UNASSIGNED: Invasive species are the primary threat to island ecosystems globally and are responsible for approximately two-thirds of all island species extinctions in the past 400 years. Non-native mammals-primarily rats, cats, mongooses, goats, sheep, and pigs-have had devastating impacts on at-risk species and are major factors in population declines and extinctions in Hawai\'i. With the development of fencing technology that can exclude all mammalian predators, the focus for some locations in Hawai\'i shifted from predator control to local eradication.
UNASSIGNED: This article describes all existing and planned full predator exclusion fences in Hawai\'i by documenting the size and design of each fence, the outcomes the predator eradications, maintenance issues at each fence, and the resulting native species responses.
UNASSIGNED: Twelve predator exclusion fences were constructed in the Hawaiian Islands from 2011-2023 and six more were planned or under construction; all were for the protection of native seabirds and waterbirds. Fences ranged in length from 304-4,877 m and enclosed 1.2-640 ha. One-third of the 18 fences were peninsula-style with open ends; the remaining two-thirds of the fences were complete enclosures. The purpose of twelve of the fences (67%) was to protect existing bird populations, and six (33%) were initiated for mitigation required under the U.S. Endangered Species Act. Of the six mitigation fences, 83% were for the social attraction of seabirds and one fence was for translocation of seabirds; none of the mitigation fences protected existing bird populations. Rats and mice were present in every predator exclusion fence site; mice were eradicated from five of six sites (83%) where they were targeted and rats (three species) were eradicated from eight of 11 sites (72%). Mongoose, cats, pigs, and deer were eradicated from every site where they were targeted. Predator incursions occurred in every fence. Rat and mouse incursions were in many cases chronic or complete reinvasions, but cat and mongoose incursions were occasional and depended on fence type (i.e., enclosed vs. peninsula). The advent of predator exclusion fencing has resulted in great gains for protecting existing seabirds and waterbirds, which demonstrated dramatic increases in reproductive success and colony growth. With threats from invasive species expected to increase in the future, predator exclusion fencing will become an increasingly important tool in protecting island species.

Congregate Nutrition Services have long been a pillar of public health assistance, championing the independence and community engagement of older Americans. The advent of COVID-19, however, restricted access to these services due to the closure of physical locations. In response, Lanakila Meals on Wheels initiated a virtual congregate meal program, Kūpuna U, in collaboration with community partners in Honolulu County. The program combined grab-and-go or home-delivered meals with virtual and in-person classes to improve both nutrition and socialization for older adults. This study aimed to capture participant feedback to assess and enhance the Kūpuna U program, developing it as a flexible and scalable congregate meal solution applicable nationwide. Five focus group discussions were conducted with program participants (n = 34). The majority of participants were female (74%), Asian (73%), and living alone (56%). Participants found the program beneficial, enhancing their nutrition, social engagement, and learning experiences on various topics tailored for older adults. Supportive staff played a crucial role in motivating participants to stay engaged. Participants also identified potential enhancements to the program, including more activities and courses, expanded hours, additional in-person options at various locations, and culturally tailored meals.

Theory predicts that compensatory genetic changes reduce negative indirect effects of selected variants during adaptive evolution, but evidence is scarce. Here, we test this in a wild population of Hawaiian crickets using temporal genomics and a high-quality chromosome-level cricket genome. In this population, a mutation, flatwing, silences males and rapidly spread due to an acoustically-orienting parasitoid. Our sampling spanned a social transition during which flatwing fixed and the population went silent. We find long-range linkage disequilibrium around the putative flatwing locus was maintained over time, and hitchhiking genes had functions related to negative flatwing-associated effects. We develop a combinatorial enrichment approach using transcriptome data to test for compensatory, intragenomic coevolution. Temporal changes in genomic selection were distributed genome-wide and functionally associated with the population\'s transition to silence, particularly behavioural responses to silent environments. Our results demonstrate how \'adaptation begets adaptation\'; changes to the sociogenetic environment accompanying rapid trait evolution can generate selection provoking further, compensatory adaptation.

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This pilot study examined differences in wait times for oncology patients who presented to the emergency department, with or without a Fast Pass, for febrile neutropenia (FN). Inadequate circulating neutrophils create a health risk for FN patients. An increased number of patients are receiving chemotherapy in an outpatient setting and may experience delays when seeking treatment in the emergency department. These delays in treatment may be due to overcrowding, patients who require life-saving medical interventions, and inconsistencies in recognizing febrile neutropenia, where fever may be the only presenting sign. The purpose of this study was to measure the impact on wait times, increasing possible risk of bacterial or viral exposure in the emergency department waiting room, for patients with a potential diagnosis of FN who presented their \"Fast Pass\" from the hospital cancer center\'s program upon arrival. Electronic medical records were reviewed over a period of 21 months, comparing wait times in the ED for oncology patients with potential FN before and after implementation of the Fast Pass program at an urban medical center in Hawai\'i. Of the 1300 oncology patient chart reviews conducted, 6 patients met the study-defined inclusion criteria pre-Fast Pass and 10 met the study-defined inclusion criteria post-Fast Pass. Influence of the use of a Fast Pass on patient wait times was tested using a multivariate regression adjusted for ED patient volume. There were no differences in overall wait times pre- and post-Fast Pass.

Given the complex ethical and emotional nature of births during the periviable period for both health care providers and families, this investigation sought to identify strategies for improved counseling of pregnant patients facing preterm birth at the cusp of viability at a tertiary care center in Hawai\'i. As part of a larger quality improvement project on periviability counseling, 10 patients were interviewed during either individual or small focus groups using a progression of hypothetical scenarios. Interviews were analyzed independently by 3 investigators to identify themes of patient experience and potential areas for improvement when counseling patients who are carrying periviable pregnancies. Several common themes emerged from the interviews. Patients expressed the desire for more information throughout the process delivered in a jargon-free manner with unified messaging from the medical teams, and emotional support. These findings add to a limited body of literature which addresses patient perceptions of interactions with health care providers in the face of uncertainty, particularly in a Pacific Islander population. The authors recommend increasing provider training and developing a more structured process to counsel pregnant women facing periviable pregnancy loss to improve the patient experience.

Hawai\'i experiences some of the highest rates of houselessness per capita in the country. COVID-19 has exacerbated these disparities and made it difficult for these individuals to seek medical care. Hawai\'i\'s Houseless Outreach in Medical Education (HOME) clinic is the largest student run free clinic in the state, which provides medical services to this patient population. This article reports the demographics, medical needs, and services provided to patients of Hawai\'i\'s HOME clinic during the era of COVID-19. From September 2020 to 2021, the HOME clinic saw 1198 unique visits with 526 distinct patients. The most common chief complaints included wound care (42.4%), pain (26.9%), and skin complaints (15.7%). A large portion of the population suffered from comorbidities including elevated blood pressure (66%), a formal reported history of hypertension (30.6%), diabetes (11.6%), and psychiatric concerns including schizophrenia (5.2%) and generalized anxiety (5.1%). Additionally, a large portion of patients (57.2%) were substance users including 17.8% of patients endorsing use of alcohol, 48.5% tobacco and 12.5% marijuana. The most common services provided were dispensation of medication (58.7%), wound cleaning/dressing changes (30.7%), and alcohol or other drug cessation counseling (25.2%). This study emphasizes that the houseless are a diverse population with complex, evolving medical needs and a high prevalence of chronic diseases and comorbidities.

Avocados are an important economic crop of Hawaii, contributing to approximately 3% of all avocados grown in the United States. To export Hawaii-grown avocados, growers must follow strict United States Department of Agriculture Animal and Plant Health Inspection Service (USDA-APHIS) regulations. Currently, only the Sharwil variety can be exported relying on a systems approach, which allows fruit to be exported without quarantine treatment; treatments that can negatively impact the quality of avocados. However, for the systems approach to be applied, Hawaii avocado growers must positively identify the avocados variety as Sharwil with APHIS prior to export. Currently, variety identification relies on physical characteristics, which can be erroneous and subjective, and has been disputed by growers. Once the fruit is harvested, variety identification is difficult. While molecular markers can be used through DNA extraction from the skin, the process leaves the fruit unmarketable. This study evaluated the feasibility of using near-infrared spectroscopy to non-destructively discriminate between different Hawaii-grown avocado varieties, such as Sharwil, Beshore, and Yamagata, Nishikawa, and Greengold, and to positively identify Sharwil from the other varieties mentioned above. The classifiers built using a bench-top system achieved 95% total classification rates for both discriminating the varieties from one another and positively identifying Sharwil while the classifier built using a handheld spectrometer achieved 96% and 96.7% total classification rates for discriminating the varieties from one another and positively identifying Sharwil, respectively. Results from chemometric methods and chemical analysis suggested that water and lipid were key contributors to the performance of classifiers. The positive results demonstrate the feasibility of NIR spectroscopy for discriminating different avocado varieties as well as authenticating Sharwil. To develop robust and stable models for the growers, distributors, and regulators in Hawaii, more varieties and additional seasons should continue to be added.

This study examined the e-cigarette and vaping resistance strategies used by Native Hawaiian and Pacific Islander (NHPI) youths in rural Hawai\'i. Focus groups (N = 17) were conducted in eight geographically dispersed elementary, middle/intermediate, and multilevel schools in low-income communities on Hawai\'i Island. Sixty-nine youths (67% NHPI, Mage = 12.5 years) participated in this study. The resistance strategies discussed across the greatest number of groups were \"refuse\" (saying no), \"explain\" (providing reasons for vaping refusal), \"avoid\" (avoiding people or places where e-cigarettes were used), and \"leave\" (walking away from a situation where e-cigarettes were being used). Participants described the challenges in using these strategies within contexts characterized by widespread peer and family vaping and strong social demands to use e-cigarettes. The findings suggest the need for multi-level interventions based on youths\' resistance strategies to meaningfully reduce youth vaping use in rural and/or NHPI communities.

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