County-level Analysis of Perinatal Health Indicators Within a Single Health System Catchment

Background: Adverse perinatal health outcomes are disproportionally impacted in rural communities. Social determinants of health (SDoH) defined by nonclinical social, behavioral, and economic factors may impact up to 90% of health outcomes in rural communities. Objective: To evaluate county-level perinatal patterns in health outcomes, health behaviors, socioeconomic vulnerability, and healthcare providers across rural and non-rural Florida counties within a single health system catchment. Methods: Socioeconomic vulnerability metrics, digital connectivity, licensed provider metrics, and behavioral data and were obtained from Floridahealthcharts.com and the County Health Rankings. County-level birth and perinatal health outcome data were obtained from the Florida Department of Health. The University of Florida Health Perinatal Catchment Area (UFHPCA) was defined as all Florida counties where ≥5% of all infants were delivered at Shands Hospital in Alachua county between June 2011 and April 2017. County-level rurality was determined by Florida Statutes 288.0656 rurality designations. Results: The UFHPCA included three non-rural and ten rural counties that represented more than 64,000 deliveries over a 5-year 9-month period. We found that nearly 1 in 3 infants resided in a rural county (n=20,899), and 7 out of 13 counties did not have a licensed obstetrician gynecologist. Nine counties reported maternal death rates that were between 1 and 4-fold higher than the statewide rate, and rural counties generally reported neonatal mortality and preterm birth rates that were higher than the statewide averages. We found maternal smoking rates (range 6.8% – 24.8%) were above the statewide rate (6.2%) for all counties in the catchment. Except for Alachua county, breastfeeding initiation rates (range 54.9% - 81.4%) and access to household computing devices (range 72.8% - 86.4%) were below the statewide rate (82.9% and 87.9%, respectively). Finally, we found that childhood poverty rates (range 16.3% - 36.9%) in our catchment was above the statewide rate (18.5%), except for Suwanee and Columbia counties.Conclusions: The health burden of the UFHPCA is characterized by both rural and non-rural counties with increased maternal and neonatal death and preterm birth, as well as adverse health behaviors that include smoking during pregnancy and lower levels of breastfeeding.

Smilax auriculata: A new host for Orchid fleck dichorhavirusvirus identified in Florida, USA

In June 2020, Orchid fleck virus (OFV) was detected in a species of Liriope in Leon and Alachua County, Florida (Fife et al; 2021). In October of the same year, four adjacent dune/ear-leaf greenbrier vines, Smilax auriculata (Smilaceae: Liliales), showed yellowing and mottling symptoms (Figure 1). Infected and healthy S. auriculata leaves samples were collected in Alachua County by the Florida Department of Agriculture and Consumer Services, Gainesville, Florida. OFV primers successfully detected in four Smilax samples by conventional RT-PCR assay. Amplicon sequences (Acc. No. MZ645935 and MZ645938) shared 99% nucleotide identity with OFV infecting orchids (LC222629) and citrus (MK522804). The OFV subgroup I (OFV-Orc1) and subgroup II (OFV-Orc2) specific primers (Kondo et al 2017) were utilized to confirm the presence of OFV type strains infecting Smilax. Sanger sequencing of subgroup I specific amplicons (MZ645934) shared 99% nucleotide identity with OFV-Orc1 (LC222629) whereas subgroup II specific amplicon sequence (MZ645930) shared 98-99 % nucleotide identity with OFV-Orc2 (AB244417). Further confirmation was done by USDA-APHIS-PPQ-Plant Pathogen Confirmatory Diagnostics Laboratory utilizing optimized conventional RT-PCR protocols (Roy et al. 2020) and deep sequencing on a on a NextSeq550 Illumina platform. Assembled reads identified seven non-overlapping viral contigs. Five RNA1 and two RNA2 contigs covered more than 97% of the bipartite OFV genome with average coverage depth of 5297.61 and 5186.04, respectively. Contigs of RNA1 and RNA2 shared 98-99% nt identity to OFV-Orc2-RNA1 (AB244417) and OFV-Orc-RNA2 (AB244418 and LC222630). No other pathogen sequences were identified. This is the first time the genus Smilax has been identified as a natural host of OFV. Very recent findings of OFV-Orc in Florida in Liriope, Aspidistra, and Ophiopogon among the Asparagaceae family members (Fife et al; 2021) and now in the Smilacaceae suggest a broader host range of the virus than previously known; further research should be conducted to better characterize the potential risk of introduction into citrus in Florida.

SARS-CoV-2 Delta vaccine breakthrough transmissibility in Alachua, Florida

Background SARS-CoV-2 Delta variant has caused a dramatic resurgence in infections in the United Sates, raising questions regarding potential transmissibility among vaccinated individuals. Methods Between October 2020 and July 2021, we sequenced 4,439 SARS-CoV-2 full genomes, 23% of all known infections in Alachua County, Florida, including 109 vaccine breakthrough cases. Univariate and multivariate regression analyses were conducted to evaluate associations between viral load (VL) level and patient characteristics. Contact tracing and phylogenetic analysis were used to investigate direct transmissions involving vaccinated individuals. Results The majority of breakthrough sequences with lineage assignment were classified as Delta variants (74.6%) and occurred, on average, about three months (104 +- 57.5 days) after full vaccination, at the same time (June-July 2021) of Delta variant exponential spread within the county. Six Delta variant transmission pairs between fully vaccinated individuals were identified through contact tracing, three of which were confirmed by phylogenetic analysis. Delta breakthroughs exhibited broad VL values during acute infection (IQR 1.2-8.64 Log copies/ml), on average 38% lower than matched unvaccinated patients (3.29-10.81 Log copies/ml, p<0.00001). Nevertheless, 49-50% of all breakthroughs, and 56-60% of Delta-infected breakthroughs exhibited VL above the transmissibility threshold (4 Log copies/ml) irrespective of time post vaccination. Conclusions Delta infection transmissibility and general VL patterns in vaccinated individuals suggest limited levels of sterilizing immunity that need to be considered by public health policies. In particular, ongoing evaluation of vaccine boosters should address whether extra vaccine doses might curb breakthrough contribution to epidemic spread.

Misdemeanor Crime Rates in the First Year of the COVID-19 Pandemic

Declared a national emergency on March 1, 2020, the Coronavirus Disease (COVID-19) has caused a major change in everyday life and crime statistics across the United States (U.S.). The research in this study aims to assess changes in reported misdemeanor crimes in Alachua County, Florida in the first year of the COVID-19 pandemic, as well as changes in the rate of misdemeanor crimes committed by certain genders and race demographics. Data was collected from the Alachua County Clerk of Circuit Court’s On-Line Court Records and Document Images Access Page from January 2019 to December 2020. The results of this study were consistent with the researcher’s hypothesis that the number of overall misdemeanor cases filed would substantially increase regardless of race or gender, likely as a result of social disorganization and community unrest. However, the original hypotheses that women and Black people would be seen committing higher rates of misdemeanor crimes in 2020 due to gender inequality and racial biases were rejected, with the data showing no statistical significance in the change in the number of cases filed for these populations. A potential explanatory factor for these findings is an overcommitment of responsibilities put upon women and girls, and a fear of racial prejudice and lack of social unity amongst Black people. These findings are important to highlight latent functions of state ordinances enacted to mitigate the spread of COVID-19, and to spotlight necessary crime control and reduction techniques that must be implemented simultaneously to adapt to the “new normal.”

SARS-CoV-2 infection of BNT162b2(mRNA)-vaccinated individuals is not restricted to variants of concern or high-risk exposure environments

The emergence of SARS-CoV-2 variants of concern (VOC) has raised questions regarding the extent of protection of currently implemented vaccines. Ten "vaccination breakthrough" infections were identified in Alachua County, Florida, among individuals fully vaccinated with the BNT162b2 mRNA vaccine as a result of social or household transmission. Eight individuals presented mild symptoms in the absence of infection with other common respiratory viruses, confirmed using viral genetic sequencing. SARS-CoV-2 genomes were successfully generated for five of the vaccine breakthroughs and 399 individuals in the surrounding area and were included for reference-based phylogenetic investigation. These five individuals were characterized by infection with both VOCs and low-frequency variants present within the surrounding population. Mutations in the Spike protein were consistent with their respective circulating lineages, with the exception of a viable, low-frequency (approximately 1%) B.1.1.7 mutation, which we describe as a mutation of potential concern. The findings indicate that in cases of limited vaccine protection, infection is not restricted to VOCs or high-risk settings, highlighting the critical need for continued testing and monitoring of infection among individuals regardless of vaccination status.

Developing Extension Programming to Help Low-Income Families Save Money and Energy: The Community Weatherization Coalition Model

This new 3-page publication of the Department of Agricultural Education and Communication is the first in a series that will help Extension agents, nonprofits, agency personnel, and other promoters of community development better understand both the issue of high utility bills among low-income residents and what they can do to help. This first publication provides an overview of one program approach taken by a group of volunteers in Alachua County, the Community Weatherization Coalition, which uses a model of trained “energy coaches.” Written by Paul Monaghan, Sarah Blucher, Marianne Schmink, Alane Humrich, Jennison Kipp, and Wendell Porter.https://edis.ifas.ufl.edu/wc368

New early Pleistocene Alligator (Eusuchia: Crocodylia) from Florida bridges a gap in Alligator evolution

The American Alligator (Alligator mississippiensis) is one of two species of Alligator in the modern world. It is only distantly related to the other extant species (A. sinensis), with much closer relatives known from the geologic past of North America. A disparity exists, though, in the fossil record between A. mississippiensis and its close relative, the late Miocene (?)—early Pliocene A. mefferdi. While A. mississippiensis is known from the mid-Pleistocene and later, few Alligator remains were known from the earliest Pleistocene of North America until the discovery of the Haile 7C and 7G early Pleistocene (Blancan Land Mammal Age) sites from Alachua County, Florida. The Haile alligators exhibit a suite of characters from both A. mississippiensis and A. mefferdi, displaying intermediate morphology in time. The Haile alligators are distinct from either of the aforementioned taxa, and a new species, Alligator hailensis is suggested, bridging an important gap in the evolution of the American Alligator.

Free Neurocognitive Screening Initiative: An Opportunity to Address Health Disparities and Promote Cultural Competence in Northcentral Florida

Objective The risk for cognitive impairment is greater in individuals with low SES and limited education. In rural areas, distance and economic concerns preclude individuals from accessing care. In Alachua County, 23% of residents live below poverty and 16% are uninsured. The Neurocognitive Screening Initiative (NSI) attempts to reduce disparities in Alachua by offering free neurocognitive screening. NSI also aspires to promote cultural competence through unique training opportunities for clinical neuropsychology doctoral students. Method Patients learned about NSI through flyers, word of mouth, or referrals. Appointments include a clinical interview, cognitive testing, and mood questionnaires. Patients receive feedback, brain health recommendations, and referrals to community resources. Phase 1 began in November 2017 and involved selection of appropriate cognitive measures, development and dissemination of advertising materials, identification of resources, and trainee recruitment. From February 2018 to August 2018, phase 2 involved administration of cognitive screeners. Phase 3 involved continued provision of clinical services, expansion of the NSI team and increased culturally relevant outreach. Outcomes NSI’s greatest challenge is recruitment of the appropriate demographic. Since phase 2, we have evaluated 10 patients with diverse racial, socioeconomic, and clinical characteristics. NSI has recruited an ethnoracially diverse cohort of trainees comprised of 4 graduate students and 2 postdoctoral fellows supervised by a clinical neuropsychologist. Discussion Efforts to provide services to marginalized individuals have uncovered challenges in attracting patients who might benefit from these services. NSI is forging community partnerships with churches, libraries, and local organizations to reach the targeted audience. Via weekly meetings, participation in community events/outreach, and clinical work, NSI provides unique training for emerging neuropsychologists.