Changes in antimicrobial use during the pandemic in relation to long-term trends in utilization among different antimicrobial stewardship program models have not been fully characterized. We analyzed data from an integrated health system using joinpoint regression and found temporal fluctuations in prescribing as well as continuation of existing trends.

OBJECTIVES/GOALS: #NAME? METHODS/STUDY POPULATION: Cell culture & protein identification: human T cells were purified from healthy blood, then activated & cultured for 5d. CAR-T cells were collected from infusion bags of cancer patients undergoing CAR-T. Silver staining of naive & activated healthy T-cell lysates was compared; B-II spectrin was upregulated and confirmed by Western blot. Migration assays: naive & activated T-cells were imaged during migration on ICAM-1 and ICAM-1 + CXCL12 coated plates. T-cells were transfected with BII-spectrin cDNA & the chemokine dependence of migration was compared with controls. In-vivo studies: in a melanoma mouse model, BII-spectrin transfected or control T-cells were injected; tumors were followed with serial imaging. Human patient records were examined to correlate endogenous BII-spectrin levels and CAR-T response. RESULTS/ANTICIPATED RESULTS: Activated T-cells downregulate the cytoskeletal protein B-II spectrin compared to naive cells, leading to chemokine-independent migration in in vitro assays and off-target trafficking when CAR-T cells are given in vivo. Restoration of B-II spectrin levels via transfection restores chemokine-dependence of activated T-cells. In a mouse melanoma model, control mice injected with standard activated T-cells showed fewer cells in the tumor site and more cells in the off-target organs (spleen, lungs) when compared to mice injected with B-II spectrin transfected cells. Furthermore, among 3 human patients undergoing CAR-T therapy, those with higher endogenous B-II spectrin levels experienced fewer side-effects, measured by the neurotoxicity and cytokine release syndrome grades. DISCUSSION/SIGNIFICANCE: A major hurdle to widespread CAR-T therapy for cancer is significant, often fatal side-effects. Our work shows that the protein B-II spectrin is downregulated during CAR-T production, and that restoring B-II spectrin levels decreases side-effects while increasing tumor clearance--hopefully translating to better CAR-T regimens for the future.

Meta-granites of the South Delhi Fold Belt, northwestern India, contain spectacular reaction textures formed during the metamorphic replacement of primary minerals. Textural relationships imply that amphibole was replaced sequentially in two stages. Epidote + titanite + quartz symplectite formed syn-tectonically on amphibole grain boundaries/fractures, followed by post-deformational growth of euhedral garnet overprinting amphibole grains. Besides occurring as symplectite grown during deformation, titanite in this rock also developed as a post-tectonic corona around magnetite. Parent magnetite contains exsolutions of ilmenite and/or ultrafine lamellae of Ti-rich oxide (Ti-oxd). Textures involving coronal titanite suggest their formation through a magnetite + ilmenite(/Ti-oxd) + plagioclase → titanite reaction. Compositional attributes and the calculation of the gain versus loss of components during the reaction suggest that the Mn2+ for garnet (XSpss = 0.23–0.29) that grew replacing amphibole was supplied by ilmenite (Mn2+ is 0.118–0.128 apfu) as it disintegrated to form coronal titanite. The redistribution of components between the metamorphic reaction sites connects the texturally unrelated domains and suggests that these zones were in chemical equilibrium during metamorphism. We estimated the P–T conditions of metamorphism for these post-tectonic assemblages as ∼650–700 °C from pseudosection modelling and conventional thermometry. Zircon data from this study suggest that the granitic rock crystallized at 988.8 ± 8.8 Ma. We propose that the metamorphic phases replaced the primary minerals during the mid Neoproterozoic tectonic activity reported from this terrane. The syn-tectonic symplectitic assemblage formed as the temperature increased during prograde metamorphism, and the post-tectonic minerals developed at peak conditions following the cessation of deformation.

The work presented in this research communication was carried out to prepare low calorie synbiotic milk beverage by optimizing water and sugar level and to investigate the effect on its storage ability of different packaging materials (polypropylene, high impact polystyrene, high-density polyethylene and glass). Addition of both water and sugar significantly (P < 0.05) affected the viscosity, probiotic count and sensory properties. Based on the findings, 40% water and 8% sugar level were optimized for the preparation of the beverage. Apparent viscosity and acidity increased whilst pH and probiotic counts declined during storage, irrespective of packaging materials. The prepared beverage remained most acceptable at refrigeration temperature up to a period of 15 and 12 d when packaged in glass and high impact polystyrene, respectively. Furthermore, it retained a minimum recommended level of probiotic (7 log cfu/ml) during storage for 15 d at 4 °C.

We develop some asymptotics for a kernel function introduced by Kohnen and use them to estimate the number of normalised Hecke eigenforms in $S_k(\Gamma _0(1))$ whose L-values are simultaneously nonvanishing at a given pair of points each of which lies inside the critical strip.

A triple-frequency operated concentric annular ring microstrip antenna which is single fed is presented. The proposed antenna with three concentric annular rings and two symmetrical notches on its outer ring and having a cross slot in its ground surface shows triple band at resonance frequency 1.22760, 1.57542, and 2.18 GHz, respectively. At the first two bands (GPS L2 and GPS L1), circular polarization characteristic is observed and the third band observes linear polarization finding its application in Universal Mobile Telecommunication System (UMTS). The complete dimension of the antenna designed and fabricated is only 51.6 × 51.6 × 1.6 mm3. Experimental results depict the proposed antenna gain of 3.31, 3.55, and 3.50 dBi in three bands, respectively, and closely matches with the theoretical results.

Malnutrition among adolescents is often associated with inadequate dietary diversity (DD). We aimed to explore the prevalence of inadequate DD and its socio-economic determinants among adolescent girls and boys in Bangladesh. A cross-sectional survey was conducted during the 2018–19 round of national nutrition surveillance in Bangladesh. Univariate and multivariable logistic regression was performed to identify the determinants of inadequate DD among adolescent girls and boys separately. This population-based survey covered eighty-two rural, non-slum urban and slum clusters from all divisions of Bangladesh. A total of 4865 adolescent girls and 4907 adolescent boys were interviewed. The overall prevalence of inadequate DD was higher among girls (55⋅4 %) than the boys (50⋅6 %). Moreover, compared to boys, the prevalence of inadequate DD was higher among the girls for almost all socio-economic categories. Poor educational attainment, poor maternal education, female-headed household, household food insecurity and poor household wealth were associated with increased chances of having inadequate DD in both sexes. In conclusion, more than half of the Bangladeshi adolescent girls and boys consumed an inadequately diversified diet. The socio-economic determinants of inadequate DD should be addressed through context-specific multisectoral interventions.

Germplasm characterization is essential to estimate variation and identify desirable genotypes for crop improvement. The current study was conducted on eight qualitative and 14 quantitative traits related to growth and floral attributes for characterization and grouping of 54 chrysanthemum genotypes. Wide variability was observed among most of the traits and principal component analysis revealed that the first two principal components explained most of the existing variation (>98%) in germplasm. Genotypic coefficient of variation exhibited a wide range from 9.41% (ratio of leaf length/width) to 105.99% (corolla tube length of ray florets), while phenotypic coefficient of variation varied from 10.49% (ratio of leaf length/width) to 106.38% (corolla tube length of ray florets). Broad sense heritability estimates were higher (>96%) for most of the characters, except for traits such as ratio of leaf length/width and peduncle thickness. Forty-four pair-wise inter-trait combinations showed positive genotypic and phenotypic correlations for 91 possible combinations. D2 analysis revealed that genotypes of clusters I and IV to be highly distinct, and hybridization between them might have better chance to obtain desirable types. D2 analysis confirmed that the cultivars in cluster IV namely, Red D Spoon, Tokyo Soldier, Yellow Reflex and hierarchical clustering showed that the cultivar Tokyo Soldier to be highly diverse. It is recommended to use the above genotypes in crossing programme for obtaining better progenies.

Although the behaviour of fluid-filled vesicles in steady flows has been extensively studied, far less is understood regarding the shape dynamics of vesicles in time-dependent oscillatory flows. Here, we investigate the nonlinear dynamics of vesicles in large amplitude oscillatory extensional (LAOE) flows using both experiments and boundary integral (BI) simulations. Our results characterize the transient membrane deformations, dynamical regimes and stress response of vesicles in LAOE in terms of reduced volume (vesicle asphericity), capillary number (${Ca}$, dimensionless flow strength) and Deborah number (${De}$, dimensionless flow frequency). Results from single vesicle experiments are found to be in good agreement with BI simulations across a wide range of parameters. Our results reveal three distinct dynamical regimes based on vesicle deformation: pulsating, reorienting and symmetrical regimes. We construct phase diagrams characterizing the transition of vesicle shapes between pulsating, reorienting and symmetrical regimes within the two-dimensional Pipkin space defined by ${De}$ and ${Ca}$. Contrary to observations on clean Newtonian droplets, vesicles do not reach a maximum length twice per strain rate cycle in the reorienting and pulsating regimes. The distinct dynamics observed in each regime result from a competition between the flow frequency, flow time scale and membrane deformation time scale. By calculating the particle stresslet, we quantify the nonlinear relationship between average vesicle stress and strain rate. Additionally, we present results on tubular vesicles that undergo shape transformation over several strain cycles. Broadly, our work provides new information regarding the transient dynamics of vesicles in time-dependent flows that directly informs bulk suspension rheology.

Anthracnose caused by Colletotrichum truncatum is a major soybean disease in India. Genetic resistance is the viable option to combat yield losses due to this disease. In the current study, 19 soybean genotypes were evaluated for anthracnose disease resistance at five locations (Medziphema, Palampur, Dharwad, Jabalpur and Indore) for three consecutive years (2017–2019) to identify stable and superior genotypes as resistant sources and to elucidate genotype (G) × environment (E) interactions. Genotype effect, environment effect and G × E interactions were found significant (P < 0.001) where G × E interactions contributed highest (42.44) to the total variation followed by environment (29.71) and genotype (18.84). Through Weighted Average of Absolute Scores (WAASB) stability analysis, PS 1611 (WAASB score = 0.33) was found to be most stable and through WAASBY superiority analysis NRC 128 (WAASBY score = 94.31) and PS 1611 (WAASBY score = 89.43) were found to be superior for mean performance and stability. These two genotypes could be candidate parents for breeding for durable and stable anthracnose resistance. Through principal component analysis, disease score was found to be positively associated with relative humidity, wind speed at 2 m above ground level, effect of temperature on radiation use efficiency and global solar radiation based on latitude and Julian day. Among the five locations, Indore was found to be highly discriminative with the highest mean disease incidence and could differentiate anthracnose-resistant and susceptible genotypes effectively, therefore can be considered an ideal location for breeding for field resistance against anthracnose disease.

Background: Ischemic stroke occurs following trauma-related blunt cerebrovascular injury (BCVI) in up to 20% of cases. Preventative treatment includes antiplatelets, anticoagulants, and/or endovascular treatment (ET), but the optimal choice remains unclear. The objective of this study was to compare the ischemic stroke rate between these three treatments. Methods: Following PRISMA guidelines, we queried the OVID Medline, Embase, Web of Science, and Cochrane Library databases from September 2019 to inception to identify studies reporting treatment-stratified outcomes in BCVI patients. Meta-analysis was performed to compare outcomes between the treatment groups, using odds ratios. Retrospective review of our institutional experience with BCVI outcomes was performed and added to the meta-analysis. Results: Analysis of seven comparative studies of antiplatelets (n=334) versus anticoagulation (n=325) found no significant difference in ischemic stroke rate (OR 1.27, 95%CI 0.40-3.99), but a decrease in hemorrhagic complications (OR 0.38, 95%CI 0.15-1.00). Analysis of seven comparative studies of antiplatelets/anticoagulants (n=805) versus ET (n=235) also found no significant difference in stroke rate (OR 0.71, 95%CI 0.35-1.42). Conclusions: Antiplatelets and anticoagulants were similarly effective in reducing ischemic stroke risk in BCVI, but antiplatelets were better tolerated in this trauma population. The addition of endovascular treatment did not further reduce stroke risk compared to antiplatelets or anticoagulants alone.

The COVID-19 pandemic has placed significant strain on emergency departments (EDs) that were not designed to care for many patients who may be highly contagious. This report outlines how a busy urban ED was adapted to prepare for COVID-19 via 3 primary interventions: (1) creating an open-air care space in the ambulance bay to cohort, triage, and rapidly test patients with suspected COVID-19, (2) quickly constructing temporary doors on all open treatment rooms, and (3) adapting and expanding the waiting room. This description serves as a model by which other EDs can repurpose their own care spaces to help ensure safety of their patients and health care workers.