For the first time in history, the United States surpassed 100 000 overdose-related deaths in a 12-month period, driven by synthetic opioids such as fentanyl. Also, for the first time, potential chemical weapons are readily available on the streets and the dark web. Opioids represent a rare trifecta, used for licit pain management, as an illicit drug of abuse, and with potential use as a weapon of terror. Community-based Response to Drug Overdose (CReDO) is an initiative to unite agencies, disciplines, government, and private partners in 1 coordinated opioid emergencies response plan under nationwide standards, and can be integrated into the disaster medicine discipline due to the risk of mass casualty incidents involving fentanyl or its derivatives. Attention to the opioid crisis through CReDO will save lives by promoting information sharing between disciplines, shortened response time to overdose clusters, community collaboration to identify criminal distribution networks, and holistic approaches to addiction.

Background: Throughout the COVID-19 pandemic, CDC Division of Healthcare Quality Promotion (DHQP) has provided technical assistance in support of state, tribal, local, and territorial health departments for COVID-19 healthcare outbreak management and infection prevention and control (IPC). We characterized the volume and trends of technical assistance provided during the pandemic to inform the future needs of health departments for COVID-19 healthcare IPC and DHQP resources required to meet these needs. Methods: In January 2020, DHQP began receiving COVID-19 IPC TA requests directly from health departments for remote assistance or from CDC staff on field deployments providing onsite support. DHQP subject-matter experts provided responses via e-mail or, for more complex inquiries, outbreaks, or field deployments, via phone consultations. Records of e-mail communications and phone consultations were entered into an inquiry database for tracking. We calculated the number, mean, and range of technical-assistance responses by jurisdiction and by month from January 2020 through December 2021. We designated months as high-volume periods for technical assistance if inquiries surpassed the 75th percentile. Results: In total, 1,869 IPC technical-assistance responses were provided. Of all technical-assistance responses, 1,725 (92%) were to state or local health departments, 115 (6%) were tribal nations, and 28 (2%) were US territories. IPC technical assistance was provided to all 50 states and the District of Columbia, 16 tribal nations, and 5 US territories. The average total number of technical assistance responses per site during the 24-month period was 34 to state and local HDs (range, 2–111), 6 to tribal nations (when tribal nation was specified; range, 1–17), and 6 to US territories (range, 1–15). E-mail communications comprised 1,164 responses (62%); phone consultations made up the remaining 705 responses (38%). Of phone consultations, 350 (50%) were with CDC field deployers providing onsite support to health departments. The average number of technical-assistance responses provided each month across all jurisdictions was 78 (range, 0–334); months with high volumes included April–August 2020 and January 2021. Conclusions: These findings highlight the high-level collaboration between federal and state, tribal, local, and territorial health department partners in remote and onsite support of COVID-19 prevention and response efforts in healthcare settings. Variations in monthly volumes of health-department COVID-19 healthcare IPC technical assistance requests may reflect factors such as fluctuations in community infection rates and changes in CDC IPC guidance. The ability to provide effective technical assistance during pandemic response depends on the CDC maintaining sufficient healthcare IPC staffing and expertise.

Funding: None

Disclosures: None

OBJECTIVES/GOALS: The purpose of this group is to foster professional and personal growth as leaders, provide peer mentoring, integrate the roles of scientist, woman, and mother, and build a self-sustaining network of peers for ongoing support throughout their careers in an academic setting. METHODS/STUDY POPULATION: - Study population: 12 Health sciences research faculty (50% protected research time); identify as female; mother of school-age and/or younger children Methods: Year-long program; including a 2-day retreat based on Brene Brown's Dare to Lead RESULTS/ANTICIPATED RESULTS: - Despite the pandemic, 100% of participants continued in the program over the one-year duration and met the attendance requirement of 75% - Screening for burnout was effective - facilitator was able to intervene when severe burnout was noted.

The perinatal period is a vulnerable time for the development of psychopathology, particularly mood and anxiety disorders. In the study of maternal anxiety, important questions remain regarding the association between maternal anxiety symptoms and subsequent child outcomes. This study examined the association between depressive and anxiety symptoms, namely social anxiety, panic, and agoraphobia disorder symptoms during the perinatal period and maternal perception of child behavior, specifically different facets of development and temperament. Participants (N = 104) were recruited during pregnancy from a community sample. Participants completed clinician-administered and self-report measures of depressive and anxiety symptoms during the third trimester of pregnancy and at 16 months postpartum; child behavior and temperament outcomes were assessed at 16 months postpartum. Child development areas included gross and fine motor skills, language and problem-solving abilities, and personal/social skills. Child temperament domains included surgency, negative affectivity, and effortful control. Hierarchical multiple regression analyses demonstrated that elevated prenatal social anxiety symptoms significantly predicted more negative maternal report of child behavior across most measured domains. Elevated prenatal social anxiety and panic symptoms predicted more negative maternal report of child effortful control. Depressive and agoraphobia symptoms were not significant predictors of child outcomes. Elevated anxiety symptoms appear to have a distinct association with maternal report of child development and temperament. Considering the relative influence of anxiety symptoms, particularly social anxiety, on maternal report of child behavior and temperament can help to identify potential difficulties early on in mother–child interactions as well as inform interventions for women and their families.

We retrospectively evaluated the effect of penicillin adverse drug reaction (ADR) labeling on surgical antibiotic prophylaxis. Cefazolin was administered in 86% of penicillin ADR-negative (−) and 28% penicillin ADR-positive (+) cases. Broad-spectrum antibiotic use was more common in ADR(+) cases and was more commonly associated with perioperative adverse drug events.

Sweet syndrome was discovered in 1964 and is now well described in the dermatology literature. Knowledge of this unique febrile and painful dermatosis is important for the emergency physician because the syndrome can be readily identified and is extremely responsive to oral steroid therapy. Early diagnosis can greatly improve patient satisfaction and avoid days of ineffective treatment. An accurate and timely diagnosis of Sweet syndrome is also important to guide investigation into a number of associated diseases.

Variation in crop–weed interference relationships has been shown for a number of crop–weed mixtures and may have an important influence on weed management decision-making. Field experiments were conducted at seven locations over 2 yr to evaluate variation in common lambsquarters interference in field corn and whether a single set of model parameters could be used to estimate corn grain yield loss throughout the northcentral United States. Two coefficients (I and A) of a rectangular hyperbola were estimated for each data set using nonlinear regression analysis. The I coefficient represents corn yield loss as weed density approaches zero, and A represents maximum percent yield loss. Estimates of both coefficients varied between years at Wisconsin, and I varied between years at Michigan. When locations with similar sample variances were combined, estimates of both I and A varied. Common lambsquarters interference caused the greatest corn yield reduction in Michigan (100%) and had the least effect in Minnesota, Nebraska, and Indiana (0% yield loss). Variation in I and A parameters resulted in variation in estimates of a single-year economic threshold (0.32 to 4.17 plants m−1 of row). Results of this study fail to support the use of a common yield loss–weed density function for all locations.

Boegoeberg 1 (BOG1) is located on the Atlantic coast of South Africa, 850 km north of Cape Town. The site is a shallow rock shelter in the side of a sand-choked gully that was emptied by diamond miners. Abundant coprolites, chewed bones, and partially digested bones implicate hyenas as the bone accumulators. The location of the site, quantity of bones, and composition of the fauna imply it was a brown hyena nursery den. The abundance of Cape fur seal bones shows that the hyenas had ready access to the coast. Radiocarbon dates place the site before 37,000 14C yr ago, while the large average size of the black-backed jackals and the presence of extralimital ungulates imply cool, moist conditions, probably during the early part of the last glaciation (isotope stage 4 or stage 3 before 37,000 14C yr ago) or perhaps during one of the cooler phases (isotope substages 5d or 5b) within the last interglaciation. Comparisons of the BOG1 seal bones to those from regional Middle Stone Age (MSA) and Later Stone Age (LSA) archeological sites suggest (1) that hyena and human seal accumulations can be distinguished by a tendency for vertebrae to be much more common in a hyena accumulation and (2) that hyena and LSA accumulations can be distinguished by a tendency for hyena-accumulated seals to represent a much wider range of individual seal ages. Differences in the way hyenas and people dismember, transport, and consume seal carcasses probably explain the contrast in skeletal part representation, while differences in season of occupation explain the contrast in seal age representation. Like modern brown hyenas, the BOG1 hyenas probably occupied the coast year-round, while the LSA people focused their coastal visits on the August–October interval when nine-to-eleven-month-old seals were abundant. The MSA sample from Klasies River Mouth Cave 1 resembles BOG1 in seal age composition, suggesting that unlike LSA people, MSA people obtained seals more or less throughout the year.

This paper considers whether highly concentrated industries are better represented in the political process, as Olson's Logic of Collective Action suggests, and, if they are, whether this is so for the reasons that the Logic claims. It begins with a review and critique of the quantitative literature that has largely tried and failed to substantiate Olson's view. The bulk of the paper consists of five longitudinal case studies of firms that dominate or have dominated industries: IBM, Intel, Microsoft, America Online, and Cisco. The cases suggest that there is merit to the Olsonian view, but that alone it does not constitute an adequate political theory of the concentrated industry or the dominant firm. Additional variables drawn from organizational and institutional theory need to be incorporated into such a theory, including variables that bear on the allocation of attention, threat perception, and information flow within dominant firms.