The national response to the COVID-19 pandemic has highlighted critical weaknesses in domestic health care and public health emergency preparedness despite nearly two decades of federal funding for multiple programs designed to encourage cross-cutting collaboration in emergency response. Health care coalitions (HCCs), which are funded through the Hospital Preparedness Program, were first piloted in 2007 and have been continuously funded nationwide since 2012 to support broad collaborations across public health, emergency management, emergency medical services, and the emergency response arms of the health care system within a geographical area. This commentary provides a SWOT analysis to summarize the strengths, weaknesses, opportunities, and threats related to the current HCC model against the backdrop of COVID-19. We close with concrete recommendations for better leveraging the HCC model for improved health care system readiness. These include better evaluating the role of HCCs and their members (including the responsibility of the HCC to better communicate and align with other sectors), reconsidering the existing framework for HCC administration, increasing incentives for meaningful community participation in HCC preparedness, and supporting next-generation development of health care preparedness systems for future pandemics.

Little empirical research has explored whether or not firm strategy is linked with corporate social responsibility (CSR) and to that end we explore the impact of low-cost and differentiation strategies on CSR. Using a sample of 229 Italian firms, a low-cost strategy is negatively associated with ethical and discretionary CSR, while a differentiation strategy is positively associated with both. Given its focus on nonfinancial outcomes and stakeholders, we test if a performance management system (PM system) acts as a moderating influence. We find that a PM system positively moderates the negative association between a low-cost strategy and ethical and discretionary CSR, while also positively moderating these relationships with respect to a differentiation strategy. These findings advance the literature on strategy and CSR, while demonstrating the contingent effect of PM systems. The findings are discussed along with limitations and directions for future research.

Background: The Changing Lives by Eradicating Antibiotic Resistance (CLEAR) Trial was a trial of 2,121 recently discharged methicillin-resistant Staphylococcus aureus (MRSA) carriers randomized to MRSA education plus a 5-day decolonization regimen repeated twice monthly for the 6 months following discharge versus MRSA education alone. Decolonization resulted in a 30% reduction in MRSA infection and a 17% reduction in all-cause infection (Huang SS et al, NEJM, 2019) in the year following discharge. We pursued an evaluation of USA300 carriers to determine whether the decolonization benefit differed for this strain type. Methods: A secondary analysis of the CLEAR randomized controlled trial (RCT) was performed, limiting the cohort to participants known to harbor USA300 at or within 30 days of enrollment and who attended all follow-up visits in the year following discharge. Within this subset, we conducted a time-to-event analysis using unadjusted and adjusted Cox proportional-hazard models. Variables in adjusted analyses included demographic data, insurance type, presence of coexisting conditions or medical devices at enrollment, hospitalization or residence in a nursing home in the year before enrollment, receipt of anti-MRSA antibiotics, protocol adherence, and randomization strata. Results: USA300 was identified in 420 of the 783 participants who attended all visits and had strains genetically tested. MRSA infections occurred in 27 of 207 education group participants (0.149 per person year) and in 19 of 213 decolonization group participants (0.099 per-person year). Point estimates from the unadjusted hazard ratios of infection reduction were similar (0.59; 95% CI, 0.32–1.09) to the full trial population (0.61; 95% CI, 0.44–0.85), suggesting nondifferential benefit for the USA300 strain type. Adjusted models were highly similar. Conclusions: The reduction in MRSA infection associated with postdischarge decolonization in the subgroup of participants who harbored the USA300 strain-type was consistent with overall trial findings. Although the original trial was not powered for the evaluation of a USA300 subset, this RCT provides a valuable design for assessing the magnitude of strain-specific responsiveness to decolonization during a time when national rates of MRSA invasive disease have plateaued and USA300 is responsible for an increasing proportion of infections. These data suggest that postdischarge decolonization should be similarly effective in carriers of either USA300 or healthcare-associated MRSA strains.

Funding: None

Disclosure: Gabrielle M. Gussin, Stryker (Sage Products): Conducting studies in which antiseptic product is provided to participating hospitals and nursing homes. Clorox: Conducting studies in which antiseptic product is provided to participating hospitals and nursing homes. Medline: Conducting studies in which antiseptic product is provided to participating hospitals and nursing homes. Xttrium: Conducting studies in which antiseptic product is provided to participating hospitals and nursing homes. Mohamad Sater, Salary-Day Zero Diagnostics.

Antarctica's ice shelves modulate the grounded ice flow, and weakening of ice shelves due to climate forcing will decrease their ‘buttressing’ effect, causing a response in the grounded ice. While the processes governing ice-shelf weakening are complex, uncertainties in the response of the grounded ice sheet are also difficult to assess. The Antarctic BUttressing Model Intercomparison Project (ABUMIP) compares ice-sheet model responses to decrease in buttressing by investigating the ‘end-member’ scenario of total and sustained loss of ice shelves. Although unrealistic, this scenario enables gauging the sensitivity of an ensemble of 15 ice-sheet models to a total loss of buttressing, hence exhibiting the full potential of marine ice-sheet instability. All models predict that this scenario leads to multi-metre (1–12 m) sea-level rise over 500 years from present day. West Antarctic ice sheet collapse alone leads to a 1.91–5.08 m sea-level rise due to the marine ice-sheet instability. Mass loss rates are a strong function of the sliding/friction law, with plastic laws cause a further destabilization of the Aurora and Wilkes Subglacial Basins, East Antarctica. Improvements to marine ice-sheet models have greatly reduced variability between modelled ice-sheet responses to extreme ice-shelf loss, e.g. compared to the SeaRISE assessments.

Wind generated near-inertial waves are ubiquitous in the upper ocean. An improved understanding of near-inertial wave dynamics following their excitation in the ocean and their subsequent interaction with mesoscale geostrophic balanced flows is key to decoding oceanic energy flow pathways. In this regard, multiple oceanic data sets accumulated over the past few decades reveal that the relative strength of near-inertial waves and geostrophic balanced eddy fields is highly variable, both geographically and seasonally. Inspired by these observations, we investigate turbulent interactions and energy exchanges between near-inertial waves and balanced flows using freely evolving numerical simulations of the non-hydrostatic Boussinesq equations. We find accelerated vertical propagation and dissipation of the waves in regimes where balanced and wave fields have comparable strengths. In such regimes we also find that near-inertial waves directly extract energy from balanced flows, with $O(10\, \%)$ being the amount of balanced energy loss. In contrast, we find that near-inertial waves transfer energy to balanced flows in regimes where balance-to-wave energy ratio is small, with the gain in balanced energy being dependent on the relative strength of waves. Furthermore, these regimes are characterized by relatively weaker vertical propagation and dissipation of the near-inertial wave field. One of the key outcomes of this study is the demonstration of the lack of a unique direction for near-inertial wave-balanced flow energy transfers. Depending on the balance-to-wave energy ratio, near-inertial waves can act as an energy sink or energy source for the geostrophic balanced flow.

Off-target paraquat movement to rice has become a major problem in recent years for rice producers in the midsouthern United States. Nitrogen (N) fertilizer is applied to rice in greater quantity and frequency than all other nutrients to optimize rice yield. Two separate field studies were conducted from 2015 to 2018 in Stoneville, MS, to assess whether starter N fertilizer can aid rice recovery from exposure to a sub-lethal concentration of paraquat and to evaluate rice response to different N fertilizer management strategies following exposure to a sub-lethal concentration of paraquat. In both studies, paraquat treatments consisted of paraquat at 0 and 84 g ai ha–1 applied to rice in the two- to three-leaf (EPOST) growth stage. In the starter fertilizer study, N fertilizer at 24 kg ha–1 as ammonium sulfate (AMS) was applied to rice at spiking- to one-leaf (VEPOST), two- to three-leaf (EPOST), or three- to four-leaf (MPOST) growth stages before and after paraquat treatment. In the N fertilizer timing study, N fertilizer at 168 kg N ha–1 was applied in a single four-leaf to one-tiller (LPOST) application or two-, three-, and two four-way split applications. Despite starter N fertilizer applications, paraquat injured rice ≥41%, reduced height 57%, reduced dry weight prior to flooding 77%, delayed maturity 10 d, reduced dry weight at maturity 33%, and reduced rough rice yield 35% in the starter fertilizer study. Similarly, in the N fertilizer timing study, paraquat injured rice ≥45%, reduced height 14%, delayed maturity 10 d, reduced dry weight at maturity 44%, and reduced rough rice yield 50% for all N fertilizer management strategies. Both studies indicate that severe complications in growth and development can occur from rice exposure to a sub-lethal concentration of paraquat. In both studies, manipulation of N fertilizer management did not facilitate rice recovery from early-season exposure to paraquat.

Commercialization of 2,4-D–tolerant crops is a major concern for sweetpotato producers because of potential 2,4-D drift that can cause severe crop injury and yield reduction. A field study was initiated in 2014 and repeated in 2015 to assess impacts of reduced rates of 2,4-D, glyphosate, or a combination of 2,4-D with glyphosate on sweetpotato. In one study, 2,4-D and glyphosate were applied alone and in combination at 1/10, 1/100, 1/250, 1/500, 1/750, and 1/1,000 of anticipated field use rates (1.05 kg ha−1 for 2,4-D and 1.12 kg ha−1 for glyphosate) to ‘Beauregard’ sweetpotato at storage root formation (10 days after transplanting [DAP]). In a separate study, all these treatments were applied to ‘Beauregard’ sweetpotato at storage root development (30 DAP). Injury with 2,4-D alone or in combination with glyphosate was generally equal or greater than with glyphosate applied alone at equivalent herbicide rates, indicating that injury is attributable mostly to 2,4-D in the combination. There was a quadratic increase in crop injury and quadratic decrease in crop yield (with respect to most yield grades) with increased rate of 2,4-D applied alone or in combination with glyphosate applied at storage root development. However, neither the results of this relationship nor of the significance of herbicide rate were observed on crop injury or sweetpotato yield when herbicide application occurred at storage root formation, with a few exceptions. In general, crop injury and yield reduction were greatest at the highest rate (1/10×) of 2,4-D applied alone or in combination with glyphosate, although injury observed at lower rates was also a concern after initial observation by sweetpotato producers. However, in some cases, yield reduction of U.S. no.1 and marketable grades was also observed after application of 1/250×, 1/100×, or 1/10× rates of 2,4-D alone or with glyphosate when applied at storage root development.

Coronavirus Disease 2019 (COVID-19), a new respiratory disease, is spreading globally. In France, Emergency Medical Service (EMS) teams are mobile medicalized resuscitation teams composed of emergency physician, nurse or anesthesiologist nurse, ambulance driver, and resident. Four types of clinical cases are presented here because they have led these EMS teams to change practices in their management of patients suspected of COVID-19 infection: cardiac arrest, hypoxia on an acute pneumonia, acute chronic obstructive pulmonary disease (COPD) exacerbation with respiratory and hemodynamic disorders, and upper function disorders in a patient in a long-term care facility. The last case raised the question of COVID-19 cases with atypical forms in elderly subjects. Providers were contaminated during the management of these patients. These cases highlighted the need to review the way these EMS teams are responding to the COVID-19 pandemic, in view of heightening potential for early identification of suspicious cases, and of reinforcing the application of staff protection equipment to limit risk of contamination.

OBJECTIVES/GOALS: Large-scale clinical proteomic studies of cancer tissues often entail complex workflows and are resource-intensive. In this study we analyzed ovarian tumors using an emerging, high-throughput proteomic technology termed SWATH. We compared SWATH with the more widely used iTRAQ workflow based on robustness, complexity, ability to detect differential protein expression, and the elucidated biological information. METHODS/STUDY POPULATION: Proteomic measurements of 103 clinically-annotated high-grade serous ovarian cancer (HGSOC) tumors previously genomically characterized by The Cancer Genome Atlas were conducted using two orthogonal mass spectrometry-based proteomic methods: iTRAQ and SWATH. The analytical differences between the two methods were compared with respect to relative protein abundances. To assess the ability to classify the tumors into subtypes based on proteomic signatures, an unbiased molecular taxonomy of HGSOC was established using protein abundance data. The 1,599 proteins quantified in both datasets were classified based on z-score-transformed protein abundances, and the emergent protein modules were characterized using weighted gene-correlation network analysis and Reactome pathway enrichment. RESULTS/ANTICIPATED RESULTS: Despite the greater than two-fold difference in the analytical depth of each proteomic method, common differentially expressed proteins in enriched pathways associated with the HGSOC Mesenchymal subtype were identified by both methods. The stability of tumor subtype classification was sensitive to the number of analyzed samples, and the statistically stable subgroups were identified by the data from both methods. Additionally, the homologous recombination deficiency-associated enriched DNA repair and chromosome organization pathways were conserved in both data sets. DISCUSSION/SIGNIFICANCE OF IMPACT: SWATH is a robust proteomic method that can be used to elucidate cancer biology. The lower number of proteins detected by SWATH compared to iTRAQ is mitigated by its streamlined workflow, increased sample throughput, and reduced sample requirement. SWATH therefore presents novel opportunities to enhance the efficiency of clinical proteomic studies.

OBJECTIVES/GOALS: HIV-specific CD8+ T-cells play a critical role in partially controlling viral replication in infected-individuals, but ultimately fail to eliminate infection. Enhancing these T-cell responses through lymphocyte engineering approaches has the potential as a novel therapy capable of achieving durable control or eradication of infection. METHODS/STUDY POPULATION: IL-15 Superagonist (IL-15SA) potently supports the in vivo persistence and antiviral activity of adoptively transferred CD8+ T-cells. The Deep-PrimingTM technology platform, developed by Torque, allows for loading of immunomodulators onto the surface of T-cells via electrostatic ‘nanogels’, which slowly release to deliver sustained autocrine immune stimulation without the harmful effects of systemic exposure. Here, we investigate the impact of IL-15SA Deep-Priming on HIV-specific CD8+ T-cells in a humanized mouse model of HIV infection. Humanized mice were generated by engrafting NOD-scid-IL2Rgnull mice with memory CD4+ T-cells isolated from an ARV-suppressed HIV+ donor. An autologous HIV-specific Cytotoxic T-Lymphocyte (CTL) clone was isolated, and killing potential confirmed. Four weeks post humanization, mice were infected with HIV and received an infusion of unmodified HIV-Specific CTLs, or IL-15SA Deep-Primed HIV-specific CTLs (CTL-DP). T-cell numbers and plasma viral loads were quantified weekly by flow cytometry and qRT-PCR. RESULTS/ANTICIPATED RESULTS: Mice receiving unmodified CTLs trended toward reduced viral loads compared to the No Treatment condition, while mice receiving CTL-DP saw significant, 2-Log10 reductions in VL (p < 0.01). At 41 days post-infection 100% (5/5) of the No Treatment, 66.7% (4/6) of the CTL treatment, and 16.7% (1/6) of CTL-DP treatment mice had detectable viremia. IL-15SA Deep-Priming increased CTL expansion and persistence in peripheral blood which correlated with improved CD4+T-cell preservation. DISCUSSION/SIGNIFICANCE OF IMPACT: Here we demonstrate the first in vivo analysis of IL-15SA Deep-Priming of HIV-Specific CTLs. These data suggest that Deep-Priming of patient T-cells can enhance in vivo function and persistence, leading to improved viral suppression; a significant advancement in the field of HIV cure research. CONFLICT OF INTEREST DESCRIPTION: Austin Boesch, Thomas Andresen, and Douglas Jones are employees of Torque. Darrell Irvine is a co-founder of Torque and Chairman of Torque’s Scientific Advisory Board.

A major concern of sweetpotato producers is the potential negative effects from herbicide drift or sprayer contamination events when dicamba is applied to nearby dicamba-resistant crops. A field study was initiated in 2014 and repeated in 2015 to assess the effects of reduced rates of N,N-Bis-(3-aminopropyl)methylamine (BAPMA) or diglycloamine (DGA) salt of dicamba, glyphosate, or a combination of these individually in separate trials with glyphosate on sweetpotato. Reduced rates of 1/10, 1/100, 1/250, 1/500, 1/750, and 1/1,000 of the 1× use rate of each dicamba formulation at 0.56 kg ha−1, glyphosate at 1.12 kg ha−1, and a combination of the two at aforementioned rates were applied to ‘Beauregard’ sweetpotato at storage root formation (10 d after transplanting) in one trial and storage root development (30 d after transplanting) in a separate trial. Injury with each salt of dicamba (BAPMA or DGA) applied alone or with glyphosate was generally equal to or greater than glyphosate applied alone at equivalent rates, indicating that injury is most attributable to the dicamba in the combination. There was a quadratic increase in crop injury and a quadratic decrease in crop yield (with respect to most yield grades) observed with an increased herbicide rate of dicamba applied alone or in combination with glyphosate applied at storage root development. However, with a few exceptions, neither this relationship nor the significance of herbicide rate was observed on crop injury or sweetpotato yield when herbicide application occurred at the storage root formation stage. In general, crop injury and yield reduction were greatest at the highest rate (1/10×) of either salt of dicamba applied alone or in combination with glyphosate, although injury observed at lower rates would be cause for concern after initial observation by sweetpotato producers. However, in some cases yield reduction of No.1 and marketable grades was observed following 1/250×, 1/100×, or 1/10× application rates of dicamba alone or with glyphosate when applied at storage root development.

In glyphosate-resistant (GR) cropping systems, paraquat applied in mixtures with residual herbicides prior to crop emergence offers an alternative herbicide mode of action (MOA) to aid in GR weed management. Rice is sensitive to off-target herbicide movement; however, severity of injury can vary with herbicide, rate, and formulation. Therefore, research was conducted from 2015 to 2017 in Stoneville, MS, to characterize rice response to a sublethal concentration of paraquat applied at 84 g ai ha–1 in combination with common residual herbicides. Paraquat plus metribuzin injured rice 68% to 69% 14 and 28 d after treatment (DAT), which was 10% to 13% greater than injury following paraquat alone or paraquat plus fomesafen. Pooled across metribuzin and fomesafen treatments, paraquat reduced rough rice yields 23%. Paraquat plus 10 different residual herbicides injured rice ≥51% 28 DAT and reduced rough rice yields ≥21%. These studies indicate a severe negative impact on rice growth and development following exposure to a sublethal concentration of paraquat alone or in mixture with common residual herbicides. Therefore, applications of paraquat plus residual herbicides to fields in proximity to rice should be avoided if conditions are conducive for off-target movement.

Aerliceaster nexosus n. gen. n. sp. (Echinodermata), one of the oldest of known asteroids, is based on six specimens from the Floian (Early Ordovician) Garden City Formation of Idaho, and Kolataster perplexus n. gen. n. sp. is based on two specimens from the Sandian (Late Ordovician) Mifflin Formation of Illinois. Although the asterozoan skeleton is subdivided into few ossicular categories, evolutionary derivations of all the categories are not fully established, and therefore published evaluations differ. Beginning with phylogenetic work placing asteroid ancestry within the Somasteroidea together with the new taxa described herein, aspects of early asteroid morphology are evaluated and ambiguities in need of further study identified. Uncertainties are considered to be founded in rapid early asterozoan diversification and the scanty fossil record.

UUID: http://zoobank.org/b43d07cc-c8fb-4a84-bc6f-40aa6e0daea2

Basal motion of ice sheets depends in part on the roughness and material properties of the subglacial bed and the occurrence of water. To date, basal motion represents one of the largest uncertainties in ice-flow models. It is that component of the total flow velocity that can change most rapidly and can, therefore, facilitate rapid variations in dynamic behaviour. In this study, we investigate the subglacial properties of the East Antarctic Ice Sheet by statistically analysing the roughness of the bed topography, inferred from radio-echo sounding measurements. We analyse two sets of roughness parameters, one derived in the spatial and the other in the spectral domain, with two roughness parameters each. This enables us to compare the suitability of the four roughness parameters to classify the subglacial landscapes below the ice sheet. We further investigate the relationship of the roughness parameters with observed surface flow velocity and modelled basal temperatures of the ice sheet. We find that one of the roughness parameters, the Hurst exponent derived in the spatial domain, coincides with the thermal condition at the base of the ice sheet for slow flow velocities and varies with flow velocity.