Protocol for the Evaluation of Data-Related Processes and Challenges at Level 1-4 Trauma Centers in Arkansas: A Mixed-Methods Case Study.

Background: In the following manuscript, we describe the detailed protocol for a mixed-methods, observational case study conducted to identify and evaluate existing data-related processes and challenges currently faced by trauma centers in a rural state. The data will be utilized to assess the impact of these challenges on registry data collection. Methods: The study relies on a series of interviews and observations to collect data from trauma registry staff at level 1-4 trauma centers across the state of Arkansas. A think-aloud protocol will be used to facilitate observations to gather keystroke-level modeling data and insight into site processes and workflows for collecting and submitting data to the Arkansas Trauma Registry. Informal, semi-structured interviews will follow the observation period to assess the participant's perspective on current processes, potential barriers to data collection or submission to the registry, and recommendations for improvement. Each session will be recorded, and de-identified transcripts and session notes will be used for analysis. Keystroke level modeling data derived from observations will be extracted and analyzed quantitatively to determine time spent performing end-to-end registry-related activities. Qualitative data from interviews will be reviewed and coded by 2 independent reviewers following a thematic analysis methodology. Each set of codes will then be adjudicated by the reviewers using a consensus-driven approach to extrapolate the final set of themes. Discussion: We will utilize a mixed methods approach to understand existing processes and barriers to data collection for the Arkansas Trauma Registry. Anticipated results will provide a baseline measure of the data collection and submission processes at various trauma centers across the state. We aim to assess strengths and limitations of existing processes and identify existing barriers to interoperability. These results will provide first-hand knowledge on existing practices for the trauma registry use case and will provide quantifiable data that can be utilized in future research to measure outcomes of future process improvement efforts. The potential implications of this study can form the basis for identifying potential solutions for streamlining data collection, exchange, and utilization of trauma registry data for clinical practice, public health, and clinical and translational research.

Sampling coverage of the Arkansas all-payer claims database by County's persistent poverty designation.

OBJECTIVES: To evaluate the quality of Arkansas All-Payer Claims Database (APCD) for disparity research in persistent poverty areas by determining (1) its representativeness of Arkansas population, (2) variation by county, and (3) differences in coverage between persistent poverty and other counties. DATA SOURCES: Cross-sectional study using 2019 Arkansas APCD member enrollment data and county-level data from various agencies. DATA COLLECTION/EXTRACTION METHODS: An alias identifier linked persons across insurance plans. County FIPS codes were used to extract county-level variables. STUDY DESIGN: Cohort 1 included individuals with ≥1 day of medical coverage in 2019. Cohort 2 included individuals with medical coverage in June, 2019. Cohort 3 included individuals with continuous medical coverage in 2019. Sampling proportions of a county's population in the three cohorts were compared between persistent poverty and other counties. Inverse-variance weighted linear regression was used to identify county-level socioeconomic and demographic characteristics associated with inclusion in each cohort. PRINCIPAL FINDINGS: In 2019, 73.6% of Arkansans had medical coverage for ≥1 day (Cohort 1), 66.3% had coverage in June (Cohort 2), and 58.8% had continuous coverage (Cohort 3) in APCD. Sampling proportions varied by county (median[range]: Cohort 1, 78% [58%-95%]; Cohort 2, 71% [51%-88%]; and Cohort 3, 64% [44%-80%]), and were higher among persistent poverty counties than others for all three cohorts (mean [SD], persistent poverty vs. other: Cohort 1: 80.9% [6.4%] vs. 77.1% [6.3%], p = 0.04; Cohort 2: 74.0% [6.4%] vs. 70.1% [6.2%], p = 0.03; Cohort 3: 66.4% [6.1%] vs. 62.7% [6.0%], p = 0.03). In the 2019 APCD, larger counties and those with higher proportions of females or persons 65+ years had higher coverage, whereas counties with higher per capita household income, median home value, or disproportionately more persons of other races (non-White and non-Black) had lower coverage (p < 0.05 for all three cohorts). CONCLUSIONS: The Arkansas APCD had good coverage of Arkansas population. Coverage was higher in persistent poverty counties than others.

Opportunity for Reduction of Intensive Care Unit Resource Utilization in Pediatric Blunt Liver and Spleen Injuries: A National Trauma Data Bank Analysis.

INTRODUCTION: Guidelines for blunt liver and spleen injury (BLSI) by the Arizona-Texas-Oklahoma-Memphis-Arkansas Consortium (ATOMAC) emphasize hemodynamic stability over injury grade when considering non-operative management (NOM). In this study, we examined rates of intensive care unit (ICU) admission for children with isolated low-risk BLSI among US hospitals. METHODS: The National Trauma Data Bank (NTDB) was queried for patients ages 1-15 admitted between 2017 and 2019 with BLSI. Patients with penetrating injuries and/or concomitant non-abdominal injuries with AIS score ≥3 were excluded. Isolated BLSI was considered low-risk if the patient had normal admission vitals and did not require operative intervention. Primary outcomes measured were ICU admission, ICU length of stay (LOS), and overall LOS. RESULTS: 5777 patients ages 15 and under presented with isolated BLSI during the study period. 2031/5777 (35.2%) were considered low-risk. Low-risk patients had lower rates of ICU admission compared to high-risk patients (30.9% vs. 41.6%, p < 0.001) and had shorter ICU LOS (median 2 days vs. 2, p < 0.001) and shorter overall LOS (median 41 h vs. 54, p < 0.001). Pediatric verified and non-pediatric verified trauma centers had similar rates of ICU admission (36.8% vs. 38.9%, p = 0.11). CONCLUSION: Further work is needed to capture opportunities for reduction in ICU utilization in isolated BLSI. LEVEL OF EVIDENCE: III.

THE COCCIDIA SPECIES PFEIFFERINELLA ELLIPSOIDES EXHIBITS SPATIAL AND SPECIES-SPECIFIC VARIATION IN PREVALENCE AMONG FRESHWATER SNAILS.

Freshwater snails are commonly studied within the context of their role as intermediate hosts for digenetic trematodes. However, there are fundamental data deficiencies related to our understanding of directly transmitted parasites, such as coccidia, for freshwater snails. Because variation in coccidia pathogenicity and transmission among snail species likely has major impacts on snail community structure, we aimed to investigate the spatial distribution and prevalence of coccidia in several freshwater snail species throughout the Ozark and Ouachita Mountains ecoregions in Arkansas. We opportunistically collected 220 freshwater snails from 24 Ozark sites in summer 2022 and scanned fecal slides for the presence of coccidia. In summer 2023, we surveyed an additional 146 snails from 19 Ouachita sites. To test for apparent interactions among coccidia and trematodes, we scanned feces from a subset of snails (Physa and Planorbella in the Ozarks) that did not have concurrent trematode infections and from those that did. We observed oocysts that morphologically conformed to Pfeifferinella ellipsoides in 2 of the 9 snail taxa from 7 of the 43 sites. Planorbella trivolvis was infected at 2 of 6 sites in the Ozarks and 0 of 5 sites in the Ouachitas. Physa species were infected at 6 of 14 sites in the Ozarks and 0 of 12 sites in the Ouachitas. In the Ozarks, Pl. trivolvis had an overall prevalence of 0.13 (6 of 47), whereas individuals in the genus Physa had an overall prevalence of 0.08 (8 of 97). Our chi-square and Fisher exact tests revealed no significant evidence for trematode-coccidia competition or synergism within the two snail species. There were no other species infected, and we did not observe any coccidia in the snails from the Ouachitas. Our survey of 366 snails among 9 taxa and 43 sites represents the largest survey for freshwater snail coccidia to date and indicates that both Pl. trivolvis and Physa spp. may be primary hosts and/or reservoir hosts for Pf. ellipsoides in freshwater snail communities. The highly aggregated distribution of Pf. ellipsoides in northwestern Arkansas requires further investigation. Our results led to proposal of several hypotheses for additional research, including questions regarding the variation of coccidia host specificity and virulence.

Field-Collected Ticks From Benton County, Arkansas, and Prevalence of Associated Pathogens.

The recovery of a Haemaphysalis longicornis Neumann (Acari: Ixodidae) tick from a dog in Benton County, Arkansas, in 2018 triggered a significant environmental sampling effort in Hobbs State Park Conservation Area. The objective of the investigation was to assess the tick population density and diversity, as well as identify potential tick-borne pathogens that could pose a risk to public health. During a week-long sampling period in August of 2018, a total of 6,154 ticks were collected, with the majority identified as Amblyomma americanum (L), (Acari: Ixodidae) commonly known as the lone star tick. No H. longicornis ticks were found despite the initial detection of this species in the area. This discrepancy highlights the importance of continued monitoring efforts to understand the dynamics of tick populations and their movements. The investigation also focused on pathogen detection, with ticks being pooled by species, age, and sex before being processed with various bioassays. The results revealed the presence of several tick-borne pathogens, including agents associated with ehrlichiosis (n = 12), tularemia (n = 2), and Bourbon virus (BRBV) disease (n = 1), as well as nonpathogenic rickettsial and anaplasmosis organisms. These findings emphasize the importance of public health messaging to raise awareness of the risks associated with exposure to tick-borne pathogens. Prevention measures, such as wearing protective clothing, using insect repellent, and conducting regular tick checks, should be emphasized to reduce the risk of tick-borne diseases. Continued surveillance efforts and research are also essential to improve our understanding of tick-borne disease epidemiology and develop effective control strategies.

CHARACTERIZATION OF EIMERIA LANCASTERENSIS AND EIMERIA ONTARIOENSIS (APICOMPLEXA: EIMERIIDAE) FOUND IN EASTERN GRAY SQUIRRELS, SCIURUS CAROLINENSIS (RODENTIA: SCIURIDAE), FROM ARKANSAS AND OKLAHOMA.

We report the morphological characteristics of oocysts of Eimeria lancasterensisJoseph, 1969, collected from 6 of 6 (100%) eastern gray squirrels, Sciurus carolinensis, collected in Arkansas (n = 3) and Oklahoma (n = 3), and Eimeria ontarioensisLee and Dorney, 1971, recovered from an individual of S. carolinensis from Arkansas. Oocysts of E. lancasterensis were ovoidal to ellipsoidal, measuring (L × W) 24.0 × 14.6 (18-29 × 12-16) µm; shape index (L/W) was 1.6 (1.3-1.8). A micropyle and an oocyst residuum were absent, but up to 2 polar granules were present. Oocysts of E. ontarioensis were piriform and measured 40.6 × 26.0 (37-44 × 23-28); L/W was 1.6 (1.5-1.7). These oocysts possessed a distinct micropyle and rarely a polar granule but lacked an oocyst residuum. The DNA was isolated from both eimerians, and the 18S rDNA genetic markers were PCR-amplified, cloned, sequenced, and analyzed. To our knowledge, this study represents the first time 18S DNA sequence data have been generated from E. lancasterensis and E. ontarioensis found in North American sciurid hosts, as well as new geographic distribution records for these coccidians. In addition, we also include a tabular summary of these 2 species of Eimeria from Sciurus spp. worldwide, with information on their hosts, distribution, and taxonomically important morphological characteristics, including key measurements of oocysts and sporocysts.

COVID-19 vaccine hesitancy among Marshallese in Northwest Arkansas (USA).

Background: COVID-19 has disproportionately affected Pacific Islander communities, with disparities in the prevalence of infection, serious illness, and death compared to non-Hispanic whites in the US. Marshallese Pacific Islanders face significant COVID-19 disparities. Design and methods: This exploratory study aimed to understand Marshallese community attitudes about the COVID-19 vaccine to identify and implement culturally relevant strategies to encourage vaccine uptake. Data were collected from 17 participants in three focus groups. Results: Using content analysis, researchers identified two global themes: (1) barriers to vaccination and (2) facilitators of COVID-19 vaccine uptake. Within these themes, participants described fear, lack of knowledge about vaccines, negative perceptions of the COVID-19 vaccine, health concerns, and transportation as barriers to vaccination. Participants described several factors influencing vaccine behavior, including location of and personnel at vaccine clinics, vaccine experiences, the need for trusted information, positive perceptions, cultural leaders, and mandates. Conclusions: The qualitative study makes a significant contribution as the first to report community perceptions and experiences related to the COVID-19 vaccine in Marshallese participants' own words. Findings show that cultural influencers and brokers are crucial bridges for public health messaging related to COVID-19 vaccination targeted to this vulnerable and underserved population. Culturally appropriate and effective public health messaging can help achieve vaccine equity and improve COVID-19-related health disparities in the Marshallese community.

Racial and Ethnic Disparities in Tuberculosis Incidence, Arkansas, USA, 2010-2021.

We conducted an epidemiologic assessment of disease distribution by race/ethnicity to identify subpopulation-specific drivers of tuberculosis (TB). We used detailed racial/ethnic categorizations for the 932 TB cases diagnosed in Arkansas, USA, during 2010-2021. After adjusting for age and sex, racial/ethnic disparities persisted; the Native Hawaiian/Pacific Islander (NHPI) group had the highest risk for TB (risk ratio 173.6, 95% CI 140.6-214.2) compared with the non-Hispanic White group, followed by Asian, Hispanic, and non-Hispanic Black. Notable racial/ethnic disparities existed across all age groups; NHPI persons 0-14 years of age were at a particularly increased risk for TB (risk ratio 888, 95% CI 403-1,962). The risks for sputum smear-positive pulmonary TB and extrapulmonary TB were both significantly higher for racial/ethnic minority groups. Our findings suggest that TB control in Arkansas can benefit from a targeted focus on subpopulations at increased risk for TB.

Protocol for the Evaluation of Data-Related Processes and Challenges at Level 1-4 Trauma Centers in Arkansas: A Mixed-Methods Case Study.

Background: In the following manuscript, we describe the detailed protocol for a mixed-methods, observational case study conducted to identify and evaluate existing data-related processes and challenges currently faced by trauma centers in a rural state. The data will be utilized to assess the impact of these challenges on registry data collection. Methods: The study relies on a series of interviews and observations to collect data from trauma registry staff at level 1-4 trauma centers across the state of Arkansas. A think-aloud protocol will be used to facilitate observations as a means to gather keystroke-level modeling data and insight into site processes and workflows for collecting and submitting data to the Arkansas Trauma Registry. Informal, semi-structured interviews will follow the observation period to assess the participant's perspective on current processes, potential barriers to data collection or submission to the registry, and recommendations for improvement. Each session will be recorded and de-identified transcripts and session notes will be used for analysis. Keystroke level modeling data derived from observations will be extracted and analyzed quantitatively to determine time spent performing end-to-end registry-related activities. Qualitative data from interviews will be reviewed and coded by 2 independent reviewers following a thematic analysis methodology. Each set of codes will then be adjudicated by the reviewers using a consensus-driven approach to extrapolate the final set of themes. Discussion: We will utilize a mixed methods approach to understand existing processes and barriers to data collection for the Arkansas Trauma Registry. Anticipated results will provide a baseline measure of the data collection and submission processes at various trauma centers across the state. We aim to assess strengths and limitations of existing processes and identify existing barriers to interoperability. These results will provide first-hand knowledge on existing practices for the trauma registry use case and will provide quantifiable data that can be utilized in future research to measure outcomes of future process improvement efforts. The potential implications of this study can form the basis for identifying potential solutions for streamlining data collection, exchange, and utilization of trauma registry data for clinical practice, public health, and clinical and translational research.

Novel Ozark Orthohantavirus in Hispid Cotton Rats (Sigmodon hispidus), Arkansas, USA.

We report a novel orthohantavirus, putatively named Ozark orthohantavirus, in hispid cotton rats captured within the Ozark Plateau in Arkansas, USA. This virus phylogenetically clusters with other orthohantaviruses that cause severe human disease. Continued orthohantavirus surveillance and virus sequencing are needed to address the potential public health threat of this virus.

FIRST RECORD OF A PARASITE, DACTYLOGYRUS CF. SKRJABINI (MONOGENOIDEA: DACTYLOGYRIDAE), INFECTING INVASIVE SILVER CARP, HYPOPHTHALMICHTHYS MOLITRIX (VALENCIENNES, 1844) (CYPRINIFORMES: XENOCYPRIDIDAE) IN NORTH AMERICA.

The parasites infecting invasive carps in North America (all Cypriniformes: Xenocyprididae: grass carp, Ctenopharyngodon idella [Valenciennes, 1844]; silver carp, Hypophthalmichthys molitrix [Valenciennes, 1844]; bighead carp, Hypophthalmichthys nobilis [Richardson, 1845]; and black carp, Mylopharyngodon piceus [Richardson, 1846]) are little studied, and no parasite has been reported from silver carp there. We herein surveyed silver carp from Barkley Reservoir and Cheatham Reservoir (Cumberland River, Tennessee; June and December 2021) and the White River (Arkansas; May 2022) and collected numerous monogenoid specimens infecting the pores on the outer face of the gill raker plate. We heat-killed, formalin-fixed, and routinely stained some specimens for morphology and preserved others in 95% ethanol for DNA extraction and sequencing of the large subunit ribosomal DNA (28S). We identified our specimens as Dactylogyrus cf. skrjabini because they had a dorsal anchor deep root that is much longer than the superficial root, an approximately parallel penis and accessory piece, and a relatively large marginal hook pair V. No type specimen of Dactylogyrus skrjabiniAkhmerov, 1954 (type host and locality is silver carp, Amur River, Russia) is publicly available, but we borrowed several vouchers (NSMT-Pl 6393) that infected the gill rakers of silver carp captured in the Watarase River, Japan. The original description of D. skrjabini was highly stylized and diagrammatical, differing from the specimens we studied from North America and Japan by the dorsal anchor having a superficial root and shaft that comprise a strongly C-shaped hook (the superficial root curves toward the dorsal anchor point) (vs. superficial root straight, at ∼45° angle to deep root and directed away from the dorsal anchor point), a single, much reduced transverse bar that is narrow for its entire breadth (vs. dorsal and ventral transverse bars robust and broad, having an irregular outline), an accessory piece that lacks digitiform projections (vs. accessory piece with 4 digitiform projections), and an accessory piece that lacks a half cardioid-shaped process (vs. accessory piece having a half cardioid-shaped process). Our 28S sequences (generated from 4 specimens of D. cf. skrjabini: 2 from Tennessee [763 base pairs (bp)] and 2 from Arkansas [776 bp]) were identical to 1 ascribed to D. skrjabini from Japan. The present study is the first verifiable and credible report of a parasite from silver carp in North America and the first nucleotide information for a parasite from silver carp in North America.

A multi-method approach for assessing the distribution of a rare, burrowing North American crayfish species.

Primary burrowing crayfishes face high extinction risk, but are challenging to study, manage, and conserve due to their difficult-to-sample habitat (i.e., terrestrial burrows) and low population densities. We apply here a variety of methods to characterize the distribution, habitat associations, and conservation status of the Boston Mountains Crayfish Cambarus causeyi (Reimer, 1966), an endemic burrowing crayfish found only in the Ozark Mountains of Arkansas, United States. We used species distribution modeling (SDM) on historic occurrence records to characterize the distribution and macro-scale habitat associations of this species. We then ground-truthed SDM predictions with conventional sampling, modeled fine-scale habitat associations with generalized linear models (GLM), and lastly developed and tested an environmental DNA (eDNA) assay for this species in comparison to conventional sampling. This represents, to our knowledge, the first successful eDNA assay for a terrestrial burrowing crayfish. Our MaxEnt-derived SDM found a strong effect of average annual precipitation on the historic distribution of C. causeyi, which occurred most frequently at locations with moderately high average annual precipitation (140-150 cm/yr) within our study region. Cambarus causeyi was difficult to detect by conventional sampling in 2019 and 2020, found at only 9 of 51 sites (17.6%) sampled by searching for and manually excavating crayfish burrows. Surprisingly, habitat suitability predicted from our MaxEnt models was not associated with contemporary C. causeyi occurrences per GLMs. Instead, C. causeyi presence was negatively associated with both sandy soils and the presence of other burrowing crayfish species. Poor SDM performance in this instance was likely caused by the omission of high resolution fine-scale habitat data (e.g., soils) and biotic interactions from MaxEnt models. Finally, our eDNA assay detected C. causeyi from six of 25 sites (24.0%) sampled in 2020, out-performing conventional surveys by burrow excavation for this species. Given the difficulty of studying primary burrowing crayfishes and their high conservation need, we propose that eDNA may become an increasingly important monitoring tool for C. causeyi and similar species.

A NEW EIMERIAN (APICOMPLEXA: EIMERIIDAE) FROM EASTERN MOLE, SCALOPUS AQUATICUS (MAMMALIA: EULIPOTYPHLA: TALPIDAE), IN CENTRAL ARKANSAS, WITH ADDITIONAL INFORMATION ON CYCLOSPORA YATESI MCALLISTER, MOTRIUK-SMITH, AND KERR.

The eastern mole, Scalopus aquaticus (L.), is a common inhabitant of loamy soils in Canada, the eastern United States, and Mexico. Seven coccidian parasites have been previously reported from S. aquaticus, including 3 cyclosporans and 4 eimerians from hosts taken in Arkansas and Texas. A single S. aquaticus, collected in February 2022 in central Arkansas, was found to be passing oocysts of 2 coccidians, a new species of Eimeria, and Cyclospora yatesiMcAllister, Motriuk-Smith, and Kerr, 2018. Oocysts of Eimeria brotheri n. sp. are ellipsoidal (sometimes ovoidal) with a smooth bilayered wall, measure 14.0 × 9.9 µm, and have a length/width (L/W) ratio of 1.5; both micropyle and oocyst residua are absent, but a single polar granule is present. Sporocysts are ellipsoidal and measure 8.1 × 4.6 µm, L/W 1.8; a flattened to knoblike Stieda body as well as a rounded sub-Stieda body are present. The sporocyst residuum is composed of an irregular mass of large granules. Additional metrical and morphological information is provided on oocysts of C. yatesi. This study demonstrates that although several coccidians were previously documented from this host, additional S. aquaticus should be examined for coccidians from Arkansas as well as other parts of its range.

Burkholderia thailandensis Isolated from the Environment, United States.

Burkholderia thailandensis, an opportunistic pathogen found in the environment, is a bacterium closely related to B. pseudomallei, the cause of melioidosis. Human B. thailandensis infections are uncommon. We isolated B. thailandensis from water in Texas and Puerto Rico and soil in Mississippi in the United States, demonstrating a potential public health risk.

A New Isospora (Apicomplexa: Eimeriidae) from the Dark-Eyed Junco, Junco hyemalis (L.) (Passeriformes: Passerellidae), in West-Central Arkansas, USA.

PURPOSE: Many passeriform birds are excellent hosts of coccidian parasites but little is known of the coccidians infecting members of the family Passerellidae, particularly from the dark-eyed junco, Junco hyemalis (Linnaeus, 1758). Here, we report from morphometric and mensural data a new species of Isospora from J. hyemalis in Arkansas, USA. METHODS: During November 2020, seven adult J. hyemalis were taken with a mist net from Polk County, Arkansas, USA, and their faecal samples examined for coccidian parasites. Samples were placed in individual vials containing aqueous potassium dichromate. They were examined for coccidia after flotation in Sheather's sugar solution, measured, and photographed. RESULTS: A single J. hyemalis (14%) was found to be passing a new species of Isospora. Oöcysts of Isospora pittmani n. sp. were spheroidal to subspheroidal with a smooth bi-layered wall, measured (L × W) 24.8 × 23.8 µm, and had a length/width (L/W) ratio of 1.04; a micropyle and oöcyst residuum was absent but typically one to up to four polar granule(s) was present. Sporocysts are ovoidal to ellipsoidal and measured 15.0 × 10.0 µm, L/W 1.5; a flattened Stieda body was present as well as a barely discernible sub-Stieda body but para-Stieda bodies were absent. The sporocyst residuum was composed of various-sized granules dispersed between and across the sporozoites. A spheroidal to ellipsoidal posterior refractile body and spheroidal anterior refractile body occasionally seen, but a nucleus was not observed. Only two previous isosporans have been reported from passerellid birds and the new species can readily be distinguished from them. CONCLUSION: This is the first coccidian reported from J. hyemalis and, more importantly, the first isosporan known from any member of the family Passerellidae in North America.

A NEW SPECIES OF MYXOBOLUS (CNIDARIA: MYXOSPOREA: MYXOBOLIDAE) FROM THE FINS OF THE WESTERN CREEK CHUBSUCKER, ERIMYZON CLAVIFORMIS (CYPRINIFORMES: CATOSTOMIDAE), FROM ARKANSAS.

Between November 2018 and December 2021, 35 juvenile and adult Western Creek Chubsuckers, Erimyzon claviformis, were collected from 5 sites in western and southern Arkansas (Ouachita and Red River drainages), and their gills, gallbladders, fins, integument, other major organs, and musculature were examined for myxozoans. The fins of 12 (34%) individuals were infected with a novel species, Myxobolus stuartae n. sp. Qualitative and quantitative morphological data were obtained from formalin-fixed preserved myxospores. Molecular data from ethanol-preserved specimens consisted of a 2,028 base pair sequence of small subunit (SSU) ribosomal DNA (rDNA) from a specimen collected in Nevada County. Three other specimens from Polk County yielded partial SSU rDNA sequences that were identical to the first sequence. Phylogenetic analyses placed M. stuartae n. sp. as sister to Myxobolus bibullatus (Kudo, 1934), both clustering with other catostomid-infecting myxobolids. This is the first fin-infecting myxozoan reported from E. claviformis.

A NEW SPECIES OF MYXOBOLUS (CNIDARIA: MYXOSPOREA: MYXOBOLIDAE) FROM THE GILLS OF CREEK CHUB, SEMOTILUS ATROMACULATUS (CYPRINIFORMES: LEUCISCIDAE: PLAGIOPTERINAE), FROM THE OUACHITA DRAINAGE OF ARKANSAS.

During October and November 2021, 33 creek chubs, Semotilus atromaculatus, were collected from 3 sites in Polk County, Arkansas (Ouachita River drainage), and their gills, gallbladder, fins, integument, musculature, and other major organs were examined for myxozoans. The gills of 9 (27%) were infected with a new myxozoan, Myxobolus fountainae n. sp. Qualitative and quantitative morphological data were from fresh and formalin-fixed preserved spores, while molecular data consisted of a 1918 base pair sequence of the partial small subunit ribosomal RNA gene. Phylogenetic analysis grouped M. fountainae n. sp. with the other leuciscid-infecting myxobolids from North America and within a larger clade of European myxozoans. In addition, histological information is provided on the infection. A previous record of Myxobolus muelleriBütschli, 1882, from the gills and ureters of S. atromaculatus is considered invalid and represents an unknown species. Myxobolus fountainae n. sp. is the only named myxozoan known to infect the gill filaments of S. atromaculatus, whereas Myxobolus pendula (Guilford, 1967) infects the gill arches.

Temporal dynamics of SARS-CoV-2 genome and detection of variants of concern in wastewater influent from two metropolitan areas in Arkansas.

Although SARS-CoV-2 can cause severe illness and death, a percentage of the infected population is asymptomatic. This, along with other factors, such as insufficient diagnostic testing and underreporting due to self-testing, contributes to the silent transmission of SARS-CoV-2 and highlights the importance of implementing additional surveillance tools. The fecal shedding of the virus from infected individuals enables its detection in community wastewater, and this has become a valuable public health tool worldwide as it allows the monitoring of the disease on a populational scale. Here, we monitored the presence of SARS-CoV-2 and its dynamic genomic changes in wastewater sampled from two metropolitan areas in Arkansas during major surges of COVID-19 cases and assessed how the viral titers in these samples related to the clinical case counts between late April 2020 and January 2022. The levels of SARS-CoV-2 RNA were quantified by reverse-transcription quantitative polymerase chain reaction (RT-qPCR) using a set of TaqMan assays targeting three different viral genes (encoding ORF1ab polyprotein, surface glycoprotein, and nucleocapsid phosphoprotein). An allele-specific RT-qPCR approach was used to screen the samples for SARS-CoV-2 mutations. The identity and genetic diversity of the virus were further investigated through amplicon-based RNA sequencing, and SARS-CoV-2 variants of concern were detected in wastewater samples throughout the duration of this study. Our data show how changes in the virus genome can affect the sensitivity of specific RT-qPCR assays used in COVID-19 testing with the surge of new variants. A significant association was observed between viral titers in wastewater and recorded number of COVID-19 cases in the areas studied, except when assays failed to detect targets due to the presence of particular variants. These findings support the use of wastewater surveillance as a reliable complementary tool for monitoring SARS-CoV-2 and its genetic variants at the community level.

Statewide trends and factors associated with genetic testing for hereditary cancer risk in Arkansas 2013-2018.

BACKGROUND: Early identification of hereditary cancer risk would save lives, but genetic testing (GT) has been inadequate. We assessed i) trends for hereditary breast and ovarian cancer (HBOC), Lynch syndrome, and other GT and ii) factors associated with receipt of GT. METHODS: We used data from the Arkansas All-Payer Claims Database from January 2013 through June 2018 (commercial, Medicaid), December 2017 (state employee), or December 2016 (Medicare) and identified enrollees with ≥1 month of enrollment. Using Current Procedural Terminology (CPT-4) codes, rates for GT were calculated per 100,000 person-quarters and time series regressions estimated. Second, GT and covariate information for enrollees with 24 months of continuous enrollment were used to estimate separate logistic regression models for each GT category. RESULTS: Among 2,520,575 unique enrollees, HBOC testing rates were 2.2 (Medicaid), 22.0 (commercial), 40.4 (state employee), and 13.1(Medicare) per 100,000 person-quarters and increased linearly across all plans. Older age (OR=1.24; 95%CI 1.20 - 1.28), female sex (OR=18.91; 95%CI 13.01 - 28.86), higher comorbidity burden (OR=1.08; 95%CI 1.05 - 1.12), mental disorders (OR=1.53; 95%CI 1.15 - 2.00), and state employee coverage (OR=1.65; 95%CI 1.37 - 1.97) were positively associated with HBOC testing. Less than 1 of 10,000 enrollees received Lynch syndrome testing, while < 5 of 10,000 received HBOC testing. CONCLUSION: GT rates for hereditary cancer syndromes have increased in Arkansas but remain low. Receipt of GT was explained with high discrimination by sex and plan type. IMPACT: Expansion of GT for hereditary cancer risk in Arkansas is needed to identify high-risk individuals who could benefit from risk-reduction strategies.

Extensive population-level sampling reveals clinal variation in (R)-(-)-linalool produced by the flowers of an endemic evening primrose, Oenothera harringtonii.

The study of floral trait diversity has a long history due to its role in angiosperm diversification. While many studies have focused on visual traits including morphology and color, few have included floral scent despite its importance in pollination. Of the studies that have included floral scent, sampling has been limited and rarely explores variation at the population level. We studied geographic variation in the flowers of Oenothera harringtonii, a rare plant endemic to a vulnerable shortgrass prairie habitat, whose population structure and conservation status are well studied. The self-incompatible flowers of O. harringtonii open at dusk, produce nectar and a strong fragrance, and are pollinated by hawkmoths. We collected floral trait (morphology, scent chemistry and emission rates) data from 650 individuals from 19 wild populations to survey floral variation across the entire range of this species. Similarly, we collected floral data from 49 individuals grown in a greenhouse common garden, to assess whether variation observed in the field is consistent when environment factors (temperature, watering regime, soil) are standardized. We identified 35 floral volatiles representing 5 biosynthetic classes. Population differentiation was stronger for floral scent chemistry than floral morphology. (R)-(-)-linalool was the most important floral trait differentiating populations, exhibiting clinal variation across the distribution of O. harringtonii without any correlated shifts in floral morphology. Populations in the north and west produced (R)-(-)-linalool consistently, those in the east and south largely lacked it, and populations at the center of the distribution were polymorphic. Floral scent emissions in wild populations varied across four years but chemical composition was largely consistent over time. Similarly, volatile emission rates and chemical composition in greenhouse-grown plants were consistent with those of wild populations of origin. Our data set, which represents the most extensive population-level survey of floral scent to date, indicates that such sampling may be needed to capture potentially adaptive geographic variation in wild populations.