VA SHIELD: A Biorepository for Veterans and the Nation.

Background: To address the COVID-19 pandemic and future threats, VA leadership assembled research and clinical teams to coordinate a unified response, which included creating the VA Science and Health Initiative to Combat Infectious and Emerging Life-Threatening Diseases (VA SHIELD). Observations: VA SHIELD is a comprehensive specimen and data repository. It links specific types of biospecimens with data regarding genetics, exposure, and disease risk by connecting data sources and the collections of biospecimens across clinical and research environments. Researchers can test novel diagnostic platforms and therapeutics for new and existing diseases, allowing for an expedited, more robust, and informed response. The existing longitudinal disease risk-factor information, records of causal processes, and outcomes data present an unparalleled opportunity to optimize prevention, diagnosis, and treatment of many acute and chronic diseases. Conclusions: VA SHIELD will expand to become an enterprise resource for investigators and public health officials. The alignment of basic science, clinical, and translational research goals under one governance is a significant advancement. VA SHIELD has the opportunity to transform the VA research enterprise by creating an entirely new biorepository.

Nationwide Genomic Surveillance and Response to COVID-19: The VA SeqFORCE and SeqCURE Consortiums.

Background: The US Department of Veterans Affairs (VA) has dedicated significant resources toward countering the COVID-19 pandemic. Sequencing for Research Clinical and Epidemiology (SeqFORCE) and Sequencing Collaborations United for Research and Epidemiology (SeqCURE) were developed as clinical and research consortiums, respectively, focused on the genetic COVID-19 surveillance. Observations: Through genetic sequencing, VA SeqFORCE and SeqCURE collaborations contributed to the COVID-19 pandemic response and scientific understanding. Future directions for each program include the assessment of the unique impact of COVID-19 on the veteran population, as well as the adaptation of these programs to future infectious disease threats. We foresee the use of these established platforms beyond infectious diseases. Conclusions: VA SeqFORCE and SeqCURE were established as clinical and research programs dedicated to sequencing COVID-19 as part of ongoing clinical and surveillance efforts. In the future, we anticipate that having these programs embedded within the largest integrated health care system in the US will enable the study of pathogens and pandemics beyond COVID-19 and at an unprecedented scale. The investment in these programs will form an integral part of our nation's response to emerging infectious diseases, with future applications to precision medicine and beyond.

The VA Research Enterprise: A Platform for National Partnerships Toward Evidence Building and Scientific Innovation.

Background: Within a year of the start of the COVID-19 pandemic, the US Department of Veterans Affairs (VA) was managing about 300 COVID-19-related research projects across roughly 100 facilities, which has since grown to more than 900 projects. This robust set of activities arose from an existing enterprise strategy and aimed at identifying needs for supporting the clinical care mission, more rapidly leveraging resources, and coordinating research across the VA. The VA's efforts to implement an enterprise strategy before March 2020 positioned its research community to dynamically partner with other federal agencies, academic institutions, and industry in addressing a national public health emergency. Observations: The VA research enterprise involves a broad range of functions, scientific and clinical leaders, and organizational resources to enhance the health and care of veterans and the nation. The scope of research activities enables it to support its priorities while also partnering with others who share in mutual commitments to veteran health. Moving toward being the nation's learning health care system, the VA's leadership support, staff, patient volunteers, and partners were key contributors to a national response to COVID-19. Swift action and consistent communication helped address the complexities of the pandemic and strengthened the VA's ability to prepare and mobilize for emergencies and other potential disease outbreaks. Documenting strategies and practices can enhance future opportunities aimed at addressing the most challenging health care needs while also focusing on the primary mission to serve veterans. Conclusions: The COVID-19 pandemic contributed to critical knowledge and lessons that enabled the VA to advance enterprise goals, particularly in the context of its health care system. Sharing these unique processes and experiences will inform current and future partnerships among research, clinical, and public health communities oriented to serve veterans and the nation through scientific innovation.

THE EYE OF CRAB-EATING FOX (CERDOCYON THOUS): ANATOMICAL CHARACTERISTICS AND NORMATIVE VALUES OF SELECTED DIAGNOSTIC TESTS, MORPHOMETRY OF CORNEAL TISSUE, AND ARRANGEMENTS OF CORNEAL STROMAL COLLAGEN FIBERS.

This study aimed to evaluate the ophthalmic parameters, morphometric features of corneal tissue, and arrangements of corneal stromal collagen fibers in crab-eating fox (Cerdocyon thous), a species of neotropical wild canid. We conducted the study on six juvenile crab-eating foxes (12 eyes), whilst 16 eyes were obtained post mortem from eight adult crab-eating foxes. The research was divided into two stages. In the first stage, eye anatomical characteristics, tear production (Schirmer 1 tear test, STT1), intraocular pressure (IOP), ocular echobiometry, and specular microscopy parameters related to morphology of corneal endothelium were studied in juvenile animals. In the second stage, morphometric features of corneal tissue (central corneal thickness [CCT] and corneal epithelium thickness) and arrangements of stromal collagen fibers were studied using eyes from adult animals. The main findings were that crab-eating fox eyes have vertical-slit pupils, holangiotic retina, and reference values (mean ± SD) of 13.37 ± 3.79 mm/min for STT1 and of 10.43 ± 3.84 mmHg for IOP. The ocular echobiometric features observed in crab-eating foxes are different from those reported for domestic dogs (Canis familiaris). Conversely, the corneal endothelial parameters are similar to those of domestic dogs. The CCT measured by tissue morphometry was 0.54 ± 0.06 mm, and the corneal epithelium thickness was 60.13 ± 8.71 µm. Mean coherency related to alignment of collagen fibers was 0.66 ± 0.12. The crab-eating fox cornea had predominantly thick collagen fibers. Crab-eating fox eyes have morphofunctional peculiarities. They resemble the eyes of domestic dogs in some aspects, but diverge in others.

Assessment of U.S. Pediatrician Knowledge of Toxocariasis.

Toxocariasis, one of a group of parasitic diseases known as neglected parasitic infections, is a disease caused by the larvae of two species of Toxocara roundworms, Toxocara canis, from dogs, and less commonly Toxocara cati, from cats. Although most infected individuals are asymptomatic, clinical manifestations may include fever, fatigue, coughing, wheezing, or abdominal pain (visceral toxocariasis) or vision loss, retina damage, or eye inflammation (ocular toxocariasis). To assess U.S. pediatrician knowledge of toxocariasis, we conducted an electronic survey of American Academy of Pediatrics members. Of the 2,684 respondents, 1,120 (47%) pediatricians correctly selected toxocariasis as the diagnosis in an unknown case presentation with findings typical for toxocariasis; overall 1,695 (85%) stated they were not confident that their knowledge of toxocariasis was current. This knowledge gap suggests a need for improved toxocariasis awareness and education for U.S. pediatricians, especially those caring for children at risk for infection.

Assessment of YouTube videos as a source of information on medication use in pregnancy.

BACKGROUND: When making decisions about medication use in pregnancy, women consult many information sources, including the Internet. The aim of this study was to assess the content of publicly accessible YouTube videos that discuss medication use in pregnancy. METHODS: Using 2023 distinct combinations of search terms related to medications and pregnancy, we extracted metadata from YouTube videos using a YouTube video Application Programming Interface. Relevant videos were defined as those with a medication search term and a pregnancy-related search term in either the video title or description. We viewed relevant videos and abstracted content from each video into a database. We documented whether videos implied each medication to be "safe" or "unsafe" in pregnancy and compared that assessment with the medication's Teratogen Information System (TERIS) rating. RESULTS: After viewing 651 videos, 314 videos with information about medication use in pregnancy were available for the final analyses. The majority of videos were from law firms (67%), television segments (10%), or physicians (8%). Selective serotonin reuptake inhibitors (SSRIs) were the most common medication class named (225 videos, 72%), and 88% of videos about SSRIs indicated that they were unsafe for use in pregnancy. However, the TERIS ratings for medication products in this class range from "unlikely" to "minimal" teratogenic risk. CONCLUSION: For the majority of medications, current YouTube video content does not adequately reflect what is known about the safety of their use in pregnancy and should be interpreted cautiously. However, YouTube could serve as a platform for communicating evidence-based medication safety information.