Caregivers can play an important role in supporting and caring for people with progressive, life-threatening, or debilitating conditions. However, this supportive role can expose caregivers to various detrimental financial, physical, and psychosocial issues. When evaluating medical technologies for reimbursement decisions, health technology assessment (HTA) agencies typically focus on the treatment’s impact on patients and ignore or downplay the impact on caregivers. Including caregiver impacts within a wider societal perspective may better enable health systems to maximize health benefits from available resources. However, the lack of clear guidance or methodological recommendations from decision makers on the inclusion of caregiver impacts limits the number of HTA submissions that consider these effects. We outline a conceptual framework based on intensity and duration of caregiving to guide researchers, industry, and decision makers when developing policies for the inclusion of caregiver outcomes and justify their inclusion based on expected caregiver burden in identified circumstances.

Breast cancer patients and survivors deal with physical and psychological challenges due to oncological treatments. The existing literature highlights the importance of compassion in reducing the main cancer-related effects in terms of emotions, quality of life, and dysfunctional coping skills. Over the past few years, compassion-based interventions (CBIs) have been considered an interesting approach to reduce anxiety and depression symptoms and improve quality of life and well-being. However, there have not been many studies that show the benefits of these interventions in breast cancer patients and survivors. The primary objective of this systematic review is to provide evidence of the impact of CBIs on specific variables identified in the literature as affected by this pathology. The variables that will be studied are (a) emotional issues (e.g., anxiety, stress, and depression symptoms); (b) quality of life; and (c) positive coping skills. A systematic search during the previous 10 years up to November 2023 was conducted following the PRISMA guidelines across multiple databases, such as PubMed, Web of Science, PsycINFO, and Scopus. Nine eligible randomized controlled trials were included in this article, with a total of 813 breast cancer patients and survivors. Findings show that CBIs increased compassion, mindful observation, and acting with awareness skills, leading to a significant reduction of anxiety and stress levels, depression, and negative affect. Additionally, less body image distress and greater body appreciation were reported as a consequence of the interventions. This review shows the CBI’s efficacy on emotions, positive coping skills, and quality of life in breast cancer patients and survivors. Guidelines for future studies are listed to promote CBIs as a clinically useful intervention for breast cancer patients and survivors.

One type of computational indeterminacy arises from partitioning a system’s physical state space into state types that correspond to the abstract state types underlying the computation concerned. The mechanistic individuative strategy posits that computation can be uniquely identified through either narrow physical properties exclusively or wide, proximal properties. The semantic strategy posits that computation should be uniquely identified through semantic properties. We develop, and defend, an alternative functional individuative strategy that appeals—when needed—to wide, distal functions. We claim that there is no actual computation outside of a functional context. Desiderata for the underlying notion of teleofunction are discussed.

Background: Radiofrequency ablation (RFA) is a minimally-invasive procedure that has been used to treat temporal lobe epilepsy (TLE), however its long-term efficacy is unknown. We aim to characterize the long-term outcomes of patients from the original series by Parrent and Blume (1999). Methods: Consecutive patients who underwent stereotactic RFA for TLE were retrospectively reviewed. Demographics, procedural details, and seizure outcomes until last follow-up were abstracted. Seizure-freedom after initial RFA treatment was estimated with Kaplan-Meier analysis. Results: 27 patients underwent RFA from 1994 to 2002. There were 14 female (52%) patients. 24 (89%) had mesial temporal sclerosis. Mean age at time of RFA was 33.1 years (range 12-45 years). 17 (63%) patients underwent left-sided RFA. 15 (56%) patients had further interventions: 4 (15%) underwent only repeat RFA, 1 (4%) had repeat RFA and anterior temporal lobectomy (ATL), and 10 (37%) underwent subsequent ATL only. Mean follow-up was 9.0 years (range 0.5-22.7 years). At last follow-up, 16 (59%) patients were seizure-free: 5 (19%) received one RFA treatment and 11 (41%) underwent additional procedures. Conclusions: Based on the original series describing the technique, stereotactic RFA for TLE is a safe, minimally-invasive procedure. The role of stereotactic RFA in the treatment of TLE remains to be determined.

In Europe, population estimates of breeding birds are produced nationally and are periodically compiled at EU or pan-European scales. Until now, no other source was available to explore the robustness of these estimates. In this study, we compared population sizes reported in the latest edition of the European Red List of Birds (ERLoB) with those produced using data from the second European Breeding Bird Atlas (EBBA2) to assess their consistency and determine parameters behind variability in population estimates that deserve further attention in the future. In general, European population estimates derived from summing local abundance data from EBBA2 were similar to those obtained from ERLoB, although for some species they differed considerably, particularly in those distributed mainly in southern Europe. National population estimates from EBBA2 also did not differ markedly from those in ERLoB. However, we found that EBBA2 provided larger national population sizes than ERLoB for widespread species, suggesting that spatial information is more relevant for properly assessing their population size than for localised species. Our analysis also showed that, in general, population estimates based on robust methodological protocols (e.g. complete counts, statistical inference) contributed to reducing differences between ERLoB and EBBA2 values. Interestingly, EBBA2 and ERLoB estimates were quite similar for species classified in Europe as “Threatened” or “Near Threatened”, whereas the values for “Least Concern” species were consistently different between these two sources. Our results indicate which type of species would benefit from additional efforts to improve national population estimates and their consistency across countries, issues that are of paramount importance for guiding conservation strategies in Europe.

OBJECTIVES/GOALS: Acidity and the lactate-to-pyruvate ratio correlate with immunotherapy resistance. AcidoCEST MRI and hyperpolarized magnetic resonance spectroscopy (HP-MRS) measure extracellular pH and lactate-to-pyruvate ratio. We will establish a baseline for these biomarkers then observe changes after combination esomeprazole and immunotherapy. METHODS/STUDY POPULATION: We used multiple melanoma models created via serial in vivo passage under immunotherapeutic pressure (FVAX, CTLA-4, PD-1, PD-L1). We used four of these corresponding to 25%, 50%, 75% and 100% resistance (TMT, F2, F3, and F4, respectively). HP-MRS was performed two weeks post implantation in male BL6 mice with AcidoCEST MRI 2-3 days later. Tumors were implanted in additional mice and grown for 1 week. We used esomeprazole as a possible immunotherapy sensitizer. Esomeprazole (or PBS) alone and in combination with immune checkpoint blockade (ICB; αCTLA-4, αPD-1) was then conducted every 3 days for 3 doses. ICB was administered 3h after esomeprazole. AcidoCEST MRI was performed the day after the final dose of combination therapy and 3h after esomeprazole (or PBS) alone. HP-MRS was performed 2-3 days after acidoCEST MRI. RESULTS/ANTICIPATED RESULTS: There was a statistical increase in the lactate-to-pyruvate ratio of the F4 group compared with TMT, F2, and F3 groups (p < 0.05). The TMT, F2, and F3 groups did not differ significantly. The extracellular pH (pHe) of the TMT group was statistically lower than the F2 and F4 groups (p < 0.05). The pHe did not differ significantly between the TMT and F3 groups nor the F2, F3, and F4 groups. The lactate-to-pyruvate ratio and pHe after combination treatment with esomeprazole and ICB did not differ compared to PBS+ICB control. Treatment with esomeprazole alone generated higher lactate-to-pyruvate ratio compared with PBS alone. Tumor volume curves and survival curves of mice bearing F4 tumors treated with esomeprazole combination with ICB showed no difference compared with PBS+ICB, PBS alone, and esomeprazole alone. DISCUSSION/SIGNIFICANCE: We differentiated between the 100% and 25% resistant models with both pHe and lactate-to-pyruvate ratio, although the pHe was counterintuitive. Esomeprazole was ineffective, but other potential sensitizers exist. A non-invasive clinical imaging tool and sensitizer would permit more personalized treatment plans so treatment is more effective.

OBJECTIVES/GOALS: At UNC-Chapel Hill’s CTSA hub – the NC Translational and Clinical Sciences Institute (NC TraCS) – we conducted a participatory evaluation of a new community and patient advisory board (CPAB) to assess member experiences, and the outcomes and early impacts of their work on institutional programming related to equity and inclusivity in research. METHODS/STUDY POPULATION: NC TraCS staff conducted informal interviews with CPAB members to discuss how they envision success in their work, ideas for measuring progress towards their goals, and how they have seen similar work measured by others. These conversations guided the development of outcomes, indicators, and data collection methods for the CPAB evaluation plan. CPAB member satisfaction, experiences, and perceptions of accomplishments were assessed via an online survey. Concurrently, an Outcome Harvesting approach was used, through which NC TraCS staff retrospectively identified key outcomes of the CPAB’s work through team discussion of programmatic changes and review of internal documents and data. RESULTS/ANTICIPATED RESULTS: CPAB members (n=10) were highly satisfied with meetings, group dynamics, activities and accomplishments, and 90% of members felt that NC TraCS was very responsive to their feedback. Key outcomes included: 1) co-creating a shared vision, goals, and operational policies for the CPAB; 2) co-developing a training series for research teams about patient and community engagement; 3) disseminating best practices for co-developing advisory boards; 4) providing guidance to improve NC TraCS consultations, services, and resources related to enhancing equitable participation in research (e.g., developing an Equity in Research Framework); and 5) contributing to institutional initiatives related to diversity, equity, and inclusion (e.g., improving compensation processes for research participants and partners). DISCUSSION/SIGNIFICANCE: Evaluations of CPABs often focus on process measures, while assessments of outcomes and impacts are lacking. Our evaluation data highlight the early outcomes and value of a newly formed CPAB. Furthermore, our approach can inform the creation and evaluation of equity-focused advisory boards within other research institutions.

Ebnerite and epiebnerite, both with the ideal formula NH4ZnPO4, are new mineral species from the Rowley mine, Maricopa County, Arizona, USA. They occur in an unusual bat-guano-related, post-mining assemblage of phases. Epiebnerite grows epitactically on ebnerite and replaces it. Ebnerite and epiebnerite are found in intimate association with alunite, halite, mimetite, newberyite, sampleite, struvite and wulfenite on hematite-rich quartz–baryte matrix. Crystals of ebnerite are colourless narrow prisms up to ~0.3 mm in length. The streak is white, lustre is vitreous, Mohs hardness is ~2, tenacity is brittle and fracture is splintery. The density is 2.78(2) g⋅cm–3. Ebnerite is optically uniaxial (–) with ω = 1.585(2) and ɛ = 1.575(2). Epiebnerite occurs as colourless prisms or blades, up to about 10 × 3 × 2 μm, in parallel growth forming ribs with serrated edges epitactic on ebnerite prisms. The streak is white, lustre is vitreous, Mohs hardness is probably ~2, tenacity is brittle. The calculated density is 2.851 g⋅cm–3. Epiebnerite is optically biaxial with all indices of refraction near 1.580. Electron microprobe analysis gave the empirical formula [(NH4)0.89K0.06]Σ0.95(Zn0.96Cu0.07)Σ1.03[(P0.97Si0.03)Σ1.00O4] for ebnerite and [(NH4)0.67K0.28]Σ0.95(Zn0.99Cu0.02)Σ1.02(P1.00O4) for epiebnerite. Ebnerite is hexagonal, P63, with a = 10.67051(16), c = 8.7140(2) Å, V = 859.25(3) Å3 and Z = 8. Epiebnerite is monoclinic, P21, with a = 8.796(16), b = 5.457(16), c = 8.960(16) Å, β = 90.34(6)°, V = 430.1(17) Å3 and Z = 4. The structures of ebnerite (R1 = 0.0372 for 1168 Io > 2σI reflections) and epiebnerite (known from synthetic monoclinic NH4ZnPO4) are zeolite-like frameworks based upon corner-sharing linkages between alternating ZnO4 and PO4 tetrahedra with channels in the frameworks hosting the NH4 groups. The two structures are topologically distinct. Ebnerite belongs to the family of ‘stuffed derivatives’ of tridymite, whereas epiebnerite possesses an ABW-type zeolite structure.

GIS data on the evolution of railway networks facilitate the study of the role played by the expansion of transport infrastructure since the industrial revolution. The arrival of the railway transformed economic and social activity and the distribution of population within the territory. Given their importance, we have reconstructed and digitised the layout of the railway lines and the location of the stations and halts that existed from the opening of Spain's first railway line, in 1848, until 2023. We have also added indicators of the quality of the network, more specifically, the dates of its electrification and when the track was doubled to allow two-way traffic. The potential of this database lies in its capacity to analyse the interrelationship between the railway infrastructure and a wide range of elements located in the territory, amongst which it is necessary to highlight other modes of transport, urban expansion and socio-economic development.

In 2022, highly pathogenic avian influenza (HPAI) A(H5N1) virus clade 2.3.4.4b became enzootic and caused mass mortality in Sandwich Tern Thalasseus sandvicensis and other seabird species across north-western Europe. We present data on the characteristics of the spread of the virus between and within breeding colonies and the number of dead adult Sandwich Terns recorded at breeding sites throughout north-western Europe. Within two months of the first reported mortalities, 20,531 adult Sandwich Terns were found dead, which is >17% of the total north-western European breeding population. This is probably an under-representation of total mortality, as many carcasses are likely to have gone unnoticed and unreported. Within affected colonies, almost all chicks died. After the peak of the outbreak, in a colony established by late breeders, 25.7% of tested adults showed immunity to HPAI subtype H5. Removal of carcasses was associated with lower levels of mortality at affected colonies. More research on the sources and modes of transmission, incubation times, effective containment, and immunity is urgently needed to combat this major threat for colonial seabirds.

This study examines the delivery components of inclusive mental health services in higher education, centering on international university students. Through interviews with 32 participants at a state university in the United States, including students, counseling staff, and faculty, six key themes emerged: mental health professionals’ multicultural self-awareness, focus on reparative services, mainstream mental health theories and approaches, professionals’ cultural background, faculty involvement and physical space and confidentiality. These findings underscore the importance of training for professionals, expansive mental health offerings, incorporation of diverse approaches, confidentiality, active faculty participation and suitable physical environments. By addressing these components, universities can enhance the quality of mental health support for international student populations, promoting their overall well-being and academic success.