scholarly journals 2020 SARS-CoV-2 diversification in the United States: Establishing a pre-vaccination baseline

2021 ◽  
Author(s):  
Adam A Capoferri ◽  
Wei A Shao ◽  
Jon Spindler ◽  
John M Coffin ◽  
Jason W Rausch ◽  
...  
Keyword(s):  
United States ◽  
Genetic Diversity ◽  
Amino Acid ◽  
Geographical Distribution ◽  
Phase 1 ◽  
The United States ◽  
Viral Population ◽  
Phase 3 ◽  
Antibody Epitopes ◽  
The U.S

In 2020, SARS-CoV-2 spread across the United States (U.S.) in three phases distinguished by peaks in the numbers of infections and shifting geographical distribution. We investigated the viral genetic diversity in each phase using sequences publicly available prior to December 15th, 2020, when vaccination was initiated in the U.S. In Phase 1 (winter/spring), sequences were already dominated by the D614G Spike mutation and by Phase 3 (fall), genetic diversity of the viral population had tripled and at least 54 new amino acid changes had emerged at frequencies above 5%, several of which were within known antibody epitopes. These findings highlight the need to track the evolution of SARS-CoV-2 variants in the U.S. to ensure continued efficacy of vaccines and antiviral treatments.

scholarly journals A Pre-Vaccination Baseline of SARS-CoV-2 Genetic Surveillance and Diversity in the United States

Viruses ◽  
2022 ◽  
Vol 14 (1) ◽  
pp. 104
Author(s):  
Adam A. Capoferri ◽  
Wei Shao ◽  
Jon Spindler ◽  
John M. Coffin ◽  
Jason W. Rausch ◽  
...  
Keyword(s):  
United States ◽  
Genetic Diversity ◽  
Rna Virus ◽  
Viral Evolution ◽  
The United States ◽  
Virus Spread ◽  
Immune Pressure ◽  
Viral Genetic Diversity ◽  
Genetic Sampling ◽  
The U.S

COVID-19 vaccines were first administered on 15 December 2020, marking an important transition point for the spread of SARS-CoV-2 in the United States (U.S.). Prior to this point in time, the virus spread to an almost completely immunologically naïve population, whereas subsequently, vaccine-induced immune pressure and prior infections might be expected to influence viral evolution. Accordingly, we conducted a study to characterize the spread of SARS-CoV-2 in the U.S. pre-vaccination, investigate the depth and uniformity of genetic surveillance during this period, and measure and otherwise characterize changing viral genetic diversity, including by comparison with more recently emergent variants of concern (VOCs). In 2020, SARS-CoV-2 spread across the U.S. in three phases distinguishable by peaks in the numbers of infections and shifting geographical distributions. Virus was genetically sampled during this period at an overall rate of ~1.2%, though there was a substantial mismatch between case rates and genetic sampling nationwide. Viral genetic diversity tripled over this period but remained low in comparison to other widespread RNA virus pathogens, and although 54 amino acid changes were detected at frequencies exceeding 5%, linkage among them was not observed. Based on our collective observations, our analysis supports a targeted strategy for worldwide genetic surveillance as perhaps the most sensitive and efficient means of detecting new VOCs.

scholarly journals Disparity in Clinical Trial Opportunities for Patients with B-Cell Malignancies in the United States

Blood ◽  
2018 ◽  
Vol 132 (Supplement 1) ◽  
pp. 4861-4861
Author(s):  
Sikander Ailawadhi ◽  
Sri Lekha Bodepudi ◽  
Zan Tahir Shareef ◽  
Fabiola Coromoto Cardozo ◽  
Salman Ahmed ◽  
...  
Keyword(s):  
United States ◽  
Clinical Trial ◽  
Clinical Trials ◽  
Geographical Distribution ◽  
Research Funding ◽  
Phase 1 ◽  
The United States ◽  
Phase 2 ◽  
B Cell Malignancies ◽  
The Us

Abstract Background: Clinical trials are fundamental to advance therapeutics systematically and improve patient outcomes. Despite this, enrollment on clinical trials remains dismal in the United States (US) and is a constant focus of healthcare policy. We studied distribution of clinical trials for B-cell malignancies over time across the US and unique clinical trial opportunities i.e. individual clinical trials for the given diagnosis at a site that patients may have access to participate. Methods: We abstracted data from clinicaltrials.gov for all trials that had non-Hodgkin lymphoma (NHL) or multiple myeloma (MM) as an inclusion indication between 1999-2018. Clinical trial characteristics and distribution over US geographical divisions (West, Midwest, Northeast, and South) were studied, and differences were assessed by Chi-square test. Results: A total of 1930 trials were identified (NHL: 982, MM: 948), of which 483 were recruiting at the time of data abstraction (NHL: 250, MM: 233). Over the past 2 decades, 182691 patients were enrolled on the various trials (NHL: 81592, MM: 101099). Trials by phase of study included phase 1: 629, phase 1/2: 316, phase 2: 813, phase 2/3: 11 and phase 3: 161. Number of trials by phase separated by NHL and MM are shown in Figure 1. Of these, 197 trials were randomized (NHL: 67, MM: 130). Geographical distribution of trials by diagnosis type is shown in Figure 2. A total of 31806 unique trial opportunities were noted for MM and NHL, of which 9,513 were international and 22,293 were in the US, with a geographical distribution of 5080 in West, 8198 in Midwest, 3944 in Northeast, and 5071 in South. 4,883 of the unique trial opportunities were available at NCI/NCCN accredited sites and 17,410 were at non-NCI/NCCN sites in the US. Treatment characteristics of the trials included monoclonal antibodies in 1218, other targeted agents in 2641, stem cell transplant in 526, and other agents in 517 trials with several trials utilizing more than one of these therapeutic options. There was no statistically significant difference in the distribution of clinical trials by phase of study across various US geographical regions for MM (p=0.71), NHL (p=0.98) or combined MM+NHL (p=0.16). On the other hand, unique trial opportunities were significantly different by study phase and geographical distribution for MM, NHL or MM+NHL (all p<0.001) (Figure 3). Conclusions: Widespread access to clinical trials within a cancer diagnosis is imperative for generalizability of trial results. In a comprehensive, national analysis we noted that while it may appear that clinical trials are available across the US, sites where they are open are distributed unevenly, giving rise to a disparity in access to evidence-based therapeutic advancements for patients. Disclosures Ailawadhi: Janssen: Consultancy; Amgen: Consultancy; Pharmacyclics: Research Funding; Takeda: Consultancy; Celgene: Consultancy. Sher:Affimed: Research Funding.

MO571PRACTICE PATTERNS ON THE MANAGEMENT OF SECONDARY HYPERPARATHYROIDISM IN THE UNITED STATES: RESULTS FROM A MODIFIED DELPHI PANEL

2021 ◽  
Vol 36 (Supplement_1) ◽  
Author(s):  
David E Henner ◽  
Beatrice Drambarean ◽  
Teresa M Gerbeling ◽  
Jessica B Kendrick ◽  
William T Kendrick ◽  
...  
Keyword(s):  
United States ◽  
Kidney Disease ◽  
Secondary Hyperparathyroidism ◽  
Phase 1 ◽  
Serum Levels ◽  
The United States ◽  
Intact Pth ◽  
Phase 3 ◽  
Modified Delphi ◽  
Virtual Meeting

Abstract Background and Aims The 2017 Kidney Disease Improving Global Outcomes (KDIGO) Chronic Kidney Disease-Mineral Bone Disorder (CKD-MBD) guidelines inform clinical practice for the management of secondary hyperparathyroidism (SHPT) internationally; however, many recommendations lacked high or moderate clinical evidence as defined by KDIGO. An expert panel was convened to establish clinical consensus for the current management of SHPT in the United States (US). Method The panel comprised 10 US healthcare providers (HCPs; [6 nephrologists, 1 surgeon, 1 nurse practitioner, 1 pharmacist, 1 dietician]) and 1 patient. HCP panelists participated in a modified Delphi process over 3 phases, addressing 126 questions based on a review of the literature and published guidelines. The threshold for consensus was 66%. In phases 1 and 2, panelists anonymously completed electronic surveys considering a ‘typical’ patient with SHPT unless otherwise specified. In phase 1, panelists answered 126 questions based on their own knowledge and experiences. In phase 2, panelists were reminded of their answers to closed-ended questions that did not achieve consensus in phase 1 and were asked if they would change their responses in light of the most common response. For open-ended questions, they were asked if they agreed with summary statements that captured the most common answers. Phase 3 was an unblinded virtual meeting where panelists reviewed the consensus reached in phases 1 and 2, and through active discussion, resolved those questions that had not reached consensus. The patient completed a separate electronic survey, which complemented key points in the HCP survey, and provided perspective during the virtual meeting. Results All 11 panelists completed the entire modified Delphi process. Sixty-three out of 126 (50%) and 116/126 (92.1%) questions reached consensus or addressed practice-specific information not requiring consensus by the end of phase 1 and 2, respectively; all questions reached consensus by the end of phase 3, including modification of 2 questions and the addition of 1 question. The panel unanimously agreed that SHPT treatment is often started too late and suggested additional markers for early identification of patients requiring treatment are needed. Serum levels of calcium, phosphate, and parathyroid hormone (PTH) should be monitored starting at CKD stage G3a at intervals of every 6 months, 3–6 months for CKD G3b, and at least every 3 months at CKD G4 and above. Thresholds for interventions could not be defined in absolute terms for all patients due to patient-and practice-specific factors. However, in patients on dialysis, serum levels of phosphate &gt; 5.5 mg/dL (1.8 mmol/L) and calcium &gt; 9.5 mg/dL (2.4 mmol/L), warrant increased monitoring and consideration of therapeutic interventions. Serum intact PTH &gt; 300 pg/mL (32 pmol/L) typically indicates a need for SHPT treatment, with a consensus preferred target of 150–300 pg/mL (16–32 pmol/L); patients on dialysis were considered out of PTH target at ≥ 8 times the upper limit of normal (&gt; 520 pg/mL [55 pmol/L] intact PTH). HCPs were concerned about vascular calcification in all patients with CKD 3a–G5D. The panel reached consensus on the use of several SHPT interventions, including a consensus preference for the intravenous calcimimetic etelcalcetide over the oral calcimimetic cinacalcet in appropriate in-center dialysis patients requiring PTH-lowering therapy; cinacalcet was agreed to be first-line therapy in appropriate patients on home dialysis (Table 1). Factors such as formularies and dialysis center protocols were recognized to influence therapeutic choices. Conclusion Ten US HCPs reached consensus on many aspects of SHPT management, further defining therapeutic strategies and highlighting the need to be proactive. While the panel expressed evidenced-based preferences for certain therapies, factors such as cost and dialysis center protocols may affect decision making.

scholarly journals Genetic Diversity and Geographical Distribution of Indigenous Soybean-Nodulating Bradyrhizobia in the United States

2013 ◽  
Vol 79 (12) ◽  
pp. 3610-3618 ◽  
Author(s):  
Sokichi Shiro ◽  
Syota Matsuura ◽  
Rina Saiki ◽  
Gilbert C. Sigua ◽  
Akihiro Yamamoto ◽  
...  
Keyword(s):  
United States ◽  
Genetic Diversity ◽  
Community Structure ◽  
Geographical Distribution ◽  
The United States ◽  
23S Rrna ◽  
Rrna Gene ◽  
Scaling Analysis ◽  
Internal Transcribed Spacer Region ◽  
Content Type

ABSTRACTWe investigated the relationship between the genetic diversity of indigenous soybean-nodulating bradyrhizobia and their geographical distribution in the United States using nine soil isolates from eight states. The bradyrhizobia were inoculated on three soybeanRjgenotypes (non-Rj,Rj2Rj3, andRj4). We analyzed their genetic diversity and community structure by means of restriction fragment length polymorphisms of PCR amplicons to target the 16S-23S rRNA gene internal transcribed spacer region, using 11 USDABradyrhizobiumstrains as reference strains. We also performed diversity analysis, multidimensional scaling analysis based on the Bray-Curtis index, and polar ordination analysis to describe the structure and geographical distribution of the soybean-nodulating bradyrhizobial community. The major clusters wereBradyrhizobium japonicumBj123, in the northern United States, andBradyrhizobium elkanii, in the middle to southern regions. Dominance of bradyrhizobia in a community was generally larger for the cluster belonging toB. elkaniithan for the cluster belonging toB. japonicum. The indigenous American soybean-nodulating bradyrhizobial community structure was strongly correlated with latitude. Our results suggest that this community varies geographically.

An American Language

2018 ◽  
Author(s):  
Rosina Lozano
Keyword(s):  
United States ◽  
National Policy ◽  
The United States ◽  
Spanish Language ◽  
Spanish Speakers ◽  
Language Recognition ◽  
Political Language ◽  
Political Issue ◽  
History Of ◽  
The U.S

An American Language is a political history of the Spanish language in the United States. The nation has always been multilingual and the Spanish language in particular has remained as an important political issue into the present. After the U.S.-Mexican War, the Spanish language became a language of politics as Spanish speakers in the U.S. Southwest used it to build territorial and state governments. In the twentieth century, Spanish became a political language where speakers and those opposed to its use clashed over what Spanish's presence in the United States meant. This book recovers this story by using evidence that includes Spanish language newspapers, letters, state and territorial session laws, and federal archives to profile the struggle and resilience of Spanish speakers who advocated for their language rights as U.S. citizens. Comparing Spanish as a language of politics and as a political language across the Southwest and noncontiguous territories provides an opportunity to measure shifts in allegiance to the nation and exposes differing forms of nationalism. Language concessions and continued use of Spanish is a measure of power. Official language recognition by federal or state officials validates Spanish speakers' claims to US citizenship. The long history of policies relating to language in the United States provides a way to measure how U.S. visions of itself have shifted due to continuous migration from Latin America. Spanish-speaking U.S. citizens are crucial arbiters of Spanish language politics and their successes have broader implications on national policy and our understanding of Americans.

Palestine Unbound

2018 ◽  
Vol 47 (3) ◽  
pp. 130-134
Keyword(s):  
United States ◽  
Human Rights ◽  
Task Force ◽  
The United States ◽  
Donald Trump ◽  
Tel Aviv ◽  
The Us ◽  
Intention To Move ◽  
Arab Israeli Conflict ◽  
The U.S

This section, updated regularly on the blog Palestine Square, covers popular conversations related to the Palestinians and the Arab-Israeli conflict during the quarter 16 November 2017 to 15 February 2018: #JerusalemIstheCapitalofPalestine went viral after U.S. president Donald Trump recognized Jerusalem as the capital of Israel and announced his intention to move the U.S. embassy there from Tel Aviv. The arrest of Palestinian teenager Ahed Tamimi for slapping an Israeli soldier also prompted a viral campaign under the hashtag #FreeAhed. A smaller campaign protested the exclusion of Palestinian human rights from the agenda of the annual Creating Change conference organized by the US-based National LGBTQ Task Force in Washington. And, UNRWA publicized its emergency funding appeal, following the decision of the United States to slash funding to the organization, with the hashtag #DignityIsPriceless.

The French Way

2011 ◽  
Author(s):  
Richard F. Kuisel
Keyword(s):  
United States ◽  
The United States ◽  
French Language ◽  
French Cinema ◽  
Free Markets ◽  
Technology Sector ◽  
Aids Epidemic ◽  
Political Reality ◽  
Politics And Culture ◽  
The U.S

There are over 1,000 McDonald's on French soil. Two Disney theme parks have opened near Paris in the last two decades. And American-inspired vocabulary such as “le weekend” has been absorbed into the French language. But as former French president Jacques Chirac put it: “The U.S. finds France unbearably pretentious. And we find the U.S. unbearably hegemonic.” Are the French fascinated or threatened by America? They Americanize yet are notorious for expressions of anti-Americanism. From McDonald's and Coca-Cola to free markets and foreign policy, this book looks closely at the conflicts and contradictions of France's relationship to American politics and culture. The book shows how the French have used America as both yardstick and foil to measure their own distinct national identity. France has charted its own path: it has welcomed America's products but rejected American policies; assailed Americ's “jungle capitalism” while liberalizing its own economy; attacked “Reaganomics” while defending French social security; and protected French cinema, television, food, and language even while ingesting American pop culture. The book examines France's role as an independent ally of the United States, but he also considers the country's failures in influencing the Reagan, Bush, and Clinton administrations. Whether investigating France's successful information technology sector or its spurning of American expertise during the AIDS epidemic, the book asks if this insistence on a French way represents a growing distance between Europe and the United States or a reaction to American globalization. Exploring cultural trends, values, public opinion, and political reality, this book delves into the complex relationship between two modern nations.

Latino Catholicism

2011 ◽  
Author(s):  
Timothy Matovina
Keyword(s):  
United States ◽  
Sixteenth Century ◽  
Catholic Church ◽  
Social Life ◽  
Social Issues ◽  
The United States ◽  
Societal Impact ◽  
Comprehensive Overview ◽  
Public Debates ◽  
The U.S

Most histories of Catholicism in the United States focus on the experience of Euro-American Catholics, whose views on social issues have dominated public debates. This book provides a comprehensive overview of the Latino Catholic experience in America from the sixteenth century to today, and offers the most in-depth examination to date of the important ways the U.S. Catholic Church, its evolving Latino majority, and American culture are mutually transforming one another. This book highlights the vital contributions of Latinos to American religious and social life, demonstrating in particular how their engagement with the U.S. cultural milieu is the most significant factor behind their ecclesial and societal impact.

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