What's in a name? Political and economic concepts differ in social media references to harmful algae blooms.

Policies and management decisions in the marine environment are driven in part by public sentiment which can grow more intense during hazard events like Harmful Algae Blooms (HABs). The public conversations on social media sites like Twitter (before X) reveal the polarized nature of HABs through nuanced language and sentiment. This article uses mixed methods of machine learned topic modeling and inductive qualitative coding to describe the ways the long-term 2017-2019 Karenia brevis "red tide" bloom were politicized across Florida's South West coast. It finds that there are topical differences in keywords related to place (e.g. beach, Florida, coast), agent (individual or organization), and epistemic values (reliance on scientific and/or media reports). These topical differences demonstrate different levels of politicization and partisanship in qualitative analysis. Conceptually, this research demonstrates the ways different dimensions of a long-duration marine hazard can be polarized. Regarding management, this research provides insights to political and organizational stakeholders and the gaps in the discourse shaping marine hazards which can be used to strategically guide future social media engagement to manage politicization. What if all the careful work that resource and environmental managers do can be undone by simple, seemingly uncontroversial words? In an era of increased environmental and marine distress-coupled with short format communication-the ways environmental managers choose their words is crucial, even between ostensibly inconsequential nouns like "red tide" or "algae bloom." Policies and management decisions in the marine environment are driven in part by public sentiment which can grow more intense during hazard events like Harmful Algae Blooms (HABs). The public conversations on social media sites like Twitter (before X) reveal the polarized nature of HABs through nuanced language and sentiment. This article relies on mining social media posts, and uses mixed methods of machine-learned topic modeling and human-driven inductive qualitative coding to describe the ways the long-term 2017-2019 Karenia brevis "red tide" blooms were politicized across Florida's South West coast. It finds that there are topical differences in keywords related to place (e.g. beach, Florida, coast), agent (individual or organization), and epistemic values (reliance on scientific and/or media reports). These topical differences demonstrate different levels of politicization and partisanship in qualitative analysis. Conceptually, this research demonstrates the ways different dimensions of a long-duration marine hazard can be polarized. Regarding management, this research provides insights to political and organizational stakeholders and the gaps in the discourse shaping marine hazards which can be used to strategically guide future social media engagement to manage politicization.

Factors associated with meningitis vaccine awareness and engagement among Latino men who have sex with men in South Florida.

Awareness and uptake of the meningitis vaccine remains low among marginalized groups, such as Latino men who have sex with men (LMSM), potentially due to structural and psychosocial barriers in accessing preventative healthcare. The current study explored awareness and uptake of meningitis vaccines among a group of LMSM (N = 99) living in South Florida. A three-pronged variable selection approach was utilized prior to conducting regression models (linear and logistic). Overall, 48.5% of the participants reported little to no knowledge about meningitis vaccines, and 20.2% reported being vaccinated. Living with HIV (OR = 10.48) and time since outbreak (OR = 1.03) were significant predictors of meningitis vaccine uptake. No significant correlates of meningitis vaccine awareness were identified. More research is needed to identify other important factors associated with meningitis vaccine awareness and uptake among LMSM, a multiple marginalized group.

Highly pathogenic avian influenza A(H5N1) virus in a common bottlenose dolphin (Tursiops truncatus) in Florida.

Since late 2021, highly pathogenic avian influenza (HPAI) viruses of A/goose/Guangdong/1/1996 (H5N1) lineage have caused widespread mortality in wild birds and poultry in the United States. Concomitant with the spread of HPAI viruses in birds are increasing numbers of mammalian infections, including wild and captive mesocarnivores and carnivores with central nervous system involvement. Here we report HPAI, A(H5N1) of clade 2.3.4.4b, in a common bottlenose dolphin (Tursiops truncatus) from Florida, United States. Pathological findings include neuronal necrosis and inflammation of the brain and meninges, and quantitative real time RT-PCR reveal the brain carried the highest viral load. Virus isolated from the brain contains a S246N neuraminidase substitution which leads to reduced inhibition by neuraminidase inhibitor oseltamivir. The increased prevalence of A(H5N1) viruses in atypical avian hosts and its cross-species transmission into mammalian species highlights the public health importance of continued disease surveillance and biosecurity protocols.

Investigating Disparities in Hypopharyngeal/Laryngeal Cancer Survival in Florida With Geospatial Mapping Analysis.

OBJECTIVE: Identify predictors of overall survival (OS) after hypopharyngeal/laryngeal cancer in Florida. MATERIAL AND METHODS: We conducted a retrospective cohort study using data from the Florida Cancer Data System (FCDS) on patients diagnosed with hypopharyngeal or laryngeal cancer from 2010-2017. Primary outcome was OS. Hazard ratios (HRs) were estimated from univariable and multivariable Cox regression models for OS. Data was analyzed from November 1, 2022, to June 30, 2023. RESULTS: We analyzed 6771 patients, who were primarily male (81.2%), White non-Hispanic (WNH) (78.2%), publicly insured (70.1%), married (51.8%), and residents of urban counties (73.6%). Black patients were more likely to be younger at diagnosis (38.9%), single (43.4%), to have distant SEER stage disease (25.6%). Median OS were lowest among patients who were uninsured (34 months), with hypopharyngeal site disease (18 months), and a smoking history (current: 34 months, former: 46 months, no smoking: 63 months). Multivariable Cox regression analysis showed worse OS for single/unmarried vs married (HR 1.47 [95%CI: 1.36-1.59], P < .001), history of tobacco use (current: HR 1.62 [95%CI: 1.440-1.817], P < .001; former smokers: (HR 1.28 [95%CI: 1.139-1.437], P < .001) vs no history). Improved OS was observed among White Hispanics (WH) vs WNH (HR .73 [95%CI: .655-.817], P < .001) and women vs men (HR .88 [95%CI: .807-.954], P = .002). Geographical mapping showed that mortality rates were highest in census tracts with low income and education. CONCLUSION: Our findings suggest that sociodemographic and clinical factors impact OS from hypopharyngeal/laryngeal cancer in Florida and vary geographically within the state. These results will help guide future public health interventions.

Regional reef fish assemblage maps provide baseline biogeography for tropicalization monitoring.

The Anthropocene rise in global temperatures is facilitating the expansion of tropical species into historically non-native subtropical locales, including coral reef fish. This redistribution of species, known as tropicalization, has serious consequences for economic development, livelihoods, food security, human health, and culture. Measuring the tropicalization of subtropical reef fish assemblages is difficult due to expansive species ranges, temporal distribution shifts with the movement of isotherms, and many dynamic density-dependent factors affecting occurrence and density. Therefore, in locales where tropical and subtropical species co-occur, detecting tropicalization changes relies on regional analyses of the relative densities and occurrence of species. This study provides a baseline for monitoring reef fish tropicalization by utilizing extensive monitoring data from a pivotal location in southeast Florida along a known transition between tropical and subtropical ecotones to define regional reef fish assemblages and use benthic habitat maps to spatially represent their zoogeography. Assemblages varied significantly by ecoregion, habitat depth, habitat type, and topographic relief. Generally, the southern assemblages had higher occurrences and densities of tropical species, whereas the northern assemblages had a higher occurrence and density of subtropical species. A total of 108 species were exclusive to regions south of the Bahamas Fracture Zone (BFZ) (South Palm Beach, Deerfield, Broward-Miami) and 35 were exclusive to the north (North Palm Beach, Martin), supporting the BFZ as a pivotal location that affects the coastal biogeographic extent of tropical marine species in eastern North America. Future tropicalization of reef fish assemblages are expected to be evident in temporal deviance of percent occurrence and/or relative species densities between baseline assemblages, where the poleward expansion of tropical species is expected to show the homogenization of assemblage regions as adjacent regions become more similar or the regional boundaries expand poleward. Ecoregions, habitat depth, habitat type, and relief should be incorporated into the stratification and analyses of reef fish surveys to statistically determine assemblage differences across the seascape, including those from tropicalization.

Crowdsourcing citizens for statewide mapping of per- and polyfluoroalkyl substances (PFAS) in Florida drinking water.

Per- and polyfluoroalkyl substances (PFAS) are a class of persistent chemicals that have been associated with a diverse array of adverse environmental and human health related effects. In addition to a growing list of health concerns, PFAS are also ubiquitously used and pervasive in our natural and built environments, and they have an innate ability to be highly mobile once released into the environment with an unmatched ability to resist degradation. As such, PFAS have been detected in a wide variety of environmental matrices, including soil, water, and biota; however, the matrix that largely dictates human exposure to PFAS is drinking water, in large part due to their abundance in water sources and our reliance on drinking water. As Florida is heavily reliant upon water and its varying sources, the primary objective of this study was to survey the presence of PFAS in drinking water collected from taps from the state of Florida (United States). In this study, 448 drinking water samples were collected by networking with trained citizen scientists, with at least one sample collected from each of the 67 counties in Florida. Well water, tap water, and bottled water, all sourced from Florida, were extracted and analyzed (31 PFAS) using isotope dilution and ultra-high-performance liquid chromatography - tandem mass spectrometry (UHPLC-MS/MS). Overall, when examining ∑PFAS: the minimum, maximum, median, and mean were ND, 219, 2.90, and 14.06 ng/L, respectively. The data herein allowed for a comparison of PFAS in drinking water geographically within the state of Florida, providing vital baseline concentrations for prospective monitoring and highlighting hotspots that require additional testing and mitigation. By incorporating citizen scientists into the study, we aimed to educate impacted communities regarding water quality issues and solutions.

Spatial and temporal analysis of HIV clinical outcomes in Florida reveals counties with persistent racial and ethnic disparities during 2012-2019.

BACKGROUND: Racial/ethnic disparities in the HIV care continuum have been well documented in the US, with especially striking inequalities in viral suppression rates between White and Black persons with HIV (PWH). The South is considered an epicenter of the HIV epidemic in the US, with the largest population of PWH living in Florida. It is unclear whether any disparities in viral suppression or immune reconstitution-a clinical outcome highly correlated with overall prognosis-have changed over time or are homogenous geographically. In this analysis, we 1) investigate longitudinal trends in viral suppression and immune reconstitution among PWH in Florida, 2) examine the impact of socio-ecological factors on the association between race/ethnicity and clinical outcomes, 3) explore spatial and temporal variations in disparities in clinical outcomes. METHODS: Data were obtained from the Florida Department of Health for 42,369 PWH enrolled in the Ryan White program during 2008-2020. We linked the data to county-level socio-ecological variables available from County Health Rankings. GEE models were fit to assess the effect of race/ethnicity on immune reconstitution and viral suppression longitudinally. Poisson Bayesian hierarchical models were fit to analyze geographic variations in racial/ethnic disparities while adjusting for socio-ecological factors. RESULTS: Proportions of PWH who experienced viral suppression and immune reconstitution rose by 60% and 45%, respectively, from 2008-2020. Odds of immune reconstitution and viral suppression were significantly higher among White [odds ratio =2.34, 95% credible interval=2.14-2.56; 1.95 (1.85-2.05)], and Hispanic [1.70 (1.54-1.87); 2.18(2.07-2.31)] PWH, compared with Black PWH. These findings remained unchanged after accounting for socio-ecological factors. Rural and urban counties in north-central Florida saw the largest racial/ethnic disparities. CONCLUSIONS: There is persistent, spatially heterogeneous, racial/ethnic disparity in HIV clinical outcomes in Florida. This disparity could not be explained by socio-ecological factors, suggesting that further research on modifiable factors that can improve HIV outcomes among Black and Hispanic PWH in Florida is needed.

Concurrent Outbreaks of Hepatitis A, Invasive Meningococcal Disease, and Mpox, Florida, USA, 2021-2022.

In 2022, concurrent outbreaks of hepatitis A, invasive meningococcal disease (IMD), and mpox were identified in Florida, USA, primarily among men who have sex with men. The hepatitis A outbreak (153 cases) was associated with hepatitis A virus genotype IA. The IMD outbreak (44 cases) was associated with Neisseria meningitidis serogroup C, sequence type 11, clonal complex 11. The mpox outbreak in Florida (2,845 cases) was part of a global epidemic. The hepatitis A and IMD outbreaks were concentrated in Central Florida and peaked during March--June, whereas mpox cases were more heavily concentrated in South Florida and had peak incidence in August. HIV infection was more common (52%) among mpox cases than among hepatitis A (21%) or IMD (34%) cases. Where feasible, vaccination against hepatitis A, meningococcal disease, and mpox should be encouraged among at-risk groups and offered along with program services that target those groups.

Barriers to Accessing and Engaging in HIV Preventive Care and Pre-Exposure Prophylaxis Experienced by Transgender Women in Florida.

BACKGROUND: PrEP, a biomedical HIV prevention option, continues to be underutilized among transgender women who could benefit from sustained use, especially women of color and those who identify as Latina and/or reside in the southeastern US. OBJECTIVE: We explored the barriers and facilitators experienced by transgender women who live in Florida regarding accessing, using, and/or staying on PrEP. METHODS: In-depth interviews and focus groups were conducted in either Spanish or English with adult transgender women living in Florida (N = 22). The interviews were audio-recorded, transcribed, and coded in ATLAS.ti using thematic analyses. RESULTS: The mean age of the participants was 42.2 years. Among the participants, 73% were Hispanic/Latina, 59% were foreign-born, and approximately one-third were living with HIV (but had past experience with PrEP). Transgender women cited the following barriers to accessing or considering PrEP: (1) costs and benefits of PrEP use; (2) under-representation in clinical trials resulting in unknown or misinformation regarding PrEP side effects; (3) chronic poverty; and (4) trauma and discrimination. Other stressors, such as behavioral healthcare needs, were identified. CONCLUSIONS: Our analysis revealed interlocking systems of oppression like transphobia, discrimination, and misgendering, which were common barriers experienced by our participants. These synergistically epidemic (i.e., syndemic) barriers contributed to their feelings of being systematically excluded in social spaces, research, public health planning and policies, laws, and social programs related to PrEP. These structural barriers are impediments to HIV preventive care but also act as a source of stress that contributes to mental health problems, financial vulnerability, substance abuse, and other deleterious health outcomes.

Changing COVID-19 cases and deaths detection in Florida.

Epidemic data are often difficult to interpret due to inconsistent detection and reporting. As these data are critically relied upon to inform policy and epidemic projections, understanding reporting trends is similarly important. Early reporting of the COVID-19 pandemic in particular is complicated, due to changing diagnostic and testing protocols. An internal audit by the State of Florida, USA found numerous specific examples of irregularities in COVID-19 case and death reports. Using case, hospitalization, and death data from the the first year of the COVID-19 pandemic in Florida, we present approaches that can be used to identify the timing, direction, and magnitude of some reporting changes. Specifically, by establishing a baseline of detection probabilities from the first (spring) wave, we show that transmission trends among all age groups were similar, with the exception of the second summer wave, when younger people became infected earlier than seniors, by approximately 2 weeks. We also found a substantial drop in case-fatality risk (CFR) among all age groups over the three waves during the first year of the pandemic, with the most drastic changes seen in the 0 to 39 age group. The CFR trends provide useful insights into infection detection that would not be possible by relying on the number of tests alone. During the third wave, for which we have reliable hospitalization data, the CFR was remarkably stable across all age groups. In contrast, the hospitalization-to-case ratio varied inversely with cases while the death-to-hospitalization ratio varied proportionally. Although specific trends are likely to vary between locales, the approaches we present here offer a generic way to understand the substantial changes that occurred in the relationships among the key epidemic indicators.

Typologies of Family Dependency Treatment Court Participants: Parental Characteristics and Differential Child Placement Outcomes.

Background: Family Dependency Treatment Court (FDTC) is a problem-solving court for parents who have child welfare involvement and designed to address parental substance misuse by providing treatment and wrap-around services, with the goal of reunifying parents with their children. Objectives: This study aimed to identify different classes of FDTC parents and compare how child placement outcomes differ by class. Parental characteristics and permanent placement outcomes for 354 parents participating in a Central Florida FDTC were assessed using administrative data. An exploratory latent class analysis was conducted to classify parents. Results: Results revealed three distinct classes of FDTC participants: 1) co-occurring issues, 2) racial/ethnic minority participants, and 3) prescription opioid, meth, and heroin users. Regression analyses showed that parents with co-occurring issues were over two times more likely to achieve permanency (OR = 2.05, p < .05), and were two times less likely to terminate their parental rights (TPR) compared to the other two classes. Conclusions: Implications for tailoring FDTC procedures to parents' individual needs, combating racial/ethnic disparities in access to services and placement outcomes, and improved child welfare and placement outcomes are discussed.

Usability of Health Care Price Transparency Data in the United States: Mixed Methods Study.

BACKGROUND: Increasing health care expenditure in the United States has put policy makers under enormous pressure to find ways to curtail costs. Starting January 1, 2021, hospitals operating in the United States were mandated to publish transparent, accessible pricing information online about the items and services in a consumer-friendly format within comprehensive machine-readable files on their websites. OBJECTIVE: The aims of this study are to analyze the available files on hospitals' websites, answering the question-is price transparency (PT) information as provided usable for patients or for machines?-and to provide a solution. METHODS: We analyzed 39 main hospitals in Florida that have published machine-readable files on their website, including commercial carriers. We created an Excel (Microsoft) file that included those 39 hospitals along with the 4 most popular services-Current Procedural Terminology (CPT) 45380, 29827, and 70553 and Diagnosis-Related Group (DRG) 807-for the 4 most popular commercial carriers (Health Maintenance Organization [HMO] or Preferred Provider Organization [PPO] plans)-Aetna, Florida Blue, Cigna, and UnitedHealthcare. We conducted an A/B test using 67 MTurkers (randomly selected from US residents), investigating the level of awareness about PT legislation and the usability of available files. We also suggested format standardization, such as master field names using schema integration, to make machine-readable files consistent and usable for machines. RESULTS: The poor usability and inconsistent formats of the current PT information yielded no evidence of its usefulness for patients or its quality for machines. This indicates that the information does not meet the requirements for being consumer-friendly or machine readable as mandated by legislation. Based on the responses to the first part of the experiment (PT awareness), it was evident that participants need to be made aware of the PT legislation. However, they believe it is important to know the service price before receiving it. Based on the responses to the second part of the experiment (human usability of PT information), the average number of correct responses was not equal between the 2 groups, that is, the treatment group (mean 1.23, SD 1.30) found more correct answers than the control group (mean 2.76, SD 0.58; t65=6.46; P<.001; d=1.52). CONCLUSIONS: Consistent machine-readable files across all health systems facilitate the development of tools for estimating customer out-of-pocket costs, aligning with the PT rule's main objective-providing patients with valuable information and reducing health care expenditures.

The Impact of Market Factors on Meaningful Use of Electronic Health Records Among Primary Care Providers: Evidence From Florida Using Resource Dependence Theory and Information Uncertainty Perspective.

BACKGROUND: Using federal funds from the 2009 Health Information Technology for Economic and Clinical Health Act, the Centers for Medicare and Medicaid Services funded the 2011-2021 Medicaid electronic health record (EHR) incentive programs throughout the country. OBJECTIVE: Identify the market factors associated with Meaningful Use (MU) of EHRs after primary care providers (PCPs) enrolled in the Florida-EHR incentives program through Adopting, Improving, or Upgrading (AIU) an EHR technology. RESEARCH DESIGN: Retrospective cohort study using 2011-2018 program records for 8464 Medicaid providers. MAIN OUTCOME: MU achievement after first-year incentives. INDEPENDENT VARIABLES: The resource dependence theory and the information uncertainty perspective were used to generate key-independent variables, including the county's rurality, educational attainment, poverty, health maintenance organization penetration, and number of PCPs per capita. ANALYTICAL APPROACH: All the county rates were converted into 3 dichotomous measures corresponding to high, medium, and low terciles. Descriptive and bivariate statistics were calculated. A generalized hierarchical linear model was used because MU data were clustered at the county level (level 2) and measured at the practice level (level 1). RESULTS: Overall, 41.9% of Florida Medicaid providers achieved MU after receiving first-year incentives. Rurality was positively associated with MU ( P <0.001). Significant differences in MU achievements were obtained when we compared the "high" terciles with the "low" terciles for poverty rates ( P =0.002), health maintenance organization penetration rates ( P =0.02), and number of PCPs per capita ( P =0.01). These relationships were negative. CONCLUSIONS: Policy makers and health care managers should not ignore the contribution of market factors in EHR adoption.

Ecological implications of allometric relationships in American alligators (Alligator mississippiensis).

Morphometric allometry, the effect of size on morphological variation, has been of great interest for evolutionary biologist and is currently used in fields such as wildlife ecology to inform management and conservation. We assessed American alligator (Alligator mississippiensis) morphological static allometry across the Greater Everglades ecosystem in South Florida, United States using a robust dataset (~ 22 years) and investigated effects of sex, habitat, and sampling area on morphological relationships. Regression models showed very strong evidence of a linear relationship between variables explaining equal to or above 92% of the variation in the data. Most trait-size relationships (8 out of 11 assessed) showed hyperallometry (positive allometry) with slope deviations from isometry between 0.1 and 0.2 units while the other three relationships were isometric. Sampling area, type of habitat, and in a lesser extent sex influenced allometric coefficients (slope and intercept) across several relationships, likely as result of differing landscapes and ecosystem dynamic alterations and sexual dimorphism. We discuss our findings in terms of the biology of the species as well as the usefulness of our results in the context of ecosystem restoration and conservation of the species. Finally, we provide recommendations when using trait-length relationships to infer population nutritional-health condition and demographics.

Assessing the effects of geometry and non-geometry related factors in work-zone crashes.

OBJECTIVE: Work zones are unique in geometry and traffic management, utilizing special traffic signs, standard channelizing devices, appropriate barriers, and pavement markings. These configurations can introduce unexpected driving conditions, potentially posing risks to drivers. This analysis aims to explore potential differences in contributing factors between work-zone crashes where geometry was identified as a factor and those where it was non-geometry factor. To gain insights into driver injury severities in single-vehicle work-zone crashes, this study analyzed work zone crash data from Florida. METHOD: This study employed random parameters logit models, accommodating potential variations in parameter estimates' means and variances. The dataset encompassed a wide array of factors known to influence driver injury severity, encompassing crash characteristics, vehicle attributes, roadway features, prevailing traffic volume, driver profiles, and spatial and temporal considerations. RESULTS: This analysis yielded significantly distinct parameters for work-zone crashes, distinguishing between geometry-related and non-geometry-related factors (primarily the human factors). This distinction suggests a complex interplay between these factors. Notably, the marginal effects of individual parameter estimates exhibited marked differences between these two categories - geometry and non-geometry factors. CONCLUSION: These findings contribute to the growing body of research indicating that geometric restrictions within work zones introduce a distinct set of risk factors compared to non-geometry-related factors. Recognizing the significance of geometric restrictions, beyond typical driving conditions, holds the implications for enhancing safety within various work zone configurations and offers valuable insights for crash scene investigators to pinpoint contributing factors accurately.

A confirmed case of xylazine-induced skin ulcers in a person who injects drugs in Miami, Florida, USA.

BACKGROUND: Xylazine is an alpha-2 adrenergic receptor agonist that has emerged as a contaminant in the illicit drug supply of fentanyl. Xylazine use may be suspected in naloxone-resistant overdoses and atypical, chronic wounds in people who use drugs (PWUD). This case is unique because it is the first case to our knowledge describing wound care for a xylazine-induced wound with a confirmatory xylazine test strip (XTS) in the setting of a syringe services program (SSP) and in the state of Florida. CASE PRESENTATION: A 43-year-old woman with a past medical history of severe opioid use disorder and stimulant use disorder presented to a student-run clinic at a Miami SSP for wound care. She had multiple ulcerations diffusely over her bilateral forearms with surrounding erythema and warmth. Seven weeks later, she presented to clinic again for wound care because her wounds had progressed. At this visit, a XTS was used to confirm the presence of xylazine in her urine. Wound care management and harm reduction strategies employed at both visits were informed by best clinical judgement due to lack of formal guidelines at the time. Wound outcomes are unknown as the patient has not returned to clinic. CONCLUSIONS: Many PWUD at highest risk for acute and chronic health consequences of xylazine-adulterated fentanyl do not have access to healthcare outside of low barrier clinics and SSPs due to lack of insurance or mistrust of the traditional healthcare system due to stigma. There is an urgent need for access to XTS for PWUD and clinical practice guidelines for the treatment of xylazine-related wounds in outpatient clinics.

Recent Latinx immigrants to Miami/Dade County (FL): Travel patterns before, during, and one year after the COVID-19 pandemic lockdown.

INTRODUCTION: Understanding the transportation needs of immigrants is crucial for the design and promotion of safe, equitable, and sustainable living environments. This study examines the transportation patterns from a sample of Recent Latinx Immigrants (RLIs) upon arrival to Miami/Dade Co (MDC), Florida. METHODS: Collected between 2018 and 2021, data came from a longitudinal study examining drinking and driving trajectories among 540 RLIs to MDC. Retrospective pre-immigration data (T0) were obtained simultaneously with the first-year post-immigration data (T1). Follow up surveys were conducted one year later, before (T2-BC) or during a pandemic lockout (T2-DC), and two years later (T3). Descriptive and repeated measures mixed-model regression were used to examine the data. RESULTS: Driving declined from T0 to T1, although remained higher than previously reported for other locations. Not having a valid driver's license was the main reason for the decline. The initial reduction in driving was paralleled by an increase in the use of transit, riding as passengers in private vehicles, and walking. A year later (T2), as RLIs' income and access to a driver's license grew, driving rates increased (even during the pandemic lockdown), while the use of other transportation modes decreased. A year after the pandemic lockdown (T3), driving as well as the use of other transportation modes receded. Reasons for this decline are unclear. CONCLUSIONS: RLIs reported elevated driving rates upon their arrival to MDC. The COVID-19 pandemic seems to have altered the RLIs' transportation patterns, provoking an overall decline in mobility that lasted even after the pandemic lockdown ceased. PRACTICAL APPLICATIONS: Transportation planners working on developing safe and equitable transportation systems in MDC should: (1) identify and address barriers to the use of transportation modes other than driving by RLIs; and (2) understand reasons for the broad decline in transportation modes after the pandemic lockdown.

The shifting impact and response to COVID-19 in Florida.

The first cases of COVID-19 in Florida were diagnosed on March 1, 2020. Three years later, more than 7.3 million people have had COVID-19 in Florida, and more than 93,000 individuals have died from this illness. When considering the impact of COVID-19 on Florida, several key factors need to be considered, including that Florida was one of the most medically vulnerable states due to a substantial proportion of older individuals and those with underlying medical conditions. Florida also has a centralized Department of Health and Division of Emergency Management structure that facilitated response activities. Looking at the impact of COVID-19 on Florida, two distinct phases need to be considered: the pre-Delta variant phase from March 2020 to July 2021 and the Delta variant and beyond phase that began July 2021 and still continues. During the 16-month first phase, about 38,000 people died. Yet, 24,000 people died during the 5-months of the Delta variant wave from July to November 2021. During the Omicron waves that followed Delta, an additional 31,000 people died. Florida thus went from ranking 26th in death per capita in the United States at the end of the first phase to 10th a few months into the Delta wave and now ranks 8th. Why did these phases differ so dramatically in terms of mortality? During the first phase of the pandemic, adherence to established nonpharmacological and older adult protection measures was recommended. When COVID-19 vaccines became available in December 2020, there was an aggressive campaign to promote COVID-19 vaccination, and public acceptance was high. The second phase followed political opposition to CDC and public health expert guidelines, the rise of anti-vaccine sentiment and misinformation, and falling vaccination rates. These factors contributed to considerable population vulnerability to severe disease when the Delta variant hit. As the former State Surgeon General and Secretary of Health of Florida from June 2019 to September 2021, this report provides perspective on the shifting impact and response to COVID-19 in Florida, which is the third most populous state in the United States. This perspective shows the clear consequences of shifting from standard public health practices and vaccine promotion to attacks on public health and vaccines.

Entanglement and ingestion of microfibers by the oyster pea crab Zaops ostreum, an endosymbiont of the eastern oyster Crassostrea virginica.

The kleptoparasitic pea crab Zaops ostreum lives within the gills of bivalves, including the economically important eastern oyster Crassostrea virginica. Previous research along the east coast of central Florida has found an average of 2.3 pieces of plastic per oyster. The goals of our research were to determine if filter-feeding oysters transfer microfibers to Z. ostreum via the crab: 1) actively consuming plastic particles, or 2) passively becoming entangled in microfibers. Our results show that both occur. While only 11.6 % of Z. ostreum (total n = 122) consumed microfibers, those that did had up to 14 pieces in their soft tissues. Similarly, only 7.4 % of Z. ostreum had microfibers entangled around their appendages. Mean lengths of consumed and entangled fibers were similar, 1.9 and 2.7 mm, respectively. Additional research is needed to understand the positive and negative impacts of microfibers associated with pea crabs on both species.