OBJECTIVES/GOALS: DR-TB care in South Africa includes decentralized treatment with shorter, all-oral regimens. Treatment guidelines direct regular clinical and laboratory evaluation to assess patient improvement. We therefore measured sputum collection frequency and follow-up time to assess fidelity to these guidelines in Gauteng Province, South Africa. METHODS/STUDY POPULATION: We included Rifampicin-resistant (RR) sputum specimens from the South African National Health Laboratory Service, which provides pathology services to 80% of the population, submitted between August 2022-September 2023. Patient data were obtained from a DR-TB registry and additional sputum specimen data were collected from follow-up laboratory worksheets. Follow-up spanned from first sputum collection date (baseline) to patient outcome date (e.g., completion, lost) or study closure date (if still on treatment). Monthly sputum submission rate was measured for those with ≥1 additional sputum submitted. We compared patient data by treatment site: at the specialized hospital vs. any other site, using Wilcoxon ranksum and χ2 tests. RESULTS/ANTICIPATED RESULTS: Baseline RR-TB specimens were available for 142 patients, of whom 28 (20%) had specimens submitted from the specialized hospital. Patients at the specialized hospital were older (median age 41 vs. 35.5 years, p=0.03), had higher baseline fluoroquinolone resistance (10% vs. 1%, p=0.01), and longer follow-up (median 5.2 vs. 3.5 months, p=0.01) compared to patients elsewhere. Further, 43 (30%) patients had ≥1 additional sputum submitted during follow-up. Among these, monthly sputum collection rates did not differ by site (0.3 vs. 0.3 sputum per month, p=0.89). We anticipate that increased sputum frequency will be associated with successful TB treatment outcomes based on preliminary findings. DISCUSSION/SIGNIFICANCE: These findings highlight ongoing challenges with routine laboratory follow-up according to DR-TB guidelines across treatment sites in South Africa. Future research is needed to determine reasons for low sputum collection rates, such as low patient adherence, variation in practice of healthcare workers, loss to follow-up, and clinical challenges.

We report the discovery of a bow-shock pulsar wind nebula (PWN), named Potoroo, and the detection of a young pulsar J1638$-$4713 that powers the nebula. We present a radio continuum study of the PWN based on 20-cm observations obtained from the Australian Square Kilometre Array Pathfinder (ASKAP) and MeerKAT. PSR J1638$-$4713 was identified using Parkes radio telescope observations at frequencies above 3 GHz. The pulsar has the second-highest dispersion measure of all known radio pulsars (1 553 pc cm$^{-3}$), a spin period of 65.74 ms and a spin-down luminosity of $\dot{E}=6.1\times10^{36}$ erg s$^{-1}$. The PWN has a cometary morphology and one of the greatest projected lengths among all the observed pulsar radio tails, measuring over 21 pc for an assumed distance of 10 kpc. The remarkably long tail and atypically steep radio spectral index are attributed to the interplay of a supernova reverse shock and the PWN. The originating supernova remnant is not known so far. We estimated the pulsar kick velocity to be in the range of 1 000–2 000 km s$^{-1}$ for ages between 23 and 10 kyr. The X-ray counterpart found in Chandra data, CXOU J163802.6$-$471358, shows the same tail morphology as the radio source but is shorter by a factor of 10. The peak of the X-ray emission is offset from the peak of the radio total intensity (Stokes $\rm I$) emission by approximately 4.7$^{\prime\prime}$, but coincides well with circularly polarised (Stokes $\rm V$) emission. No infrared counterpart was found.

Globally, human house types are diverse, varying in shape, size, roof type, building materials, arrangement, decoration and many other features. Here we offer the first rigorous, global evaluation of the factors that influence the construction of traditional (vernacular) houses. We apply macroecological approaches to analyse data describing house features from 1900 to 1950 across 1000 societies. Geographic, social and linguistic descriptors for each society were used to test the extent to which key architectural features may be explained by the biophysical environment, social traits, house features of neighbouring societies or cultural history. We find strong evidence that some aspects of the climate shape house architecture, including floor height, wall material and roof shape. Other features, particularly ground plan, appear to also be influenced by social attributes of societies, such as whether a society is nomadic, polygynous or politically complex. Additional variation in all house features was predicted both by the practices of neighouring societies and by a society's language family. Collectively, the findings from our analyses suggest those conditions under which traditional houses offer solutions to architects seeking to reimagine houses in light of warmer, wetter or more variable climates.

The present study aims to explore how pre- and in-service language teachers incorporate the cutting-edge technology of immersive virtual reality (iVR) into their teaching practice. Specifically, the study examined how their different knowledge levels and teaching experiences influenced their integration of technology by analyzing their performance-based tasks in microteaching in an iVR environment. This particular technology was selected for the study because it was expected to bring multiple pedagogical benefits to future foreign language learning classrooms, such as contextualized learning, increased learner motivation and interest, and enhanced interaction and communicative skill training. The study employed in-depth qualitative analysis. Data (lesson plans, screen recordings of microteaching episodes, and reflection papers) were collected from one preservice teacher training course and one in-service teacher training course at a Korean university. The study found a large gap between pre- and in-service teacher performance and identified the sources of the differences based on qualitative data analysis. The results showed that not only teachers’ technological knowledge but also their pedagogical knowledge of the use of technology and confidence in teaching affected technology integration. As technology integration has become more important in language education, the current study provided insight into how to better prepare teachers for future learners.

This paper discusses the future role of periodization in the wake of recent critiques of culture-historical chronologies concurrent with the rise of high-definition radiocarbon dating. It is argued that periodization has two distinct facets, a narrative function and a dating function, which should be separated. Archaeology may eventually be able to abandon the latter, but not the former. However, the two aspects are closely intertwined and the goal of this paper is to disentangle them and, through a case study of archaeological periodization in Iceland, demonstrate the need to re-engage with culture-historical taxonomies by reverse engineering their construction. Only in this way will the utility or poverty of such culture-historical periods be exposed to proper scrutiny and the ground cleared for building new, narrative periodizations.

As the proportion of the elderly population in the USA expands, so will the demand for rehabilitation and social care, which play an important role in maintaining function and mediating motor and cognitive decline in older adults. The use of social robotics and telemedicine are each potential solutions but each have limitations. To address challenges with classical telemedicine for rehabilitation, we propose to use a social robot-augmented telepresence (SRAT), Flo, which was deployed for long-term use in a community-based rehabilitation facility catering to older adults. Our goals were to explore how clinicians and patients would use and respond to the robot during rehab interactions. In this pilot study, three clinicians were recruited and asked to rate usability after receiving training for operating the robot and two of them conducted multiple rehab interactions with their patients using the robot (eleven patients with cognitive impairment and/or motor impairment and 23 rehab sessions delivered via SRAT in total). We report on the experience of both therapists and patients after the interactions.

Recent research has shown the potential of speleothem δ13C to record a range of environmental processes. Here, we report on 230Th-dated stalagmite δ13C records for southwest Sulawesi, Indonesia, over the last 40,000 yr to investigate the relationship between tropical vegetation productivity and atmospheric methane concentrations. We demonstrate that the Sulawesi stalagmite δ13C record is driven by changes in vegetation productivity and soil respiration and explore the link between soil respiration and tropical methane emissions using HadCM3 and the Sheffield Dynamic Global Vegetation Model. The model indicates that changes in soil respiration are primarily driven by changes in temperature and CO2, in line with our interpretation of stalagmite δ13C. In turn, modelled methane emissions are driven by soil respiration, providing a mechanism that links methane to stalagmite δ13C. This relationship is particularly strong during the last glaciation, indicating a key role for the tropics in controlling atmospheric methane when emissions from high-latitude boreal wetlands were suppressed. With further investigation, the link between δ13C in stalagmites and tropical methane could provide a low-latitude proxy complementary to polar ice core records to improve our understanding of the glacial–interglacial methane budget.

Radiocarbon (14C) dating of sediment deposition around Antarctica is often challenging due to heterogeneity in sources and ages of organic carbon in the sediment. Chemical and thermochemical techniques have been used to separate organic carbon when microfossils are not present. These techniques generally improve on bulk sediment dates, but they necessitate assumptions about the age spectra of specific molecules or compound classes and about the chemical heterogeneity of thermochemical separations. To address this, the Rafter Radiocarbon Laboratory has established parallel ramped pyrolysis oxidation (RPO) and ramped pyrolysis-gas chromatography-mass spectrometry (Py-GC-MS) systems to thermochemically separate distinct carbon fractions, diagnose the chemical composition of each fraction, and target suitable RPO fractions for radiocarbon dating. Three case studies of sediment taken from locations around Antarctica are presented to demonstrate the implementation of combined RPO-AMS and Py-GC-MS to provide more robust age determination in detrital sediment stratigraphy. These three depositional environments are good examples of analytical and interpretive challenges related to oceanographic conditions, carbon sources, and other factors. Using parallel RPO-AMS and Py-GC-MS analyses, we reduce the number of radiocarbon measurements required, minimize run times, provide context for unexpected 14C ages, and better support interpretations of radiocarbon measurements in the context of environmental reconstruction.

This study evaluated the feasibility and safety of a telehealth delivered exercise plus plant-based protein diet in adults with non-alcoholic fatty liver disease (NAFLD). This was a 12-week, randomised controlled feasibility trial including twenty-eight adults aged > 45 years with NAFLD randomised to a home muscle strengthening program (3 d/week) with increased protein intake (target ∼1·2–1·5 g/kg/d) from predominately plant-based sources and behavioural change support (3–4 text messages/week) (Pro-Ex n 14) or usual care (UC, n 14). Feasibility was assessed via retention (≤ 10 % attrition), adherence (exercise ≥ 66 %; recommended daily protein serves ≥ 80 %) and safety (adverse events). Secondary outcomes included macronutrient intake (3 × 24-h records), weight, moderate-to-vigorous physical activity (MVPA) and 30 s sit-to-stand (STS) performance. Study retention was 89 %. Mean exercise adherence (Pro-Ex) was 52 % with one adverse event from 241 sessions. In Pro-Ex, mean daily plant protein serves increased (0·9 to 1·4/d) and animal protein decreased (1·5 to 1·2/d) after 12-weeks, but overall adherence (serves/day) was 32[RD1] % (plant) and 42 % (animal). Relative to UC, Pro-Ex experienced a mean 2·7 (95 % CI: 0·9, 4·4) increase in 30 s STS number, 46-minute (95 % CI: −153, 245) increase in MVPA, 1·7 kg (95 % CI: −3·5, 0·2) decrease in weight, 35·2 g (95 % CI: 11·0, 59·3) increase in protein. In adults with NAFLD a telehealth home exercise and dietary intervention was safe and improved habitual plant and animal protein intake, but overall adherence was modest suggesting more intensive healthcare support may be required.

We present a deep probabilistic convolutional neural network (PCNN) model for predicting local values of small-scale mixing properties in stratified turbulent flows, namely the dissipation rates of turbulent kinetic energy and density variance, $\varepsilon$ and $\chi$. Inputs to the PCNN are vertical columns of velocity and density gradients, motivated by data typically available from microstructure profilers in the ocean. The architecture is designed to enable the model to capture several characteristic features of stratified turbulence, in particular the dependence of small-scale isotropy on the buoyancy Reynolds number $Re_b:=\varepsilon /(\nu N^2)$, where $\nu$ is the kinematic viscosity and $N$ is the background buoyancy frequency, the correlation between suitably locally averaged density gradients and turbulence intensity and the importance of capturing the tails of the probability distribution functions of values of dissipation. Empirically modified versions of commonly used isotropic models for $\varepsilon$ and $\chi$ that depend only on vertical derivatives of density and velocity are proposed based on the asymptotic regimes $Re_b\ll 1$ and $Re_b\gg 1$, and serve as an instructive benchmark for comparison with the data-driven approach. When trained and tested on a simulation of stratified decaying turbulence which accesses a range of turbulent regimes (associated with differing values of $Re_b$), the PCNN outperforms assumptions of isotropy significantly as $Re_b$ decreases, and additionally demonstrates improvements over the fitted empirical models. A differential sensitivity analysis of the PCNN facilitates a comparison with the theoretical models and provides a physical interpretation of the features enabling it to make improved predictions.