in hospitalized veterans with COVID-19. Methods: In this observational, cross-sectional study, we reviewed veterans diagnosed with COVID-19 from August 1 through September 30, 2021, who were admitted to VISN9 facilities. Use of antibiotics was assessed during the first 4 days of admission. If antibiotics were prescribed, their use was determined to be appropriate or inappropriate based on the presence or absence of a finding concerning for bacterial coinfection as outlined in the guideline (Table 1). Additional data including procalcitonin results as well as positive sputum cultures were collected. Results: In total, 377 veterans were admitted for COVID-19 during the study period. Among them, 42 veterans (11%) received antibiotics for nonrespiratory infections and were removed from this analysis. Of the remaining 335 veterans, 229 (68%) received antibiotics and 116 (51%) of those met guideline criteria that were concerning for bacterial coinfection. Additionally, 32 (14%) of the 229 veterans who received antibiotics had >1 finding concerning for bacterial coinfection. Procalcitonin levels were obtained in 97 (42%) of 229. Only 33 veterans (14%) who received antibiotics had an elevated procalcitonin, and only 19 (8%) had a positive sputum culture. Conclusions: Antibiotic use was common in hospitalized veterans with COVID-19 in VISN9 facilities. This results are comparable to findings in the published literature. Among those receiving antibiotics early in their hospitalization, half were considered appropriate based on our guideline. Quality improvement initiatives are needed to improve implementation of the network guideline to reduce the overuse of antibiotics for management of COVID-19. Additionally, procalcitonin may be a helpful tool for hospitalized veterans with COVID-19.

Funding: None

Disclosures: None

Objectives: Apathy is a debilitating symptom of Huntington’s disease (HD) and manifests before motor diagnosis, making it an excellent therapeutic target in the preclinical phase of Huntington’s disease (prHD). HD is a neurological genetic disorder characterized by cognitive and motor impairment, and psychiatric abnormalities. Apathy is not well characterized within the prHD. In previous literature, damage to the caudate and putamen has been correlated with increased apathy in other neurodegenerative and movement disorders. The objective of this study was to determine whether apathy severity in individuals with prHD is related to striatum volumes and cognitive control. We hypothesized that, within prHD individuals, striatum volumes and cognitive control scores would be related to apathy. Methods: We constructed linear mixed models to analyze striatum volumes and cognitive control, a composite measure that includes tasks assessing with apathy scores from 797 prHD participants. The outcome variable for each model was apathy, and the independent variables for the four separate models were caudate volume, putamen volume, cognitive control score, and motor symptom score. We also included depression as a covariate to ensure that our results were not solely related to mood. Results: Caudate and putamen volumes, as well as measures of cognitive control, were significantly related to apathy scores even after controlling for depression. Conclusions: The behavioral apathy expressed by these individuals was related to regions of the brain commonly associated with isolated apathy, and not a direct result of mood symptoms. (JINS, 2019, 25, 462–469)

The short-range diurnal dispersal pattern of adult western flower thrips Frankliniella occidentalis (Pergande), in relation to spatial distribution of French beans, was determined in the field. A total of 1200 adult female F. occidentalis were released on 60 French bean plants with 20 adult thrips per plant at the central release point of 3.14 m2. Dispersal was determined in terms of the number of thrips recorded on French beans planted on concentric circles at 0.9, 1.8, 3.6, 7.2 and 14.4 m radii from a circular central release point for five days. Results indicated that there was a steady increase in the proportion of dispersing adult F. occidentalis from the first to the fourth day in the first planting season, and from the first to the third day in the second planting season. The peak hour for dispersal was 10.15 h in the first season while it was 13.15 h in the second season. Temperature and wind speed were positively associated with the dispersal activity of adult F. occidentalis. Minimal flight activity was at temperatures below 15 °C and peak flight activity was at 19 °C. The prevailing wind direction did not influence the dispersal pattern of adult F. occidentalis in both seasons. Adult F. occidentalis moved up to 7.2 m on French beans on the first day. In both seasons, the mean direction of thrips dispersal was mostly uniformly distributed (not oriented to a particular compass direction) around the central release point. The results provide an insight into developing integrated management strategies against the pest based on isolation of farm fields, management of alterative hosts around French bean fields and insecticide application.

Objectives: Huntington’s disease (HD) is a debilitating genetic disorder characterized by motor, cognitive and psychiatric abnormalities associated with neuropathological decline. HD pathology is the result of an extended chain of CAG (cytosine, adenine, guanine) trinucleotide repetitions in the HTT gene. Clinical diagnosis of HD requires the presence of an otherwise unexplained extrapyramidal movement disorder in a participant at risk for HD. Over the past 15 years, evidence has shown that cognitive, psychiatric, and subtle motor dysfunction is evident decades before traditional motor diagnosis. This study examines the relationships among subcortical brain volumes and measures of emerging disease phenotype in prodromal HD, before clinical diagnosis. Methods: The dataset includes 34 cognitive, motor, psychiatric, and functional variables and five subcortical brain volumes from 984 prodromal HD individuals enrolled in the PREDICT HD study. Using cluster analyses, seven distinct clusters encompassing cognitive, motor, psychiatric, and functional domains were identified. Individual cluster scores were then regressed against the subcortical brain volumetric measurements. Results: Accounting for site and genetic burden (the interaction of age and CAG repeat length) smaller caudate and putamen volumes were related to clusters reflecting motor symptom severity, cognitive control, and verbal learning. Conclusions: Variable reduction of the HD phenotype using cluster analysis revealed biologically related domains of HD and are suitable for future research with this population. Our cognitive control cluster scores show sensitivity to changes in basal ganglia both within and outside the striatum that may not be captured by examining only motor scores. (JINS, 2017, 23, 159–170)

Field experiments were conducted to determine the effect of shattercane interference on corn grain yield and nitrogen uptake in central Missouri. A glyphosate-resistant corn variety was planted, and atrazine was used to control all weeds except shattercane. Glyphosate was applied when shattercane was 8, 15, 23, 31, 38, or 46 cm tall, and plots were hand weeded weekly thereafter. Season-long shattercane interference resulted in an 85% yield loss in 1999 and a 43% yield loss in 2000. Yield reductions occurred when shattercane was allowed to remain with corn until it was 31 cm tall. In both years, late-season corn biomass N content was highly correlated (r = 0.95 and 0.84, respectively) with corn yield. When shattercane was allowed to reach the maximum recommended height for nicosulfuron or primisulfuron application (31 cm), significant yield losses occurred, and shattercane accumulated 10 and 20 kg N/ha, whereas corn accumulated 10 and 16 kg N/ha, respectively, in 1999 and 2000. Corn grain yield was reduced 0.66% (r2 = 0.71) for each day of interference before a postemergence (POST) application of glyphosate.