OBJECTIVES/GOALS: The COVID-19 pandemic disrupted established social support networks (faith-based, community, family, friends), resulting in unprecedented health-related, financial, and employment challenges among African Americans (AAs). This study explores the psychosocial influences of the pandemic on the health and wellness of AAs. METHODS/STUDY POPULATION: The FAITH! (Fostering African-American Improvement in Total Health!) Program, an academic-community partnership with AA churches, shifted focus to COVID-19 prevention in AA communities. Funded by the Mayo Clinic Center for Clinical and Translation Sciences, this cross-sectional study recruited AA adults from FAITH!-affiliated churches and social media to complete a survey exploring the personal impact of the pandemic from hardships (e.g., food and housing insecurity, paying utilities) on healthy lifestyle (HL). The primary outcome was difficulty maintaining a HL during the pandemic. Logistic regression (odds ratios and associated 95% confidence intervals (CIs)) was used to examine the associations between difficulty maintaining a HL and factors including COVID-19 hardships and mental health. RESULTS/ANTICIPATED RESULTS: Participants (N=169, 71.4% female, 41.4% essential workers) had a mean age [SD] of 49.4 [14.9] years. Over half (91/169, 54%) reported difficulty maintaining a HL. Those reporting unemployment (OR 2.3; 95% CI [1.2,4.4]; p=0.008), difficulty paying rent (OR 4.1; 95% CI [2.1,8.6]; p<0.001), or food/utilities (OR 5.5; 95% CI [2.7,11.5]; p<0.001) all had greater odds of difficulty maintaining a HL. High stress (≥5/10, scale 1-10) was associated with difficulty maintaining a HL (OR 4.1; 95% CI [2.1,8.5]; p<0.001) compared to AAs with low stress. Negative mental health (depression (OR 3.4; 95% CI [1.0,13.7]; p<0.001), anger (OR 2.5; 95% CI [0.5,18.9]; p=0.005), and nervousness (OR 4.1; 95% CI [1.1,19.5]; p=0.003) was associated with difficulty maintaining a HL compared to AAs with positive mental health. DISCUSSION/SIGNIFICANCE: Our study findings revealed that COVID-19 hardships, stress, and negative mental health impacted the ability of AAs to maintain a HL. These issues should be considered in the design and implementation of community-based health programs to promote healthy living during future public health emergencies.

We evaluated diagnostic test and antibiotic utilization among 252 patients from 11 US hospitals who were evaluated for coronavirus disease 2019 (COVID-19) pneumonia during the severe acute respiratory coronavirus virus 2 (SARS-CoV-2) omicron variant pandemic wave. In our cohort, antibiotic use remained high (62%) among SARS-CoV-2–positive patients and even higher among those who underwent procalcitonin testing (68%).

There is no all-encompassing or universally accepted definition of the difficult airway, and it has traditionally been approached as a problem chiefly rooted in anesthesiology. However, with airway obstruction reported as the second leading cause of mortality on the battlefield and first-pass success (FPS) rates for out-of-hospital endotracheal intubation (ETI) as low as 46.4%, the need to better understand the difficult airway in the context of the prehospital setting is clear. In this review, we seek to redefine the concept of the “difficult airway” so that future research can target solutions better tailored for prehospital, and more specifically, combat casualty care. Contrasting the most common definitions, which narrow the scope of practice to physicians and a handful of interventions, we propose that the difficult airway is simply one that cannot be quickly obtained. This implies that it is a situation arrived at through a multitude of factors, namely the Patient, Operator, Setting, and Technology (POST), but also more importantly, the interplay between these elements. Using this amended definition and approach to the difficult to manage airway, we outline a target-specific approach to new research questions rooted in this system-based approach to better address the difficult airway in the prehospital and combat casualty care settings.

Excavations conducted by Beloit College in 1958 and 1960 identified the site of La Magdalena in the Bajío of Mexico. Investigators have since highlighted three primary phases of occupation at La Magdalena, two of which were proposed to have been culturally influenced by Teotihuacan or Tula. Modern research in the Bajío mostly diverges from those postulations of distant connections, supplanting them with local patterns that hold much more explanatory power. Archaeometric studies are pivotal in this regard but have thus far been infrequently used. This research analyzes the obsidian assemblage from La Magdalena and finds a nearly ubiquitous utilization of a local obsidian source known as Ojo Zarco. These findings merit a reevaluation of obsidian in the eastern Bajío and argue for more archaeometric studies that elucidate local procurement patterns.

We assessed breakpoint changes of 13,101 Enterobacterales and Pseudomonas aeruginosa isolates from the past decade. All β-lactams and fluoroquinolones demonstrated decreased susceptibilities following breakpoint changes. Enterobacter cloacae experienced the largest average decrease in susceptibility amongst the Enterobacterales at 5.3% and P. aeruginosa experienced an average decrease in susceptibility of 9.3%.

Since Donald Trump took office in 2017, the White House has issued several clear anti-LGBTQIA signals and initiatives. Reflecting on Trump's election as U.S. president, many political scientists have analyzed his rise in the context of the literature on American political development (e.g., Skowronek 2017) and comparative governments (e.g., Levitsky and Ziblatt 2018). Some of this work has received significant media attention and attained a popular readership. The American political development analyses have often focused on the lens of political time and potential party realignment, exploring the possibility of a “disjunctive presidency,” which foretells the demise of the coalition that has enabled the Republican Party to dominate U.S. politics since the Reagan Revolution of the 1980s. Comparative work in the discipline argues that Trump initiatives are threatening to democratic principles, portending a turn toward authoritarianism that parallels the rise of right-wing authoritarian leaders across the globe.

We study how the properties of forcing and dissipation affect the scaling behaviour of the vortex population in the two-dimensional turbulent inverse energy cascade. When the flow is forced at scales intermediate between the domain and dissipation scales, the growth rates of the largest vortex area and the spectral peak length scale are robust to all simulation parameters. For white-in-time forcing the number density distribution of vortex areas follows the scaling theory predictions of Burgess & Scott (J. Fluid Mech., vol. 811, 2017, pp. 742–756) and shows little sensitivity either to the forcing bandwidth or to the nature of the small-scale dissipation: both narrowband and broadband forcing generate nearly identical vortex populations, as do Laplacian diffusion and hyperdiffusion. The greatest differences arise in comparing simulations with correlated forcing to those with white-in-time forcing: in flows with correlated forcing the intermediate range in the vortex number density steepens significantly past the predicted scale-invariant $A^{-1}$ scaling. We also study the impact of the forcing Reynolds number $Re_{f}$, a measure of the relative importance of nonlinear terms and dissipation at the forcing scale, on vortex formation and the scaling of the number density. As $Re_{f}$ decreases, the flow changes from one dominated by intense circular vortices surrounded by filaments to a less structured flow in which vortex formation becomes progressively more suppressed and the filamentary nature of the surrounding vorticity field is lost. However, even at very small $Re_{f}$, and in the absence of intense coherent vortex formation, regions of anomalously high vorticity merge and grow in area as predicted by the scaling theory, generating a three-part number density similar to that found at higher $Re_{f}$. At late enough stages the aggregation process results in the formation of long-lived circular vortices, demonstrating a strong tendency to vortex formation, and via a route distinct from the axisymmetrization of forcing extrema seen at higher $Re_{f}$. Our results establish coherent vortices as a robust feature of the two-dimensional inverse energy cascade, and provide clues as to the dynamical mechanisms shaping their statistics.

Petrological studies of the Sherwood Sandstone of the Marchwood Borehole show that the formation is made up of two units of differing primary lithological character: a lower unit with lithic sandstone and conglomerate, and an upper unit with arkosic sandstone. A combination of compaction and calcite cementation (early and late) has severely reduced porosity and permeability in the lower unit. In the upper unit compaction is again important, but several beds have largely escaped cementation, and their primary porosity has been enhanced by leaching of feldspars. The secondary porosity reaches 7% in some samples. Oxygen and carbon isotope data for the early (calcrete) cements indicate isotopic equilibrium with typical freshwater compositions. The later cements yield more variable values, indicating precipitation under a wider range of conditions.

The Carnmenellis granite and its aureole contain the only recorded thermal groundwaters (up to 52 °C) in British granites. They occur as springs in tin mines at depths between 200 and 700 m and most are saline (maximum mineralization 19 310 mg 1−1). Mining activity has disturbed the groundwater circulation pattern developed over a geological time-scale and levels of bomb-produced tritium (> 4 TU) indicate that a significant component (up to 65 %) of the most saline waters are of recent origin. All components of all the mine waters are of meteoric origin. Radiogenic 4He contents, 40Ar/36Ar ratios, and uranium series geochemistry suggest that the thermal component has a likely residence time of at least 5 × 104 years and probably of order 106 years.

The thermal waters have molar Na+/Cl− ratios considerably less than 1 but they are enriched relative to sea water in all major cations except Mg. The groundwater is also particularly enriched in Li with contents ranging up to 125 mg 1−1. The groundwater salinity, which may reach a maximum of 30 000 mg 1−1, is shown to result from weathering reactions of biotite (probably through a chloritization step) and plagioclase feldspar, to kaolinite. On volumetric considerations, fluid inclusions cannot contribute significantly to the groundwater salinity, and stable isotope ratios rule out any contribution from sea water.

Groundwater silica contents and molar Na+/K+ ratios suggest that the likely equilibration temperature is 54°C, which would imply a depth of circulation of about 1.2 km.

Introduction: BACKGOUND In the modern era of terrorism and senseless violence, it is essential that hospital staff have expertise in implementation of a mass casualty incident (MCI) plan. OBJECTIVES 1. To assess current gaps in implementation of an academic urban hospital code orange plan using live simulation and tabletop exercise. 2. To identify and educate front-line staff to champion a hospital-wide MCI plan. INNOVATION Historically, in order to limit resource utilization and impact on patient care, disaster response training of front-line staff involved tabletop exercises only. The tenets of experiential learning suggest that learner engagement through realistic active practice of skills achieves deeper uptake of new knowledge. We enhanced the traditional tabletop approach through novel use of live actor patients presenting to an academic, urban emergency department (ED) during a hospital-wide MCI simulation. Methods: To assess the current code orange plan, an interprofessional, committee comprising expert leaders in trauma, emergency preparedness, emergency medicine and simulation integrated tabletop and live simulation to stage a MCI based on a mock incident at a new subway station. ED staff, the trauma team and champions from medicine, surgery and critical care participated along with support departments such as Patient Flow, Patient Transport, Environmental Services and the Hospital Emergency Operations Centre. Ten live actor patients and eight virtual patients presented to the ED. The exercise occurred in situ in the ED. Other participating departments conducted tabletop exercises and received live actor patients. Results: CURRICULUM Staff decanted the ED and other participating units using their current knowledge of hospital code orange policy. Live and virtual patients were triaged and managed according to severity of injuries. Live actor patients were assessed, intervened and transported to their designated unit. Virtual patients were managed through verbal discussion with the simulation controllers. An ED debrief took place using a plus/delta approach followed by a hospital-wide debrief. Conclusion: CONCLUSION An interprofessional hospital-wide MCI simulation revealed important challenges such as communication, command and control and patient-tracking . The exercise ignited enthusiasm and commitment to longitudinal practice and improvement for identified gaps.

Prestahnúkur is a 570m high rhyolite glaciovolcanic edifice in Iceland’s Western Rift Zone with a volume of 0.6 km3. Uniform whole rock, mineral and glass compositions suggest that Prestahnúkur was constructed during the eruption of one magma batch. Ar-Ar dating gives an age of 89± 24 ka, which implies eruption during the transition (Oxygen Isotope substages 5d to 5a) between the Eemian interglacial and the Weichselian glacial period. Prestahnu´kur is unique among published accounts of rhyolite tuyas because a base of magmatically-fragmented tephra appears to be absent. Instead, basal exposures consist of glassy lava lobes and coarse hyaloclastite, above which are single and multiple lava sheets with matrix-supported basal breccias and hyaloclastite upper carapaces. Steepening ramp structures at sheet termini are interpreted as ice-contact features. Interactions between erupting magma and water/ice have affected all lithologies. A preliminary model for the construction of Prestahnúkur involves an effusive subglacial eruption between 2–19 years duration which never became emergent, into an ice sheet over 700m thick. If 700m of ice had built up during this interglacial–glacial transition, this would corroborate models arguing for the swift accumulation of land-based ice in rapid response to global cooling.

Despite containing only 14% of the Greenland ice sheet by area, the southeastern sector has the highest accumulation rates, and hence receives ∼30% of the total snow accumulation. We present accumulation rates obtained during our 2010 Arctic Circle Traverse derived from three 50 m firn cores dated using geochemical analysis. We tracked continuous internal reflection horizons between the firn cores using a 400 MHz ground-penetrating radar (GPR). GPR data combined with depth-age scales from the firn cores provide accumulation rates along a 70 km transect. We followed an elevation gradient from ∼2350 to ∼1830m to understand how progressive surface melt may affect the ability to chemically date the firn cores and trace the internal layers with GPR. From the firn cores, we find a 52% (∼0.43 m w.e. a-1) increase in average snow accumulation and greater interannual variability at the lower site than the upper site. The GPR profiling reveals that accumulation rates are influenced by topographic undulations on the surface, with up to 23% variability over 7 km. These measurements confirm the presence of high accumulation rates in the southeast as predicted by the calibrated regional climate model Polar MM5.