CATCH-UP vaccines: protocol for a randomized controlled trial using the multiphase optimization strategy (MOST) framework to evaluate education interventions to increase COVID-19 vaccine uptake in Oklahoma.

BACKGROUND: Oklahoma's cumulative COVID-19 incidence is higher in rural than urban counties and higher than the overall US incidence. Furthermore, fewer Oklahomans have received at least one COVID-19 vaccine compared to the US average. Our goal is to conduct a randomized controlled trial using the multiphase optimization strategy (MOST) to test multiple educational interventions to improve uptake of COVID-19 vaccination among underserved populations in Oklahoma. METHODS: Our study uses the preparation and optimization phases of the MOST framework. We conduct focus groups among community partners and community members previously involved in hosting COVID-19 testing events to inform intervention design (preparation). In a randomized clinical trial, we test three interventions to improve vaccination uptake: (1) process improvement (text messages); (2) barrier elicitation and reduction (electronic survey with tailored questions/prompts); and (2) teachable moment messaging (motivational interviewing) in a three-factor fully crossed factorial design (optimization). DISCUSSION: Because of Oklahoma's higher COVID-19 impact and lower vaccine uptake, identifying community-driven interventions is critical to address vaccine hesitancy. The MOST framework provides an innovative and timely opportunity to efficiently evaluate multiple educational interventions in a single study. TRIAL REGISTRATION: ClinicalTrials.gov: NCT05236270, First Posted: February 11, 2022, Last Update Posted: August 31, 2022.

Draft Genome Sequence of Marinobacter sp. Strain P4B1, an Electrogenic Perchlorate-Reducing Strain Isolated from a Long-Term Mixed Enrichment Culture of Marine Bacteria.

The perchlorate-reducing strain Marinobacter sp. strain P4B1 was isolated from a long-term perchlorate-degrading enrichment culture seeded with marine sediment. The draft genome of Marinobacter sp. P4B1 is comprised of the bacterial chromosome (3.60 Mbp, G+C 58.51%, 3,269 predicted genes) and its associated plasmid pMARS01 (0.14 Mbp, G+C 52.95%, 165 predicted genes).

Using sequence discovery to target outreach for diabetes medication adherence.

OBJECTIVES: To investigate exposure sequences correlated with gaps in diabetes medication refills and to identify opportunities for targeted outreach for improved adherence. STUDY DESIGN: Sequence discovery was used to identify exposures from various data sources that preceded a gap in diabetes medication refills. METHODS: Patients who refilled a diabetes medication and had 6 months of continuous refill history were included. Patients with a therapy gap between February 1, 2012, and March 31, 2013, formed the gap group; those without formed the no-gap group. Gaps were defined as a prescription refill obtained 6 days or more after the days' supply of the previous refill. Exposure sequences were explored in the 90 days before the gap, or before the date of last refill in the study period for the no-gap group. Exposures and sequences offering opportunity for health plan outreach were identified based on sequence length, confidence, number of intervention points, and higher gap group prevalence. RESULTS: Three exposure sequences with the greatest outreach opportunity to impact downstream adherence were identified within individuals taking diabetes medications who: 1) are prescribed a new medication-especially those with multiple out-of-network claims and/or visit a specialty physician after the new medication is prescribed; 2) have a prescription claim reversed by a pharmacist-particularly patients who are subsequently prescribed a new medication or visit a specialty physician; and 3) have multiple out-of-network claims and a hospitalization. CONCLUSIONS: As medication adherence is a persisting challenge, novel application of sequence discovery techniques identified unique sequences of events with opportunities for outreach.

TCR mu recombination and transcription relative to the conventional TCR during postnatal development in opossums.

Marsupials are a distinct lineage of mammals notable for giving birth to highly altricial (relatively less developed) young. The recent discovery of a unique TCR chain in marsupials, TCRmu, raises questions about its possible role in early development. Here we compare the timing of V(D)J recombination and appearance of TCRmu transcripts relative to the conventional TCRalpha, beta, gamma, and delta mRNA during postnatal development in the opossum. There are two TCRmu transcript isoforms, TCRmu1.0 and TCRmu2.0. TCRmu1.0, which uses prejoined V(D)J segments, is detectable as early as day 1, when the thymus is primarily undifferentiated epithelium. The other isoform, TCRmu2.0, which requires V(D)J recombination and contains an unusual double V configuration, is not detectable until day 13 when the thymus is histologically mature. Surprisingly, we were able to detect TCRalpha, beta, and delta mRNA transcribed from loci that had completed V(D)J recombination as early as day 1 as well. At this early age there is apparent evidence for preference in the V segments used in the TCRalpha and beta genes. In the case of Valpha this preference appears to be associated with position in the TCRalpha/delta locus. In Vbeta, however, preference may be due to the use of microhomology in the V, D, and J segments. Mature TCRgamma transcripts were not detected until day 8, suggesting that, in contrast to eutherian mammals, in the opossum alphabeta T cell development precedes gammadelta T cell development. The results support that there may be differences in T cell subset development between marsupials and placental mammals.

Comparative genomic analysis and evolution of the T cell receptor loci in the opossum Monodelphis domestica.

BACKGROUND: All jawed-vertebrates have four T cell receptor (TCR) chains: alpha (TRA), beta (TRB), gamma (TRG) and delta (TRD). Marsupials appear unique by having an additional TCR: mu (TRM). The evolutionary origin of TRM and its relationship to other TCR remain obscure, and is confounded by previous results that support TRM being a hybrid between a TCR and immunoglobulin locus. The availability of the first marsupial genome sequence allows investigation of these evolutionary relationships. RESULTS: The organization of the conventional TCR loci, encoding the TRA, TRB, TRG and TRD chains, in the opossum Monodelphis domestica are highly conserved with and of similar complexity to that of eutherians (placental mammals). There is a high degree of conserved synteny in the genomic regions encoding the conventional TCR across mammals and birds. In contrast the chromosomal region containing TRM is not well conserved across mammals. None of the conventional TCR loci contain variable region gene segments with homology to those found in TRM; rather TRM variable genes are most similar to that of immunoglobulin heavy chain genes. CONCLUSION: Complete genomic analyses of the opossum TCR loci continue to support an origin of TRM as a hybrid between a TCR and immunoglobulin locus. None of the conventional TCR loci contain evidence that such a recombination event occurred, rather they demonstrate a high degree of stability across distantly related mammals. TRM, therefore, appears to be derived from receptor genes no longer extant in placental mammals. These analyses provide the first genomic scale structural detail of marsupial TCR genes, a lineage of mammals used as models of early development and human disease.