Objective Between January 2005 and July 2020, 171 rural hospitals closed across the United States. Little is known about the extent that other providers step in to fill the potential reduction in access from a rural hospital closure. The objective of this analysis is to evaluate the trends of Federally Qualified Health Centers (FQHCs) and Rural Health Clinics (RHCs) in rural areas prior to and following hospital closure. Data Sources/Study Setting We used publicly available data from Centers for Medicare and Medicaid Provider of Services files, Cecil G. Sheps Center rural hospital closures list, and Small Area Income and Poverty Estimates. Study Design We described the trends over time in the number of hospitals, hospital closures, FQHC sites, and RHCs in rural and urban ZIP codes, 2006–2018. We used two‐way fixed effects and pooled generalized linear models with a logit link to estimate the probabilities of having any RHC and any FQHC within 10 straight‐line miles. Data Collection/Extraction Methods Not applicable. Principal Findings Compared to hospitals that never closed, the predicted probability of having any FQHC within 10 miles increased post closure by 5.95 and 11.57 percentage points at 1 year and 5 years, respectively (p < 0.05). The predicted probability of having any RHC within 10 miles was not significantly different following rural hospital closure. A percentage point increase in poverty rate was associated with a 1.98 and a 1.29 percentage point increase in probabilities of having an FQHC or RHC, respectively (p < 0.001). Conclusions In areas previously served by a rural hospital, there is a higher probability of new FQHC service‐delivery sites post closure. This suggests that some of the potential reductions in access to essential preventive and diagnostic services may be filled by FQHCs. However, many rural communities may have a persistent unmet need for preventive and therapeutic care.

Reptiles show varying degrees of facultative parthenogenesis. Here we use genetic methods to determine that an isolated, captive female Asian water dragon produced at least nine offspring via parthenogenesis. We identified microsatellites for the species from shotgun genomic sequences, selected and optimized primer sets, and tested all of the offspring for a set of seven microsatellites that were heterozygous in the mother. We verified that the seven loci showed high levels of polymorphism in four wild Asian water dragons from Vietnam. In all cases, the offspring (unhatched, but developed eggs, or hatched young) had only a single allele at each locus, and contained only alleles present in the mother’s genotype (i.e., were homozygous or hemizygous). The probability that our findings resulted from the female mating with one or more males is extremely small, indicating that the offspring were derived from a single female gamete (either alone or via duplication and/or fusion) and implicating parthenogenesis. This is the first documented case of parthenogenesis in the Squamate family Agamidae.

Conservation strategies for crocodilians often include captive breeding to create stable assurance populations. Evaluating adrenal and gonadal hormone patterns can provide animal managers with data to more effectively monitor animal welfare and reproductive status. This study evaluated the effects of season (breeding, nesting, or off), sex (male and female), and reproductive status of females (egg-laying/housed with a male or non-laying/housed solo) on concentrations of fecal glucocorticoid metabolite (FGM), fecal androgen metabolite (FAM), and fecal progestogen metabolite (FPM) in seven Cuban crocodiles, Crocodylus rhombifer, at the Smithsonian's National Zoological Park. Overall, seasonal changes in FGM and FPM concentrations were only observed in egg-laying females; FGM and FPM concentrations were both higher during the nesting season compared to the breeding and off seasons. Seasonal changes in FAM concentrations were only observed in males; males had higher FAM concentrations during the breeding and nesting seasons compared to the off season. Future studies investigating the use of fecal hormone metabolites in crocodilians are necessary to understand differences between individuals and species, to further elucidate the interactions between hormones and environmental factors, such as social housing, and to develop long-term datasets for the management of this species. K E Y W O R D S crocodilians, fecal hormone metabolites, zoo management 1 | INTRODUCTION Crocodilians are often propagated ex situ for sustainable population management and to create assurance colonies for species conservation as recommended by the IUCN SSC Crocodilian Specialist Group. These managed animals are often critical to the preservation of species, particularly those for which the in situ populations are experiencing drastic declines due to loss of habitat and illegal hunting. The Association of Zoos and Aquariums manages sustainable populations of seven crocodilian species in North America to promote conservation through species management, education, and research. While space is the limiting factor in many of these programs, the consistent reproduction of some species remains a challenge (e.g., the Indian Gharial, Gavialis gangeticus). Hormone monitoring in crocodilians can provide valuable data on the reproductive status of individuals and the external factors (stressors) that may be negatively impacting reproductive success in captive populations; however, blood collection can be difficult for many species and can produce skewed results due to the effects of capture

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Background: The coronavirus (COVID-19) pandemic has shifted life in the United States. It is reasonable to expect the challenges of cannabis use in the U.S. are amplified given the vast shutdowns and economic insecurity. The purpose of the research is to examine changes in adult cannabis use during COVID-19. Methods: This one-group, longitudinal, cohort study reports results from an online survey and six-month follow-up. Both surveys examined cannabis use and additional questions regarding COVID-19 were added to the follow-up. Quantitative analysis (e.g., ANOVA) was conducted on the questionnaire and thematic analysis was performed on a text question. Results: A majority of the sample (65.7%) reported no significant change in cannabis use as a result of COVID-19. A one-way ANOVA of CUDIT-R scores showed statistical significance (p < .01) between age groups. Contrary to the quantitative analysis, thematic analysis revealed many changes in cannabis use as a response to COVID-19. Conclusions:. Self-efficacy can be seen through the empowered behaviors to change cannabis products but those with an increase in CUDIT-R scores may need targeted assessments and education to promote healthier cannabis use. Additionally, this study calls for a larger examination of changes in cannabis use by age and working conditions.