Modular coral-like fossils occur in thrombolitic reefal beds at two stratigraphic levels within the Lower Ordovician (Floian) Barbace Cove Member of the Boat Harbour Formation, in the St. George Group of western Newfoundland. They are here assigned to Reptamsassia n. gen.; R. divergens n. gen. n. sp. is present at both levels, whereas a comparatively small-module species, R. minuta n. gen. n. sp., is confined to the upper level. Reptamsassia n. gen. resembles the Ordovician genus Amsassia in its phacelocerioid structure, back-to-back walls of adjoining modules, module increase by longitudinal fission involving infoldings of the wall, tabula-like structures that are continuous with the vertical module wall, and calices with concave-up bottoms. The new genus is differentiated by its encrusting habit, modules with highly variable growth directions and shapes throughout skeletal growth, and modules that may separate slightly or diverge from one another following fission. Together, Amsassia and Reptamsassia n. gen. are considered to represent a distinct group of calcareous algae, the Amsassiaceae n. fam., which possibly belongs to the green algae. The Early Ordovician origination of Amsassia followed by Reptamsassia n. gen. contributed to the beginning of the rise in diversity on a global scale and in reefal settings during the Great Ordovician Biodiversification Event. Reptamsassia minuta n. gen. n. sp. was an obligate symbiont that colonized living areas on its host, R. divergens n. gen. n. sp., with isolated modules of R. divergens n. gen. n. sp. able to persist in the resulting intergrowth with R. minuta n. gen. n. sp. This is the earliest known symbiotic intergrowth of macroscopic modular species, exemplifying the development of ecologic specialization and ecosystem complexity in Early Ordovician reefs.

Modular coral-like fossils from Lower Ordovician (Tremadocian) thrombolitic mounds in the St. George Group of western Newfoundland were initially identified as Lichenaria and thought to include the earliest tabulate corals. They are here assigned to Amsassia terranovensis n. sp. and Amsassia? sp. A from the Watts Bight Formation, and A. diversa n. sp. and Amsassia? sp. B from the overlying Boat Harbour Formation. Amsassia terranovensis n. sp. and A. argentina from the Argentine Precordillera are the earliest representatives of the genus. Amsassia is considered to be a calcareous alga, possibly representing an extinct group of green algae. The genus originated and began to disperse in the Tremadocian, during the onset of the Great Ordovician Biodiversification Event, on the southern margin of Laurentia and the Cuyania Terrane. It inhabited small, shallow-marine reefal mounds constructed in association with microbes. The paleogeographic range of Amsassia expanded in the Middle Ordovician (Darriwilian) to include the Sino-Korean Block, as well as Laurentia, and its environmental range expanded to include non-reefal, open- and restricted-marine settings. Amsassia attained its greatest diversity and paleogeographic extent in the Late Ordovician (Sandbian–Katian), during the culmination of the Great Ordovician Biodiversification Event. Its range included the South China Block, Tarim Block, Kazakhstan, and Siberia, as well as the Sino-Korean Block and Laurentia, and its affinity for small microbial mounds continued during that time. In the latest Ordovician (Hirnantian), the diversity of Amsassia was reduced, its distribution was restricted to non-reefal environments in South China, and it finally disappeared during the end-Ordovician mass extinction.

UUID: http://zoobank.org/ef0abb69-10a6-46de-8c78-d6ec7de185fe

Background: The rise of antimicrobial resistance has made it critical for clinicians to understand antimicrobial stewardship principles. We sought to determine whether the opportunity to participate in an American Board of Pediatrics Maintenance of Certification Part 4 (MOC4) quality improvement (QI) project would engage pediatricians and improve their knowledge about antimicrobial stewardship. Methods: In August 2019, a new clinical algorithm for acute appendicitis, spearheaded by the antimicrobial stewardship program (ASP), was implemented at UCSF Benioff Children’s Hospital Oakland to standardize care and optimize antimicrobial use. Medical staff were invited to participate in a QI project evaluating the impact of this algorithm. Data were collected for the 2 quarters preceding implementation (baseline), for the quarter of implementation (transition period), and for the quarter after implementation. Participants were offered MOC4 credit for reviewing these 3 cycles of data and associated materials highlighting information about antimicrobial stewardship. An initial survey was given to participants to assess their baseline knowledge via 4 questions about antimicrobial use in surgical patients (Table 1). At the conclusion of the QI project, another survey was conducted to reassess participant knowledge and to evaluate overall satisfaction with the project. Results: In total, 150 clinicians completed the initial survey. Of these, 44% were general pediatricians and 56% were pediatric subspecialists. Based on years out of training, their levels of experience varied: >20 years in 24%, 11–20 years in 32.7%, 0–10 years in 34.7%, and currently in training in 8.7%. Of the 150 initial participants, 133 (89%) completed the QI project and the second survey. Between surveys, there was significant improvement in knowledge about the appropriate timing and duration of surgical antibiotic prophylaxis (Table 1). Moreover, 88% of participants responded that the QI project was extremely effective in helping them learn about antimicrobial stewardship principles and about ASP interventions. Conclusions: Participation in this MOC4 QI project resulted in significant improvement in knowledge about antimicrobial use in surgical patients, and the activity was perceived as a highly effective way to learn about antimicrobial stewardship. QI projects that leverage MOC4 credit can be a powerful tool for engaging pediatricians and disseminating education about antimicrobial stewardship.

Funding: No

Disclosures: None

Table 1.

We identified quality indicators (QIs) for care during transitions of older persons (≥ 65 years of age). Through systematic literature review, we catalogued QIs related to older persons’ transitions in care among continuing care settings and between continuing care and acute care settings and back. Through two Delphi survey rounds, experts ranked relevance, feasibility, and scientific soundness of QIs. A steering committee reviewed QIs for their feasible capture in Canadian administrative databases. Our search yielded 326 QIs from 53 sources. A final set of 38 feasible indicators to measure in current practice was included. The highest proportions of indicators were for the emergency department (47%) and the Institute of Medicine (IOM) quality domain of effectiveness (39.5%). Most feasible indicators were outcome indicators. Our work highlights a lack of standardized transition QI development in practice, and the limitations of current free-text documentation systems in capturing relevant and consistent data.

ABSTRACT IMPACT: The model of the Clinical Research Support Center at the University of Minnesota of streamlining clinical trial infrastructure can be leveraged by the larger clinical trial community to create valuable efficiencies and facilitate faster initiation of research activities by supporting researchers from concept to dissemination. OBJECTIVES/GOALS: Substantial time, energy, and money are spent bridging disparate resources in research. We describe how the University of Minnesota’s (UMN) Clinical Research Support Center (CRSC) streamlines trial infrastructure, creating valuable efficiencies to support researchers from concept to dissemination. METHODS/STUDY POPULATION: The CRSC, established in 2018 through the Clinical and Translational Science Award (CTSA) program, brings resources together in a single, centralized, and convenient location to help researchers navigate the UMN clinical research startup process and specifically to assist with the development and initiation of a research study from feasibility assessment to project opening. Diverse expertise in components of human subject research is available to support the broad scope of projects at a large institution like the UMN. We present how CRSC services, when coordinated by Clinical Research Specialists, have been used to improve access to clinical research resources during the start up process. RESULTS/ANTICIPATED RESULTS: Since inception in 2018, the CRSC has provided support to over 1700 studies with 437 research projects referred to a Clinical Research Specialist within the CRSC. Of those projects, 97 (22.2%) received comprehensive support from the following expert groups: regulatory guidance (n=74), biostatistics (n=68), clinical (hospital or clinic) partners (n=60), recruitment (n=36), budget development assistance (n=30), and (bio)informatics (n=27). Successful examples of synergies to streamlining study start up include shortening the window between protocol development support from Clinical Research Specialists and IRB submission preparation through to Regulatory Specialists to 3 days. DISCUSSION/SIGNIFICANCE OF FINDINGS: Providing cross-functional support to research teams through the CRSC increases the likelihood of quicker and successful execution and completion of research initiation and subsequently impacts the dissemination of that research to patients and the broader community.

ABSTRACT IMPACT: In a global pandemic where data development and dissemination are integral to combating the disease, the Clinical Research Support Center at the University of Minnesota provides a model of comprehensive virtual support, helping to attain and disseminate novel research on COVID-19, its individual and community impact, and treatment initiatives/outcomes. OBJECTIVES/GOALS: The pandemic created massive disruption to the conduct of clinical research with an unprecedented reorientation towards COVID-19. In this fast-paced environment, the Clinical Research Support Center (CRSC) rapidly developed innovative means of supporting diverse research initiatives. METHODS/STUDY POPULATION: The CRSC rapidly transitioned into a virtual environment and developed tools for the clinical research community to enhance remote clinical trial start up. This includes supporting remote consent, eBinders, COVID-19 research training for clinical staff, and easier identification of potential participants for COVID-19 studies; all through virtual support. Support provided research teams guidance on study protocols, regulatory requirements, informatics, biostatistics, financial management, recruitment strategies to support critical, urgent COVID-19 research. We outline proactive examples of how the CRSC now provides support to research teams through the pandemic. RESULTS/ANTICIPATED RESULTS: From March-November 2020, 116 COVID-19 projects received virtual support from the CRSC for COVID-19 research: disease understanding (n=27), treatment (n=23), pandemic impact (n=20), clinical care innovation (n=18), disease control and surveillance (n=10), prevention (n=9), detection (n=5), and impact on minorities (n=4). The diversity of these studies demonstrates the demand for and benefit from multidisciplinary expertise supporting study design and implementation. Through successful articulation and acceleration of research activities, the CRSC met the need for speed and rapidly adapted to new challenges created by the pandemic. DISCUSSION/SIGNIFICANCE OF FINDINGS: In a global pandemic where rapidly changing barriers to research is ongoing, through multidisciplinary efforts, the CRSC continues to provide comprehensive, virtual support to attain and disseminate novel research on COVID-19, its individual and community impact, and treatment initiatives/outcomes.

In this roundtable discussion, five scholars of modern India with diverse methodological training examine aspects of Rupa Viswanath's 2014 book, The Pariah Problem: Caste, Religion, and the Social in Modern India, and assess its arguments and contributions. This book has made strong challenges to the scholarly consensus on the nature of caste in India, arguing that, in the Madras presidency under the British, caste functioned as a form of labour control of the lowest orders and, in this roundtable, she calls colonial Madras a ‘slave society’. The scholars included here examine that contention and the major subsidiary arguments on which it is based. Uday Chandra identifies The Pariah Problem with a new social history of caste and Dalitness. Brian K. Pennington links the ‘religionization’ of caste that Viswanath identifies to the contemporary Hindu right's concerns for religious sentiment and authenticity. Lucinda Ramberg takes up Viswanath's account of the constitution of a public that excluded the Dalit to inquire further about the gendered nature of that public and the private realm it simultaneously generated. Zoe Sherinian calls attention to Viswanath's characterization of missionary opposition to social equality for Dalits and examines missionary and Dalit discourses that stand apart from those that Viswanath studied. Joel Lee extends some of Viswanath's claims about the Madras presidency by showing strong parallels to social practices in colonial North India. Finally, Viswanath's own response addresses the assessments of her colleagues.

Loeys–Dietz syndrome is a connective tissue disorder known to cause aggressive aortopathy in paediatric patients, but it is extremely rare for cardiovascular events to present during infancy. We report the first successful aortic repair in a neonate with LDS presenting in extremis with an early onset, massive aortic aneurysm.

We report a case of two-month old with a functionally univentricular heart and parallel circulation who presented to the emergency department with Covid-19 and subsequently developed acute respiratory distress syndrome. The course of illness, clinical values, and laboratory markers are characterized in this report.

This paper examines the stability of egocentric networks as reported over time using a novel touchscreen-based participant-aided sociogram. Past work has noted the instability of nominated network alters, with a large proportion leaving and reappearing between interview observations. To explain this instability of networks over time, researchers often look to structural embeddedness, namely the notion that alters are connected to other alters within egocentric networks. Recent research has also asked whether the interview situation itself may play a role in conditioning respondents to what might be the appropriate size and shape of a social network, and thereby which alters ought to be nominated or not. We report on change in these networks across three waves and assess whether this change appears to be the result of natural churn in the network or whether changes might be the result of factors in the interview itself, particularly anchoring and motivated underreporting. Our results indicate little change in average network size across waves, particularly for indirect tie nominations. Slight, significant changes were noted between waves one and two particularly among those with the largest networks. Almost no significant differences were observed between waves two and three, either in terms of network size, composition, or density. Data come from three waves of a Chicago-based panel study of young men who have sex with men.