Clinical outcomes among patients infected with Omicron (B.1.1.529) SARS-CoV-2 variant in southern California

Background: The Omicron (B.1.1.529) variant of SARS-CoV-2 has rapidly achieved global dissemination, accounting for most infections in the United States by December 2021. Risk of severe outcomes associated with Omicron infections, as compared to earlier SARS-CoV-2 variants, remains unclear. Methods: We analyzed clinical and epidemiologic data from cases testing positive for SARS-CoV-2 infection within the Kaiser Permanente Southern California healthcare system from November 30, 2021 to January 1, 2022, using S gene target failure (SGTF) as assessed by the ThermoFisher TaqPath ComboKit assay as a proxy for Omicron infection. We fit Cox proportional hazards models to compare time to any hospital admission and hospital admissions associated with new-onset respiratory symptoms, intensive care unit (ICU) admission, mechanical ventilation, and mortality among cases with Omicron and Delta (non-SGTF) variant infections. We fit parametric competing risk models to compare lengths of hospital stay among admitted cases with Omicron and Delta variant infections. Results: Our analyses included 52,297 cases with SGTF (Omicron) and 16,982 cases with non-SGTF (Delta [B.1.617.2]) infections, respectively. Hospital admissions occurred among 235 (0.5%) and 222 (1.3%) of cases with Omicron and Delta variant infections, respectively. Among cases first tested in outpatient settings, the adjusted hazard ratios for any subsequent hospital admission and symptomatic hospital admission associated with Omicron variant infection were 0.48 (0.36-0.64) and 0.47 (0.35-0.62), respectively. Rates of ICU admission and mortality after an outpatient positive test were 0.26 (0.10-0.73) and 0.09 (0.01-0.75) fold as high among cases with Omicron variant infection as compared to cases with Delta variant infection. Zero cases with Omicron variant infection received mechanical ventilation, as compared to 11 cases with Delta variant infections throughout the period of follow-up (two-sided p<0.001). Median duration of hospital stay was 3.4 (2.8-4.1) days shorter for hospitalized cases with Omicron variant infections as compared to hospitalized patients with Delta variant infections, reflecting a 69.6% (64.0-74.5%) reduction in hospital length of stay. Conclusions: During a period with mixed Delta and Omicron variant circulation, SARS-CoV-2 infections with presumed Omicron variant infection were associated with substantially reduced risk of severe clinical endpoints and shorter durations of hospital stay.

Advancing stream classification and hydrologic modeling of ungaged basins for environmental flow management in coastal southern California

Environmental streamflow management can improve the ecological health of streams by returning modified flows to more natural conditions. The Ecological Limits of Hydrologic Alteration (ELOHA) framework for developing regional environmental flow criteria has been implemented to reverse hydromodification across the heterogenous region of coastal southern California (So. CA) by focusing on two elements of the flow regime: streamflow permanence and flashiness. Within ELOHA, classification groups streams by hydrologic and geomorphic similarity to stratify flow-ecology relationships. Analogous grouping techniques are used by hydrologic modelers to facilitate streamflow prediction in ungaged basins (PUB) through regionalization. Most watersheds, including those needed for stream classification and environmental flow development, are ungaged. Furthermore, So. CA is a highly heterogeneous region spanning a gradient of urbanization, which presents a challenge for regionalizing ungaged basins. In this study, we develop a novel classification technique for PUB modeling that uses an inductive approach to group regional streams by modeled hydrologic similarity followed by deductively determining class membership with hydrologic model errors and watershed metrics. As a new type of classification, this “Hydrologic Model-based Classification” (HMC) prioritizes modeling accuracy, which in turn provides a means to improve model predictions in ungaged basins, while complementing traditional classifications and improving environmental flow management. HMC is developed by calibrating a regional catalog of process-based rainfall-runoff models, quantifying the hydrologic reciprocity of calibrated parameters that would be unknown in ungaged basins, and grouping sites according to hydrologic and physical similarity. HMC was applied to 25 USGS streamflow gages in the south coast region of California and was compared to other hybrid PUB approaches combining inductive and deductive classification. Using an Average Cluster Error metric, results show HMC provided the most hydrologically similar groups according to calibrated parameter reciprocity. Hydrologic Model-based Classification is relatively complex and time-consuming to implement, but it shows potential for advancing ungaged basin management. This study demonstrates the benefits of thorough stream classification using multiple approaches, and suggests that Hydrologic Model-based Classification has advantages for PUB and building the hydrologic foundation for environmental flow management.

Tectonic controls on Quaternary landscape evolution in the Ventura basin, southern California, USA, quantified using cosmogenic isotopes and topographic analyses

The quantification of rates for the competing forces of tectonic uplift and erosion has important implications for understanding topographic evolution. Here, we quantify the complex interplay between tectonic uplift, topographic development, and erosion recorded in the hanging walls of several active reverse faults in the Ventura basin, southern California, USA. We use cosmogenic 26Al/10Be isochron burial dating and 10Be surface exposure dating to construct a basin-wide geochronology, which includes burial dating of the Saugus Formation: an important, but poorly dated, regional Quaternary strain marker. Our ages for the top of the exposed Saugus Formation range from 0.36 +0.18/−0.22 Ma to 1.06 +0.23/−0.26 Ma, and our burial ages near the base of shallow marine deposits, which underlie the Saugus Formation, increase eastward from 0.60 +0.05/−0.06 Ma to 3.30 +0.30/−0.41 Ma. Our geochronology is used to calculate rapid long-term reverse fault slip rates of 8.6−12.6 mm yr−1 since ca. 1.0 Ma for the San Cayetano fault and 1.3−3.0 mm yr−1 since ca. 1.0 Ma for the Oak Ridge fault, which are both broadly consistent with contemporary reverse slip rates derived from mechanical models driven by global positioning system (GPS) data. We also calculate terrestrial cosmogenic nuclide (TCN)-derived, catchment-averaged erosion rates that range from 0.05−1.14 mm yr−1 and discuss the applicability of TCN-derived, catchment-averaged erosion rates in rapidly uplifting, landslide-prone landscapes. We compare patterns in erosion rates and tectonic rates to fluvial response times and geomorphic landscape parameters to show that in young, rapidly uplifting mountain belts, catchments may attain a quasi-steady-state on timescales of &lt;105 years even if catchment-averaged erosion rates are still adjusting to tectonic forcing.

Implementing a Critical Community of Practice Within a University-Based Teacher Induction Program

This chapter describes the initial stage of implementing a critical community of practice within a university-based teacher induction program in Southern California. This case highlights how novice critical teachers work together to support one another, engage in problem-solving, and bridge theories to action to address challenges they face in their teaching. Implications for using critical community of practice in academic programs and professional programs to bridge critical theories to equitable practice are presented.