Background: Carbapenem-resistant Enterobacterales (CRE) are an increasing threat to patient safety but only a small percentage of CRE identified are NDMs. Since 2018, clinical CRE isolates have been submitted to the Ohio Department of Health for sequencing and NDM cases have notably increased since that time. Candida auris is an emerging pathogen with similar risk factors for colonization as CRE. Methods: A point-prevalence study was initiated after an index patient was identified with NDM CRE infection or colonization during their inpatient admission. Two patient populations were included in the study: current patients on the same unit as the index patient and currently hospitalized patients who overlapped on any unit with the index patient for at least 72 hours. Patients had perirectal screening for CRE (via PCR) and axilla or groin screening for C. auris (via Xpert Carba-R Assay). Patients were excluded if they had been discharged, expired, or refused testing. Results: We completed 5 point-prevalence studies from March 21, 2021, to October 15, 2021. The index patients were admitted at different times and across 2 campuses including medical, cardiac, and surgical ICUs as well as medical-surgical and inpatient rehabilitation units. Moreover, 3 species of NDM were identified from urine and 2 species were identified from bronchoalveolar lavage: Enterobacter hormaechei, Citrobacter freundii, and Enterobacter cloacae complex. C. freundii and E. cloacae complex both had dual mechanisms of NDM and KPC. Although some of the index patients overlapped temporally within the health system, none overlapped in the same unit or building. None of the patients had recently received health care outside the United States, although 1 patient had emigrated from Togo >5 years prior and 4 had had prior local healthcare exposure within 12 months of admission. Also, 147 patients were identified for screening; 105 consented, 32 declined, and 10 were excluded due to being discharged, deceased, or unable to consent. Inpatient point-prevalence screening tests for all patients tested (n = 105) were negative for NDM CRE and C. auris. Conclusions: Despite an increase of inpatients with NDM CRE, evidence of patient-to-patient transmission was not identified, likely resulting from adherence to standard precautions. The diversity of species and lack of international travel suggests that these patients likely acquired NDM CRE from a local reservoir in the community or healthcare settings. Given the continued increase in NDM CRE without traditional risk factors, it is critical for hospitals and public health agencies to collaborate to identify these organisms and that they develop surveillance programs to clarify risk factors for colonization.

Funding: None

Disclosures: None

Fluting is a technological and morphological hallmark of some of the most iconic North American Paleoindian stone points. Through decades of detailed artifact analyses and replication experiments, archaeologists have spent considerable effort reconstructing how flute removals were achieved, and they have explored possible explanations of why fluting was such an important aspect of early point technologies. However, the end of fluting has been less thoroughly researched. In southern North America, fluting is recognized as a diagnostic characteristic of Clovis points dating to approximately 13,000 cal yr BP, the earliest widespread use of fluting. One thousand years later, fluting occurs more variably in Dalton and is no longer useful as a diagnostic indicator. How did fluting change, and why did point makers eventually abandon fluting? In this article, we use traditional 2D measurements, geometric morphometric (GM) analysis of 3D models, and 2D GM of flute cross sections to compare Clovis and Dalton point flute and basal morphologies. The significant differences observed show that fluting in Clovis was highly standardized, suggesting that fluting may have functioned to improve projectile durability. Because Dalton points were used increasingly as knives and other types of tools, maximizing projectile functionality became less important. We propose that fluting in Dalton is a vestigial technological trait retained beyond its original functional usefulness.

Field studies were conducted in North Carolina in 2018 and 2019 to determine sweetpotato tolerance to indaziflam and its effectiveness in controlling Palmer amaranth in sweetpotato. Treatments included indaziflam pre-transplant; 7 d after transplanting (DATr) or 14 DATr at 29, 44, 58, or 73 g ai ha−1; and checks (weedy and weed-free). Indaziflam applied postemergence caused transient foliar injury to sweetpotato. Indaziflam pretransplant caused less injury to sweetpotato than other application timings regardless of rate. Palmer amaranth control was greatest when indaziflam was applied pretransplant or 7 DATr. In a weed-free environment, sweetpotato marketable yield decreased as indaziflam application was delayed. No differences in storage root length to width ratio were observed.

Monitoring population trends is important for evaluating the effectiveness of conservation interventions. An annual aerial census of three crane species, the Grey Crowned Crane Balearica regulorum, Blue Crane Anthropoides paradiseus and Wattled Crane Bugeranus carunculatus, was performed in KwaZulu-Natal province, South Africa over the past 23 years. These crane species are listed as ‘Endangered’, ‘Vulnerable’, and ‘Vulnerable’, respectively, on the IUCN Red List. KwaZulu-Natal was chosen as a key site for monitoring as it covers an important region for cranes that has received concerted conservation effort since the 1980s. These annual surveys are conducted by Ezemvelo KwaZulu-Natal Wildlife, a provincial conservation agency, and the Endangered Wildlife Trust, a conservation non-profit organisation. We estimated crane population trends from data collected by means of standardised surveys conducted between 2003 and 2019. Results from the surveys show a steady and significant increase in the population size of all three crane species. Interventions including power line collision mitigation and engagement with landowners have been implemented in formal conservation programs to protect these cranes. Results from the annual census suggest that conservation interventions have been effective.

This study quantified CO2 emissions from tropical peat swamp soils in Brunei Darussalam. At each site, soil was collected from areas of intact and degraded peat and CO2 flux, and total organic content were measured ex situ. Soil organic content (~20–99%) was not significantly different between intact and degraded forest samples. CO2 flux was higher for intact forest samples than degraded forest samples (~1.0 vs. ~0.6 μmol CO2 m−2 s−1, respectively) but did not differ among forest locations. From our laboratory experiments, we estimated a potential emissions of ~10–20 t CO2 ha−1 y−1 which is in the lower range of values reported for other tropical peat swamps. However, our results are likely affected by unmeasured variation in root respiration and the lability of resident carbon. Overall, these findings provide experimental evidence to support that clearance of tropical peat swamp forests can increase CO2 emissions due to faster rates of decomposition.

Monoclonal antibody therapeutics to treat coronavirus disease (COVID-19) have been authorized by the US Food and Drug Administration under Emergency Use Authorization (EUA). Many barriers exist when deploying a novel therapeutic during an ongoing pandemic, and it is critical to assess the needs of incorporating monoclonal antibody infusions into pandemic response activities. We examined the monoclonal antibody infusion site process during the COVID-19 pandemic and conducted a descriptive analysis using data from 3 sites at medical centers in the United States supported by the National Disaster Medical System. Monoclonal antibody implementation success factors included engagement with local medical providers, therapy batch preparation, placing the infusion center in proximity to emergency services, and creating procedures resilient to EUA changes. Infusion process challenges included confirming patient severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) positivity, strained staff, scheduling, and pharmacy coordination. Infusion sites are effective when integrated into pre-existing pandemic response ecosystems and can be implemented with limited staff and physical resources.

A global ageing population presents opportunities and challenges to designing urban environments that support ageing in place. The World Health Organization's Global Age-Friendly Cities movement has identified the need to develop communities that optimise health, participation and security in order to enhance quality of life as people age. Ensuring that age-friendly urban environments create the conditions for active ageing requires cities and communities to support older adults’ rights to access and move around the city (‘appropriation’) and for them to be actively involved in the transformation (‘making and remaking’) of the city. These opportunities raise important questions: What are older adults’ everyday experiences in exercising their rights to the city? What are the challenges and opportunities in supporting a rights to the city approach? How can the delivery of age-friendly cities support rights to the city for older adults? This paper aims to respond to these questions by examining the lived experiences of older adults across three cities and nine neighbourhoods in the United Kingdom. Drawing on 104 semi-structured interviews with older adults between the ages of 51 and 94, the discussion centres on the themes of: right to use urban space; respect and visibility; and the right to participate in planning and decision-making. These themes are illustrated as areas in which older adults’ rights to access and shape urban environments need to be addressed, along with recommendations for age-friendly cities that support a rights-based approach.