Six vertebrae (one cervical, three articulated thoracic, and two lumbar) and an incomplete thoracic neural spine from a new late Pleistocene site at Anolaima, Cundinamarca, Colombia, are attributed to the extinct gomphothere (Elephantoidea, Proboscidea) Notiomastodon platensis. The preserved bones exhibit a range of alterations, including porosities, piercings, hollows, and deep bone lesions on the spinous process and the neural arch; asymmetrical zygapophyseal articulations; and osteoarthritic lesions. Diet, behaviour, ecological aspects, selective pressures, and disease have the potential to affect the bones, so the study of individual variations and palaeopathology provides important information for understanding aspects of the life of extinct organisms. Osteological anomalies in the Anolaima gomphothere are interpreted as the result of nutritional deficiencies in essential minerals caused by environmental stresses, possibly related to the palaeoenvironmental instability that characterized the late Pleistocene and that coincides with the age of the fossils. Excessive biomechanical loading on already weakened bones from locomotion through the uneven, upland terrain of the Anolaima region may have contributed to the pathologies. This palaeopathological analysis is the first for Colombian megafauna, and thereby broadens our knowledge of the health conditions of South American gomphotheres.

The rate at which the coronavirus disease (COVID-19) spread required a rapid response across many, if not all, industries. Academic medical centers had to rapidly evaluate, prioritize, and coordinate the multiple requests for clinical trial participation. This involved redirecting resources and developing a collaborative system for assessment, decision making, and implementation. Our institution formed a team with diverse representation from multiple stakeholders to review and prioritize all research protocols related to COVID-19. To accomplish this, a prioritization matrix was developed to help determine the order in which the protocols should be placed for consideration by the treating clinician. The purpose of the team was to review the COVID-19 clinical trials in the pipeline, prioritize those trials that best met the needs of our patients, oversee training and resource needs, and lead the formulation of procedures for integration with clinical care. Resources from the Clinical Research Unit were then allocated to support the swift execution of such studies. This manuscript describes that process, the challenges encountered, and the lessons learned on how to make all clinical trials more successful in a complex and dynamic environment.

The attribution of osteological remains of a bird discovered in Preceramic deposits at Nemocón IV rockshelter (Sabana de Bogotá, Colombia) to Ara sp. (macaws) is confirmed through osteological and morphometrical analyses. Thirteen bones were recovered from two adjacent, arbitrary excavation levels; and are considered the remains of a single individual because of the rarity of the taxon, their similar size and taphonomic alteration, and the presence of paired elements. Radiocarbon dating of the macaw reveals it comes from the ninth millennium cal BP, the oldest date recorded from Nemocón IV. Paleoenvironmental data suggest that, during the deposition of the Preceramic levels at Nemocón IV, climatic conditions were close to those of today. The modern range of the macaws is outside these climatic parameters, and all modern Ara species are allochthonous to the Sabana de Bogotá, indicating the archaeological macaw was also allochthonous in Preceramic times. Analysis of the remains shows the macaw was not dismembered, so it is unlikely that it was used as food. Early conquest records indicate macaws were traded and maintained outside their natural ranges as pets, as a source of feathers, for use in rituals, or for a combination of uses.

The objective of the Caribbean Strong Summit was to plan an intersectoral summit to address the equity of community health and resilience for disaster preparedness, response and recovery and develop a set of integrated and actionable recommendations for Puerto Rico and the Caribbean Region post Hurricanes Irma and Maria. A three-day meeting was convened with a wide range of community, organizational and private sector leaders along with representatives from Puerto Rico, the Caribbean, the Americas, and global experts to generate recommendations for enhanced resilience based upon lessons learned and evidence-based approaches. More than 500 participants from the region gave 104 presentations with recommendations for resilience. Over 150 recommendations were generated and ranked for importance and actionability by participants. A representative sample of these are presented along with five major themes for building health resilient communities in the Caribbean. This summit was successful in compiling a set of integrated recommendations from more than 19 diverse sectors and in defining five major thematic areas for future work to enhance resilience for all types of future disasters. A follow-up meeting should be planned to continue this discussion and to showcase work that has been accomplished in these areas. A complete set of the recommendations from the Caribbean Strong Summit and their analysis and compilation would be published and should serve as a foundational effort to enhance preparedness and resiliency towards future disasters in the Caribbean.

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.

Severe temper outbursts (STO) in children are associated with impaired school and family functioning and may contribute to negative outcomes. These outbursts can be conceptualized as excessive frustration responses reflecting reduced emotion regulation capacity. The anterior cingulate cortex (ACC) has been implicated in negative affect as well as emotional control, and exhibits disrupted function in children with elevated irritability and outbursts. This study examined the intrinsic functional connectivity (iFC) of a region of the ACC, the anterior midcingulate cortex (aMCC), in 5- to 9-year-old children with STO (n = 20), comparing them to children with attention-deficit/hyperactivity disorder (ADHD) without outbursts (ADHD; n = 18). Additional analyses compared results to a sample of healthy children (HC; n = 18) and examined specific associations with behavioral and emotional dysregulation. Compared to the ADHD group, STO children exhibited reduced iFC between the aMCC and surrounding regions of the ACC, and increased iFC between the aMCC and precuneus. These differences were also seen between the STO and HC groups; ADHD and HC groups did not differ. Specificity analyses found associations between aMCC–ACC connectivity and hyperactivity, and between aMCC–precuneus iFC and emotion dysregulation. Disruption in aMCC networks may underlie the behavioral and emotional dysregulation characteristic of children with STO.

In a longitudinal study including 642 healthy 8–11-year-old Danish children, we investigated associations between vitamin D dependent SNP and serum 25-hydroxyvitamin D (25(OH)D) concentrations across a school year (August–June). Serum 25(OH)D was measured three times for every child, which approximated measurements in three seasons (autumn, winter, spring). Dietary and supplement intake, physical activity, BMI and parathyroid hormone were likewise measured at each time point. In all, eleven SNP in four vitamin D-related genes: Cytochrome P450 subfamily IIR1 (CYP2R1); 7-dehydrocholesterol reductase/nicotinamide adenine dinucleotide synthetase-1(DHCR7/NADSYN1); group-specific complement (GC); and vitamin D receptor were genotyped. We found minor alleles of CYP2R1 rs10500804, and of GC rs4588 and rs7041 to be associated with lower serum 25(OH)D concentrations across the three seasons (all P<0·01), with estimated 25(OH)D differences of −5·8 to −10·6 nmol/l from major to minor alleles homozygosity. In contrast, minor alleles homozygosity of rs10741657 and rs1562902 in CYP2R1 was associated with higher serum 25(OH)D concentrations compared with major alleles homozygosity (all P<0·001). Interestingly, the association between season and serum 25(OH)D concentrations was modified by GC rs7041 (Pinteraction=0·044), observed as absence of increase in serum 25(OH)D from winter to spring among children with minor alleles homozygous genotypes compared with the two other genotypes of rs7041 (P<0·001). Our results suggest that common genetic variants are associated with lower serum 25(OH)D concentrations across a school year. Potentially due to modified serum 25(OH)D response to UVB sunlight exposure. Further confirmation and paediatric studies investigating vitamin D-related health outcomes of these genotypic differences are needed.

Biotypes of eastern black nightshade were found in Illinois and Indiana that were not controlled by postemergence applications of imazethapyr. Greenhouse studies were conducted to determine whole-plant responses to the imidazolinone herbicides imazethapyr and imazamox and to the sulfonylurea herbicide primisulfuron-methyl. The Illinois and Indiana resistant biotypes were highly resistant to imazamox and imazethapyr but were not cross-resistant to primisulfuron-methyl. DNA sequencing of acetolactate synthase (ALS) genes showed that the molecular basis for resistance in both resistant biotypes was a single base-pair mutation within Domain C that changed an alanine to a threonine in their encoded enzymes. In vitro enzyme assays showed that the Illinois resistant biotype's ALS enzyme was 789- and 881-fold less sensitive than that of the susceptible biotype to imazamox and imazethapyr, respectively. The Indiana resistant biotype's ALS enzyme was 110- and 158-fold less sensitive than that of the susceptible biotype to imazamox and imazethapyr, respectively. These results are consistent with the amino acid substitution found in the ALS enzyme of both resistant biotypes of eastern black nightshade.

Low aspartic acid d:l ratios and modern collagenlike concentration values indicate that amino acids in bones from the Rancho La Brea asphalt deposit, Los Angeles, California are better preserved than amino acids in bones of equivalent age that have not been preserved in asphalt. Amino acids were recovered from 10 Rancho La Brea bone samples which range in age from less than 200 to greater than 36,000 yr. The calibrated rates of aspartic acid racemization range from 2.1 to 5.0 × 10−6yr−1. Although this wide range of rate constants decreases the level of confidence for age estimates, use of the larger rate constant of 5.0 × 10−6yr−1 provides minimum age estimates which fit the known stratigraphic and chronologic records of the Rancho La Brea deposits.