Hybrid whole genome sequencing was used to investigate if nosocomial Verona integron-encoded metallo-β-lactamase (VIM) carbapenemase transmission occurred between two patients without epidemiological links or common pathogens. Challenges in genomic methodology and appropriate analytical depth for mobile carbapenemase outbreaks are described including how inappropriate choices can mislead results and impact infection control practices.

Background: Carbapenem-resistant Acinetobacter (CRA) bacteria are an urgent public health threat. Accurate and timely testing of CRA is important for proper infection control practices to minimize spread. In 2017, the CDC estimated 8,500 CRA cases among hospitalized patients, 700 deaths, and $281 million in attributable healthcare costs. Treatment options are extremely limited for carbapenem-resistant Acinetobacter baumannii (CRAB) infections, making CRAB a unique concern. Colonization screening is a valuable tool for containment but requires sampling of 4 body sites. Identifying a reliable specimen collection site for CRAB is important to inform public health recommendations as screening can cost healthcare facilities valuable time and resources. Methods: Results of all screening specimens of patients with at least 1 site positive for CRAB on a unique collection date were extracted from the Southeast Regional data of Antimicrobial Resistance Lab Network (SEARLN) data. Non-CRAB screening and screenings that did not yield at least 1 positive result on a single collection date were excluded. We also limited our data to include only the following screening sites, which have been validated by the Tennessee Department of Health’s State Public Health Laboratory: axilla and groin, rectal, sputum, and wound. For each specimen source, we calculated the percentage of positive specimen among CRAB-colonized patients. Data were extracted and analyzed using SAS version 9.4 software. Results: The SEARLN data contained 594 CRAB screening specimens collected over 4 years, 2018 through 2021, and 486 of those specimens yielded CRAB. For CRAB-colonized patients screened in this study, wound specimens had the highest positivity rate at 93.4% (95% CI, 89.9%–96.9%) of samples culturing CRAB. Sputum followed at 87.7%, then axilla and groin at 77.6% and rectal at 59.7%. Conclusions: Wound specimens produced the highest proportion of positive cultures among CRAB-positive patients, making them the sample type with the highest prevalence in our study. For healthcare facilities with limited time and resources seeking to optimize their CRAB screening process, wound specimens may be the most reliable single site for detecting CRAB colonization in patients with an open wound. When a wound is not present, sputum may be a good alternative single-source collection site. More research should be conducted before CRAB screening recommendations are updated.

Disclosures: None

Myopia is one of the leading causes of preventable blindness in the world. Its prevalence has risen drastically over recent decades, and it is estimated that close to half the world population will be myopic by 2050.The rise in myopia is lifestyle related. Myopia occurs as a consequence of excessive eye growth, which may be related to general growth. Diet, therefore, is a potential risk factor. A number of Asian studies have reported lower levels of zinc in myopic adolescents, when compared to controls. Currently, there are no reliable indicators of zinc status. This study explores the association between zinc status and myopia using a combination of zinc assessment methods.

Participants from two different population-based studies were used. Data from 1,095 adolescents aged 12–19 years, from the US National Health and Nutrition Examination Study were used to examine the relationship between dietary zinc intake and myopia. Data from 304 subjects of similar age from the Korean National Health and Nutrition Examination Study were used to examine the association between serum zinc levels and myopia using multivariate logistic regression.

43% (NHANES) and 84% (KNHANES) of subjects were found to be myopic. Mean dietary intake of zinc was lower among myopes relative to non-myopes, but not significantly. In multivariate logistic regression, dietary zinc was not significantly associated with myopia. Among Korean subjects mean serum zinc was found to be higher in non-myopes v. myopes (p = 0.809). Multiple logistic regression did not show any significant relationship between serum zinc and myopia, after adjustment for confounders.

In contrast to previous studies, no relationship was found between lower dietary zinc intake or lower serum zinc, and myopia. Currently the BOND Zinc Expert Panel recommend plasma zinc concentration to assess zinc status, despite its extreme sensitivity to both internal and external factors like; inflammation, fasting, pregnancy, oral contraception and diurnal rhythm. Biological samples are very easily contaminated, meaning strict quality controls and procedures are required. These factors severely impact reliability, and thus, comparison between studies is challenging, particularly in the case of contrasting findings.As zinc is a vital micronutrient and an estimated one-third of the population are affected by zinc deficiency. A reliable biomarker of status is important, for clinical and research needs.

Contrast sensitivity functions reveal information about a subject’s overall visual ability and have been investigated in several species of nonhuman primates (NHPs) with experimentally induced amblyopia and glaucoma. However, there are no published studies comparing contrast sensitivity functions across these species of normal NHPs. The purpose of this investigation was to compare contrast sensitivity across these primates to determine whether they are similar. Ten normal humans and eight normal NHPs (Macaca fascicularis) took part in this project. Previously published data from Macaca mulatta and Macaca nemestrina were also compared. Threshold was operationally defined as two misses in a row for a descending method of limits. A similar paradigm was used for the humans except that the descending method of limits was combined with a spatial, two-alternative forced choice (2-AFC) technique. The contrast sensitivity functions were fit with a double exponential function. The averaged peak contrast sensitivity, peak spatial frequency, acuity, and area under the curve for the humans were 268.9, 3.40 cpd, 27.3 cpd, and 2345.4 and for the Macaca fascicularis were 99.2, 3.93 cpd, 26.1 cpd, and 980.9. A two-sample t-test indicated that the peak contrast sensitivities (P = 0.001) and areas under the curve (P = 0.010) were significantly different. The peak spatial frequencies (P = 0.150) and the extrapolated visual acuities (P = 0.763) were not different. The contrast sensitivities for the Macaca fascicularis, Macaca mulatta, and Macaca nemestrina were qualitatively and quantitatively similar. The contrast sensitivity functions for the NHPs had lower peak contrast sensitivities and areas under the curve than the humans. Even though different methods have been used to measure contrast sensitivity in different species of NHP, the functions are similar. The contrast sensitivity differences and similarities between humans and NHPs need to be considered when using NHPs to study human disease.

OBJECTIVES/SPECIFIC AIMS: This study will use face-to-face interviewers with Medicare-eligible stroke survivors, and adult caregivers of stroke survivors, to extend the aims of a quantitative study on healthcare utilization in elderly stroke survivors. The objective of this research is to better understand, in more detail, relevant barriers and facilitators to accessing healthcare among older stroke survivors. The ultimate goal of this research is to develop strategies to improve access to healthcare, such as home modifications; changes to the neighborhood physical environment; or interventions at the provider/service level. This research will also serve as a precursor for future intervention work that will be proposed as a part of a K01 proposal. METHODS/STUDY POPULATION: Participants were recruited from Ann Arbor and Flint, MI using an existing academic-community partnership as well as through the University of Michigan Stroke Clinic. A total of 8–10 stroke survivors and 1–2 caregivers were recruited through the partnership and clinic records, as well as some use of snowball sampling to obtain a socially, economically, and racially representative sample. Participants must be 65+ years old, eligible for Medicare, living in the community, identify as either White or Black, and have no major cognitive/language deficits that jeopardize informed consent. Face-to-face interviews were conducted, and open-ended questions emphasized environmental barriers and facilitators to accessing healthcare, with a focus on social and physical barriers in the home and neighborhood. Interviews were audio recorded and transcribed, and field notes from 1 to 2 sources were also documented and will be used to triangulate the data and increase coding validity. Audio recordings will be reviewed multiple times and quotes relevant to the research questions and underlying theoretical framework will be transcribed verbatim. The transcripts will be analyzed using thematic coding based on literature and the study objectives and hypotheses. I will identify primary themes related to environmental barriers and facilitators to accessing healthcare among the stroke-survivors. RESULTS/ANTICIPATED RESULTS: Preliminary results suggest that participants are primarily concerned about the social environment. Several interviews revealed that stroke survivors felt socially isolated and were often hesitant to ask for help because they did not want to be a burden on their family and friends. Transportation to appointments was also identified as a barrier due to the fact that many people are no longer able to drive, yet are not comfortable navigating other forms of transportation. We expect to identify additional physical and social environmental challenges to both health care utilization and well-being more generally, among older stroke survivors. Anticipated themes may include: barriers in the physical environment such as transportation to care and services, social support and social environmental factors to support feeling safe leaving home to access care. DISCUSSION/SIGNIFICANCE OF IMPACT: Despite the physical and economic burden of stroke, and attempts to improve outcomes for stroke survivors living in the community, stroke survivors have high rates of disability and unmet medical and psychological needs. The results from this research are anticipated to directly inform future partnerships and intervention in these, or in similar communities. Understanding how the environment influences access to healthcare for elderly stroke survivors is essential if we want to increase recommended preventative care and treatment in this vulnerable population with unique healthcare needs. The results of this study will be used to directly inform the aims and methods for other translational research projects, including a K01 proposal, in which I will develop and pilot a community-based intervention to ameliorate environmental barriers and enhance facilitators of access to healthcare for older, disabled adults.

A biotype of johnsongrass cross resistant to clethodim, sethoxydim, quizalofop-P, and fluazifop-P was identified in several fields in Washington County, MS. Absorption, translocation, and metabolism studies using 14C-clethodim and acetyl-coenzyme A carboxylase (ACCase) activity assays were conducted to determine the resistance mechanism. Absorption of 14C-clethodim was higher in the resistant than the susceptible biotype 4 hours after treatment (HAT), but at 24, 48, and 72 HAT, similar levels of radioactivity were detected in both johnsongrass biotypes. Consequently, resistant plants had more radioactivity present in the treated leaves at 4 and 24 HAT. However, there was no difference between resistant and susceptible biotypes in the translocation of 14C out of the treated leaf at 4, 8, 24, 48, and 72 HAT as a percentage of total absorbed. Metabolism of clethodim was similar in the resistant and susceptible biotypes. There was no difference in the specific activity of ACCase from the susceptible and resistant johnsongrass biotypes (means of 0.221 and 0.223 nmol mg−1 protein min−1, respectively). ACCase from the susceptible biotype was sensitive to clethodim, with an I 50 value of 0.29 μM clethodim. The ACCase enzyme from the resistant biotype was less sensitive, with an I 50 value of 1.32 μM clethodim. The resultant R/S ratio for clethodim was 4.5. These results indicate that resistance to clethodim in this johnsongrass biotype resulted from an altered ACCase enzyme that confers resistance to clethodim.

Three studies were conducted to develop pollen tests for the screening of acetyl coenzyme-A carboxylase (ACCase) target-site resistance in a biotype of johnsongrass. The assays were based on germination of johnsongrass pollen in media supplemented with clethodim. Two different methods were used to evaluate pollen germination—a visual assessment and a spectrophotometric assay. The response of pollen to the germination media was linear for 16 h. At 6 h after treatment, absorbance at 500 nm was nearly 0.5; consequently, 6 h was chosen to conduct the pollen assays using the spectrophotometer. Both assessment methods differentiated the susceptible (S) and resistant (R) biotypes. Pollen from the susceptible biotype of johnsongrass was strongly inhibited by increasing concentrations of clethodim, with a GR50 of 25.8 ± 0.6 (SE) µM and GR50 of 16.4 ± 1.7 (SE) µM clethodim by visual assessment and spectrophotometric assessment, respectively. Minimum R/S values were > 3.9 by visual assessment and > 6.1 by spectrophotometric assessment. ACCase target-site resistance is expressed in johnsongrass pollen.

A seedling bioassay was developed for the rapid diagnosis of resistance to clethodim and fluazifop-P in johnsongrass. The assay was based on differences in the coleoptile length of susceptible (S) and resistant (R) seedlings exposed to clethodim and fluazifop-P in petri dishes for 5 d. Bioassay concentrations of 0.09 mg/L clethodim and 0.18 mg/L fluazifop-P were chosen as discriminant based on rate responses of each biotype to increasing herbicide dose. At 5 d after treatment (DAT), the amounts of clethodim required to reduce coleoptile length by 50% (GR50) for the R and S seedlings were 462.5 and 24.8 mg/L, respectively, resulting in an R:S ratio of 18.7. The fluazifop GR50 values for the R and S seedlings were 618.7 and 17.5 mg/L, respectively, resulting in a R:S ratio of 35.4.

Pedogenically significant chemical extracts of iron, aluminum, and phosphorus are related mainly to time in chronosequences from Baffin Island (Canadian Arctic), the alpine Sierra Nevada and Wind River Range (western United States), the alpine Khumbu Glacier area (Himalaya, Nepal), and the alpine Southern Alps (New Zealand). Based on the accumulation index for Fe and Al, and the depletion index for P in each region, the following ranking of chemical pedogenic development is obtained: Southern Alps > Khumbu Glacier area ≅ Wind River Range > Sierra Nevada > coastal Baffin Island > inland Baffin Island. The ranking mainly follows regional climate, with the greatest accumulation and depletion to the warmest and wettest environment, and the least accumulation and depletion in the coldest and driest environment.

Operation Canine Lifeline was a tabletop exercise developed by students and faculty of Boston University School of Medicine’s Healthcare Emergency Management master’s program. The tabletop exercise led to discussion on current protocols for canines working in the field, what occurs if a canine encounters a toxin in the field, and what to do in situations of national security that require working with civilian agencies. This discussion led to the creation of a set of recommendations around providing prehospital veterinary care to government working dogs. The recommendations include a government-run veterinary toxicology hotline for the sole use of the government, issuing handlers deployment kits and preprogrammed smartphones that contain information on the care practices for dogs, and an increased effort for civilian integration, through local emergency medical services, in the emergency care of government canines. (Disaster Med Public Health Preparedness. 2017;11:15–20)

The Dark Energy Survey is undertaking an observational programme imaging 1/4 of the southern hemisphere sky with unprecedented photometric accuracy. In the process of observing millions of faint stars and galaxies to constrain the parameters of the dark energy equation of state, the Dark Energy Survey will obtain pre-discovery images of the regions surrounding an estimated 100 gamma-ray bursts over 5 yr. Once gamma-ray bursts are detected by, e.g., the Swift satellite, the DES data will be extremely useful for follow-up observations by the transient astronomy community. We describe a recently-commissioned suite of software that listens continuously for automated notices of gamma-ray burst activity, collates information from archival DES data, and disseminates relevant data products back to the community in near-real-time. Of particular importance are the opportunities that non-public DES data provide for relative photometry of the optical counterparts of gamma-ray bursts, as well as for identifying key characteristics (e.g., photometric redshifts) of potential gamma-ray burst host galaxies. We provide the functional details of the DESAlert software, and its data products, and we show sample results from the application of DESAlert to numerous previously detected gamma-ray bursts, including the possible identification of several heretofore unknown gamma-ray burst hosts.

Scholars in the fields of instructional development and pedagogy note that learning outcomes can be improved when teachers use “narratives” to communicate how complex processes work or how problems are addressed. In this article, the authors describe a narrative-centered approach to graduate-level instruction in research methodology. This approach is intended to supplement, not replace, conventional graduate seminars in quantitative or qualitative methods. In a series of lectures, scholars reflected on how their published articles originally were framed, the trade-offs that were necessary to advance the investigation, the methodological challenges and non-findings that had to be addressed—but may not have been printed—and the evolution of a piece as it progressed through the peer-review stages. This approach to exposing graduate students to the entirety of the research process is termed Social Science Mechanics: A Look under the Hood at Innovative Research Designs. Surveys used to evaluate the series confirmed that graduate students who attended the presentations found them to be highly engaging and beneficial. Many faculty members also attended and found the lectures to be equally instructive.