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The causes for variability of pro-inflammatory surface antigens that affect gut commensal/opportunistic dualism within the phylum Bacteroidota remain unclear (1, 2). Using the classical lipopolysaccharide/O-antigen ‘rfb operon’ in Enterobacteriaceae as a surface antigen model (5-gene-cluster rfbABCDX), and a recent rfbA-typing strategy for strain classification (3), we characterized the architecture/conservancy of the entire rfb operon in Bacteroidota. Analyzing complete genomes, we discovered that most Bacteroidota have the rfb operon fragmented into non-random gene-singlets and/or doublets/triplets, termed ‘minioperons’. To reflect global operon integrity, duplication, and fragmentation principles, we propose a five-category (infra/supernumerary) cataloguing system and a Global Operon Profiling System for bacteria. Mechanistically, genomic sequence analyses revealed that operon fragmentation is driven by intra-operon insertions of predominantly Bacteroides-DNA (thetaiotaomicron/fragilis) and likely natural selection in specific micro-niches. Bacteroides-insertions, also detected in other antigenic operons (fimbriae), but not in operons deemed essential (ribosomal), could explain why Bacteroidota have fewer KEGG-pathways despite large genomes (4). DNA insertions overrepresenting DNA-exchange-avid species, impact functional metagenomics by inflating gene-based pathway inference and overestimating ‘extra-species’ abundance. Using bacteria from inflammatory gut-wall cavernous micro-tracts (CavFT) in Crohn’s Disease (5), we illustrate that bacteria with supernumerary-fragmented operons cannot produce O-antigen, and that commensal/CavFT Bacteroidota stimulate macrophages with lower potency than Enterobacteriaceae, and do not induce peritonitis in mice. The impact of ‘foreign-DNA’ insertions on pro-inflammatory operons, metagenomics, and commensalism offers potential for novel diagnostics and therapeutics.

Deformation microstructures can be used to decipher multiple stages of deformation in ancient terranes through the assessment of classical high-temperature minerals, fabrics, and textures (e.g., alteration minerals, reduction of grain size) as well as low-temperature cross-cutting features (e.g., brittle fracture). Microstructural studies are typically necessary, in conjunction with hand-sample and/or outcrop work, to fully characterize the spectrum of deformation events and mechanisms in a system and to understand the impact that future deformation events may have on similar rock masses. In this study, we focus on samples from SE Nebraska, where crystalline basement, chiefly the Central Plains orogeny, dates from the Proterozoic assembly of the central craton of North America. This basement was deformed by the evolution of two major features: (1) the 1.1 Ga Mid-Continent Rift System (MCRS) and (2) the >300 Ma Nemaha Uplift (NU). Due to the uplift on the flanks of the MCRS and the NU, ~60 m of these basement rocks were recovered in a fragmented small-diameter core. This so-called “Capitol/Capital Beach core”, one of exceedingly few basement cores in SE Nebraska, was drilled in 1887 as part of an unsuccessful search for rock salt or brine. Pieces of it were distributed as souvenirs, then painstakingly reclaimed and rearticulated by the state geologist. We present a first-ever textural and microstructural analysis of the basement rock from this historic core.Preliminary thin section petrography indicates that the groundmass of the basement rock is primarily quartz, twinned feldspar, mica and some opaques (zircon?) with remnant intergrowths and textures consistent with cooling from a melt; therefore, we consider the basement in this area to be granitic. Under crossed polars, we observe undulose extinction in the quartz grains, implying high strain. Quartz grains also show subgrain development at grain boundaries. Thin sections and hand samples also reveal the development of phyllosilicate shear zones, altered from the precursor micas that are folded and kinked themselves. Furthermore, we note at least two generations of brittle fracture in quartz and feldspar grains, some of which propagate through and displace the phyllosilicate shear zones and are filled with alteration minerals, including possible epidote.Our microstructural data implies that the granitic basement has undergone no less than four discrete phases of deformation since accretion. We associate two of these phases with the evolution of the MRCS and NU evolution, but other two phases of deformation occurred earlier, probably during the Cambrian to Mississippian, an interval about which little in terms of regional tectonism and deformation is known. Our work highlights the importance of cratonic uplift events in the fracture of rock masses, even on the microscopic scale, during basement evolution. It also portends important insights from continued investigation.

Extrusion tectonics has been invoked to explain recent magmatism across Indochina (e.g., Hoang & Flower, 1998). Lithospheric mantle xenoliths sampled from two alkali basalts in south-central Vietnam, Pleiku and Xuan Loc, comprise fertile spinel peridotites. To better determine the origins of the Indochinese subcontinental lithospheric mantle (SCLM), including impacts of tectonic extrusion, we present major and trace elements, and 87Sr/86Sr, 143Nd/144Nd, 206Pb/204Pb, 207Pb/204Pb, and 208Pb/204Pb in xenolith mineral separates. Most peridotites from Pleiku and Xuan Loc have fertile major element compositions, “depleted” and “spoon-shaped” rare earth element (REE) patterns, interpreted to record prior melt depletion followed by melt metasomatism, and depleted isotopic signatures (e.g., 87Sr/86Sr = 0.70238–0.70337 and 143Nd/144Nd = 0.512921–0.514190). A small group of refractory peridotites have “enriched” REE patterns suggesting more extensive metasomatism, and enriched isotope ratios (87Sr/86Sr = 0.70405 and 143Nd/144Nd = 0.512755-0.512800). The presence of both fertile and refractory xenoliths records a heterogeneous SCLM beneath Vietnam. Based on geothermobarometry calculations, fertile xenoliths have equilibrium temperatures of 923-1,034 °C and pressures of 11.7-15.8 kbar, while refractory xenoliths have comparable temperatures of 923-1,006 ºC, but lower pressures of 7.1-10.0 kbar, suggesting refractory rocks are dominantly present at shallower depths. We suggest that the regional lithospheric mantle has experienced variable melt extraction, producing heterogeneous compositions. While we cannot rule out partial removal and replacement of the lithosphere, large-scale delamination is not necessary to explain observed characteristics. The entire SCLM was more recently metasomatized by melts resembling Cenozoic basalts, suggesting recent asthenospheric melting has modified the SCLM by melt infiltration.

In Nebraska, carbon dioxide emissions come from burning fossil fuels, (~15 million tons of CO2 per year) and from ethanol plants (~4 million tons of CO2 per year). Carbon capture and storage (CCS) is therefore vital to improve the air quality in Nebraska and to enable these industries to operate. The study area for this project covers that region of Western Nebraska not fully evaluated to date, wherein we postulate that there is extensive storage space specifically in the stacked carbonates of the Pennsylvanian cyclothems. There is evidence of strong primary and secondary seals overlying the potential reservoir units. We use existing well call outs (available through the Nebraska Oil and Gas Conservation Commission) and wireline logs to construct a framework 3D subsurface model. We have also logged and sampled core at the USGS Core Research Center to further understand the stratigraphy and validity of wireline data; as well as conducting geomechanical tests on core samples to evaluate porosity, permeability, and storage efficiency properties. Using volumes extracted from the model and the geomechanical data, numerical simulations will be run using the National Energy Transition Lab’s (NETL) CO2-Screen, a Monte Carlo-based package that generates a probabilistic range of storage volumes. We demonstrate that the study region is viable and promising for a further stage of data gathering, including seismic surveys and the drilling of a stratigraphic test well to completely evaluate the reservoir units. The aim is to define a reservoir space with 50 million tons of storage capacity injected over the span of a decade, i.e., the CarbonSAFE goal. The subsurface storage of CO2 is critical to global efforts to reduce the effects of greenhouse gas-induced climate change. Reducing emissions will improve local air quality and aid in the larger goal of curtailing emissions of greenhouse gases to mitigate the impacts of climate change.

Introduction Falls have significant morbidity and mortality in Nursing Home (NH) residents. By improving education to NH staff we aim to reduce 999 calls and associated adverse outcomes. NH residents are more likely to fall than people living in the community and are more at risk of further falls as interventions and risk factor modification is more difficult. Methods Phase 1 - Ambulance calls, where a vehicle attended the scene, between 01/01/2020-28/02/2022 from NH in Swansea Bay University Health Board (SBUHB) concerning Falls/?Falls (Haemorrhage/lacerations, Unconscious/fainting, traumatic injuries, sick person, convulsions/fitting) were analysed and survey was sent out to all NH. Phase 2 - Education was provided about CWTCH (hug in Welsh) and staff were surveyed post intervention. Can you move them, Will it harm them? - new neck/back pain, anticoagulation, Treat them – analgesia, wound-care, Cup of Tea – can eat and drink, Help – when contact 999. Results Phase 1 - Between 01/01/2020-28/02/2022, of 4907 calls, 866 were falls (17.65%) and 1032 ?Falls (21.07%), 60.49% conveyed to hospital. 47% of NH do not have falls guidelines and 100% patients are Nil by Mouth and 88.24% are not moved. Emergency services were contacted 88.24%. Phase 2 - Education was delivered to all NH in Swansea (122 staff). Feedback showed 100% feel more confident in giving food and drink, moving patients, with 90.98% less likely to contact 999 and 75.40% not having previous training with 96.72 % more confident in giving analgesia. Conclusions Falls remain a significant burden and a rapid service would improve care with conveyance reduction to 53.1% post education (60.55% pre-education). Future directions include offering this education to NH in Neath/Port Talbot. From March 2022, we offer same-day assessment for NH residents (and others) from primary care and ambulances and are developing a PRN analgesia pathway e.g. PENTHROX.

Introduction The medical intake at Morriston Hospital is accepted on two units; Rapid Assessment Unit (RAU) and Acute Medical Assessment Unit. Both were acute physician-led until July 2021 Method (Phase 1). From July 2021, RAU became geriatrician-led (Phase 2). This evaluation concerns the performance of RAU. Phase 1 (Acute Physician-Led Unit) Between 01/08/2020-30/06/2021, there were 3102 admissions with a median length of stay (LOS) of 2 days on RAU. 37.2% of patients were discharged directly from the unit. (SBUHB data). A detailed analysis of 496 patients consecutively assessed between November 2020–January 2021 showed a median LOS on RAU of 1, 28.8% were discharged directly from RAU. Overall health board (HB) median LOS for the cohort was 7. In over 70 years, median LOS on RAU was 1, overall HB LOS 9. Phase 2 (Geriatrician-Led Unit) 1237 patients were assessed July-December 2021, with a median LOS of 2 days. 42.8% of patients were discharged from RAU. (SBUHB data). A detailed analysis of 566 patients consecutively assessed between September-November 2021 showed a median LOS on RAU of 2, 41.7% discharged directly from RAU. Overall HB median LOS for the entire cohort was 5. For the > 70 years, median LOS on RAU was 2, overall HB LOS was 7. Patient flow through assessment areas is dependent on the function of downstream medical wards. Mean LOS within medicine at Morriston increased 1.5 days between Phase 1 and Phase 2. Results Acute geriatricians have delivered the 72hr LOS standard that SBUHB has set for assessment areas. The unit has achieved a reduction in overall LOS for the cohort of patients evaluated (p 70 years (p=.007). Conclusion This data supported a change in practice; RAU has taken a frailty specific intake since January 2022.

(Neuron 110, 1671–1688; May 18, 2022) It was brought to our attention that there is a clerical mistake in one of the panels of Figure 1 (Figure 1E) in our recent publication. The representative blots for the CNS Stmn2 protein levels in the F 2 generation of Stmn2 mutants included an incorrect duplicated blot for the GAPDH loading control in the brain samples. We have corrected this error and replaced the figure online with one that includes the correct blot for the GAPDH loading control for those samples. We would like to profoundly apologize to the readers for the oversight and honest mistake.[Formula

Paleozoic sedimentary rocks in the southern midcontinent of the United States have been affected by multiple events of deformation and fluid flow, resulting in petroleum migration, thermal alteration, Mississippi Valley-type mineralization, and a complex diagenetic history. This record is a hidden history of how cratonal settings respond to tectonic and non-tectonic drivers. The aim of this contribution is to better understand the controls on fluid migration in Paleozoic strata to evaluate whether hydrothermal activity is forced by tectonic or non-tectonic processes. This paper summarizes and vets the distribution of published dates related to thermal events in the southern midcontinent. In addition, we present new U-Pb dates obtained by laser ablation–inductively coupled plasma–mass spectrometry (LA-ICP-MS) on calcite cements that were formed from hydrothermal fluids. These are from three samples from the Berexco Wellington KGS 1-32 core in Sumner County, Kansas; an ore sample from the Tri-State Mineral District, Neck City, Missouri; and a core sample from the Blackbird 4-33 well in Osage County, Oklahoma. Previous studies of these calcite samples provided evidence for hydrothermal fluid flow, with one of the Wellington samples possibly recording vertical hydrothermal fluid flow out of the basement. The sample from the Tri-State Mineral District (Missouri) yields a mid-Cretaceous age of 115.6±3.1 Ma. This age falls into the timing of the Sevier Orogeny along the west coast and the development of its foreland basin in the midcontinent. Calcites from the Mississippian interval in the Wellington KGS 1-32 core yield dates of 305±10.5 Ma and 305.1±9.1 Ma. Calcite in Mississippian strata from the Blackbird 4-33 core yields a date of 308.6±2.5 Ma. These dates from Mississippian calcite cements indicate hydrothermal fluid flow in the Late Pennsylvanian that coincides with the timing of the Marathon-Ouachita Orogeny or the Ancestral Rocky Mountains Orogeny. A calcite sample from the Ordovician Arbuckle Group from the Berexco Wellington KGS 1-32 core yielded an age of 5.6±1.6 Ma, coinciding with a time after high elevation uplift of the Rocky Mountains was already far advanced. We propose that this hydrothermal fluid flow may have been associated with increased meteoric recharge and increased regional fluid pressure in a basement aquifer that activated local seismic events far into the continental interior. The distribution of ages of hydrothermal fluid flow confirms a syntectonic driver during the Ouachita Orogeny and Ancestral Rocky Mountains Orogeny deformation. Continuation of hydrothermal fluid flow well into the Permian and tailing off early in the Triassic indicates a post-tectonic driver, where uplifted areas continued to provide the recharge from gravity-driven fluid flow, until the mountains were mostly beveled by the early part of the Triassic. A dearth of Triassic and Jurassic hydrothermal events suggests Gulf of Mexico rifting and extension were less important. Rejuvenation of hydrothermal fluid flow in the Cretaceous and continuing into the Paleogene indicates that elevation and regional flexure from both the Sevier and Laramide events continued to drive hydrothermal fluid flow far from the main sites of mountainous uplift and deformation. Finally, hydrothermal fluid flow associated with more recent uplift of the Rocky Mountains may have been activated by recharge events that pressurized a regional basement aquifer and triggered seismic activity.

Background Identifying frailty can lead to improvements in patient outcomes through interventions such as CGA and prompt discussions around resuscitation and ACP. [Welsh; International Journal of Clinical Practice; 2014; 290– 293] Frailty is associated with a higher risk of postoperative mortality and morbidity, and mortality due to COVID-19.[Parmar; Annals of Surgery; 2021; 709–718, Dumitrascu; Journal of the American Geriatrics Society; 2021; 2, 419– 2, 429] Our audit considers whether the pandemic had any effect on documentation of frailty, and identifies interventions to improve this process. Method We retrospectively reviewed notes to look for elements of social history which identify frailty including mobility, ADLs, and CFS. We conducted a series of spot audits in February 2020 (pre-pandemic), April 2021 (Wave 2), and November 2021 (Wave 3) across surgical and medical wards. Interventions and Results February 2020 This cohort consisted of 62 patients and showed poor documentation across both medicine and surgery with an average of only 21% relevant social history recorded and 0% CFS scoring. Interventions that followed included an educational series by geriatricians and introduction of triaging tools based on CFS in response to the pandemic e.g. Swansea Hip interrogation Fracture Tool (SHiFT). [Cronin; British Orthopaedic Association; 2020] April 2021 The relevant documentation improved to an average of 31% in this cohort of 37 patients. Interventions that followed included further educational sessions on frailty, a surgical liaison service, and the appointment of an orthogeriatrician. November 2021 This cohort consisted of 149 patients, average relevant social history continued to improve to 49%. Subgroup analysis showed 76% of orthopaedics patients had a CFS score, including 100% of NOF patients. Conclusion Frailty is important as it is linked to an increased risk of mortality and morbidity. In the pre-pandemic cohort, the results were poor. Improvements were seen after interventions such as educational sessions, pandemic triaging tools, and the surgical liaison service. However, there are still inconsistencies between teams. Future interventions include a CFS app, expansion of the surgical liaison service, and improved proformas.

Introduction There is evidence that dedicated units that provide comprehensive geriatric assessment can reduce inpatient falls and other iatrogenic harm1. The Emergency Department (ED) in Morriston Hospital has 90,000 attendances a year. 4,000 patients >65 years presented with falls. Between January 2018–November 2021, ED reported 207 incidents of falls via the Health Board Datix System. Intervention Phase 1 In April 2018, the Older Person’s Assessment Service (OPAS) (Geriatrician led Multidisciplinary team) began a liaison service to ED, taking referrals from the medical and ED teams for patients presented with frailty syndromes. Phase 2 In June 2020, OPAS was allocated a dedicated Emergency Frailty Unit within the Emergency Department footprint, allowing patients to be assessed rapidly by a specialist team and nursed in a specialist environment. Results Between June 2020–November 2021, the service saw 1,317 new patients. The average age of an OPAS patient was 83 years and had a Rockwood Clinical Frailty Scale Score of >5. 73% of patients presented with falls as a primary presenting complaint. Between June 2020–November 2021, there was one reported fall within the unit. The mean incident reported of inpatient falls in ED in phase 2 (M = 5.50, SD = 2.66) is statistically significantly higher than phase 1 (M = 3.96, SD = 1.87), t(42) = −2.26, p = 0.03. The service did not show any impact on the incidence of inpatient falls in ED. Conclusion The unit was an effective intervention to prevent falls for the patients it assessed within the unit but had no impact on inpatient falls within the main ED. The impact of this service is difficult to determine given the low reported falls in ED. 1. Fox MT, Persaud M, Maimets I et al. J Am Geriatr Soc, 2012, 60:2237–2,245.

Introduction Innovative models of service delivery are required to provide Comprehensive Geriatric Assessment for older patients presenting to the Emergency Department with frailty syndromes. Method In 2018, the Older Person’s Assessment Service began a liaison service to the ED, taking referrals from the medical and ED teams for patients who presented with frailty syndromes (falls, cognitive impairment, care dependence, polypharmacy). The service saw 437 patients April–August 2018. 76% of the patients assessed were discharged by utilising available community services, rapid access outpatient follow up and inpatient reablement off the acute site. The service was estimated to avoid 50–80 admissions per month to medicine (saving 17–23 beds a year) and was commissioned as a permanent service. Phase 2 In 2020, a dedicated unit within ED was allocated to OPAS, enabling the acceptance of patients directly from triage and from the Ambulance Service by direct referral. This provided rapid access to specialist assessment, continued access to Elderly Care services, avoided exposure to coronavirus related admissions and the risks of nosocomial infection associated with admission. The service operates from 8 am-4 pm on weekdays. Results Between June 2020 and October 2021, the service saw 1,173 new patients. 988 patients (84.5%) were discharged off the acute site on the day of assessment. 68 (5.79%) patients were admitted to other facilities run by the Health Board (e.g Inpatient Reablement). The average age of an OPAS patient was 83 yrs and had a CFS > 5. Readmission rate at 14 days was 4% (47).Of the 253 patients who were admitted to an inpatient setting, 13.5% (35) contracted nosocomial covid-19. Conclusion The service has been supported and funded to expand into extended weekday hours as a result of this success and there are plans for future 7 day working.