Distribution and Occurrence of Amblyomma maculatum sensu lato (Acari: Ixodidae) and Rickettsia parkeri (Rickettsiales: Rickettsiaceae), Arizona and New Mexico, 2017-2019

Amblyomma maculatum Koch sensu lato (s.l.) ticks are the vector of Rickettsia parkeri in Arizona, where nine cases of R. parkeri rickettsiosis have been identified since the initial case in 2014. The current study sought to better define the geographic ranges of the vector and pathogen and to assess the potential public health risk posed by R. parkeri in this region of the southwestern United States. A total of 275 A. maculatum s.l. ticks were collected from 34 locations in four counties in Arizona and one county in New Mexico and screened for DNA of Rickettsia species. Rickettsia parkeri was detected in 20.4% of the ticks, including one specimen collected from New Mexico, the first report of R. parkeri in A. maculatum s.l. from this state. This work demonstrates a broader distribution of A. maculatum s.l. ticks and R. parkeri in the southwestern United States than appreciated previously to suggest that R. parkeri rickettsiosis is underrecognized in this region.

Awareness and perceptions of advanced practice pharmacists among health care providers in New Mexico

OBJECTIVE

The purpose of this study was to evaluate health care provider awareness and perceptions of the 2 types of advanced practice pharmacists (APPhs) in New Mexico: pharmacist clinicians (PhCs) and community pharmacists with independent prescriptive authority (iRPhs).

METHODS

A cross-sectional electronic survey was administered to health care providers in New Mexico to describe awareness and perceptions of APPhs and benefits and barriers to collaborative practice with APPhs.

RESULTS

A total of 5905 providers received the emailed survey, and 634 (11%) completed the survey, with 68% of the respondents indicating that they were not aware of the 2 types of APPhs in New Mexico. The top benefits of working with a PhC identified by the respondents were access to medication knowledge, enhanced clinical outcomes, and increased access to patient care. The barriers to employing a PhC at their practice included cost, difficulty in billing for services, and limited reimbursement. Importantly, 80% of the respondents felt that PhCs should be recognized as providers for insurance reimbursement. Awareness of iRPhs varied by prescriptive authority service, ranging from 34% for tuberculin skin testing to 84% for adult vaccinations. Overall, 80%-92% indicated that iRPhs should be reimbursed, depending on the prescriptive authority service.

CONCLUSION

Provider awareness of APPhs in New Mexico was low; however, the willingness to refer patients to APPhs for clinical services was high. Cost, difficulty in billing for services, and reimbursement for PhC services were the primary identified barriers to adding a PhC into practice. Most of the respondents indicated that both types of APPhs should be granted provider status and reimbursed by third-party payers for their services.

New Mexico Permian Basin Measured Well Pad Methane Emissions Are a Factor of 5-9 Times Higher Than U.S. EPA Estimates

Methane emission fluxes were estimated for 71 oil and gas well pads in the western Permian Basin (Delaware Basin), using a mobile laboratory and an inverse Gaussian dispersion method (OTM 33A). Sites with emissions that were below detection limit (BDL) for OTM 33A were recorded and included in the sample. Average emission rate per site was estimated by bootstrapping and by maximum likelihood best log-normal fit. Sites had to be split into "complex" (sites with liquid storage tanks and/or compressors) and "simple" (sites with only wellheads/pump jacks/separators) categories to achieve acceptable log-normal fits. For complex sites, the log-normal fit depends heavily on the number of BDL sites included. As more BDL sites are included, the log-normal distribution fit to the data is falsely widened, overestimating the mean, highlighting the importance of correctly characterizing low end emissions when using log-normal fits. Basin-wide methane emission rates were estimated for the production sector of the New Mexico portion of the Permian and range from ∼520 000 tons per year, TPY (bootstrapping, 95% CI: 300 000-790 000) to ∼610 000 TPY (log-normal fit method, 95% CI: 330 000-1 000 000). These estimates are a factor of 5.5-9.0 times greater than EPA National Emission Inventory (NEI) estimates for the region.

Air quality and source apportionment modeling of year 2017 ozone episodes in Albuquerque/Bernalillo County, New Mexico

Albuquerque/Bernalillo County, New Mexico, is currently in attainment of the 2015 National Ambient Air Quality Standard (NAAQS) for ozone (70 ppb), but its ozone design values have increased in recent years. Air quality and source apportionment modeling with the Comprehensive Air Quality Model with Extensions (CAMx) was conducted for Albuquerque/Bernalillo County to develop a refined understanding of ozone source apportionment in the region, estimate ozone concentrations in the year 2025 based on projected changes in anthropogenic emissions, and evaluate the sensitivity of future ozone concentrations to various changes in local and non-local emissions. The study focused on two ozone episodes during June and July 2017 when 8-hr average ozone concentrations were greater than 70 ppb. Based on the modeling results, ozone during the June 2017 episode was found to be driven largely by contributions from non-local and regional emissions, whereas ozone during the July 2017 episode was driven more strongly by local emissions from within Albuquerque/Bernalillo County. On high ozone days, anthropogenic emissions from within Albuquerque/Bernalillo County contributed between 8% and 19% (6-14 ppb) of total ozone. Half of this local ozone contribution was from on-road mobile sources. Fire emissions contributed as much as 2 ppb of ozone on a given day. Contributions from large power plants in New Mexico were as large as 1 ppb on a given day but less than 0.5 ppb on most days. Modeled ozone concentrations in Albuquerque/Bernalillo County were also sensitive to emissions from oil and gas emissions in New Mexico. If projected emission reductions by 2025 materialize, these reductions could reduce future peak 8-hr average ozone concentrations by as much as 3-4% compared to 2017 values. Implications: The results of this study have important implications for air quality management in Albuquerque/Bernalillo County. Ozone in Albuquerque/Bernalillo County is the result of local and non-local emissions, is impacted by wildfires, and is sensitive to statewide oil and gas emissions. The magnitude of modeled contributions from anthropogenic emissions within Albuquerque/Bernalillo County is strongly influenced by meteorological conditions, transport pathways, and the presence of wildfire. This modeling is important for understanding the potential effectiveness of local emission controls in Albuquerque/Bernalillo County, and can serve as a basis for testing future regional and local emission control options.

Overcoming Barriers: Individual Experiences Obtaining Medication-Assisted Treatment for Opioid Use Disorder

Medication-assisted treatment (MAT) for opioid use disorder (OUD) is accessed half as often in rural versus urban areas in the United States. To better understand this disparity, we used a qualitative descriptive approach to explore the experiences of individuals with OUD seeking MAT in rural New Mexico. Guided interviews were conducted with 20 participants. The frameworks of critical social theory, intersectionality theory, and the brain opioid theory of social attachment were used to guide data analysis and interpretation. Thematic content analysis derived five major themes which identified novel barriers and facilitators to MAT success, including a perceived gender disparity in obtaining MAT, challenges in building a recovery-oriented support system, and the importance of navigating a new normal social identity. This deeper knowledge of the experiences and perspectives of rural individuals with OUD could serve to address the rural-urban MAT disparity, leading to enhanced recovery capacity and transformative policies.

Diverse Thaumarchaeota Dominate Subsurface Ammonia-oxidizing Communities in Semi-arid Floodplains in the Western United States

Subsurface microbial communities mediate biogeochemical transformations that drive both local and ecosystem-level cycling of essential elements, including nitrogen. However, their study has been largely limited to the deep ocean, terrestrial mines, caves, and topsoils (< 30 cm). Here, we present regional insights into the microbial ecology of aerobic ammonia oxidation within the terrestrial subsurface of five semi-arid riparian sites spanning a 900-km N-S transect. We sampled sediments, profiled communities to depths of ≤ 10 m, and compared them to reveal trends regionally within and surrounding the Upper Colorado River Basin (CRB). The diversity and abundance of ammonia-oxidizing microbial communities were evaluated in the context of subsurface geochemistry by applying a combination of amoA (encoding ammonia monooxygenase subunit A) gene sequencing, quantitative PCR, and geochemical techniques. Analysis of 898 amoA sequences from ammonia-oxidizing archaea (AOA) and bacteria (AOB) revealed extensive ecosystem-scale diversity, including archaeal amoA sequences from four of the five major AOA lineages currently found worldwide as well as distinct AOA ecotypes associated with naturally reduced zones (NRZs) and hydrogeochemical zones (unsaturated, capillary fringe, and saturated). Overall, AOA outnumber AOB by 2- to 5000-fold over this regional scale, suggesting that AOA may play a prominent biogeochemical role in nitrification within terrestrial subsurface sediments.

The Phenotypic and Transcriptomic Response of the Caenorhabditis elegans Nematode to Background and Below-Background Radiation Levels

Studies of the biological effects of low-level and below-background radiation are important in understanding the potential effects of radiation exposure in humans. To study this issue we exposed the nematode Caenorhabditis elegans to average background and below-background radiation levels. Two experiments were carried-out in the underground radiation biology laboratory at the Waste Isolation Pilot Plant (WIPP) in New Mexico USA. The first experiment used naïve nematodes with data collected within 1 week of being placed underground. The second experiment used worms that were incubated for 8 months underground at below background radiation levels. Nematode eggs were placed in two incubators, one at low radiation (ca.15.6 nGy/hr) and one supplemented with 2 kg of natural KCl (ca. 67.4 nGy/hr). Phenotypic variables measured were: (1) egg hatching success (2) body size from larval development to adulthood, (3) developmental time from egg to egg laying adult, and (4) egg laying rate of young adult worms. Transcriptome analysis was performed on the first experiment on 72 h old adult worms. Within 72 h of being underground, there was a trend of increased egg-laying rate in the below-background radiation treatment. This trend became statistically significant in the group of worms exposed to below-background radiation for 8 months. Worms raised for 8 months in these shielded conditions also had significantly faster growth rates during larval development. Transcriptome analyses of 72-h old naïve nematode RNA showed significant differential expression of genes coding for sperm-related proteins and collagen production. In the below-background radiation group, the genes for major sperm protein (msp, 42% of total genes) and sperm-related proteins (7.5%) represented 49.5% of the total genes significantly up-regulated, while the majority of down-regulated genes were collagen (col, 37%) or cuticle-related (28%) genes. RT-qPCR analysis of target genes confirmed transcriptomic data. These results demonstrate that exposure to below-background radiation rapidly induces phenotypic and transcriptomic changes in C. elegans within 72 h of being brought underground.

Methods and Findings on Diet and Lifestyle Used to Support Estimation of Radiation Doses from Radioactive Fallout from the Trinity Nuclear Test

The Trinity nuclear test was detonated in south-central New Mexico on 16 July 1945; in the early 2000s, the National Cancer Institute undertook a dose and cancer risk projection study of the possible health impacts of the test. In order to conduct a comprehensive dose assessment for the Trinity test, we collected diet and lifestyle data relevant to the populations living in New Mexico around the time of the test. This report describes the methodology developed to capture the data used to calculate radiation exposures and presents dietary and lifestyle data results for the main exposure pathways considered in the dose reconstruction. Individual interviews and focus groups were conducted in 2017 among older adults who had lived in the same New Mexico community during the 1940s or 1950s. Interview questions and guided group discussions focused on specific aspects of diet, water, type of housing, and time spent outdoors for different age groups. Thirteen focus groups and 11 individual interviews were conducted among Hispanic, White, and Native American participants. Extensive written notes and audio recordings aided in the coding of all responses used to derive ranges, prevalence, means, and standard deviations for each exposure variable for various age categories by region and ethnicity. Children aged 11-15 y in 1940s or 1950s from the rural plains had the highest milk intakes (993 mL d), and lowest intakes were among 11- to 15-y-olds in mountainous regions (191 mL d). Lactose intolerance rates were 7-71%, and prevalence was highest among Native Americans. Meat was not commonly consumed in the summer in most communities, and if consumed, it was among those aged 11-15 y of age or older who had relatively small amounts of 100-200 g d. Most drinking and cooking water came from covered wells, and most homes were made of adobe, which provided more protection from external radiation than wooden structures. The use of multiple approaches to trigger memory and collect participant reports on diet and other factors from the distant past seemed effective. These data were summarized, and together with other information, these data have been used to estimate radiation doses for representative persons of all ages in the main ethnic groups residing in New Mexico at the time of the Trinity nuclear test.

Behind the Mask: An Exploratory Assessment of Female Surgeons' Experiences of Gender Bias

Though overt sexism is decreasing, women now experience subtle, often unconscious, gender bias as microaggressions. The authors sought to explore the prevalence and impact of the sexist microaggressions female surgeons experience, using a sequential exploratory mixed methods approach (January 2018-April 2018), to identify opportunities for education and prevention. First, all resident, fellow, and attending female surgeons at the University of New Mexico Health Sciences Center (UNM HSC) were invited to participate in focus groups conducted by experienced moderators using a semistructured interview guide based on the 7 Sexist Microaggressions Experiences and Stress Scale (Sexist MESS) domains. Qualitative analysis was performed using line-by-line manual coding to identify themes aligned with the Sexist MESS domains as well as other gender bias experiences of female surgeons. Next, a survey was sent to all resident, fellow, and attending female surgeons at the UNM HSC, which included the Sexist MESS questionnaire and questions related to surgeon-specific experiences of gender bias that the authors developed based on major thematic categories from the focus groups.Four focus groups of 23 female surgeons were conducted, revealing 4 themes: exclusion, increased effort, adaptation, and resilience to workplace slights. The survey response rate was 64% (65/101 surgeons). Across Sexist MESS domains, the frequency and severity of microaggressions was higher for trainees than attendings. The variables of non-White race/ethnicity, having children under 18, and fellowship training generally did not demonstrate statistical significance. This exploratory study adds to the growing body of evidence that gender bias in surgery continues and frequently manifests as microaggressions. Trainees reported the highest rates and severity of microaggressions and bias experiences. Further research should investigate how to address microaggressions, the experiences of male surgeons, the perspectives of medical students and groups who were reported as often perpetuating gender bias, and the efficacy of possible interventions.

Impact of a Primary Care Provider Tele-Mentoring and Community Health Worker Intervention on Utilization in Medicaid Patients with Diabetes

OBJECTIVE

The Endocrinology ECHO intervention utilized a tele-mentoring model that connects primary care providers (PCPs) and community health workers (CHWs) with specialists for training in diabetes care. We evaluated the impact of the Endo ECHO intervention on healthcare utilization and care for Medicaid patients with diabetes in New Mexico.

METHODS

Between January 2015 and April 2017, patients with complex diabetes from 10 health centers in NM were recruited to receive diabetes care from a PCP and CHW upskilled through Endo ECHO. We matched intervention patients in the NM Medicaid claims database to comparison Medicaid beneficiaries using 5:1 propensity matching. We used a difference-in-difference (DID) approach to compare utilization and processes of care between intervention and comparison patients.

RESULTS

Of 541 Medicaid patients enrolled in Endo ECHO, 305 met inclusion criteria and were successfully matched. Outpatient visits increased with Endo ECHO for intervention patients as compared to comparison patients (rate ratio, 1.57; 95% confidence interval [CI], 1.43 to 1.72). The intervention was associated with an increase in emergency department (ED) visits (rate ratio, 1.30; 95% CI, 1.04 to 1.63) but no change in hospitalizations (rate ratio, 1.47; 95% CI, 0.95 to 2.23). Among intervention patients, utilization of metformin increased from 57.1% to 60.7%, with a DID between groups of 8.8% (95% CI, 4.0% to 13.6%). We found similar increases in use of statins (DID, 8.5%; 95% CI, 3.2% to 13.8%), angiotensin-converting enzyme inhibitors (DID, 9.5%; 95% CI, 3.5% to 15.4%), or antidepressant therapies (DID, 9.4%; 95% CI, 1.1% to 18.1%).

CONCLUSION

Patient enrollment in Endo ECHO was associated with increased outpatient and ED utilization and increased uptake of prescription-related quality measures. No impact was observed on hospitalization.

Subscriber continuity in health insurance plans: factors associated with re-enrollment and coverage changes

Aims: This study examined the extent to which Marketplace health insurance subscribers re-enroll a second year. Among re-enrollees, we sought to examine movement to more and less generous insurance plans (based on actuarial value), and the extent to which adverse selection, adverse retention, and aging in place are evident from re-enrollment choices made.Methods: Re-enrollment from 2015 to 2016 and 2016 to 2017 and movement to more and less generous insurance plans was examined using enrollment and insurance claims data from two US Federally-facilitated Marketplace insurance carriers operating in the state of New Mexico for 2015-2017. Insurance plans are assigned to metal levels based on estimated plan actuarial value: Bronze (60%), Silver (70%), and Gold (80%). Odds ratios (ORs) and 95% confidence intervals (OR CI) were estimated using logistic regressions for subscribers with base-year healthcare utilization. ORs were estimated for (1) re-enrollment in the year following the base year, and (2) movement to a higher or lower actuarial value plan.Results: Approximately 50% of subscribers re-enrolled with the same carrier for 2016 and 60% for 2017. Being enrolled 12 months was the strongest predictor for second year re-enrollment. Older individuals were more likely to re-enroll. Re-enrollment was lower for the insurance carrier with higher second year premium changes. Chronic condition utilization characteristics were positively associated with re-enrollment. Approximately 12% of Bronze subscribers moved to Silver or Gold, and had higher utilization after re-enrollment. Among Silver subscribers, 6% moved to Gold and 6% to Bronze. Approximately 37% of Gold subscribers moved to Silver or Bronze.Discussion: Re-enrollment was similar to published non-group insurance rates. Adverse selection and aging in place were observed. Evidence was weak for adverse retention. Some coverage change choices were rational, while others suggest subscribers may have difficulty making insurance choice decisions.

Projected Landscape Impacts from Oil and Gas Development Scenarios in the Permian Basin, USA

Projecting landscape impacts from energy development is essential to land management decisions. We forecast landscape alteration resulting from oil and gas well-pad construction across the economically important Permian Basin of Texas and New Mexico, USA, by projecting current landscape trends through 2050. We modeled three landscape-impact scenarios (low, medium, and high) using recent (2008-2017) trends in well-pad construction and energy production. The results of low-, medium-, and high-impact scenarios suggest that ~60,000, ~180,000, and ~430,000 new well pads could be constructed, potentially causing ~1000, ~2800, and ~6700 km² of new direct landscape alteration. Almost two-thirds of all new well pads will be constructed within the geologic boundaries of the Delaware and Midland Basins. This translates into a 40, 120, and 300% increase in direct landscape alteration compared with direct alteration from existing well pads. We found that indirect effects (from edges) could increase by twofold, and that the ratio between indirect and direct alteration could decline by half as alteration intensifies and overlaps with existing alteration. The Chihuahuan Desert occupies the largest portion of the study area, and is projected to experience the largest area of alteration from future well-pad construction in the Permian Basin; the degree of direct alteration could increase by 70, 200, and 500% in this desert region, under low-, medium-, and high-impact scenarios. These scenarios can be used to design proactive conservation strategies to reduce landscape impacts from future oil and gas development.

NM GRADS: Lessons Learned from Implementing a School-Based Program for Young Parents Across New Mexico

PURPOSE

The New Mexico Graduation Reality and Dual-role Skills (GRADS) program provides services for expectant and parenting students at high schools. The GRADS program has operated since 1989, serving more than 17,000 youth. This study summarizes the GRADS program model and program administrators' lessons learned from implementing this comprehensive, large-scale program.

DESCRIPTION

The GRADS program is a multicomponent intervention that can include a classroom intervention, case management, linkages to child care and health care, and support for young fathers. The program aims to support expectant and parenting youth in finishing high school, delaying a repeat pregnancy, promoting health outcomes for their children, and preparing for college and career. This study presents program administrators' lessons learned to increase understanding of how to implement a statewide program to support expectant and parenting students.

ASSESSMENT

During the 2010-2017 school years, the GRADS program operated in 26-31 sites each year, serving a total of 2691 parenting youth. Program administrators identified lessons learned from implementing the GRADS program during that period of expansion, including allowing variation across sites based on resources and needs, providing centralized implementation support, fostering buy-in from school and district leaders, and collecting consistent data to better understand participant outcomes.

CONCLUSIONS

Although not based on a rigorous impact or implementation study, this article provides lessons learned from a statewide, school-based program that may be a promising way to serve a large number of expectant and parenting youth and help them overcome challenges for completing high school.

Perspectives on prescribing hormonal contraception among rural New Mexican pharmacists

OBJECTIVES

New Mexico is a large rural state with high rates of unintended pregnancy and limited access to contraception. In 2017, the New Mexico Pharmacist Prescriptive Authority Act was amended to allow pharmacists to prescribe hormonal contraception. We explored pharmacist perspectives on prescribing hormonal contraceptives, including perceived barriers and facilitators to implementation in rural New Mexico and opinions on over-the-counter (OTC) access, and prescribing and inserting subdermal contraceptive implants.

METHODS

This qualitative study recruited rural pharmacists using contact information from the New Mexico Board of Pharmacy and at a state-level pharmacist conference. We conducted semistructured telephone interviews with pharmacists focusing on benefits and concerns about prescribing hormonal contraception, resources required, perspectives on OTC access, and interest in prescribing and placing contraceptive implants. Deidentified transcribed interviews were analyzed by 2 independent coders for emerging themes.

RESULTS

From November 2017 to January 2018, we recruited 25 rural pharmacists and conducted 21 interviews. The majority of participants were male (71%), aged over 60 years (43%), and in practice for over 20 years (52%). Interviewees were mostly positive about prescribing hormonal contraception citing community benefits. The top 3 perceived barriers were training needs, reimbursement, and liability. The top 3 facilitators were the availability of private areas within pharmacies, pharmacists' role as knowledgeable health care team members, and pharmacist accessibility without appointments. Most pharmacists did not support OTC access to hormonal contraception, and over half were interested in certification to prescribe and place subdermal contraceptive implants.

CONCLUSION

New Mexico pharmacists identified community benefits of pharmacy access to hormonal contraception and were interested in training. Several barriers must be addressed to realize the potential of this practice expansion.

The politics of baselining in the Grants uranium mining district of northwestern New Mexico

During the second half of the twentieth century, northwestern New Mexico served as the primary production site for one of the world's largest nuclear arsenals. From 1948 to 1970 the "Grants uranium district" provided almost half of the total uranium ore accumulated by the United States federal government for the production of nuclear weapons, in addition to becoming a national source for commercial nuclear energy from the late 1960s to the early 1990s. By the twenty-first century, after a prolonged period of economic decline that began in the late 1970s, all uranium mining and milling in New Mexico had ceased, leaving a legacy of environmental health impacts. What was once referred to as "The Uranium Capital of the World" now encompasses over a thousand abandoned uranium mines and seven massive uranium mill tailings piles, which are associated with airborne and soil contamination as well as groundwater plumes of uranium and other contaminants of concern, in a landscape that has been fractured by underground mine workings and punctured by thousands of exploratory boreholes. This article presents an ethnographic study of the diverse forms of expertise involved in monitoring and managing the mine waste and mill tailings. Drawing from over two years of ethnographic research, I describe the relationship between different stakeholders from local communities, government agencies, and transnational mining corporations as they deliberate about the possibility of cleaning up the former mining district. My thesis is that the possibility of cleaning up the Grants district hinges on the "politics of baselining"-a term I introduce to describe the relationship between stakeholders and their competing environmental models and hydrogeological theories; each accounts for a different geological past prior to mining that can be deemed "natural," as the background against which to measure the anthropogenic impacts from mining.

A Biodegradable Formulation of MCH (3-Methylcyclohex-2-en-1-one) for Protecting Pseudotsuga menziesii from Dendroctonus pseudotsugae (Coleoptera: Curculionidae) Colonization

Douglas-fir, Pseudotsuga menziesii (Mirb.) Franco, trees and stands can be protected from Douglas-fir beetle, Dendroctonus pseudotsugae Hopkins (DFB)-caused mortality by application of synthetic formulations of the beetle's antiaggregation pheromone, 3-methylcyclohex-2-en-1-one (MCH). A biodegradable formulation of MCH, SPLAT MCH, was developed and evaluated for protecting individual Douglas-fir trees and small stands from colonization and mortality by DFB. In an individual-tree experiment in Idaho, both MCH bubble capsules and SPLAT MCH significantly reduced the proportion of treated trees colonized and killed by DFB compared to untreated controls. SPLAT MCH was as effective as MCH bubble capsules for protecting individual trees. Both MCH bubble capsules and SPLAT MCH significantly reduced the proportion of trees colonized and killed by DFB within 0.04-ha circular plots surrounding each treated tree compared to untreated controls. In 0.41 ha stands in New Mexico, both MCH bubble capsules and SPLAT MCH significantly reduced the proportion of trees colonized and killed by DFB compared to untreated controls, again with no differences observed between MCH treatments. In a similar stand level trial in Idaho, neither MCH treatment significantly reduced the proportion of trees colonized by DFB, and only MCH bubble capsules significantly reduced levels of tree mortality compared to untreated controls, but no significant difference was observed between SPLAT MCH and MCH bubble capsules. Overall, the results indicate that SPLAT MCH is as effective as MCH bubble capsules for protecting individual trees and small stands of Douglas-fir from DFB-caused mortality.

Francis I. Proctor, MD and his wife Elizabeth C. Proctor: Their lives and legacy

The Francis I. Proctor Foundation for Research in Ophthalmology is internationally recognized for its research in the fields of ocular inflammatory and infectious diseases. Although the name of one of its founders, Francis I. Proctor, MD (1864-1936) is memorialized, the legacy of his wife, Elizabeth C. Proctor (1882-1975) is not as well known. They were both full partners in this endeavor. Francis, a successful and wealthy ophthalmologist, retired to Santa Fe, New Mexico. After their marriage, they became interested in the problem of blinding trachoma, then an endemic problem on the Native American Indian reservations. The couple selected Phillips Thygeson, MD (1903-2002), a young ophthalmologist with an interest in infectious diseases, as their lead investigator. Using their own funds, the Proctors paid for Thygeson and themselves to study trachoma in Egypt, and then establish a trachoma research laboratory in Arizona where the causative agent of trachoma was identified. Not only did the Proctors fund these studies, they also studied bacteriology so they could help in the laboratory themselves. After Francis' death, Elizabeth endowed the Foundation in 1947 and continued to support it. She also established the Proctor Medal for The Association for Research in Vision and Ophthalmology.

Heavy metal content of produce grown in San Juan County (New Mexico, USA)

The Animas River Watershed has long received discharges of naturally occurring acid rock drainage; however, on August 5, 2015, three million gallons flowed into the agricultural region of Farmington, New Mexico and the Navajo Nation. Consumers and growers in the region were fearful that produce might absorb heavy metals from contaminated irrigation water originating from these rivers. Samples were collected from the region including corn (n = 30), pumpkin (n = 10), squash (n = 10), and cucumber (n = 10) then processed and tested using inductively coupled plasma-optical emission spectrometry (ICP-OES) for concentrations of nine metals of interest. These include toxic metals: Al, As, and Pb, which were compared to the World Health Organization limits, 18.29 mg d^-1, 0.192 mg d^-1, and 0.05 mg kg^-1, respectively and essential metals: Cr, Fe, Mn, Zn, Ca, and Cu whose levels were compared to the National Academies' dietary references for tolerable upper intake levels. Results indicate that produce grown in the region contained significantly less metal than the allowable limits, except for Pb in two corn samples. This research is the first attempt to monitor and analyze heavy metal absorption of produce in the area.

Barriers to Pap Smear Among Homeless Women at Albuquerque Healthcare for the Homeless

The purpose of this cross-sectional survey study was to explore common barriers to adequate Pap smear utilization among homeless women, and the factors that may relate to cervical cancer testing in this population. Participants consisted of adult women recruited at a healthcare facility for the homeless. Data were collected through a self-completed questionnaire on knowledge, attitudes and intentions about Pap smears and cervical cancer. Analyses included descriptive and inferential statistics. Sixty participants who had experienced homelessness within the past year completed the study. The most frequently mentioned barrier to testing was not having enough time to obtain a Pap smear (n = 33; 55%). Linear regression found that there were no significant relationships between knowledge and attitudes about cervical cancer and intention to get a Pap smear. However, the study did find that women with a positive previous Pap smear experience had more positive attitudes about the process and outcomes of Pap smears (p = 0.011, p = 0.00, respectively). Participants with more knowledge about cervical cancer were less negative about Pap smear outcomes (p = 0.05), and that women with negative attitudes about Pap smear outcomes were less likely to have obtained a Pap smear in the past (p = 0.033). Interventions that promote positive attitudes about testing and outcomes, minimizing stress and inconvenience during the test, as well as increasing the ease of scheduling an appointment may help break down barriers to cervical cancer screening among homeless women.

Cost-effectiveness analysis of a large jail-based methadone maintenance treatment continuation program in New Mexico

The U.S. has the second-highest incarceration rate in the world and spends more than $80 billion annually to house inmates. The clinical research literature suggests that methadone maintenance treatment (MMT) is an effective method to treat opioid use disorders (OUD) and that jails are a potentially valuable environment to implement MMT. Currently, jail-based MMT is rarely implemented in practice, due in part to resource limitations and other economic considerations. The primary goal of this study was to perform a cost-effectiveness analysis (CEA) of jail-based MMT using data from a unique MMT continuation program located in a large urban jail in New Mexico. Recidivism data were collected for a three-year period both before and after incarceration, and quasi-control groups were constructed from both substance-using and general populations within the jail. Base models show that inmates enrolled in jail-based MMT exhibited significantly fewer days of incarceration due to recidivism (29.33) than a group of inmates with OUDs who did not receive MMT. Economic estimates indicate that it cost significantly less ($23.49) to reduce an incarcerated day using jail-based MMT than incarceration per se ($116.49). To mitigate potential sample selection bias, we used both propensity-score-matching and difference-in-differences estimators, which provided comparable estimates when using the OUD non-MMT comparison group. Difference-in-differences models find that, on average, MMT reduced recidivism by 24.80 days and it cost $27.78 to reduce an incarcerated day using jail-based MMT. Assuming a willingness to pay threshold of the break-even cost of reducing one incarcerated day, we estimate a 93.3% probability that this MMT program is cost-effective. Results were not as strong or consistent when using other comparison groups (e.g., alcohol-detoxified and general-population inmates). Overall, results suggest that it costs substantially less to provide jail-based MMT than incarceration alone. Jail administrators and policymakers should consider incorporating MMT in other jail systems and settings.

Genomic Signatures of Local Adaptation in Clam Shrimp (Eulimnadia texana) from Natural Vernal Pools

Vernal pools are unique in their isolation and the strong selection acting on their resident species. Vernal pool clam shrimp (Eulimnadia texana) are a promising model due to ease of culturing, short generation time, small genomes, and obligate desiccated diapaused eggs. Clam shrimp are also androdioecious (sexes include males and hermaphrodites), and here we use population-scaled recombination rates to support the hypothesis that the heterogametic sex is recombination free in these shrimp. We collected short-read sequence data from pooled samples from different vernal pools to gain insights into local adaptation. We identify genomic regions in which some populations have allele frequencies that differ significantly from the metapopulation. BayPass (Gautier M. 2015. Genome-wide scan for adaptive divergence and association with population-specific covariates. Genetics 201(4):1555-1579.) detected 19 such genomic regions showing an excess of population subdivision. These regions on average are 550 bp in size and had 2.5 genes within 5 kb of them. Genes located near these regions are involved in Malpighian tubule function and osmoregulation, an essential function in vernal pools. It is likely that salinity profiles vary between pools and over time, and variants at these genes are adapted to local salinity conditions.

Francisella tularensis infection in dogs: 88 cases (2014-2016)

OBJECTIVE

To characterize the epidemiology, clinical signs, and treatment of dogs with Francisella tularensis infection in New Mexico.

ANIMALS

87 dogs in which 88 cases of tularemia (1 dog had 2 distinct cases) were confirmed by the New Mexico Department of Health Scientific Laboratory Division from 2014 through 2016 and for which medical records were available.

PROCEDURES

Dogs were confirmed to have tularemia if they had a 4-fold or greater increase in anti-F tularensis antibody titer between acute and convalescent serum samples or F tularensis had been isolated from a clinical or necropsy specimen. Epidemiological, clinical, and treatment information were collected from the dogs' medical records and summarized.

RESULTS

All 88 cases of tularemia were confirmed by paired serologic titers; the first (acute) serologic test result was negative for 84 (95%) cases. The most common reported exposure to F tularensis was wild rodent or rabbit contact (53/88 [60%]). Dogs had a median number of 3 clinical signs at initial evaluation; lethargy (81/88 [92%]), pyrexia (80/88 [91%]), anorexia (67/88 [76%]), and lymphadenopathy (18/88 [20%]) were most common. For 32 (36%) cases, the dog was hospitalized; all hospitalized dogs survived.

CONCLUSIONS AND CLINICAL RELEVANCE

Dogs with F tularensis infection often had nonspecific clinical signs and developed moderate to severe illness, sometimes requiring hospitalization. Veterinarians examining dogs from tularemia-enzootic areas should be aware of the epidemiology and clinical signs of tularemia, inquire about potential exposures, and discuss prevention methods with owners, including reducing exposure to reservoir hosts and promptly seeking care for ill animals.

Genetic and functional variation across regional and local scales is associated with climate in a foundational prairie grass

Global change forecasts in ecosystems require knowledge of within-species diversity, particularly of dominant species within communities. We assessed site-level diversity and capacity for adaptation in Bouteloua gracilis, the dominant species in the Central US shortgrass steppe biome. We quantified genetic diversity from 17 sites across regional scales, north to south from New Mexico to South Dakota, and local scales in northern Colorado. We also quantified phenotype and plasticity within and among sites and determined the extent to which phenotypic diversity in B. gracilis was correlated with climate. Genome sequencing indicated pronounced population structure at the regional scale, and local differences indicated that gene flow and/or dispersal may also be limited. Within a common environment, we found evidence of genetic divergence in biomass-related phenotypes, plasticity, and phenotypic variance, indicating functional divergence and different adaptive potential. Phenotypes were differentiated according to climate, chiefly median Palmer Hydrological Drought Index and other aridity metrics. Our results indicate conclusive differences in genetic variation, phenotype, and plasticity in this species and suggest a mechanism explaining variation in shortgrass steppe community responses to global change. This analysis of B. gracilis intraspecific diversity across spatial scales will improve conservation and management of the shortgrass steppe ecosystem in the future.

Cost Analysis of Carbon Capture and Sequestration of Process Emissions from the U.S. Industrial Sector

The industrial sector represents roughly 22% of U.S. emissions. Unlike emissions from fossil-fueled power plants, the carbon footprint of the industrial sector represents a complex mixture of stationary combustion and process emissions produced as a reaction byproduct of cement, iron and steel, glass, and oil production. This study quantifies the potential opportunities for low-cost carbon capture and storage (CCS) scenarios with process emissions from the U.S. industrial sector by analyzing the variabilities in point-source capture and geographic proximity to relevant sinks, specifically enhanced oil recovery (EOR) and geologic sequestration opportunities. Using a technology-agnostic cost model developed from mature CO₂ capture technologies, costs of CCS are calculated for each of the 656 facilities considered, with application of the U.S. federal tax credit 45Q to qualifying facilities. Capture of these targeted industrial process emission streams may lead to the avoidance of roughly 195 MtCO₂/yr (188 MtCO₂/yr qualifying for 45Q). A total of 123 facilities have the potential to avoid roughly 68.5 MtCO₂/yr at costs below $40/tCO₂ delivered. This could be competitive for using CO₂ for EOR depending on the price of oil. At regional CO₂ collection hubs, emissions of 40 MtCO₂/yr can be avoided within 100 miles of the existing Louisiana-Mississippi and Texas-New Mexico pipelines.