Background: Infections lead to high mortality among patients on chronic dialysis; knowledge of multi-drug resistant infections is limited. The Centers for Disease Control and Prevention’s Emerging Infections Program (EIP) conducts laboratory- and population-based surveillance for carbapenem-resistant Enterobacterales (CRE) in 10 U.S. sites and carbapenem-resistant Acinetobacter baumannii (CRAB) in 9 U.S. sites. We investigated clinical characteristics, healthcare exposures, and outcomes of CRE and CRAB cases in persons on chronic dialysis from 2016-2021. Methods: Among EIP catchment-area residents on chronic dialysis, we defined a CRE case as the first isolation of Escherichia coli, Enterobacter cloacae complex, Klebsiella aerogenes (formerly Enterobacter aerogenes), Klebsiella oxytoca, Klebsiella pneumoniae, or Klebsiella variicola resistant to any carbapenem, from a normally sterile site or urine in a 30-day period. A CRAB case was defined as the first isolation of Acinetobacter baumannii complex resistant to any carbapenem (excluding ertapenem), from a normally sterile site or urine (or lower respiratory tract or wound since 2021) in a 30-day period. Medical records were reviewed. A case was considered colonized if the case culture had no associated infection type or colonization was documented in the medical record. Descriptive analyses, including analyses stratified by pathogen, were conducted. Results: Among 426 cases, 314 were CRE, and 112 were CRAB; most cases were male (235, 55.2%), Black (229, 53.8%), and 51-80 years old (320, 75.1%) (Table). An infection was associated with 363 (85.2%) case cultures; bloodstream infections (148; 40.8%), urinary tract infections (134; 36.9%), and pneumonia (17; 4.7%) were the most frequent. Overall, most cases had documented healthcare exposures (excluding outpatient dialysis) in the year before incident specimen collection, including: 366 (85.9%) hospitalizations, 235 (55.2%) surgeries, 209 (49.1%) long-term care facility stays, 54 (12.7%) long-term acute care facility stays. Additionally, 125 (29.3%) had an intensive care unit admission within the 7 days before incident specimen collection. Compared to CRE cases, a higher proportion of CRAB cases (a) had a long-term care facility stay (82/112 [73.2%] versus 127/314 [40.5%], P<.0001) or hospitalization (103/112 [92%] versus 263/314 [83.8%], P = .03) within the preceding year and (b) died within 30 days of incident specimen collection (40/112 [35.7%] versus 64/314 [20.4%], P = .001). Discussion: Among CRE and CRAB cases in persons on chronic dialysis, healthcare exposures were common, and mortality was high. Additional efforts to better describe the burden of these organisms and associated risk factors in the dialysis population are needed for tailoring infection prevention strategies to this vulnerable.

A number of nearby dwarf galaxies have globular cluster (GC) candidates that require spectroscopic confirmation. Here, we present Keck telescope spectra for 15 known GCs and GC candidates that may be associated with a host dwarf galaxy and an additional 3 GCs in the halo of M31 that are candidates for accretion from a now-disrupted dwarf galaxy. We confirm six star clusters (of intermediate-to-old age) to be associated with NGC 247. The vast bulk of its GC system remains to be studied spectroscopically. We also confirm the GC candidates in F8D1 and DDO190, finding both to be young star clusters. The three M31 halo GCs all have radial velocities consistent with M31 and are old and very metal-poor. Their ages and metallicities are consistent with accretion from a low-mass satellite galaxy. Finally, three objects are found to be background galaxies – two are projected near NGC 247 and one (candidate GCC7) is near the IKN dwarf. The IKN dwarf thus has only five confirmed GCs but still a remarkable specific frequency of 124.

The prevalence of food allergies in New Zealand infants is unknown; however, it is thought to be similar to Australia, where the prevalence is over 10% of 1-year-olds(1). Current New Zealand recommendations for reducing the risk of food allergies are to: offer all infants major food allergens (age appropriate texture) at the start of complementary feeding (around 6 months); ensure major allergens are given to all infants before 1 year; once a major allergen is tolerated, maintain tolerance by regularly (approximately twice a week) offering the allergen food; and continue breastfeeding while introducing complementary foods(2). To our knowledge, there is no research investigating whether parents follow these recommendations. Therefore, this study aimed to explore parental offering of major food allergens to infants during complementary feeding and parental-reported food allergies. The cross-sectional study included 625 parent-infant dyads from the multi-centred (Auckland and Dunedin) First Foods New Zealand study. Infants were 7-10 months of age and participants were recruited in 2020-2022. This secondary analysis included the use of a study questionnaire and 24-hour diet recall data. The questionnaire included determining whether the infant was currently breastfed, whether major food allergens were offered to the infant, whether parents intended to avoid any foods during the first year of life, whether the infant had any known food allergies, and if so, how they were diagnosed. For assessing consumers of major food allergens, 24-hour diet recall data was used (2 days per infant). The questionnaire was used to determine that all major food allergens were offered to 17% of infants aged 9-10 months. On the diet recall days, dairy (94.4%) and wheat (91.2%) were the most common major food allergens consumed. Breastfed infants (n = 414) were more likely to consume sesame than non-breastfed infants (n = 211) (48.8% vs 33.7%, p≤0.001). Overall, 12.6% of infants had a parental-reported food allergy, with egg allergy being the most common (45.6% of the parents who reported a food allergy). A symptomatic response after exposure was the most common diagnostic tool. In conclusion, only 17% of infants were offered all major food allergens by 9-10 months of age. More guidance may be required to ensure current recommendations are followed and that all major food allergens are introduced by 1 year of age. These results provide critical insight into parents’ current practices, which is essential in determining whether more targeted advice regarding allergy prevention and diagnosis is required.

In this paper we produce infinite families of counterexamples to Jantzen's question posed in 1980 on the existence of Weyl $p$-filtrations for Weyl modules for an algebraic group and Donkin's tilting module conjecture formulated in 1990. New techniques to exhibit explicit examples are provided along with methods to produce counterexamples in large rank from counterexamples in small rank. Counterexamples can be produced via our methods for all groups other than when the root system is of type ${\rm A}_{n}$ or ${\rm B}_{2}$.

Under what conditions does the US public support the domestic use of different institutions of coercive state power? We theorize how the type of situation, the type of actor, the mission, and the type of intervention influence public support for such missions. We use a preregistered conjoint survey experiment to test our hypotheses and find that participants (i) are less supportive of interventions in response to protests than to natural disasters or terrorism, (ii) generally prefer the police or the National Guard to the military, (iii) mistrust order maintenance interventions, and (iv) prefer intervening actors be unarmed. Preferences (ii)–(iv) are strongly conditioned on the type of event. We also find that Republicans are more accepting of military actors, order maintenance interventions, armed interventions, and policing responses to protests. We note implications for public trust in the military, the militarization of policing, and the domestic use of federal forces.

Heart University [https://www.heartuniversity.org/] is a free educational website providing structured training curricula with knowledge-based testing and access to webinars and conference recordings for practicing and in-training providers of paediatric and congenital cardiac care. To date, there are over 15,000 registered website users from over 140 countries on Heart University, with over 2,000 training modules and/or recorded educational videos. Heart University has developed an “asynchronous” educational lecture series entitled “Pediatric and Congenital Cardiac Care in Resource-Limited Settings.” This recorded lecture series is specifically focused on topics relevant to practicing paediatric and/or congenital cardiac care in low-resource settings.

A relatively new initiative, “Cardiology Across Continents,” supplements the existing educational resources for providers of paediatric and/or congenital cardiac care in low-income countries and lower-middle-income countries by providing an additional live, interactive, case-based forum. Sessions occur every 1–2 months and focus on challenging cases from diagnostic or management perspective with a view to promote collaboration between partnered institutions. “Cardiology Across Continents” is an expanding initiative that facilitates learning and collaboration between clinicians across varied practice settings via interactive case discussions. We welcome trainees and providers of paediatric and congenital cardiac care to join the sessions and invite any insight that can enhance learning for clinicians around the world. This manuscript describes “Cardiology Across Continents” and discusses the development, history, current status, and future plans of Heart University.

OBJECTIVES/GOALS: Contingency management (CM) procedures yield measurable reductions in cocaine use. This poster describes a trial aimed at using CM as a vehicle to show the biopsychosocial health benefits of reduced use, rather than total abstinence, the currently accepted metric for treatment efficacy. METHODS/STUDY POPULATION: In this 12-week, randomized controlled trial, CM was used to reduce cocaine use and evaluate associated improvements in cardiovascular, immune, and psychosocial well-being. Adults aged 18 and older who sought treatment for cocaine use (N=127) were randomized into three groups in a 1:1:1 ratio: High Value ($55) or Low Value ($13) CM incentives for cocaine-negative urine samples or a non-contingent control group. They completed outpatient sessions three days per week across the 12-week intervention period, totaling 36 clinic visits and four post-treatment follow-up visits. During each visit, participants provided observed urine samples and completed several assays of biopsychosocial health. RESULTS/ANTICIPATED RESULTS: Preliminary findings from generalized linear mixed effect modeling demonstrate the feasibility of the CM platform. Abstinence rates from cocaine use were significantly greater in the High Value group (47% negative; OR = 2.80; p = 0.01) relative to the Low Value (23% negative) and Control groups (24% negative;). In the planned primary analysis, the level of cocaine use reduction based on cocaine-negative urine samples will serve as the primary predictor of cardiovascular (e.g., endothelin-1 levels), immune (e.g., IL-10 levels) and psychosocial (e.g., Addiction Severity Index) outcomes using results from the fitted models. DISCUSSION/SIGNIFICANCE: This research will advance the field by prospectively and comprehensively demonstrating the beneficial effects of reduced cocaine use. These outcomes can, in turn, support the adoption of reduced cocaine use as a viable alternative endpoint in cocaine treatment trials.

Microbial reduction of clay mineral structural Fe(III) decreases the swelling of nontronite gels, most importantly at intermediate oxidation states (40 to 80 cmol Fe(II) kg−1 clay). The purpose of this study was to establish whether microbial reduction of structural Fe(III) decreased the swelling of other Fe-bearing smectites and to discern the influence that organic compounds of microbial origin (bacterial cells, cell fragments and/or exudates) may have on clay swelling and texture. Structural Fe(III) was reduced by incubating smectite suspensions with either a combination of Pseudomonas bacteria or a mixture of anaerobic bacteria. The influence of organics on clay swelling was estimated on smectites suspended in either organic or inorganic media in the absence of bacteria. The gravimetric water content of the reduced clay gels equilibrated at various applied pressures was recorded as a function of Fe oxidation state. Transmission electron microscopy (TEM) was employed to determine the influence of bacteria and type of media on the texture of reduced smectite gels. Reduction of structural Fe(III) by bacteria decreased the swelling pressure of all Fe-bearing smectites. Increased clay swelling, due to the presence of organics (organic medium, exudates or cell fragments), was correlated to the total Fe content, the extent of structural Fe reduction, as well as the initial swelling characteristics of the Fe-bearing smectites. High structural Fe(II) contents (>50 cmol Fe(II) kg−1) resulted in increased attractive forces between clay platelets that decreased clay swelling, even in organic medium suspensions. Microbial reduction resulted in increased face-face association of individual clay layers, forming larger and more distinct crystallite subunits than in nonreduced clay gels. But, perhaps more importantly, microbial reduction of structural Fe(III) resulted in an increased association between crystallite subunits and, thus, an overall larger particle size and pore size distribution, due to the interaction of bacteria ceils, cell fragments and organic exudates.

PEPAdb (Prehistoric Europe's Personal Adornment Database) is a long-term, open-ended project that aims to improve access to archaeological data online. Its website (https://pepadb.us.es) publishes and analyses datasets about prehistoric personal adornment, drawing on the results of various research projects and bibliographic references.