Assessment of a Digital Health Coordination Program to Mitigate Telehealth Access Disparities.

Objective: Patients with digital disparity experience challenges with utilizing and accessing virtual care. This study implemented a digital coordination program for patients in outpatient psychiatry. Methods: Clinicians referred patients to a digital health coordinator who provided training to enhance virtual access. Outcomes were patient sociodemographics, barriers to digital health care utilization, change in completed video visits, and clinician satisfaction. Results: The patient cohort included 44 patients with a mean age of 59.8, 75% female, 73% Caucasian, and 84% non-Hispanic. The median household income was less than $25,000. The most common barrier to completing a video visit was difficulty using Zoom. The proportion of completed to scheduled video visits increased in 27% of patients. In such patients, the mean increase in completed visits was 32%. A majority of referring providers (64%) reported increased meaningfulness of work. Conclusion: This pilot proactively identified disparities in virtual care access and mitigated digital literacy barriers, boosting meaningfulness of work for clinicians.

The effects of three chemical algaecides on cell numbers and toxin content of the cyanobacteria Microcystis aeruginosa and Anabaenopsis sp.

Toxic cyanobacteria blooms are a growing concern for public health and safety, due in part to the production of the hepatotoxin microcystin by certain species, including Microcystis aeruginosa. Management strategies for controlling cyanobacteria blooms include algaecide treatments, often with copper sulfate, and more recently oxidizers such as sodium percarbonate that produce hydrogen peroxide. This study assessed the effects of two copper-containing algaecides and one sodium percarbonate-containing algaecide on mitigating cell numbers and toxin content of cultured M. aeruginosa and summer (July) bloom samples of Anabaenopsis sp. in a brackish stormwater detention pond. Monitoring of the bloom revealed that Anabaenopsis sp. was associated with elevated levels of orthophosphate compared to nitrogen (dissolved inorganic nitrogen to phosphorus ratios were 0.19-1.80), and the bloom decline (September-October) was likely due to lower autumn water temperatures combined with potential grazing by the dinoflagellate Protoperidinium quinquecorne. Laboratory-based algaecide experiments included three dose levels, and cyanobacteria cell numbers and microcystin concentrations (particulate and dissolved) were evaluated over 7 d. Following exposure, copper-containing treatments generally had lower cell numbers than either sodium percarbonate-containing or control (no algaecide) treatments. Addition of algaecides did not reduce overall microcystin levels, and a release of toxin from the particulate to dissolved phase was observed in most treatments. These findings indicate that algaecide applications may visibly control cyanobacteria bloom densities, but not necessarily toxin concentrations, and have implications for public health and safety.

Effects of ocean acidification on the shells of four Mediterranean gastropod species near a CO2 seep.

Marine CO2 seeps allow the study of the long-term effects of elevated pCO2 (ocean acidification) on marine invertebrate biomineralization. We investigated the effects of ocean acidification on shell composition and structure in four ecologically important species of Mediterranean gastropods (two limpets, a top-shell snail, and a whelk). Individuals were sampled from three sites near a volcanic CO2 seep off Vulcano Island, Italy. The three sites represented ambient (8.15pH), moderate (8.03pH) and low (7.73pH) seawater mean pH. Shell mineralogy, microstructure, and mechanical strength were examined in all four species. We found that the calcite/aragonite ratio could vary and increased significantly with reduced pH in shells of one of the two limpet species. Moreover, each of the four gastropods displayed reductions in either inner shell toughness or elasticity at the Low pH site. These results suggest that near-future ocean acidification could alter shell biomineralization and structure in these common gastropods.