As COVID-19 was declared a health emergency in March 2020, there was immense demand for information about the novel pathogen. This paper examines the clinician-reported impact of Project ECHO COVID-19 Clinical Rounds on clinician learning. Primary sources of study data were Continuing Medical Education (CME) Surveys for each session from the dates of March 24, 2020 to July 30, 2020 and impact surveys conducted in November 2020, which sought to understand participants’ overall assessment of sessions. Quantitative analyses included descriptive statistics and Mann-Whitney testing. Qualitative data were analyzed through inductive thematic analysis. Clinicians rated their knowledge after each session as significantly higher than before that session. 75.8% of clinicians reported they would ‘definitely’ or ‘probably’ use content gleaned from each attended session and clinicians reported specific clinical and operational changes made as a direct result of sessions. 94.6% of respondents reported that COVID-19 Clinical Rounds helped them provide better care to patients. 89% of respondents indicated they ‘strongly agree’ that they would join ECHO calls again.COVID-19 Clinical Rounds offers a promising model for the establishment of dynamic peer-to-peer tele-mentoring communities for low or no-notice response where scientifically tested or clinically verified practice evidence is limited.

Field studies were conducted at four locations in North Carolina in 1998 and 1999 to evaluate the use of the Herbicide Application Decision Support System (HADSS™) for weed management in nontransgenic, bromoxynil-resistant, and glyphosate-resistant cotton. Weed management systems included trifluralin preplant incorporated (PPI) plus fluometuron preemergence (PRE) or no soil-applied herbicides. Postemergence (POST) options included bromoxynil, glyphosate, or pyrithiobac early POST (EPOST) followed by (fb) MSMA plus prometryn late postemergence–directed (LAYBY) or herbicide recommendations given by HADSS. Glyphosate-resistant systems provided control equivalent to or better than control provided by bromoxynil-resistant and nontransgenic systems for smooth pigweed, Palmer amaranth, large crabgrass, goosegrass, ivyleaf morningglory, and fall panicum. Trifluralin PPI fb fluometuron PRE fb HADSS POST provided equivalent or higher levels of weed control and yield than trifluralin PPI fb fluometuron PRE fb bromoxynil, glyphosate, or pyrithiobac EPOST fb MSMA plus prometryn LAYBY. The trifluralin PPI fb fluometuron PRE fb HADSS POST systems controlled large crabgrass at Goldsboro and fall panicum better than HADSS POST-only systems in nontransgenic cotton. Cotton yield and net returns in the glyphosate-resistant systems were always equal to or higher than the nontransgenic and bromoxynil-resistant systems. Net returns were higher for the soil-applied fb HADSS POST treatments in 8 of 12 comparisons with HADSS POST systems without soil-applied herbicides. Early-season weed interference reduced cotton lint yields and net returns in POST-only systems.

Field studies were conducted at four locations in North Carolina in 1998 and 1999 to evaluate a computer program, Herbicide Application Decision Support System (HADSS™), for weed management in peanut (Arachis hypogaea). Weed management systems included metolachlor or ethalfluralin preplant-incorporated (PPI) used alone or in combination with diclosulam preemergence (PRE) or flumioxazin PRE. These herbicide combinations were used alone, followed by (fb) postemergence (POST) herbicides recommended by HADSS™ or fb a standard POST program of paraquat plus bentazon early postemergence (EPOST) fb acifluorfen plus bentazon POST. The standard POST herbicide system and HADSS™ POST recommendations were also used without soil-applied herbicides. Ethalfluralin PPI alone controlled large crabgrass (Digitaria sanguinalis) better than metolachlor PPI. Combinations of metolachlor or ethalfluralin PPI with either diclosulam or flumioxazin PRE provided equivalent control of all weeds evaluated except yellow nutsedge (Cyperus esculentus). The addition of diclosulam or flumioxazin PRE to systems containing metolachlor or ethalfluralin PPI always improved control of ivyleaf morningglory (Ipomoea hederacea) and yellow nutsedge and improved yield and net returns in 15 of 16 comparisons where no POST herbicides were used. For systems that used diclosulam or flumioxazin PRE, the HADSS™ POST and standard POST herbicide systems improved yield in 4 of 12 and 2 of 12 comparisons, respectively, compared with similar systems that did not use diclosulam or flumioxazin. However, in systems using either HADSS™ POST or the standard POST system, yield was always improved when compared with metolachlor or ethalfluralin PPI alone. HADSS™ POST provided equal or higher weed control, peanut yield, and net returns when compared with the standard POST herbicide system.

Approximately half of the variation in wellbeing measures overlaps with variation in personality traits. Studies of non-human primate pedigrees and human twins suggest that this is due to common genetic influences. We tested whether personality polygenic scores for the NEO Five-Factor Inventory (NEO-FFI) domains and for item response theory (IRT) derived extraversion and neuroticism scores predict variance in wellbeing measures. Polygenic scores were based on published genome-wide association (GWA) results in over 17,000 individuals for the NEO-FFI and in over 63,000 for the IRT extraversion and neuroticism traits. The NEO-FFI polygenic scores were used to predict life satisfaction in 7 cohorts, positive affect in 12 cohorts, and general wellbeing in 1 cohort (maximal N = 46,508). Meta-analysis of these results showed no significant association between NEO-FFI personality polygenic scores and the wellbeing measures. IRT extraversion and neuroticism polygenic scores were used to predict life satisfaction and positive affect in almost 37,000 individuals from UK Biobank. Significant positive associations (effect sizes <0.05%) were observed between the extraversion polygenic score and wellbeing measures, and a negative association was observed between the polygenic neuroticism score and life satisfaction. Furthermore, using GWA data, genetic correlations of -0.49 and -0.55 were estimated between neuroticism with life satisfaction and positive affect, respectively. The moderate genetic correlation between neuroticism and wellbeing is in line with twin research showing that genetic influences on wellbeing are also shared with other independent personality domains.

Rett syndrome (RTT) is a severe neurodevelopmental disorder affecting females almost exclusively and is characterized by a wide spectrum of clinical manifestations. Mutations in the X-linked methyl-CpG-binding protein 2 (MECP2) gene have been found in up to 95% of classical RTT cases and a lesser proportion of atypical cases. Recently, mutations in another X-linked gene, CDKL5 (cyclin-dependent kinase-like 5) have been found to cause atypical RTT, in particular the early onset seizure (Hanefeld variant) and one female with autism. In this study we screened several cohorts of children for CDKL5 mutations, totaling 316 patients, including individuals with a clinical diagnosis of RTT but who were negative for MECP2 mutations (n = 102), males with X-linked mental retardation (n = 9), patients with West syndrome (n = 52), patients with autism (n = 59), patients with epileptic encephalopathy (n = 33), patients with Aicardi syndrome (n = 7) and other patients with intellectual disability with or without seizures (n = 54). In all, seven polymorphic variations and four de novo mutations (c.586C>T [p.S196L]; c.58G>C [p.G20R]; c.2504delC [p.P835fs]; deletion of exons 1 - 3) were identified, and in all instances of the latter the clinical phenotype was that of an epileptic encephalopathy. These results suggest that pathogenic CDKL5 mutations are unlikely to be identified in the absence of severe early-onset seizures and highlight the importance of screening for large intragenic and whole gene deletions.