Clinical and Genomic Epidemiology of Coxsackievirus A21 and Enterovirus D68 in Homeless Shelters, King County, Washington, USA, 2019-2021.

Congregate homeless shelters are disproportionately affected by infectious disease outbreaks. We describe enterovirus epidemiology across 23 adult and family shelters in King County, Washington, USA, during October 2019-May 2021, by using repeated cross-sectional respiratory illness and environmental surveillance and viral genome sequencing. Among 3,281 participants >3 months of age, we identified coxsackievirus A21 (CVA21) in 39 adult residents (3.0% [95% CI 1.9%-4.8%] detection) across 7 shelters during October 2019-February 2020. We identified enterovirus D68 (EV-D68) in 5 adult residents in 2 shelters during October-November 2019. Of 812 environmental samples, 1 was EV-D68-positive and 5 were CVA21-positive. Other enteroviruses detected among residents, but not in environmental samples, included coxsackievirus A6/A4 in 3 children. No enteroviruses were detected during April 2020-May 2021. Phylogenetically clustered CVA21 and EV-D68 cases occurred in some shelters. Some shelters also hosted multiple CVA21 lineages.

Incidence of SARS-CoV-2 infection and associated risk factors among staff and residents at homeless shelters in King County, Washington: an active surveillance study.

Homeless shelter residents and staff may be at higher risk of SARS-CoV-2 infection. However, SARS-CoV-2 infection estimates in this population have been reliant on cross-sectional or outbreak investigation data. We conducted routine surveillance and outbreak testing in 23 homeless shelters in King County, Washington, to estimate the occurrence of laboratory-confirmed SARS-CoV-2 infection and risk factors during 1 January 2020-31 May 2021. Symptom surveys and nasal swabs were collected for SARS-CoV-2 testing by RT-PCR for residents aged ≥3 months and staff. We collected 12,915 specimens from 2,930 unique participants. We identified 4.74 (95% CI 4.00-5.58) SARS-CoV-2 infections per 100 individuals (residents: 4.96, 95% CI 4.12-5.91; staff: 3.86, 95% CI 2.43-5.79). Most infections were asymptomatic at the time of detection (74%) and detected during routine surveillance (73%). Outbreak testing yielded higher test positivity than routine surveillance (2.7% versus 0.9%). Among those infected, residents were less likely to report symptoms than staff. Participants who were vaccinated against seasonal influenza and were current smokers had lower odds of having an infection detected. Active surveillance that includes SARS-CoV-2 testing of all persons is essential in ascertaining the true burden of SARS-CoV-2 infections among residents and staff of congregate settings.

The Clinical and Genomic Epidemiology of Rhinovirus in Homeless Shelters-King County, Washington.

BACKGROUND: Rhinovirus (RV) is a common cause of respiratory illness in all people, including those experiencing homelessness. RV epidemiology in homeless shelters is unknown. METHODS: We analyzed data from a cross-sectional homeless shelter study in King County, Washington, October 2019-May 2021. Shelter residents or guardians aged ≥3 months reporting acute respiratory illness completed questionnaires and submitted nasal swabs. After 1 April 2020, enrollment expanded to residents and staff regardless of symptoms. Samples were tested by multiplex RT-PCR for respiratory viruses. A subset of RV-positive samples was sequenced. RESULTS: There were 1066 RV-positive samples with RV present every month of the study period. RV was the most common virus before and during the coronavirus disease 2019 (COVID-19) pandemic (43% and 77% of virus-positive samples, respectively). Participants from family shelters had the highest prevalence of RV. Among 131 sequenced samples, 33 RV serotypes were identified with each serotype detected for ≤4 months. CONCLUSIONS: RV infections persisted through community mitigation measures and were most prevalent in shelters housing families. Sequencing showed a diversity of circulating RV serotypes, each detected over short periods of time. Community-based surveillance in congregate settings is important to characterize respiratory viral infections during and after the COVID-19 pandemic. CLINICAL TRIALS REGISTRATION: NCT04141917.

Human Parainfluenza Virus in Homeless Shelters before and during the COVID-19 Pandemic, Washington, USA.

To determine the epidemiology of human parainfluenza virus in homeless shelters during the COVID-19 pandemic, we analyzed data and sequences from respiratory specimens collected in 23 shelters in Washington, USA, during 2019-2021. Two clusters in children were genetically similar by shelter of origin. Shelter-specific interventions are needed to reduce these infections.

Sharing health information online in South Korea: motives, topics, and antecedents.

This study aimed to examine the motives, topics and antecedents for sharing health information online among Korean Internet users. Eight hundred adults completed a web-based survey exploring the motives; topics; physical, cognitive, affective and environmental factors; and experiences relating to sharing health information online. The motives for not sharing information included information absence and inappropriateness. The most preferred topic was disease. Good subjective health was significantly associated with frequent information sharing while individuals with a history of disease involving themselves or family members were more likely to share health information than were those without such a history. Further, a higher level of depressed mood was related to a higher level of sharing. Internet-related self-efficacy and trust in information delivery channels were positively related to sharing. Future research could extend the factors related to information sharing to include the evaluation of shared information.

Comparative study of new autologous material, bone-cartilage composite graft, for ossiculoplasty with Polycel® and Titanium.

OBJECTIVE: Ossiculoplasty is a surgical procedure that recreates sound transmission of the middle ear in conductive hearing loss. Various materials have been used for ossicular reconstruction, but the most ideal material for ossiculoplasty remains controversial. The purpose of this study was to introduce a novel method of autologous ossiculoplasty, bone-cartilage composite graft (BCCG) and to compare its surgical results with different types of ossiculoplastic prostheses. STUDY DESIGN: A retrospective study was performed in a tertiary referral centre. METHODS: Data of 275 patients who received ossiculoplasty using the three different materials of BCCG, Polycel® and titanium were analysed according to type of ossiculoplasty: partial or total ossicular replacement prosthesis (PORP or TORP). Hearing results, complication rates and clinical parameters including age, sex, past history, preoperative diagnosis and surgery type were compared among different groups. RESULTS: Ossiculoplasty with BCCG showed satisfactory hearing outcomes and the lowest complication rate among the three different materials. In particular, its extrusion rate was 0%. CONCLUSION: We propose that the BCCG technique is a useful alternative method for ossiculoplasty, with proper patient selection.

Preoperative detection and predictors of level V lymph node metastasis in patients with papillary thyroid carcinoma.

BACKGROUND: Papillary thyroid carcinoma (PTC) frequently metastasizes to regional lymph nodes. Metastasis to the posterior neck, level V, is uncommon, and level V lymphadenectomy may lead to spinal accessory nerve injury and associated postoperative morbidities. The aim of this study was to assess the diagnostic efficiency of preoperative ultrasonography and to identify predictors of level V metastasis in patients with PTC. METHODS: This study involved patients with previously untreated PTC that had metastasized to the lateral neck, and who underwent total thyroidectomy with central and lateral neck dissection. Histopathological findings were compared with ultrasound results for various neck levels. Clinical and histopathological factors that predicted level V metastasis were identified. RESULTS: Of 143 patients, 26 (18·2 per cent) had lymph node metastasis at level V. The sensitivity and positive predictive value of ultrasonography for level V metastasis were 46·2 and 30·0 per cent respectively. Univariable analysis showed that male sex, extranodal disease extension, a metastatic lymph node ratio in the ipsilateral lateral neck of more than 0·2, and simultaneous involvement of ipsilateral levels II-IV or level III were associated with ipsilateral level V metastasis. Multivariable analysis revealed an independent association between macroscopic extranodal disease extension and level V metastasis (odds ratio 26·05, 95 per cent confidence interval 5·63 to 120·56; P < 0·001). CONCLUSION: Preoperative ultrasonography frequently failed to detect level V metastasis in patients with metastatic PTC. Level V lymphadenectomy may be considered in patients with lymph node metastasis in the ipsilateral lateral neck with macroscopic extranodal extension.

Interpreting experiments on egg production--statistical considerations.

A given data set can be analyzed many ways, but only one is the correct analysis based on the design actually used when running the experiment. This work gives a tutorial-like illustration of the effects of the presence of a regression variable (or covariate) on the recorded responses in an experiment set up as a standard factorial design and shows how the analysis results are to be adjusted for the presence of covariates. An underlying assumption of a factorial model is that each of the treatments (e.g., diets) is randomly allocated to different subjects (hens). When many measurements (e.g., over time) are made on the same subject (hen), this independence assumption is violated; in these cases, the design is an example from the class of repeated measures designs. The difference in analysis between factorial designs and repeated measures designs is also discussed. Then, the 2 concepts are merged wherein the results for a repeated measures analysis have to be adjusted for the presence of covariates. The paper concludes with analyses on the results of egg production responses from an experiment in which repeated measurements were made on the same hens and in which an unanticipated temperature covariate was present.

Effects of balanced dietary protein levels on egg production and egg quality parameters of individual commercial layers.

The effects of a series of balanced dietary protein levels on egg production and egg quality parameters of laying hens from 18 through 74 wk of age were investigated. One hundred forty-four pullets (Bovans) were randomly assigned to individual cages with separate feeders including 3 different protein level series of isocaloric diets. Diets were separated into 4 phases of 18-22, 23-32, 33-44, and 45-74 wk of age. The high protein (H) series contained 21.62, 19.05, 16.32, and 16.05% CP, respectively. Medium protein (M) and low protein (L) series were 2 and 4% lower in balanced dietary protein. The results clearly demonstrated that the balanced dietary protein level was a limiting factor for BW, ADFI, egg weight, hen day egg production (HDEP), and feed per kilogram of eggs. Feeding with the L series resulted in lower ADFI and HDEP (90.33% peak production) and more feed per kilogram of eggs compared with the H or M series (HDEP; 93.23 and 95.68% peak production, monthly basis). Egg weight responded in a linear manner to balanced dietary protein level (58.78, 55.94, and 52.73 g for H, M, and L, respectively). Feed intake of all hens, but especially those in the L series, increased considerably after wk 54 when the temperature of the house decreased due to winter conditions. Thus, hens fed the L series seemed particularly dependent on house temperature to maintain BW, ADFI, and HDEP. For egg quality parameters, percent yolk, Haugh units, and egg specific gravity were similar regardless of diets. Haugh units were found to be greatly affected by the variation of housing temperature (P = 0.025). Maximum performance cannot always be expected to lead to maximum profits. Contrary to the idea of a daily amino acid requirement for maximum performance, these results may be used to determine profit-maximizing levels of balanced dietary protein based on the cost of protein and returns from different possible protein levels that may be fed.

Effect of feeding low-oil distillers dried grains with solubles on the performance of broilers.

Manufacturers of distillers dried grains with solubles (DDGS) are changing practices to extract corn oil from DDGS in the process of ethanol production. The resulting product is called low-oil DDGS (LO-DDGS) and may be included in broiler diets. Two LO-DDGS and one unextracted DDGS were used in a broiler performance trial to determine maximum levels of inclusion without detrimental effects. Corn- and soybean meal-based mash diets were used with different DDGS samples included at 10 or 20%. Six hundred thirty Cobb 500 male by-product chicks were randomly assigned to 6 replicate pens containing 15 chicks each and fed diets from 0 to 18 d of age. There was a significant interaction between source and level on BW at d 11 and 18 when 10 and 20% of LO-DDGS was included compared with the control group. There was also a significant effect of source and level interaction on BW at d 18 (P < 0.05). Feed efficiency from d 0 to 18 was improved when 10% LO-DDGS was used compared with 20% inclusion. Abdominal fat pad weights were higher when LO-DDGS samples were included at 10 or 20% compared with the control group. There was a significant effect of DDGS source and level on fat pad weights (P < 0.05). Producers may achieve an increase in performance when including 10% LO-DDGS in broiler diets. Up to 20% inclusion levels may have no detrimental effects on performance parameters compared with a standard corn-soybean diet.

Amino acid digestibility and metabolizable energy of genetically selected soybean products.

To determine the ME and amino acid digestibility of 5 soybean meal (SBM) samples, a precision-fed rooster assay and a chick assay were conducted. The 5 samples were cold-pressed (extruded) soybean meals or solvent-extracted (defatted) soybean meal. Of the cold-pressed varieties (unheated), there was an ultra-low trypsin SBM, a low-trypsin SBM, and a heated and unheated commodity SBM. The solvent-extracted SBM was a heated commodity blend. The TME and AME values were compared between each category: cold-pressed and defatted, as well as between the 2 assays. Semipurified diets containing dextrose as the main energy source were formulated to meet the bird's nutrient requirements, with each diet containing a different SBM product. The TME rooster assay was a precision-fed rooster assay in which 5 birds per diet were fasted for 24 h, crop intubated with 35 g of the test diet containing 46.58% cold-pressed or defatted SBM, and excreta was then collected for 48 h. The total aromatic amino acids rooster assay followed the same protocol, but cecectomized birds were used. For the chick assay, 480 one-day-old chicks were fed a standard corn-SBM starter diet until 17 d of age, and on d 18, the chicks were allowed ad libitum access to the SB-dextrose diets. Excreta were collected on d 22, dried, ground, and analyzed for gross energy and CP to determine ME. The SBM samples that were genetically selected to have lower trypsin inhibitor levels and higher protein had higher ME values and increased amino acid digestibility than the commodity cold-pressed SBM samples. Genetic selection of soybeans for certain traits can have positive effects on the ME value and amino acid digestibility for roosters and chicks.

A spreadsheet to construct power curves and clarify the meaning of the word equivalent in evaluating experiments with poultry.

Persons conducting research trials often want to be able to declare that treatments, or particularly products, are equivalent (will provide indistinguishable results). However, all research trials can ever provide is the probability that the observed differences in an experiment were due to chance. Also, in trials in which variances are high and there are few replications, it is quite easy to declare no significant differences and equivalency. This paper describes a Microsoft Excel spreadsheet that can be used to easily construct experimental power curves. Such curves predict the proportion of experiments that would yield a given level of significance as the difference between the 2 means increases. The spreadsheet uses the mean and variances from an experiment with the Norm.inv and Rand functions of Excel to simulate outcomes from identical experiments. An experiment that declared GMO and normal feed ingredients to be equivalent was used to illustrate the application of power curves. The experiment had 12 replicate pens of broilers per treatment. The outcomes of 90,000 simulated experiments, each with the same overall variance, but 0 through 8 percent differences in treatment means, were graphed. When the published experiment purported to show equivalence, really it showed that a significant difference in growth (P < 0.05) would be expected to be detected 50% of the time if the means were different by 3.1%; a difference of 4.6% in treatment means could be detected 80% of the time by such an experiment. This Excel spreadsheet enables such a power analysis to be conducted. Easy modifications of the spreadsheet can illustrate the influence of changing the variance or number of replications on the expected power of future experiments. The economic impact of small changes in performance is also discussed.

The effects of broiler chicken growth rate on valgus, varus, and tibial dyschondroplasia.

An experiment was conducted to test the hypothesis that the growth rate of broilers influences their susceptibilities to bone abnormalities, causing major leg problems. Leg angulations, described in the twisted legs syndrome as valgus and bilateral or unilateral varus, were investigated in 2 subpopulations of mixed-sex Arkansas randombred broilers. Valgus angulation was classified as mild (tibia-metatarsus angle between 10 and 25°), intermediate (25-45°), or severe (> 45°). Body weight was measured at hatch and weekly until 6 wk of age. There were 8 different settings of approximately 450 eggs each. Two subpopulations, slow growing (bottom quarter, n = 581) and fast growing (top quarter, n = 585), were created from a randombred population based on their growth rate from hatch until 6 wk of age. At 6 wk of age, tibial dyschondroplasia incidences were determined by making a longitudinal cut across the right tibia. The tibial dyschondroplasia bone lesion is characterized by an abnormal white, opaque, unmineralized, and unvascularized mass of cartilage occurring in the proximal end of the tibia. It was scored from 1 (mild) to 3 (severe) depending on the cartilage plug abnormality size. Mean lesion scores of left and right valgus and tibial dyschondroplasia (0.40, 0.38, and 0.06) of fast-growing broilers were higher than those (0.26, 0.28, and 0.02) of slow-growing broilers (P = 0.0002, 0.0037, and 0.0269), respectively. Growth rate was negatively associated with the twisted legs syndrome and a bone abnormality (tibial dyschondroplasia) in this randombred population.

Evaluation of near-infrared reflectance spectroscopy (NIRS) techniques for total and phytate phosphorus of common poultry feed ingredients.

The purpose of this study was to determine the feasibility of estimating the total and phytate P content of common poultry feed ingredients by near-infrared reflectance spectroscopy (NIRS). Samples of 8 plant-origin feedstuffs were collected from poultry producers in the USA and Canada during the summer of 2009: corn (133), soybean meal (114), corn distillers dried grains with solubles (DDGS; 89), bakery by-product meal (95), wheat (22), wheat middlings (31), canola meal (21), and wheat shorts (15). The samples were assayed by standard wet chemical techniques for total and phytate P contents. There was considerable variation found in most of the ingredient components. The average values for the laboratory determinations versus NIRS predictions were all within 0.030 for total phosphorus and 0.012 for phytate P. For phytate P, the magnitude of the standard errors of the predictions ranged from 0.009% for soybean meal to 0.012% for canola meal. These values may be sufficiently precise for nutritionists to use the NIRS predictions to estimate how much of the P in their ingredients is not available to the birds. For total P, the magnitude of the standard errors of the predictions ranged from 0.027% for corn DDGS to 0.142% for wheat middlings. In general, total P predictions by NIRS were not generally sufficiently precise for most nutritionists to use in feed formulation. Decision making may be quite easy in using NIRS estimates for the phytate P content of bakery by-product meal [R(2) = 0.89 for predicted = f (determined)] but not for the total P content of soybean meal (R(2) = 0.03). It is concluded that precise estimates of phytate P through NIRS should allow nutritionists for more efficient formulate and mix feed, lowering feed costs and reducing the amount of residual polluting phosphorus in poultry excreta.

Strain and sex effects on growth performance and carcass traits of contemporary commercial broiler crosses.

In total, 3,840 sexed birds from 6 commercial cross broiler strains (4 male and 3 female) were raised and processed to analyze the effect of strain and sex on growth performance and carcass traits. Chicks from M1 × F1, M2 × F1, M3 × F1, M4 × F1, M3 × F2, and M4 × F3 crosses were sexed. Fifty female and 40 male chicks were randomly allocated to 24 floor pens (119 × 300 cm) covered with pine shavings in each of 4 rooms. The FCR was adjusted for the weight of dead birds (AFCR). Four birds/pen were processed at 7 wk of age. Carcasses were deboned after 2 h of chilling (n = 32 birds per treatment). There were significant strain by sex interactions for BW gain from 0 to 21 and 0 to 48 d. Strain differences in growth rate and mortality increased with age. The cross with the fastest growth rate also had the highest mortality. Because of differences in mortality and carcass yields, birds with the fastest growth (0-48 d) did not produce the most salable meat. Both the heaviest live BW per bird at 48 d (3.45 kg) and highest mortality (13.40%) were observed with the M4 × F3 cross. However, the heaviest live BW per 1,000 chicks placed was from the M3 × F2 cross (3,107 kg). The highest chilled carcass yield was from the M3 × F2 cross (76.05% of live BW) as was the highest meat yield (2,364 kg per 1,000 chicks placed) and highest pectoralis meat yield (805 kg per 1,000 chicks placed). The M3 × F2 cross produced the most total white meat (1,058 kg per 1,000 chicks placed), but interestingly the slowest-growing strain (M1 × F1) produced more white meat (breast + tenders + wings) than did the fastest-growing M4 × F3 strain (980 kg vs. 1,002 kg per 1,000 chicks placed). These results demonstrate the complexity of choosing between commercial strain crosses. The most profitable choice will be dependent on whether whole birds or parts are marketed and the relative values of the parts.

The effects of growth rate on leg morphology and tibia breaking strength, mineral density, mineral content, and bone ash in broilers.

Fast-growing broilers are especially susceptible to bone abnormalities, causing major problems for broiler producers. The cortical bones of fast-growing broilers are highly porous, which may lead to leg deformities. Leg problems were investigated in 6-wk-old Arkansas randombred broilers. Body weight was measured at hatch and at 6 wk. There were 8 different settings of approximately 450 eggs each. Two subpopulations, slow-growing (SG; bottom quarter, n=511) and fast-growing (FG; top quarter, n=545), were created from a randombred population based on their growth rate from hatch until 6 wk of age. At 6 wk of age, the broilers were processed and chilled at 4°C overnight before deboning. Shank (78.27±8.06 g), drum stick (190.92±16.91 g), and thigh weights (233.88±22.66 g) of FG broilers were higher than those of SG broilers (54.39±6.86, 135.39±15.45, and 168.50±21.13 g, respectivly; P<0.001). Tibia weights (15.36±2.28 g) of FG broilers were also greater than those of SG broilers (11.23±1.81 g; P<0.001). Shank length (81.50±4.71 g) and tibia length (104.34±4.45 mm) of FG broilers were longer than those of SG broilers (71.88±4.66 and 95.98±4.85 mm, respectively; P<0.001). Shank diameter (11.59±1.60 mm) and tibia diameter (8.20±0.62 mm) of FG broilers were wider than those of SG broilers (9.45±1.74, 6.82±0.58 mm, respectively; P<0.001). Tibia breaking strength (28.42±6.37 kg) of FG broilers was higher than those of SG broiler tibia (21.81±5.89 kg; P<0.001). Tibia density and bone mineral content (0.13±0.01 g/cm2 and 1.29±0.23 g, respectively) of FG broilers were higher than those of SG broiler tibia (0.11±0.01 g/cm2 and 0.79±0.1 g; P<0.001). Tibia percentage of ash content (39.76±2.81) of FG broilers was lower than that of SG broilers (39.99±2.67; P=0.173). Fast-growing broiler bones were longer, wider, heavier, stronger, more dense, and contained more ash than SG ones. After all parameters were calculated per unit of final BW at 6 wk, tibia density and bone ash percentage of FG broilers were lower than those of SG broilers.

Phytate and other nutrient components of feed ingredients for poultry.

Samples of feed ingredients were collected from poultry feed mills in the United States and Canada: corn (133), soybean meal (114), corn distillers dried grains with solubles (DDGS; 89), bakery by-product meal (95), wheat (22), wheat middlings (31), canola meal (21), and wheat shorts (15). The samples were assayed by standard wet chemical techniques for CP, fat, neutral detergent fiber (NDF), acid detergent fiber, calcium, phosphorus, phytate phosphorus, and ash. There was considerable variation found in most of the ingredient components. Forty-two of the 64 CV were above 10.0%. The calcium contents of the ingredients were the most variable, followed by the fat contents. The CP contents were the least variable. There were some fairly consistent relationships observed across samples; in general, acid detergent fiber and NDF were positively correlated, as were ash and mineral levels. Crude protein and fiber levels were positively related, except for wheat shorts, but the relationships were not strong. Phytate P was found to be positively related to ash and total P, as expected, except for corn DDGS. The fat content of corn was found to be negatively related to the NDF content. Significant (P < 0.004) linear regressions were found between phytate P and total P for corn, soybean meal, bakery by-product meal, wheat, wheat middlings, and wheat shorts. The average nonphytate P content of the ingredients was 49.8%, ranging from 38.8% for wheat middlings to 73.2% for DDGS. The phytate P content of wheat and wheat by-products could be predicted from their proximate compositions, with coefficients of determination in excess of 0.740. Predictions for the other ingredients were not as good.

Protein Profile in Corpus Luteum during Pregnancy in Korean Native Cows.

Steroidogenesis requires coordination of the anabolic and catabolic pathways of lipid metabolism, but the profile of proteins associated with progesterone synthesis in cyclic and pregnant corpus luteum (CL) is not well-known in cattle. In Experiment 1, plasma progesterone level was monitored in cyclic cows (n = 5) and pregnant cows (n = 6; until d-90). A significant decline in the plasma progesterone level occurred at d-19 of cyclic cows. Progesterone level in abbatoir-derived luteal tissues was also determined at d 1 to 5, 6 to 13 and 14 to 20 of cyclic cows, and d-60 and -90 of pregnant cows (n = 5 each). Progesterone level in d-60 CL was not different from those in d 6 to 13 CL and d-90 CL, although the difference between d 6 to 13 and d-90 was significant. In Experiment 2, protein expression pattern in CL at d-90 (n = 4) was compared with that in CL of cyclic cows at d 6 to 13 (n = 5). Significant changes in the level of protein expression were detected in 32 protein spots by two-dimensional polyacrylamide gel electrophoresis (2-DE), and 23 of them were identified by matrix-assisted laser desorption/ionization time-of-flight mass spectrometry (MALDI-TOF-MS). Six proteins were found only in pregnant CL, while the other 17 proteins were found only in cyclic CL. Among the above 6 proteins, vimentin which is involved in the regulation of post-implantation development was included. Thus, the protein expression pattern in CL was disorientated from cyclic luteal phase to mid pregnancy, and alterations in specific CL protein expression may contribute to the maintenance of pregnancy in Korean native cows.

Trends in COVID-19 vaccination intent and factors associated with deliberation and reluctance among adult homeless shelter residents and staff, 1 November 2020 to 28 February 2021 - King County, Washington.

INTRODUCTION: Little is known about COVID-19 vaccination intent among people experiencing homelessness. This study assesses surveyed COVID-19 vaccination intent among adult homeless shelter residents and staff and identifies factors associated with vaccine deliberation (responded "undecided") and reluctance (responded "no"), including time trends. METHODS: From 11/1/2020-2/28/21, we conducted repeated cross-sectional surveys at nine shelters in King County, WA as part of ongoing community-based SARS-CoV-2 surveillance. We used a multinomial model to identify characteristics associated with vaccine deliberation and reluctance. RESULTS: A total of 969 unique staff (n = 297) and residents (n = 672) participated and provided 3966 survey responses. Among residents, 53.7% (n = 361) were vaccine accepting, 28.1% reluctant, 17.6% deliberative, and 0.6% already vaccinated, whereas among staff 56.2% were vaccine accepting, 14.1% were reluctant, 16.5% were deliberative, and 13.1% already vaccinated at their last survey. We observed higher odds of vaccine deliberation or reluctance among Black/African American individuals, those who did not receive a seasonal influenza vaccine, and those with lower educational attainment. There was no significant trend towards vaccine acceptance. CONCLUSIONS: Strong disparities in vaccine intent based on race, education, and prior vaccine history were observed. Increased vaccine intent over the study period was not detected. An intersectional, person-centered approach to addressing health inequities by public health authorities planning vaccination campaigns in shelters is recommended. Clinical Trial Registry Number: NCT04141917.