Burden of bacteraemia is rising due to increased average life expectancy in developed countries. This study aimed to compare the epidemiology and outcomes of bacteraemia in two similarly ageing populations with different ethnicities in Singapore and Denmark. Historical cohorts from the second largest acute-care hospital in Singapore and in the hospitals of two Danish regions included patients aged 15 and above who were admitted from 1 January 2006 to 31 December 2016 with at least 1 day of hospital stay and a pathogenic organism identified. Among 13 144 and 39 073 bacteraemia patients from Singapore and Denmark, similar 30-day mortality rates (16.5%; 20.3%), length of hospital stay (median 14 (IQR: 9–28) days; 11 (6–21)), and admission rate to ICU (15.5%; 15.6%) were observed, respectively. Escherichia coli, Klebsiella pneumoniae, and Staphylococcus aureus ranked among the top four in both countries. However, Singaporeans had a higher proportion of patients with diabetes (46.8%) and renal disease (29.5%) than the Danes (28.0% and 13.7%, respectively), whilst the Danes had a higher proportion of patients with chronic pulmonary disease (18.0%) and malignancy (35.3%) than Singaporeans (9.7% and 16.2%, respectively). Our study showed that top four causative organisms and clinical outcomes were similar between the two cohorts despite pre-existing comorbidities differed.

Objectives: Influenza vaccination is encouraged for all healthcare workers (HCWs) to reduce the risk of acquiring the infection and onward transmission to colleagues and patients during the influenza season. Thus, vaccination was introduced at Singapore General Hospital (SGH) in 2007 and has been offered to all HCWs at no cost. The HCW influenza vaccination program is conducted annually in October and biannually during years with vaccine mismatch. However, influenza vaccine uptake remained low among HCWs. We sought to determine the impact of the coronavirus disease 2019 (COVID-19) pandemic on influenza vaccine uptake among HCWs. Methods: At SGH, 2 methods of vaccine delivery are offered: centralized (1-month drop-in system during office hours) and decentralized (administered by vaccination teams in offices or ward staff in inpatient locations). In the 4-year study period between 2018 and 2021, 6 influenza vaccination exercise campaigns were conducted during 8 influenza seasons. During each exercise, ~9,000 HCWs were eligible for vaccination. Results: Prior to the COVID-19 pandemic, vaccine uptake in the Southern Hemisphere was 77.6% (6,964 of 8,977) in 2018 and 84.2% (7,296 of 8,670) in 2019. During the COVID-19 pandemic in 2020, vaccine uptake in the Southern Hemisphere increased by 10% to 94.1% (8,361 of 8,889). In the Northern Hemisphere, vaccine uptake was 79.2% (7,114 of 8,977) in 2018, and this increased by 17.9% to 97.1% (8,926 of 9,194) during the COVID-19 pandemic in 2020. During the 2021 Southern Hemisphere influenza season, no vaccination program was conducted because the risk of influenza was considered low due to the closure of international borders and the implementation of public health measures. In addition, priority was given to COVID-19 vaccination efforts. Conclusions: Increased uptake of the influenza vaccination was observed during the COVID-19 pandemic. Anxiety created by the respiratory disease pandemic and debate surrounding vaccines likely contributed to increased awareness and uptake in influenza vaccine among HCWs.

Background: Antibiotics targeted against Clostridioides difficile bacteria are necessary, but insufficient, to achieve a durable clinical response because they have no effect on C. difficile spores that germinate within a disrupted microbiome. ECOSPOR-III evaluated SER-109, an investigational, biologically derived microbiome therapeutic of purified Firmicute spores for treatment of rCDI. Herein, we present the interim analysis in the ITT population at 8 and 12 weeks. Methods: Adults ≥18 years with rCDI (≥3 episodes in 12 months) were screened at 75 US and CAN sites. CDI was defined as ≥3 unformed stools per day for <48 hours with a positive C. difficile assay. After completion of 10–21 days of vancomycin or fidaxomicin, adults with symptom resolution were randomized 1:1 to SER-109 (4 capsules × 3 days) or matching placebo and stratified by age (≥ or <65 years) and antibiotic received. Primary objectives were safety and efficacy at 8 weeks. Primary efficacy endpoint was rCDI (recurrent toxin+ diarrhea requiring treatment); secondary endpoints included efficacy at 12 weeks after dosing. Results: Overall, 287 participants were screened and 182 were randomized (59.9% female; mean age, 65.5 years). The most common reason for screen failure was a negative C. difficile toxin assay. A significantly lower proportion of SER-109 participants had rCDI after dosing compared to placebo at week 8 (11.1% vs 41.3%, respectively; relative risk [RR], 0.27; 95% confidence interval [CI], 0.15–0.51; p-value <0.001). Efficacy rates were significantly higher with SER-109 vs placebo in both stratified age groups (Figure 1). SER-109 was well-tolerated with a safety profile similar to placebo. The most common treatment-emergent adverse events (TEAEs) were gastrointestinal and were mainly mild to moderate. No serious TEAEs, infections, deaths, or drug discontinuations were deemed related to study drug. Conclusions: SER-109, an oral live microbiome therapeutic, achieved high rates of sustained clinical response with a favorable safety profile. By enriching for Firmicute spores, SER-109 achieves high efficacy while mitigating risk of transmitting infectious agents, beyond donor screening alone. SER-109 represents a major paradigm shift in the clinical management of patients with recurrent CDI. Clinicaltrials.gov Identifier NCT03183128. These data were previously presented as a late breaker at American College of Gastroenterology 2020.

Funding: Seres Therapeutics

Disclosures: None

Figure 1.

We have previously shown that higher intake of cruciferous vegetables is inversely associated with carotid artery intima-media thickness. To further test the hypothesis that an increased consumption of cruciferous vegetables is associated with reduced indicators of structural vascular disease in other areas of the vascular tree, we aimed to investigate the cross-sectional association between cruciferous vegetable intake and extensive calcification in the abdominal aorta. Dietary intake was assessed, using a FFQ, in 684 older women from the Calcium Intake Fracture Outcome Study. Cruciferous vegetables included cabbage, Brussels sprouts, cauliflower and broccoli. Abdominal aortic calcification (AAC) was scored using the Kauppila AAC24 scale on dual-energy X-ray absorptiometry lateral spine images and was categorised as ‘not extensive’ (0–5) or ‘extensive’ (≥6). Mean age was 74·9 (sd 2·6) years, median cruciferous vegetable intake was 28·2 (interquartile range 15·0–44·7) g/d and 128/684 (18·7 %) women had extensive AAC scores. Those with higher intakes of cruciferous vegetables (>44·6 g/d) were associated with a 46 % lower odds of having extensive AAC in comparison with those with lower intakes (<15·0 g/d) after adjustment for lifestyle, dietary and CVD risk factors (ORQ4 v. Q1 0·54, 95 % CI 0·30, 0·97, P = 0·036). Total vegetable intake and each of the other vegetable types were not related to extensive AAC (P > 0·05 for all). This study strengthens the hypothesis that higher intake of cruciferous vegetables may protect against vascular calcification.

Field evaluations were made on the effects of imazaquin {2-[4,5-dihydro-4-methyl-4-(1-methylethyl)-5-oxo-1H-imidazol-2-yl]-3-quinolinecarboxylic acid} on Florida beggarweed [Desmodium tortuosum (SW) DC. # DEDTO] and sicklepod (Cassia obtusifolia L. # CASOB) control in peanuts (Arachis hypogaea L.). Crop yield was reduced at 392 and 504 g ae/ha and with preemergence applications. Florida beggarweed control was not achieved with this herbicide. Maximum sicklepod control (approximately 80%) was achieved with 392 and 504 g/ha applied postemergence. In a separate study, several herbicide systems utilizing imazaquin were compared to a standard weed control program. All these systems provided weed control and yields that were comparable to the standard weed control system; thus the inclusion of imazaquin offered no advantage over the standard system.

Studies were conducted to investigate the reproductive biology and herbicide response of horsenettle (Solanum carolinense L. # SOLCA) and robust horsenettle (Solanum dimidiatum Raf. # SOLDM) that are common in peanut (Arachis hypogaea L.) production. Of these two species, horsenettle had a higher rate of seed germination, greater ability for seedling establishment in a competitive situation (pasture), greater ability to regenerate from smaller root fragments, and greater ability to regenerate from progressively greater depths in soil. Horsenettle was relatively more sensitive to glyphosate [N-(phosphonomethyl)glycine] (1.1 and 2.2 ai kg/ha), propylene glycol butyl ether esters of 2,4-D [(2,4-dichlorophenoxy)acetic acid] (0.8 and 1.7 ae kg/ha), and the ethanolamine salt of 2,4-D (1.7 ae kg/ha) than robust horsenettle. Conversely, robust horsenettle was more sensitive to dicamba [3,6-dichloro-2-methoxybenzoic acid)] (0.3 and 0.6 ae kg/ha). In a field study, dicamba applied annually in July or August for 2 yr at a rate of at least 1.1 kg/ha controlled 92% or more.

The thickness of varves in the sediments of Skilak Lake, Alaska, are correlated with the mean annual temperature (r = 0.574), inversely correlated with the mean annual cumulative snowfall (r = −0.794), and not correlated with the mean annual precipitation (r = 0.202) of the southern Alaska climatological division for the years 1907–1934 A.D. Varve thickness in Skilak Lake is sensitive to annual temperature and snowfall because Skilak Glacier, the dominant source of sediment for Skilak Lake, is sensitive to these climatic parameters. Trends of varve thickness are well correlated with trends of mean annual cumulative snowfall ( = −0.902) of the southern Alaska climatological division and with trends of mean annual temperature of the southern ( = 0.831) and northern ( = 0.786) Alaska climatological divisions. Trends of varve thickness also correlate with trends of annual temperature in Seattle and North Head, Washington ( = 0.632 and 0.850, respectively). Comparisons of trends of varve thickness with trends of annual temperature in California, Oregon, and Washington suggest no widespread regional correlation. Trends of annual snowfall in the southern Alaska climatological division and trends of annual temperature in the southern and northern Alaska climatological divisions are reconstructed for the years 1700–1906 A.D. Climatic reconstructions on the basis of varve thickness in Skilak Lake utilize equations derived from the regression of series of smoothed climatological data on series of smoothed varve thickness. Reconstruction of trends of mean annual cunulative snowfall in the southern Alaska climatological division suggests that snowfall during the 1700s and 1800s was much greater than that during the early and mid-1900s. The periods 1770–1790 and 1890–1906 show marked decreases in the mean annual snowfall. Reconstructed trends of the annual temperature of the northern and southern Alaska climatological divisions suggest that annual temperatures during the 1700s and 1800s were lower than those of the early and mid-1900s. Two periods of relatively high annual temperatures coincide with the periods of low annual snowfall thus determined.

The remains of scales of Hysterocarpus traski Gibbons (Tule perch) were found throughout a 27.44-m core from Clear Lake. Most scales occurred between the mud surface and deposits approximately 11,000 years old. Changes in growth rates of the animals were examined by measuring scale annuli and applying an empirically established regression of fish length on scale radius. The data indicate a pattern of accelerating growth rates, reaching a peak between ⋍4000 and 2800 BP. After ⋍2800 BP, growth rates decline markedly. Because the growth rates of these animals are essentially dependent on temperature, the changes observed in the patterns of growth probably reflect changes in climate in the northern Coast Range. The general pattern of inferred temperature increase during the early and middle Holocene, ending between ⋍4000 and 2800 BP, is consistent with evidence from tree-line studies and palynology indicating higher temperatures in parts of the western United States during this period.

We investigate topological realizations of higher-rank graphs. We show that the fundamental group of a higher-rank graph coincides with the fundamental group of its topological realization. We also show that topological realization of higher-rank graphs is a functor and that for each higher-rank graph Λ, this functor determines a category equivalence between the category of coverings of Λ and the category of coverings of its topological realization. We discuss how topological realization relates to two standard constructions for k-graphs: projective limits and crossed products by finitely generated free abelian groups.