Forest succession drives concomitant changes in associated faunal communities. Thus, maintaining landscapes with high successional diversity can be an important consideration in habitat management. We sought to describe avian community characteristics across a successional gradient created by reforestation efforts in a tropical premontane wet forest in Costa Rica. Specifically, we examined the effects of successional stage on overall abundance, species richness, diet niche, migratory status, and community composition. We hypothesised that these metrics of bird abundance, diversity and community composition would differ across successional stages. Using data from transects conducted in 2018, we found that several metrics of avian abundance, diversity and community composition varied as a function of successional stage. Surprisingly, the earliest successional stage exhibited the greatest abundance, species richness and proportion of migrant species. We suggest that an ephemeral vegetation structure present for only a short period (early in succession) creates a unique habitat that results in a distinct avian community. This highlights the potential importance of early successional forests for avian communities, especially neotropical migrants.

Background: Despite a higher prevalence of traumatic spinal cord injury (TSCI) amongst Canadian Indigenous peoples, there is a paucity of studies focused on Indigenous TSCI. We present the first Canada-wide study comparing TSCI amongst Canadian Indigenous and non-Indigenous peoples. Methods: This study is a retrospective analysis of prospectively-collected TSCI data from the Rick Hansen Spinal Cord Injury Registry (RHSCIR) from 2004-2019. We divided participants into Indigenous and non-Indigenous cohorts and compared them with respect to demographics, injury mechanism, level, severity, and outcomes. Results: Compared with non-Indigenous patients, Indigenous patients were younger, more female, less likely to have higher education, and less likely to be employed. The mechanism of injury was more likely due to assault or transportation-related trauma in the Indigenous group. The length of stay for Indigenous patients was longer. Indigenous patients were more likely to be discharged to a rural setting, less likely to be discharged home, and more likely to be unemployed following injury. Conclusions: Our results suggest that more resources need to be dedicated for transitioning Indigenous patients sustaining a TSCI to community living and for supporting these patients in their home communities. A focus on resources and infrastructure for Indigenous patients by engagement with Indigenous communities is needed.

ABSTRACT IMPACT: Indiana CTSI Team Science to maximize rapid collection, analyses and dissemination of biosamples collected from patients with Covid-19 to provide preliminary data for grant applications on the pathogenesis and outcomes of patients with Covid-19. OBJECTIVES/GOALS: When Covid-19 hit Indiana in April, there was an immediate need to respond rapidly to coordinate research across our healthcare systems. The CTSI became a point of contact for coordinating research endeavors including activation of clinical trials and use of precious samples from patients with Covid-19 to maximize preliminary data for grants. METHODS/STUDY POPULATION: The Indiana CTSI coordinated collection of biospecimens at multiple hospitals using in person and remote consenting via telephone or on a smartphone utilizing a QR code. We also retrieved existing samples from the Indiana Biobank previously collected for future research and from subject positive for Covid-19 by search of the linked electronic health record (EHR). A total of 224 subject samples (7 children, 36 previously collected, and 6 with both acute and recovered specimens) were obtained over a four month period. Our CTSI cores ran varied analyses collated to a single database, linked to the EMR for use as preliminary data for grant applications to avoid redundancy of measures on limited samples. RESULTS/ANTICIPATED RESULTS: The 224 subject samples were used for whole exome DNA sequencing, RNA seq, analyses of 48 plasma cytokine/chemokines by multiplex analyses, and PBMC isolated for culture and assessment of secreted cytokines. The clinical data were linked and included demographics, hospitalization length of stay and need for mechanical ventilation, max and min oxygen levels, liver function tests, IL-6, D-dimer, CRP, LDH, and ferritin, need for dialysis, and echocardiography. Additional clinical data were available upon request. A survey was sent to our CTSI email to query for potential interest in the data with 87 inquiries, and to date 46 investigators have requested data and/or additional samples. DISCUSSION/SIGNIFICANCE OF FINDINGS: During the first surge of Covid-19, the CTSI coordinated analyses for the dissemination of results for use by CTSI investigators to minimize duplication of assays and increase availability. The collaboration of research coordinators, biobank, research cores, and informatics demonstrates the power and agility of team science in the Indiana CTSI.

Background: Although antibiotic stewardship programs (ASP) are now required in nursing homes, assimilating and responding to data to improve prescribing in nursing homes is novel. Four Atlanta-based skilled nursing facilities (SNFs) began collaborating (EASIL: Emory Antibiotic Stewardship in Long-Term Care) to share standardized prescribing data to allow interfacility comparisons and action. Methods: After SNF ASPs were evaluated and trained, standardized prescribing logs were submitted (January 2019 to June 2019) including the following data: start date, treatment site, prescriber attribution of order (ie, SNF order vs hospital order) and monthly resident days. SNF-specific point estimates of usage rates were calculated as pooled means for all antibiotic starts, SNF-order starts, and days of therapy (DOT), by treatment site per 1,000 resident days. Duration of urinary tract infection (UTI) therapy was assessed by calculating percentage of SNF-UTI starts over recommended duration defined by the local treatment guideline. Rate ratios (RRs) of use were calculated to compare SNF-specific rates to the largest SNF. The 95% CIs were calculated using normal approximation. Results: Monthly starts ranged from 124 to 177, with a pooled mean of 7.8 antibiotic starts (any type), 4.5 SNF-order starts, and 1.2 SNF-UTI starts per 1,000 resident days. Approximately half of all starts were SNF starts (range, 43%–53%), and less than half of DOT were attributed to SNF starts (range, 35%–45%). Overall, SNF-order treatment sites were most often UTIs (29%), lower respiratory infections (17%), and skin and soft-tissue infections (17%). SNF-order UTI starts per 1,000 patient days varied at 1 SNF (SNF B RR, 1.57; 95% CI, 1.04–2.36). SNF-order UTI DOT per 1,000 patient days was more variable, with SNFs B and C having significantly higher rates (B RR, 1.49, 1.24, and 1.82; C RR, 5.42; 95% CI, 4.65–6.34) than SNF A (Fig. 1). The percentage of SNF-order UTI starts that were over recommended duration ranged from 8% (nitrofurantoin, SNF A) to 100% (fluoroquinolones, SNF C) (Fig. 1). Conclusions: Although UTIs are the single most common reason to prescribe antibiotics after arriving in a SNF, they account for a small fraction of overall starts and an even smaller fraction of DOT. We identified outlier prescribing by different SNFs using 3 metrics, suggesting that distinct corrective actions are necessary to target distinct prescribing challenges (starts, duration, and transitions of care).

Funding: None

Disclosures: Scott Fridkin reports that his spouse receives consulting fees from the vaccine industry.

Successful management of an event where health-care needs exceed regional health-care capacity requires coordinated strategies for scarce resource allocation. Publications for rapid development, training, and coordination of regional hospital triage teams to manage the allocation of scarce resources during coronavirus disease 2019 (COVID-19) are lacking. Over a period of 3 weeks, over 100 clinicians, ethicists, leaders, and public health authorities convened virtually to achieve consensus on how best to save the most lives possible and share resources. This is referred to as population-based crisis management. The rapid regionalization of 22 acute care hospitals across 4500 square miles in the midst of a pandemic with a shifting regulatory landscape was challenging, but overcome by mutual trust, transparency, and confidence in the public health authority. Because many cities are facing COVID-19 surges, we share a process for successful rapid formation of health-care care coalitions, Crisis Standard of Care, and training of Triage Teams. Incorporation of continuous process improvement and methods for communication is essential for successful implementation. Use of our regional health-care coalition communications, incident command system, and the crisis care committee helped mitigate crisis care in the San Diego and Imperial County region as COVID-19 cases surged and scarce resource collaborative decisions were required.

The occurrence of herbicide tank contamination with dicamba or 2,4-D will likely increase with the recent commercialization of dicamba- and 2,4-D-resistant soybean. High-value sensitive crops, including dry bean, will be at higher risks for exposure. In 2017 and 2018, two separate field experiments were conducted in Michigan to understand how multiple factors may influence dry bean response to dicamba and 2,4-D herbicides, including 1) the interaction between herbicides applied POST to dry bean and dicamba or 2,4-D, and 2) the impact of low rates of glyphosate with dicamba or 2,4-D. Dry bean injury was 20% and 2% from POST applications of dicamba (5.6 h ae ha−1) and 2,4-D (11.2 g ae ha−1), respectively, 14 days after treatment (DAT). The addition of glyphosate (8.4 g ae ha−1) did not increase dry bean injury from dicamba or 2,4-D. Over 2 site-years the addition of dry bean herbicides to dicamba or dicamba + glyphosate (8.4 g ae ha−1) increased dry bean injury and reduced yield by 6% to 10% more than when dicamba or dicamba + glyphosate was applied alone. The interaction between 2,4-D (11.2 g ae ha−1) and dry bean herbicides was determined to be synergistic. However, 2,4-D (11.2 g ae ha−1) had little effect on dry bean with or without the addition of a dry bean herbicide program. These studies document that synergy also occurs between dicamba and dicamba + glyphosate and both common dry bean herbicide programs tested: 1) imazamox (35 g ha−1) + bentazon (560 g ha−1), and 2) fomesafen (280 g ha−1). The synergy between dry bean herbicide and dicamba and dicamba + glyphosate can increase plant injury, delay maturity, and reduce yield to a greater extent than dicamba or dicamba + glyphosate alone. This work emphasizes the need to properly clean out sprayers after applications of dicamba to reduce the risk of exposure to other crops.

Dicamba and 2,4-D exposure to sensitive crops, such as dry bean, is of great concern with the recent registrations of dicamba- and 2,4-D–resistant soybean. In 2017 and 2018, field experiments were conducted at two Michigan locations to understand how multiple factors, including dry bean market class, herbicide rate, and application timing, influence dry bean response to dicamba and 2,4-D. Dicamba and 2,4-D at rates of 0.1%, 1%, and 10% of the field use rate for dicamba and 2,4-D choline were applied to V2 and V8 black and navy bean. Field-use rates for dicamba and 2,4-D choline were 560 and 1,120 g ae ha−1, respectively. There were few differences between market classes or application timings when dry bean was exposed to dicamba or 2,4-D. Estimated rates to cause 20% dry bean injury 14 d after treatment were 4.5 and 107.5 g ae ha−1 for dicamba and 2,4-D, respectively. When dicamba was applied at 56 g ae ha−1, light interception was reduced up to 51% and maturity was delayed up to 16 d. Although both herbicides caused high levels of injury to dry bean, yield reductions were not consistently observed. At four site-years, 2,4-D did not reduce dry bean yield or seed weight with any rate tested. However, when averaged over site-years, dicamba rates of 3.7, 9.8 and 17.9 g ae ha−1 were estimated to cause 5%, 10%, and 15% yield loss, respectively. Dicamba also reduced seed weight by 10% when 56 g ae ha−1 was applied. However, the germination of harvested seed was not affected by dicamba or 2,4-D. Long delays in dry bean maturity from dicamba injury can also indirectly increase losses in yield and quality due to harvestability issues. This work further stresses the need for caution when using dicamba or 2,4-D herbicides near sensitive crops.