We evaluated whether universal chlorhexidine bathing (decolonization) with or without COVID-19 intensive training impacted COVID-19 rates in 63 nursing homes (NHs) during the 2020–2021 Fall/Winter surge. Decolonization was associated with a 43% lesser rise in staff case-rates (P < .001) and a 52% lesser rise in resident case-rates (P < .001) versus control.

Background: Antibiotics targeted against Clostridioides difficile bacteria are necessary, but insufficient, to achieve a durable clinical response because they have no effect on C. difficile spores that germinate within a disrupted microbiome. ECOSPOR-III evaluated SER-109, an investigational, biologically derived microbiome therapeutic of purified Firmicute spores for treatment of rCDI. Herein, we present the interim analysis in the ITT population at 8 and 12 weeks. Methods: Adults ≥18 years with rCDI (≥3 episodes in 12 months) were screened at 75 US and CAN sites. CDI was defined as ≥3 unformed stools per day for <48 hours with a positive C. difficile assay. After completion of 10–21 days of vancomycin or fidaxomicin, adults with symptom resolution were randomized 1:1 to SER-109 (4 capsules × 3 days) or matching placebo and stratified by age (≥ or <65 years) and antibiotic received. Primary objectives were safety and efficacy at 8 weeks. Primary efficacy endpoint was rCDI (recurrent toxin+ diarrhea requiring treatment); secondary endpoints included efficacy at 12 weeks after dosing. Results: Overall, 287 participants were screened and 182 were randomized (59.9% female; mean age, 65.5 years). The most common reason for screen failure was a negative C. difficile toxin assay. A significantly lower proportion of SER-109 participants had rCDI after dosing compared to placebo at week 8 (11.1% vs 41.3%, respectively; relative risk [RR], 0.27; 95% confidence interval [CI], 0.15–0.51; p-value <0.001). Efficacy rates were significantly higher with SER-109 vs placebo in both stratified age groups (Figure 1). SER-109 was well-tolerated with a safety profile similar to placebo. The most common treatment-emergent adverse events (TEAEs) were gastrointestinal and were mainly mild to moderate. No serious TEAEs, infections, deaths, or drug discontinuations were deemed related to study drug. Conclusions: SER-109, an oral live microbiome therapeutic, achieved high rates of sustained clinical response with a favorable safety profile. By enriching for Firmicute spores, SER-109 achieves high efficacy while mitigating risk of transmitting infectious agents, beyond donor screening alone. SER-109 represents a major paradigm shift in the clinical management of patients with recurrent CDI. Clinicaltrials.gov Identifier NCT03183128. These data were previously presented as a late breaker at American College of Gastroenterology 2020.

Funding: Seres Therapeutics

Disclosures: None

Figure 1.

OBJECTIVES/SPECIFIC AIMS: Incomplete spinal cord injury typically results in life-long disability, often in the form of profound loss of locomotion capability. Individuals who have experienced incomplete spinal cord injury exhibit persistent eccentric motor deficits, which are particularly prevalent in the weight acceptance phase of gait and emphasized in sagittal plane knee motion and frontal plane hip motion. METHODS/STUDY POPULATION: Motion analysis can capture the kinematic and joint-level deficits of these individuals, but it is impossible to directly calculate the contributions of individual muscles to weight acceptance due to the complexity of the musculoskeletal system. Instead, those muscle contributions must be simulated in order to approximate muscle power during locomotion. RESULTS/ANTICIPATED RESULTS: The traditional method for driving these simulations with electromyography readings is unavailable for individuals who have neuromuscular deficits (e.g., spasticity or paralysis), due to the need to generate reliable maximum voluntary isometric contractions for baseline purposes. Instead, this research develops a novel method for using resting electromyography data to drive musculoskeletal simulations using a muscle activation threshold paradigm. DISCUSSION/SIGNIFICANCE OF IMPACT: The simulation results of this method more closely resemble experimental results, but further simulation refinement is needed to fully capture the true muscle activity.

OBJECTIVES/SPECIFIC AIMS: Incomplete spinal cord injury (iSCI) is a life-long disability that typically results in a profound loss of locomotion capability. Current rehabilitation methods rarely restore full community ambulation, which in turn limits quality of life. Most individuals with iSCI exhibit persistent deficits in eccentric muscle control and reach recovery plateaus below the levels necessary for independent community ambulation. Eccentric motor control is essential during the weight acceptance phase of gait, which is emphasized during downhill walking. METHODS/STUDY POPULATION: The overground locomotion of subjects with chronic iSCI was analyzed both prior to and following a 12-week downhill body-weight-supported treadmill training regimen and compared to that of matched healthy controls in terms of kinematics, kinetics, and EMG activation. RESULTS/ANTICIPATED RESULTS: We expect to find significant differences between the controls and subjects with iSCI, with deficits in eccentric motor control accounting for some of these differences. In addition, we expect the downhill training to yield significant improvement in eccentric muscle control that translates into improvements in functional, overground walking for the subjects with iSCI. DISCUSSION/SIGNIFICANCE OF IMPACT: The goal is to determine if downhill training can improve eccentric motor control and extend recovery beyond established plateaus. OpenSim modeling of the experimental data will help quantify changes in eccentric control of individual muscles to clarify where specific gains are made.

We present a multi-frequency study of the intermediate spiral SAB(r)bc type galaxy NGC 6744, using available data from the Chandra X-Ray telescope, radio continuum data from the Australia Telescope Compact Array and Murchison Widefield Array, and Wide-field Infrared Survey Explorer infrared observations. We identify 117 X-ray sources and 280 radio sources. Of these, we find nine sources in common between the X-ray and radio catalogues, one of which is a faint central black hole with a bolometric radio luminosity similar to the Milky Way’s central black hole. We classify 5 objects as supernova remnant (SNR) candidates, 2 objects as likely SNRs, 17 as H ii regions, 1 source as an AGN; the remaining 255 radio sources are categorised as background objects and one X-ray source is classified as a foreground star. We find the star-formation rate (SFR) of NGC 6744 to be in the range 2.8–4.7 M⊙~yr − 1 signifying the galaxy is still actively forming stars. The specific SFR of NGC 6744 is greater than that of late-type spirals such as the Milky Way, but considerably less that that of a typical starburst galaxy.

Many China scholars have explored shirking by local officials and “effective implementation,” but fewer have examined polices that are implemented with great enthusiasm. The Microfinance for Women Programme fits in this last category. Especially in Sichuan, targets for lending were set by the province, exceeded, raised by cities and counties, and then exceeded again. The immediate reason that lending took off in 2012 was the relaxation of collateral requirements that shifted the risk of defaults away from local authorities. But the surge in lending also had deeper roots in the policy's vagueness, institutional incentives, bureaucratic pressure, and local fiscal and organizational interests. Although enthusiastic implementation occurred (and generated much-needed revenues for local governments), the history of the programme also shows that it can be halted, as was the case when instability loomed and the authorities reversed bureaucratic pressure by calling for local cost-sharing and introducing uncertainty over whether interest subsidies would continue.

Chinese local officials frequently employ relational repression to demobilize protesters. When popular action occurs, they investigate activists' social ties, locate individuals who might be willing to help stop the protest, assemble a work team and dispatch it to conduct thought work. Work team members are then expected to use their personal influence to persuade relatives, friends and fellow townspeople to stand down. Those who fail are subject to punishment, including suspension of salary, removal from office and prosecution. Relational repression sometimes works. When local authorities have considerable say over work team members and bonds with protesters are strong, relational repression can help demobilize protesters and halt popular action. Even if relational repression does not end a protest entirely, it can limit its length and scope by reducing tension at times of high strain and providing a channel for negotiation. Often, however, as in a 2005 environmental protest in Zhejiang, insufficiently tight ties and limited concern about consequences creates a commitment deficit, partly because thought workers recognize their ineffectiveness with many protesters and partly because they anticipate little or no punishment for failing to demobilize anyone other than a close relative. The practice and effectiveness of relational, “soft” repression in China casts light on how social ties can demobilize as well as mobilize contention and ways in which state and social power can be combined to serve state ends.

Self-ligating brackets have become increasingly established in orthodontics in recent decades. While proponents haveprofessed overwhelming advantages of self-ligation, most notably a reduction in treatment time and a reduced requirement for extractions, there has been little convincing evidence to support many of these claims. In this review the evidence concerning the influence of self-ligating brackets on the efficiency of orthodontic treatment is considered.

A persistent difficulty in terrestrial planet formation models is creating Mars analogs with the appropriate mass: Mars is typically an order of magnitude too large in simulations. Some recent work found that a small Mars can be created if the planetesimal disk from which the planets form has an outermost edge at 1.0 AU. However, that work and no previous work could produce a truncation of the planetesimal disk while also explaining the mass and structure of the asteroid belt. We show that gas-driven migration of Jupiter inward to 1.5 AU, before its subsequent outward migration, can truncate the disk and repopulate the asteroid belt. This dramatic migration history of Jupiter suggests that the dynamical behavior of our giant planets was more similar to that inferred for extra-solar planets than previously thought, as both have been characterised by substantial radial migration.

What precipitated the 2003–06 “high tide” of petitioning Beijing and why did the tide wane? Interviews and archival sources suggest that a marked increase in petitioners coming to the capital was at least in part a response to encouraging signals that emerged when Hu Jintao and Wen Jiabao adopted a more populist leadership style. Because the presence of tens of thousands of petitioners helped expose policy failures of the previous leadership team, the Hu-Wen leadership appeared reasonably accommodating when petitioners arrived en masse in Beijing. Soon, however, the authorities shifted towards control and suppression, partly because frustrated petitioners employed disruptive tactics to draw attention from the Centre. In response to pressure from above, local authorities, especially county leaders, turned to coercion to contain assertive petitioners and used bribery to coax officials in the State Bureau of Letters and Visits to delete petition registrations. The high tide receded in late 2006 and was largely over by 2008. This article suggests that a high tide is more likely after a central leadership change, especially if a populist programme strikes a chord with the population and elite turnover augments confidence in the Centre and heightens expectations that it will be responsive to popular demands.

A developmental cascade model of early emotional and social competence predicting later peer acceptance was examined in a community sample of 440 children across the ages of 2 to 7. Children's externalizing behavior, emotion regulation, social skills within the classroom and peer acceptance were examined utilizing a multitrait–multimethod approach. A series of longitudinal cross-lag models that controlled for shared rater variance were fit using structural equation modeling. Results indicated there was considerable stability in children's externalizing behavior problems and classroom social skills over time. Contrary to expectations, there were no reciprocal influences between externalizing behavior problems and emotion regulation, although higher levels of emotion regulation were associated with decreases in subsequent levels of externalizing behaviors. Finally, children's early social skills also predicted later peer acceptance. Results underscore the complex associations among emotional and social functioning across early childhood.

This article argues that there are five major challenges currently facing Western intelligence communities. First – ensuring skills retention for intelligence officers and analysts, while developing knowledgeable managers and customers, all in an increasingly-complex security environment. Second – instituting and inculcating knowledge and expertise in these staff – while addressing an opponent in al-Qaeda which demonstrates increasingly sophisticated use of IT, new media, etc. Third – drawing-in outside expertise from the research and business communities, as is done currently in the US and Canada but in only a very limited manner in the UK. Fourth – overcoming institutional rigidity in dividing the foreign and domestic – alongside rigid sharing and co-operation relationships. Fifth – creating truly collaborative environments that offer genuine socio-cultural incentives to collaboration rather than mere ‘IT solutions’.

FF-GDMS and MIC-ICP-MS methods were developed for the determination of mg/kg- and μg/kg-level B, Mg, Al, Ca, Ti, V, Cr, Mn, Fe, Co, Ni, Cu, Zn, Zr, Mo, Sb, W and Pb in nuclear-grade graphite. Consistent results have been achieved in determining trace elements like B, Ti, Cr, Mn, Zr, Sb and Pb by both methods, which vary mostly less than ±30%, and are in line with the manufacturer reference values. On Mg, Al, Fe, Co, Zn, Mo and W, FF-GDMS analyses also show good agreement with the manufacturer's data. Continuing efforts in identifying source of interference, which has limited the MIC-ICP-MS analysis of these elements, is currently underway.

Three different language samples were collected from a group of young adults, 18 to 28 years of age, and a group of elderly adults, 60 to 92 years of age: an oral questionnaire eliciting information about the adults' background, education, and current health and activities; an oral statement describing the person they most admired; and a written statement recounting the most significant event in their lives. In addition, the WAIS vocabulary and digit-span tests were administered to the adults. Age-related changes in the length, clause structure, and fluency of the adults' oral answers and oral and written statements were investigated. There was an overall decrement in the complexity of adults' oral and written statements attributable to an age-related loss of left-branching clauses which occurred in all three language samples. Correlations between the length, clause, and fluency measures from the language samples and the education, health, and WAIS vocabulary and digit-span tests revealed that better-educated adults scored higher on the WAIS vocabulary test, produced longer utterances, and used more right-branching clauses, and that adults with greater memory capacity, as measured by the WAIS Digits Backward test, produced more complex utterances and used more right- and left-branching clauses. Judges found the statements from the elderly adults to be more interesting and clearer than those from the young adults. This finding suggests that there is a trade-off between producing complex syntactic structures and producing clear and interesting prose.