OBJECTIVES/GOALS: As hospitals across the nation respond to the need to address community violence, there is a dearth of Hospital-based Violence Intervention Programs (HVIPs) in the South despite having disproportionate rates. This research aims to identify key factors and strategies for implementation of an HVIP among rural patient populations in a southern state. METHODS/STUDY POPULATION: Semi-structured interviews will be conducted with medical providers, social service organizations, and patients transferred from four high-risk rural areas in Arkansas. Data will be analyzed using Framework Analysis, a rapid analysis approach involving framework development, code application, impactful statement identification, and content analysis. Evidence- Based Quality Improvement (EBQI), a group consensus making process, will be conducted to identify key implementation strategies and factors to adapt based interview findings. Priority areas for adaptation will be identified via systematic rating. The EBQI team, including researchers and key rural stakeholders will engage in a series of discussion, vote on final strategies, and develop a guide for future HVIP implementation and pilot testing. RESULTS/ANTICIPATED RESULTS: Findings from this study will result in a prioritized list of barriers and facilitators across sample groups. Factors will be rated by level of importance. Cluster maps will display the relationships among factors. Go and no-go zones will be identified based on importance and feasibility. Implementation strategies will be mapped to barriers and facilitators. DISCUSSION/SIGNIFICANCE: The findings will result in a culturally and geographically relevant HVIP model and package of implementation strategies to test in future hybrid trials (feasibility pilot & multi-site RCT); and shape the future of violence prevention efforts in healthcare settings across the rural South.

Intensive agricultural crop production is typically associated with low biodiversity. Low biodiversity is associated with a deficit of ecosystem services, which may limit crop yield (e.g., low pollination of insect-pollinated crops) at the individual field level or exacerbate the landscape-level impacts of intensive agriculture. To increase biodiversity and enhance ecosystem services with minimal loss of crop production area, farmers can plant desirable non-crop species near crop fields. Adoption of this practice is limited by inefficiencies in existing establishment methods. We have developed a novel seed-molding method allowing non-crop species to be planted with a conventional corn (Zea mays L.) planter, reducing labor and capital costs associated with native species establishment. Common milkweed (Asclepias syriaca L.) was selected as a model native species, because Asclepias plants are the sole food source for monarch butterfly (Danaus plexippus L.) larvae. Stratified A. syriaca seeds were added to a mixture of binder (maltodextrin) and filler (diatomaceous earth and wood flour) materials in a 3D-printed mold with the dimensions of a corn seed. The resulting Multi-Seed Zea Pellets (MSZP), shaped like corn seeds, were tested against non-pelleted A. syriaca seeds in several indoor and outdoor pot experiments. Molding into MSZP did not affect percent emergence or time to emergence from a 2-cm planting depth. Intraspecific competition among seedlings that emerged from an MSZP did not differ from competition among seedlings that emerged from a cluster of non-pelleted seeds. These findings demonstrate the potential of MSZP technology as a precise and efficient method for increasing agroecosystem biodiversity.

We describe the management of two linked severe acute respiratory coronavirus 2 (SARS-CoV-2) outbreaks, predominantly amongst 18–35-year-olds, in a UK county in July-to-September 2021, following the lifting of national coronavirus disease 2019 (COVID-19)-associated social restrictions. One was associated with a nightclub and one with five air force bases. On week beginning 2nd August 2021, air force contact tracing teams detected 68 cases across five bases within one county; 21 (30.9%) were associated with a night-time economy venue, 13 (19.1%) with night-time economy venues in the county's main town and at least one case per base (n = 6, 8.8%) with a particular nightclub in this town, which itself had been associated with 302 cases in the previous week (coinciding with its reopening following a national lockdown). In response, Public Health England/United Kingdom Health Security Agency, air force and local authority teams collaboratively implemented communication strategies and enhanced access to SARS-CoV-2 testing and vaccination. Key challenges included attempting to encourage behaviours that reduce likelihood of transmission to a population who may have considered themselves at low risk from severe COVID-19. This report may inform future preparation for, and management of, easing of potential future pandemic-related social restrictions, and how an outbreak in this context may be addressed.

Exertional syncope has been suggested to correlate with a cardiac aetiology, particularly when occurring in mid-stride. The aim of the study is to evaluate the incidence of cardiac disease among children presenting with exertional syncope, determine the influence of timing within activity, and determine the utility of genetic testing and implantable event monitors in the evaluation of cardiac syncope. The patients ≤18 years old with exertional syncope who underwent exercise stress testing between 2008 and 2019 were retrospectively included. Patients were assessed to be in one of three groups: mid-exertion (mid-stride syncope), peri-exertion (syncope during activity but not moving), and post-exertion (within minutes of the activity). A total of 334 patients were included; 46 % were mid-exertion, 18 % were peri-exertion, and 36 % were post-exertion. Thirteen patients (3.8 %) were diagnosed with cardiac syncope; n = 9 (69 %) mid-exertion. Only mid-exertional syncope was significantly associated with a cardiac diagnosis (OR: 2.6). Cardiac diagnoses included inherited arrhythmia syndromes (n = 9), abnormal coronary origins (n = 2), and supraventricular tachycardia (n = 2). Only catecholaminergic polymorphic ventricular tachycardia (n = 5) was associated with mid-exertional syncope (OR: 1.4). The definitive diagnostic test was exercise testing (n = 8), echocardiogram (n = 2), genetic testing (n = 1), ambulatory monitor (n = 1), and EKG (n = 1). Mid-stride syncope was more likely to result in a cardiac diagnosis, and exercise testing is the most common definitive test as catecholaminergic polymorphic ventricular tachycardia was the primary aetiology of exertional syncope in our cohort. Implantable event monitors and genetic testing could be helpful in ruling out cardiac disease.

For a pseudo-Anosov flow $\varphi $ without perfect fits on a closed $3$-manifold, Agol–Guéritaud produce a veering triangulation $\tau $ on the manifold M obtained by deleting the singular orbits of $\varphi $. We show that $\tau $ can be realized in M so that its 2-skeleton is positively transverse to $\varphi $, and that the combinatorially defined flow graph $\Phi $ embedded in M uniformly codes the orbits of $\varphi $ in a precise sense. Together with these facts, we use a modified version of the veering polynomial, previously introduced by the authors, to compute the growth rates of the closed orbits of $\varphi $ after cutting M along certain transverse surfaces, thereby generalizing the work of McMullen in the fibered setting. These results are new even in the case where the transverse surface represents a class in the boundary of a fibered cone of M. Our work can be used to study the flow $\varphi $ on the original closed manifold. Applications include counting growth rates of closed orbits after cutting along closed transverse surfaces, defining a continuous, convex entropy function on the ‘positive’ cone in $H^1$ of the cut-open manifold, and answering a question of Leininger about the closure of the set of all stretch factors arising as monodromies within a single fibered cone of a $3$-manifold. This last application connects to the study of endperiodic automorphisms of infinite-type surfaces and the growth rates of their periodic points.

Abstract

Turning the wealth of health and social data into insights to promote better public health, while enabling more effective personalized care, is critically important for society. In particular, social determinants of health have a significant impact on individual health, well-being, and inequalities in health. However, concerns around accessing and processing such sensitive data, and linking different datasets, involve significant challenges, not least to demonstrate trustworthiness to all stakeholders. Emerging datatrust services provide an opportunity to address key barriers to health and social care data linkage schemes, specifically a loss of control experienced by data providers, including the difficulty to maintain a remote reidentification risk over time, and the challenge of establishing and maintaining a social license. Datatrust services are a sociotechnical evolution that advances databases and data management systems, and brings together stakeholder-sensitive data governance mechanisms with data services to create a trusted research environment. In this article, we explore the requirements for datatrust services, a proposed implementation—the Social Data Foundation, and an illustrative test case. Moving forward, such an approach would help incentivize, accelerate, and join up the sharing of regulated data, and the use of generated outputs safely amongst stakeholders, including healthcare providers, social care providers, researchers, public health authorities, and citizens.

Attentional bias toward health-threat may theoretically contribute to the development and maintenance of health anxiety, but the empirical findings have been controversial. This study aimed to synthesize and explore the heterogeneity in a health-threat related attentional bias of health-anxious individuals, and to determine the theoretical model that better represents the pattern of attentional bias in health anxiety. Four databases (Web of Science, PubMed, PsycINFO, and Scopus) were searched for relevant studies, with 17 articles (N = 1546) included for a qualitative review and 16 articles (18 studies) for a three-level meta-analysis (N = 1490). The meta-analytic results indicated that the health anxiety group, compared to the control group, showed significantly greater attentional bias toward health-threat (g = 0.256). Further analyses revealed that attentional bias type, paradigm, and stimuli type were significant moderators. Additionally, compared to the controls, health-anxious individuals displayed significantly greater attention maintenance (g = 0.327) but nonsignificant attention vigilance to health-threat (g = −0.116). Our results provide evidence for the attention maintenance model in health-anxious individuals. The implications for further research and treatment of elevated health anxiety in the context of coronavirus disease-2019 (COVID-19) were also discussed.

The military punishment of decimatio, the cudgelling by lot of one in ten men in a disgraced unit, often described as a cornerstone of Roman military discipline, was never practised during the third and second centuries BC. The punishment was possibly used as an extraordinary measure a couple of times in the fifth and fourth centuries BC. It soon fell into total desuetude but was cultivated as a rhetorical construct that proclaimed theoretical powers commanders no longer dared effect. It was only revived, or rather reinvented, during the Late Republic, a violent moment that saw the confluence of antiquarian enthusiasm with military dynasts whose unrestrained powers allowed them to manifest what had previously been an aristocratic talking point.

New occurrences of flask-shaped and envelope-bearing microfossils, including the predominantly Cambrian taxon Granomarginata, are reported from new localities, as well as from earlier in time (Ediacaran) than previously known. The stratigraphic range of Granomarginata extends into the Cambrian System, where it had a cosmopolitan distribution. This newly reported Ediacaran record includes areas from Norway (Baltica), Newfoundland (Avalonia) and Namibia (adjacent to the Kalahari Craton), and puts the oldest global occurrence of Granomarginata in the Indreelva Member (< 563 Ma) of the Stáhpogieddi Formation on the Digermulen Peninsula, Arctic Norway. Although Granomarginata is rare within the assemblage, these new occurrences together with previously reported occurrences from India and Poland, suggest a potentially widespread palaeogeographic distribution of Granomarginata through the middle–late Ediacaran interval. A new flask-shaped microfossil Lagoenaforma collaris gen. et sp. nov. is also reported in horizons containing Granomarginata from the Stáhpogieddi Formation in Norway and the Dabis Formation in Namibia, and flask-shaped fossils are also found in the Gibbett Hill Formation in Newfoundland. The Granomarginata–Lagoenaforma association, in addition to a low-diversity organic-walled microfossil assemblage, occurs in the strata postdating the Shuram carbon isotope excursion, and may eventually be of use in terminal Ediacaran biostratigraphy. These older occurrences of Granomarginata add to a growing record of body fossil taxa spanning the Ediacaran–Cambrian boundary.

Electroencephalographic (EEG) abnormalities are greater in mild cognitive impairment (MCI) with Lewy bodies (MCI-LB) than in MCI due to Alzheimer’s disease (MCI-AD) and may anticipate the onset of dementia. We aimed to assess whether quantitative EEG (qEEG) slowing would predict a higher annual hazard of dementia in MCI across these etiologies. MCI patients (n = 92) and healthy comparators (n = 31) provided qEEG recording and underwent longitudinal clinical and cognitive follow-up. Associations between qEEG slowing, measured by increased theta/alpha ratio, and clinical progression from MCI to dementia were estimated with a multistate transition model to account for death as a competing risk, while controlling for age, cognitive function, and etiology classified by an expert consensus panel.

Over a mean follow-up of 1.5 years (SD = 0.5), 14 cases of incident dementia and 5 deaths were observed. Increased theta/alpha ratio on qEEG was associated with increased annual hazard of dementia (hazard ratio = 1.84, 95% CI: 1.01–3.35). This extends previous findings that MCI-LB features early functional changes, showing that qEEG slowing may anticipate the onset of dementia in prospectively identified MCI.