Adapting STEMM in Hawai'i: Necessary actions for one of the most diverse places in the United States.

Hawai'i's diverse population prime it to be an exemplary environment to study representation in science, technology, engineering, mathematics, and medicine (STEMM). In actuality, Hawai'i has low STEMM enrollment and therefore, low representation in STEMM. What primarily inhibits Hawai'i from having a strong STEMM workforce is the lack of education in STEMM, resources allocated to STEMM, and mentorship to succeed in STEMM. Other factors such as cultural values, high costs of living, and geographical barriers also contribute to Hawai'i's low STEMM enrollment. To combat these issues, I offer suggestions to encourage STEMM enrollment, such as directing funds toward after-school education. I also suggest combatting the lack of resources by providing more online opportunities for students and workers. As for Hawai'i's low mentorship, I suggest that more programs be created within communities and universities to create a platform for mentors and mentees to network. This manuscript seeks to highlight these areas of improvement and recognize lessons to be learned from Hawai'i, thus serving as a resource for individuals internationally.

Risk factors associated with 1-year mortality after osteoporotic hip fracture in Hawai'i: higher mortality risk among Native Hawaiians and other Pacific Islanders.

We studied factors affecting osteoporotic hip fracture mortality in Hawai'i, a region with unique geography and racial composition. Men, older adults, higher ASA score, lower BMI, and NHPI race were associated with higher mortality. This is the first study demonstrating increased mortality risk after hip fracture in NHPI patients. PURPOSE: To estimate mortality rates and identify specific risk factors associated with 1-year mortality after osteoporotic hip fracture in Hawai'i. METHODS: A retrospective review of adults (≥ 50 years) hospitalized with an osteoporotic hip fracture at a large multicenter healthcare system in Hawai'i from 2011 to 2019. The Kaplan-Meier curves and log-rank tests examined survival probability by sex, age group, race/ethnicity, primary insurance, body mass index (BMI), and American Society of Anesthesiologists (ASA) physical status classification. After accounting for potential confounders, adjusted hazard ratios (aHR) and 95% confidence intervals (CI) were obtained from Cox proportional hazards regression models. RESULTS: We identified 1755 cases of osteoporotic hip fracture. The cumulative mortality rate 1 year after fracture was 14.4%. Older age (aHR 3.50; 95% CI 2.13-5.76 for ≥ 90 vs 50-69), higher ASA score (aHR 5.21; 95% CI 3.09-8.77 for ASA 4-5 vs 1-2), and Native Hawaiian/Pacific Islander (NHPI) race (aHR 1.84; 95% CI 1.10-3.07 vs. White) were independently associated with higher mortality risk. Female sex (aHR 0.64; 95% CI 0.49-0.84 vs male sex) and higher BMI (aHR 0.35; 95% CI 0.18-0.68 for obese vs underweight) were associated with lower mortality risk. CONCLUSION: In our study, men, older adults, higher ASA score, lower BMI, and NHPI race were associated with significantly higher mortality risk after osteoporotic hip fracture. NHPIs are an especially vulnerable group and comprise a significant portion of Hawai'i's population. Further research is needed to address the causes of higher mortality and interventions to reduce hip fractures and associated mortality.

Amphistomy increases leaf photosynthesis more in coastal than montane plants of Hawaiian 'ilima (Sida fallax).

PREMISE: The adaptive significance of amphistomy (stomata on both upper and lower leaf surfaces) is unresolved. A widespread association between amphistomy and open, sunny habitats suggests the adaptive benefit of amphistomy may be greatest in these contexts, but this hypothesis has not been tested experimentally. Understanding amphistomy informs its potential as a target for crop improvement and paleoenvironment reconstruction. METHODS: We developed a method to quantify "amphistomy advantage" ( AA $\text{AA}$ ) as the log-ratio of photosynthesis in an amphistomatous leaf to that of the same leaf but with gas exchange blocked through the upper surface (pseudohypostomy). Humidity modulated stomatal conductance and thus enabled comparing photosynthesis at the same total stomatal conductance. We estimated AA $\text{AA}$ and leaf traits in six coastal (open, sunny) and six montane (closed, shaded) populations of the indigenous Hawaiian species 'ilima (Sida fallax). RESULTS: Coastal 'ilima leaves benefit 4.04 times more from amphistomy than montane leaves. Evidence was equivocal with respect to two hypotheses: (1) that coastal leaves benefit more because they are thicker and have lower CO2 conductance through the internal airspace and (2) that they benefit more because they have similar conductance on each surface, as opposed to most conductance being through the lower surface. CONCLUSIONS: This is the first direct experimental evidence that amphistomy increases photosynthesis, consistent with the hypothesis that parallel pathways through upper and lower mesophyll increase CO2 supply to chloroplasts. The prevalence of amphistomatous leaves in open, sunny habitats can partially be explained by the increased benefit of amphistomy in "sun" leaves, but the mechanistic basis remains uncertain.

30 years of youth system of care lessons learned - a qualitative study of Hawai'i's partnership with the Substance Abuse and Mental Health Services Administration.

BACKGROUND: The Hawai'i State Department of Health, Child and Adolescent Mental Health Division (CAMHD) has maintained a longstanding partnership with Substance Abuse and Mental Health Services Administration (SAMHSA) to enhance capacity and quality of community-based mental health services. The current study explored CAMHD's history of SAMHSA system of care (SOC) awards and identified common themes, lessons learned, and recommendations for future funding. METHODS: Employing a two-phase qualitative approach, the study first conducted content analysis on seven final project reports, identifying themes and lessons learned based on SOC values and principles. Subsequently, interviews were conducted with 11 system leaders in grant projects and SOC award projects within the state. All data from project reports and interview transcripts were independently coded and analyzed using rapid qualitative analysis techniques. RESULTS: Content validation and interview coding unveiled two content themes, interagency collaboration and youth and family voice, as areas that required long-term and consistent efforts across multiple projects. In addition, two general process themes, connection and continuity, emerged as essential approaches to system improvement work. The first emphasizes the importance of fostering connections in family, community, and culture, as well as within workforce members and child-serving agencies. The second highlights the importance of nurturing continuity throughout the system, from interagency collaboration to individual treatment. CONCLUSIONS: The study provides deeper understanding of system of care evaluations, offering guidance to enhance and innovate youth mental health systems. The findings suggest that aligning state policies with federal guidelines and implementing longer funding mechanisms may alleviate administrative burdens.

Improving the prediction of wildfire susceptibility on Hawai'i Island, Hawai'i, using explainable hybrid machine learning models.

This study presents a comparative analysis of four Machine Learning (ML) models used to map wildfire susceptibility on Hawai'i Island, Hawai'i. Extreme Gradient Boosting (XGBoost) combined with three meta-heuristic algorithms - Whale Optimization (WOA), Black Widow Optimization (BWO), and Butterfly Optimization (BOA) - were employed to map areas susceptible to wildfire. To generate a wildfire inventory, 1408 wildfire points were identified within the study area from 2004 to 2022. The four ML models (XGBoost, WOA-XGBoost, BWO-XGBoost, and BOA-XGBoost) were run using 14 wildfire-conditioning factors categorized into four main groups: topographical, meteorological, vegetation, and anthropogenic. Six performance metrics - sensitivity, specificity, positive predictive values, negative predictive values, the Area Under the receiver operating characteristic Curve (AUC), and the average precision (AP) of Precision-Recall Curves (PRCs) - were used to compare the predictive performance of the ML models. The SHapley Additive exPlanations (SHAP) framework was also used to interpret the importance values of the 14 influential variables for the modeling of wildfire on Hawai'i Island using the four models. The results of the wildfire modeling indicated that all four models performed well, with the BWO-XGBoost model exhibiting a slightly higher prediction performance (AUC = 0.9269), followed by WOA-XGBoost (AUC = 0.9253), BOA-XGBoost (AUC = 0.9232), and XGBoost (AUC = 0.9164). SHAP analysis revealed that the distance from a road, annual temperature, and elevation were the most influential factors. The wildfire susceptibility maps generated in this study can be used by local authorities for wildfire management and fire suppression activity.

Characterizing breast cancer incidence and trends among Asian American, Native Hawaiian, and non-Hispanic White women in Hawai'i, 1990-2014.

PURPOSE: To characterize breast cancer (BC) incidence by age at diagnosis and BC subtype among disaggregated Asian American, Native Hawaiian, and Pacific Islander (AANHPI) women and non-Hispanic White (NHW) women in Hawai'i. METHODS: Using 1990-2014 data from the Hawai'i tumor registry, we estimated age-adjusted incidence rates (AAIR) of BC and the annual percent change in BC incidence by age (<50 and ≥50 years) and BC subtype (hormone receptor [HR]+/human epidermal growth factor receptor 2 [HER2]-, HR+/HER2+, HR-/HER2+, triple negative BC) for Filipino American (FA), Japanese American (JA), Native Hawaiian (NH), and NHW women. RESULTS: Among young (<50 years) women, annual BC incidence increased 2.9% (1994-2014) among JA and 1.0% (1990-2014) among NHW women. Incidence was highest among young JA women (2010-2014 AAIR 52.0 per 100,000; 95% confidence interval [CI] 45.6, 58.9). HR+/HER2- BC, the major BC subtype, was similarly highest among young JA women (AAIR 39.5; 95% CI 33.9, 45.4). Among older (≥50 years) women, annual BC incidence increased 1.6% (1990-2014) among FA and 4.2% (2006-2014) for JA women. BC incidence was highest among older NH women (AAIR 137.6, 95% CI 128.2, 147.4), who also displayed highest incidence of two subtypes: HR+/HER2- (AAIR 106.9; 95% CI 98.6, 115.5) and HR+/HER2+ (AAIR 12.1; 95% CI 9.4, 15.1). CONCLUSION: We observed high and increasing BC incidence among JA women ages <50 years and high incidence among NH women ages ≥50 years. These results highlight racial and ethnic differences in BC incidence among disaggregated AANHPI populations in Hawai'i by age and BC subtype.

Plumbing the depths with environmental DNA (eDNA): Metabarcoding reveals biodiversity zonation at 45-60 m on mesophotic coral reefs.

Mesophotic coral ecosystems (MCEs) are tropical reefs found at depths of ~30-150 m, below the region most heavily impacted by heat stress and other disturbances. Hence, MCEs may serve as potential refugia for threatened shallow reefs, but they also harbour depth-endemic fauna distinct from shallow reefs. Previous studies have characterized biodiversity patterns along depth gradients, but focussed primarily on conspicuous taxa (fishes, corals, etc.). Environmental DNA (eDNA) metabarcoding offers a more holistic approach to assess biodiversity patterns across the tree of life. Here, we use three metabarcoding assays targeting fishes (16S rRNA), eukaryotes (18S rDNA) and metazoans (COI) to assess biodiversity change from the surface to ~90 m depth across 15-m intervals at three sites within the Hawaiian Archipelago. We observed significant community differences between most depth zones, with distinct zonation centred at 45-60 m for eukaryotes and metazoans, but not for fishes. This finding may be attributable to the higher mobility of reef fishes, although methodological limitations are likely a contributing factor. The possibility for MCEs to serve as refugia is not excluded for fishes, but invertebrate communities >45 m are distinct, indicating limited connectivity for the majority of reef fauna. This study provides a new approach for surveying biodiversity on MCEs, revealing patterns in a much broader context than the limited-taxon studies that comprise the bulk of our present knowledge.

Microbiomes associated with avian malaria survival differ between susceptible Hawaiian honeycreepers and sympatric malaria-resistant introduced birds.

Of the estimated 55 Hawaiian honeycreepers (subfamily Carduelinae) only 17 species remain, nine of which the International Union for Conservation of Nature considers endangered. Among the most pressing threats to honeycreeper survival is avian malaria, caused by the introduced blood parasite Plasmodium relictum, which is increasing in distribution in Hawai'i as a result of climate change. Preventing further honeycreeper decline will require innovative conservation strategies that confront malaria from multiple angles. Research on mammals has revealed strong connections between gut microbiome composition and malaria susceptibility, illuminating a potential novel approach to malaria control through the manipulation of gut microbiota. One honeycreeper species, Hawai'i 'amakihi (Chlorodrepanis virens), persists in areas of high malaria prevalence, indicating they have acquired some level of immunity. To investigate if avian host-specific microbes may be associated with malaria survival, we characterized cloacal microbiomes and malaria infection for 174 'amakihi and 172 malaria-resistant warbling white-eyes (Zosterops japonicus) from Hawai'i Island using 16S rRNA gene metabarcoding and quantitative polymerase chain reaction. Neither microbial alpha nor beta diversity covaried with infection, but 149 microbes showed positive associations with malaria survivors. Among these were Escherichia and Lactobacillus spp., which appear to mitigate malaria severity in mammalian hosts, revealing promising candidates for future probiotic research for augmenting malaria immunity in sensitive endangered species.

Variability in seed salinity tolerance in an island coastal community.

BACKGROUND AND AIMS: Islands, with their long coastlines and increased vulnerability to sea level rise, offer compelling opportunities to investigate the salinity tolerance of coastal plants. Seeds are generally more vulnerable than other plant stages to increased stressors. The aim of this study was to characterize salinity tolerance during germination across a diverse pool of 21 species from 14 plant families found in coastal communities throughout the Hawaiian Islands in order to increase our general understanding of coastal plant ecology for conservation and restoration. METHODS: Seeds of each species were exposed to unfiltered/untreated seawater (35 ppt total salinity) and two salinity treatments (10 and 20 ppt) in which the seawater was diluted with distilled water, and germination percent and timing were compared to seeds in a distilled water control. Non-germinated seeds were then tested for recovery germination. We quantified and compared germination percent, time and recovery among species and across salinity levels and tested for heterogeneity related to seed size, dormancy class, habit and threatened status. KEY RESULTS: Although salinity tolerance varied considerably among species, salinity exposure generally reduced and delayed germination. The greatest effects were detected at higher salinity levels. Recovery germination overall was higher for seeds that had been exposed to higher salinity. None of the factors we explored emerged as predictors of salinity tolerance except seed mass, which tended to enhance germination at higher salinity. CONCLUSIONS: Species responses to salinity exposure indicate high vulnerability of coastal systems to increased salinity stress, and variability among species could lead to shifts in community assembly and composition under sea level rise. These results can help guide coastal ecosystem conservation and restoration management decisions in the face of climate change.

Gene expression reveals immune response strategies of naïve Hawaiian honeycreepers experimentally infected with introduced avian malaria.

The unprecedented rise in the number of new and emerging infectious diseases in the last quarter century poses direct threats to human and wildlife health. The introduction to the Hawaiian archipelago of Plasmodium relictum and the mosquito vector that transmits the parasite has led to dramatic losses in endemic Hawaiian forest bird species. Understanding how mechanisms of disease immunity to avian malaria may evolve is critical as climate change facilitates increased disease transmission to high elevation habitats where malaria transmission has historically been low and the majority of the remaining extant Hawaiian forest bird species now reside. Here, we compare the transcriptomic profiles of highly susceptible Hawai'i 'amakihi (Chlorodrepanis virens) experimentally infected with P. relictum to those of uninfected control birds from a naïve high elevation population. We examined changes in gene expression profiles at different stages of infection to provide an in-depth characterization of the molecular pathways contributing to survival or mortality in these birds. We show that the timing and magnitude of the innate and adaptive immune response differed substantially between individuals that survived and those that succumbed to infection, and likely contributed to the observed variation in survival. These results lay the foundation for developing gene-based conservation strategies for Hawaiian honeycreepers by identifying candidate genes and cellular pathways involved in the pathogen response that correlate with a bird's ability to recover from malaria infection.

Maternal telehealth: innovations and Hawai'i perspectives.

Access to maternal-fetal medicine (MFM) subspecialty services is a critical part of a healthcare system that optimizes pregnancy outcomes for women with complex medical and obstetrical disorders. Healthcare services in the State of Hawai'i consist of a complicated patchwork of independently run community health clinics and hospital systems which are difficult for many pregnant patients to navigate. Maternal telehealth services have been identified as a solution to increase access to subspecialty prenatal services for women in rural communities or neighboring islands, especially during the COVID-19 pandemic. Telehealth innovations have been rapidly developing in the areas of remote ultrasound, hypertension management, diabetes management, and fetal monitoring. This report describes how telehealth innovations are being introduced by MFM specialists to optimize care for a unique population of high-risk patients in a remote area of the world such as Hawai'i, as well as review currently available telemedicine technologies and future innovations.

Understanding the origins of and influences on precipitation major ion chemistry on the Island of O'ahu, Hawai'i.

Precipitation is the primary groundwater source for the Island of O'ahu, Hawai'i, USA, and is an important source of terrestrial nutrients. Since Pacific Islands are particularly vulnerable to the impacts of climate change, they are important venues for studying the controls on and fluctuations in precipitation chemistry. Spatial variations in some of the dissolved rainfall ions can also be of value as natural geochemical tracers in examining surface and groundwater flow. This study collected and chemically analyzed bulk precipitation from 20 sites across the Island of O'ahu approximately quarterly between April 2018 and August 2021. The new precipitation chemistry data were integrated with previously published precipitation data to characterize major ion composition and examine the atmospheric processes controlling inorganic ion deposition. Linear regression and multivariate analysis were used to quantify the relationships among major ions and to assess the impacts of various environmental and meteorological factors on precipitation chemistry. Ordinary kriging and inverse distance weighted interpolations were conducted to help visualize spatial variations in major ion deposition. The results clearly indicate that ocean sea spray is the primary driver of precipitation inorganic chemistry, with marine sea salt aerosols accounting for more than 90% of the measured ion load. However, they also show that various weather patterns and nutrient sources impact inorganic deposition. Most notably, upper atmospheric transport of Asian continental dust during Hawaiian wet seasons, Ca2+ from local sedimentary deposits, and anthropogenic K+ from agricultural activity appear to be substantial non-marine deposition sources. This study synthesizes data from multiple sources into the most spatially and topographically diverse precipitation collector network on O'ahu to date. The findings from this effort help establish a baseline for assessing future fluctuations in inorganic ion deposition and lay important groundwork for examining connections between precipitation and groundwater chemistry within the study area.

Early detection of a tree pathogen using airborne remote sensing.

Native forests of Hawai'i Island are experiencing an ecological crisis in the form of Rapid 'Ohi'a Death (ROD), a recently characterized disease caused by two fungal pathogens in the genus Ceratocystis. Since approximately 2010, this disease has caused extensive mortality of Hawai'i's keystone endemic tree, known as 'ohi'a (Metrosideros polymorpha). Visible symptoms of ROD include rapid browning of canopy leaves, followed by death of the tree within weeks. This quick progression leading to tree mortality makes early detection critical to understanding where the disease will move at a timescale feasible for controlling the disease. We used repeat laser-guided imaging spectroscopy (LGIS) of forests on Hawai'i Island collected by the Global Airborne Observatory (GAO) in 2018 and 2019 to derive maps of foliar trait indices previously found to be important in distinguishing between ROD-infected and healthy 'ohi'a canopies. Data from these maps were used to develop a prognostic indicator of tree stress prior to the visible onset of browning. We identified canopies that were green in 2018, but became brown in 2019 (defined as "to become brown"; TBB), and a corresponding set of canopies that remained green. The data mapped in 2018 showed separability of foliar trait indices between TBB and green 'ohi'a, indicating early detection of canopy stress prior to the onset of ROD. Overall, a combination of linear and non-linear analyses revealed canopy water content (CWC), foliar tannins, leaf mass per area (LMA), phenols, cellulose, and non-structural carbohydrates (NSC) are primary drivers of the prognostic spectral capability which collectively result in strong consistent changes in leaf spectral reflectance in the near-infrared (700-1300 nm) and shortwave-infrared regions (1300-2500 nm). Results provide insight into the underlying foliar traits that are indicative of physiological responses of M. polymorpha trees infected with Ceratocycstis and suggest that imaging spectroscopy is an effective tool for identifying trees likely to succumb to ROD prior to the onset of visible symptoms.

The role of microtopography and resident species in post-disturbance recovery of arid habitats in Hawai'i.

Habitat-suitability indices (HSI) have been employed in restoration to identify optimal sites for planting native species. Often, HSI are based on abiotic variables and do not include biotic interactions, even though similar abiotic conditions can favor both native and nonnative species. Biotic interactions such as competition may be especially important in invader-dominated habitats because invasive species often have fast growth rates and can exploit resources quickly. In this study, we test the utility of an HSI of microtopography derived from airborne LiDAR to predict post-disturbance recovery and native planting success in native shrub-dominated and nonnative, invasive grass-dominated dryland habitats in Hawai'i. The HSI uses high-resolution digital terrain models to classify sites' microtopography as high, medium, or low suitability, based on wind exposure and topographic position. We used a split-plot before-after-control-impact design to implement a disturbance experiment within native shrub (Dodonaea viscosa) and nonnative, invasive grass (Cenchrus clandestinus)-dominated ecosystems across three microtopography categories. In contrast to previous studies using the same HSI, we found that microtopography was a poor predictor of pre-disturbance conditions for soil nutrients, organic matter content, or foliar C:N, within both Dodonaea and Cenchrus vegetation types. In invader-dominated Cenchrus plots, microtopography helped predict cover, but not as expected (i.e., highest cover would be in high-suitability plots): D. viscosa had the greatest cover in low-suitability and C. clandestinus had the greatest cover in medium-suitability plots. Similarly, in native-dominated Dodonaea plots, microtopography was a poor predictor of D. viscosa, C. clandestinus, and total plant cover. Although we found some evidence that microtopography helped inform post-disturbance plant recovery of D. viscosa and total plant cover, vegetation type was a more important predictor. Important for considering the success of plantings, percent cover of D. viscosa decreased while percent cover of C. clandestinus increased within both vegetation types 20 months after disturbance. Our results are evidence that HSIs based on topographic features may prove most useful for choosing planting sites in harsh habitats or those already dominated by native species. In more productive habitats, competition from resident species may offset any benefits gained from "better" suitability sites.

Can the impact of canopy trees on soil and understory be altered using litter additions?

Trees can have large effects on soil nutrients in ways that alter succession, particularly in the case of nitrogen-(N)-fixing trees. In Hawai'i, forest restoration relies heavily on use of a native N-fixing tree, Acacia koa (koa), but this species increases soil-available N and likely facilitates competitive dominance of exotic pasture grasses. In contrast, Metrosideros polymorpha ('ohi'a), the dominant native tree in Hawai'i, is less often planted because it is slow growing; yet it is typically associated with lower soil N and grass biomass, and greater native understory recruitment. We experimentally tested whether it is possible to reverse high soil N under koa by adding 'ohi'a litter, using additions of koa litter or no litter as controls, over 2.5 yr. We then quantified natural litterfall and decomposition rates of 'ohi'a and koa litter to place litter additions in perspective. Finally, we quantified whether litter additions altered grass biomass and if this had effects on native outplants. Adding 'ohi'a litter increased soil carbon, but increased rather than decreased inorganic soil N pools. Contrary to expectations, koa litter decomposed more slowly than 'ohi'a, although it released more N per unit of litter. We saw no reduction in grass biomass due to 'ohi'a litter addition, and no change in native outplanted understory survival or growth. We conclude that the high N soil conditions under koa are difficult to reverse. However, we also found that outplanted native woody species were able to decrease exotic grass biomass over time, regardless of the litter environment, making this a better strategy for lowering exotic species impacts.

Variation in floral volatiles across time, sexes, and populations of wind-pollinated Schiedea globosa.

PREMISE: Floral scent is a key aspect of plant reproduction, but its intraspecific variation at multiple scales is poorly understood. Sexual dimorphism and temporal regulation of scent can be shaped by evolution, and interpopulation variation may be a bridge to species differences. We tested whether intraspecific chemical diversity in a wind-pollinated species where selection from biotic pollination is absent is associated with genetic divergence across the Hawaiian archipelago. METHODS: Floral volatiles from females, males, and hermaphrodites of subdioecious Schiedea globosa grown in a common environment from 12 populations were sampled day and night and analyzed by gas chromatography-mass spectrometry. Variation among groups was analyzed by constrained ordination. We also examined the relationships of scent dissimilarity to geographic and genetic distance between populations. RESULTS: Flowers increased total emissions at night through higher emissions of several ketones, oximes, and phenylacetaldehyde. Females emitted less total scent per flower at night but more of some aliphatic compounds than males, and males emitted more ketones and aldoximes. Scent differed among populations during day and night. Divergence in scent produced at night increased with geographic distance within 70-100 km and increased with genetic distance for males during the day and night, but not for females. CONCLUSIONS: Schiedea globosa exhibits diel and sex-based variation in floral scent despite wind pollination and presumed loss of biotic pollination. In males, interpopulation scent differences are correlated with genetic differences, suggesting that scent evolved with dispersal within and across islands.

Nontuberculous mycobacterial skin and soft tissue infection in Hawai'i.

BACKGROUND: Hawai'i has the highest nontuberculous mycobacterial (NTM) lung infection prevalence in the United States. Limited data regarding skin and soft tissue infections (SSTI) due to NTM in Hawai'i exists. This study describes patient demographics, clinical courses of infection, treatment patterns, and clinical outcomes of NTM SSTIs in Hawai'i. METHODS: A retrospective chart review (n = 50) of patients diagnosed and treated at Hawai'i Pacific Health facilities for NTM SSTIs between January 2010 and July 2021 was conducted. Patient demographics, clinical course, and treatment data were collected from electronic medical records. RESULTS: Half of the patient population consisted of females, and the average age of patients during infection was 49 years (SD = 25.6). The majority of cases (80%) were caused by rapidly growing mycobacteria (RGM), most commonly Mycobacterium abscessus. NTM SSTI by race were Asian (48%), White (28%), and Native Hawaiian and Other Pacific Islanders (16%). Almost all Asian patients with NTM SSTI were Filipino or Japanese. Diagnosis was frequently delayed. The average time to diagnosis was 116 days. Most patients achieved complete resolution (72%) following a prolonged course of antimicrobial treatment (mean = 196 days) with surgical debridement. CONCLUSION: Increased awareness among physicians and the community of non-mycobacterial skin infections is essential in Hawai'i due to the high prevalence of NTM and the high percentage of predisposed populations. Increased awareness of NTM could reduce delayed diagnosis and improve patient care. Further studies are required to inform optimal treatment and diagnostic strategies, improve patient outcomes, and aid public health surveillance efforts.

Isolation of Metrosideros ('Ohi'a) Taxa on O'ahu Increases with Elevation and Extreme Environments.

Species radiations should be facilitated by short generation times and limited dispersal among discontinuous populations. Hawaii's hyper-diverse, landscape-dominant tree, Metrosideros, is unique among the islands' radiations for its massive populations that occur continuously over space and time within islands, its exceptional capacity for gene flow by both pollen and seed, and its extended life span (ca. >650 years). Metrosideros shows the greatest phenotypic and microsatellite DNA diversity on O'ahu, where taxa occur in tight sympatry or parapatry in mesic and montane wet forest on 2 volcanoes. We document the nonrandom distributions of 12 taxa (including unnamed morphotypes) along elevation gradients, measure phenotypes of ~6-year-old common-garden plants of 8 taxa to verify heritability of phenotypes, and examine genotypes of 476 wild adults at 9 microsatellite loci to compare the strengths of isolation across taxa, volcanoes, and distance. All 8 taxa retained their diagnostic phenotypes in the common garden. Populations were isolated by taxon to a range of degrees (pairwise FST between taxa: 0.004-0.267), and there was no pattern of isolation by distance or by elevation; however, significant isolation between volcanoes was observed within monotypic species, suggesting limited gene flow between volcanoes. Among the infraspecific taxa of Metrosideros polymorpha, genetic diversity and isolation significantly decreased and increased, respectively, with elevation. Overall, 5 of the 6 most isolated taxa were associated with highest elevations or otherwise extreme environments. These findings suggest a principal role for selection in the origin and maintenance of the exceptional diversity that occurs within continuous Metrosideros stands on O'ahu.

Pollen on Stigmas of Herbarium Specimens: A Window into the Impacts of a Century of Environmental Disturbance on Pollen Transfer.

Pollination is necessary for plant reproduction but often highly susceptible to disruption, for example, by habitat fragmentation and climate change. Here, we indirectly evaluated on a century timescale pollination interactions for species in one of the historically most disturbed habitats on earth-tropical dry forests of Hawai'i. We employed a novel method for acquiring a historical perspective on temporal change in pollination by characterizing pollen on stigmas of herbarium specimens from six remnant native species collected from 1909-2002. We determine whether temporal shifts occurred in (1) pollination quantity and quality or (2) the composition of species interacting via pollen transfer. While pollen quantity remained constant, these remnant species interact with different species in modern times via pollen transfer than they did nearly 100 years ago. Species that are resilient to long-term environmental change may also be the ones subject to changes in pollination interactions.

Environmental gradients influence differences in leaf functional traits between native and non-native plants.

Determining the characteristics of non-native plants that can successfully establish and spread is central to pressing questions in invasion ecology. Evidence suggests that some non-native species establish and spread in new environments because they possess characteristics (functional traits) that allow them to either successfully compete with native residents or fill previously unfilled niches. However, the relative importance of out-competing native species vs. filling empty niche space as potential mechanisms of invasion may depend on environmental characteristics. Here, we measured plant functional traits, proxies indicative of competitive and establishment strategies, to determine if these traits vary among native and invasive species and if their prevalence is dependent on environmental conditions. Using a natural environmental gradient in Hawai'i Volcanoes National Park, we evaluated how functional traits differ between native and non-native plant communities and if these differences change along an environmental gradient from hot, dry to cool, wet conditions. Functional trait differences suggested that both competition and open niche space may be important for invasion. Non-native communities tended to have traits associated with faster growth strategies such as higher specific leaf area and lower leaf thickness. However, native and non-native community traits became more dissimilar along the gradient, suggesting that non-native species may be occupying previously unfilled niche space at the hot, dry end of the gradient. We also found that most of the variation in functional trait values amongst plots was due to species turnover rather than intraspecific variation. These results highlight the role of environmental context when considering invasion mechanisms.