Objectives/Goals: Kentucky (KY) is a high priority ending the HIV epidemic state, with high rates of new HIV diagnoses tied to injection drug use. The overall goal of this pilot is to launch sentinel surveillance of bloodborne infections and drug compounds among people who inject drugs (PWID) to monitor trends in near-real time and inform rapid community response. Methods/Study Population: In collaboration with the Clark County, KY, syringe service program (SSP), the pilot study involves two 1-month waves of data collection: enrolling eligible SSP participants and conducting anonymous behavioral surveys, collection of participants’ syringes, laboratory testing of syringes to detect HIV and hepatitis C (HCV), drug residue testing through National Institute of Standards and Technology, and statistical modeling approaches to produce outputs of bloodborne infection and drug detection. Syringes are tested from each enrolled individual for: 1) HIV antibody; 2) HCV antibody; 3) HIV and HCV PCR; 4) HIV antigen; and 5) drug residue. Collaboration with community and PWID stakeholders will identify optimal messaging for reporting results. Results/Anticipated Results: The first wave community-facing pilot was conducted in September–October 2024. 29 survey responses were obtained; median age of the sample is 42 years, 55.2% are gender female; 37.9% reported unstable housing in the past week. Primary drugs of injection reported via survey in the prior month were methamphetamine (62.1%), heroin (13.8%), fentanyl (13.8%), buprenorphine (10.3%), meth and fentanyl in combination (3.4%). PWID reported returning 900 used syringes and a median of 15 per participant visit. At most recent testing, 69.0% reported a positive HCV test; 0% reported a positive HIV test. Some level of drug checking with fentanyl test strips in past month was reported by 51.7%. Initially, 20 syringes were tested for drug compounds; results are pending. HIV and HCV detection testing will be completed by early 2025. Discussion/Significance of Impact: Early results document proof of concept for our sentinel surveillance study; all individuals screened were willing to participate in surveys and syringe collection. New methods to identify risk for disease outbreaks and emerging drugs can inform rapid allocation of prevention resources at a community level, especially where testing is infrequent.

To facilitate and sustain community-engaged research (CEnR) conducted by academic-community partnerships (ACPs), a Clinical Translational Science Award (CTSA)-funded Community Engagement Core (CEC) and Community Partner Council (CPC) co-created two innovative microgrant programs. The Community Health Grant (CHG) and the Partnership Development Grant (PDG) programs are designed to specifically fund ACPs conducting pilot programs aimed at improving health outcomes. Collectively, these programs have engaged 94 community partner organizations while impacting over 55,000 individuals and leveraging $1.2 million to fund over $10 million through other grants and awards. A cross-sectional survey of 57 CHG awardees demonstrated high overall satisfaction with the programs and indicated that participation addressed barriers to CEnR, such as building trust in research and improving partnership and program sustainability. The goal of this paper is to (1) describe the rationale and development of the CHG and PDG programs; (2) their feasibility, impact, and sustainability; and (3) lessons learned and best practices. Institutions seeking to implement similar programs should focus on integrating community partners throughout the design and review processes and prioritizing projects that align with specific, measurable goals.

Despite promising steps towards the elimination of hepatitis C virus (HCV) in the UK, several indicators provide a cause for concern for future disease burden. We aimed to improve understanding of geographical variation in HCV-related severe liver disease and historic risk factor prevalence among clinic attendees in England and Scotland. We used metadata from 3829 HCV-positive patients consecutively enrolled into HCV Research UK from 48 hospital centres in England and Scotland during 2012–2014. Employing mixed-effects statistical modelling, several independent risk factors were identified: age 46–59 y (ORadj 3.06) and ≥60 y (ORadj 5.64) relative to <46 y, male relative to female sex (ORadj 1.58), high BMI (ORadj 1.73) and obesity (ORadj 2.81) relative to normal BMI, diabetes relative to no diabetes (ORadj 2.75), infection with HCV genotype (GT)-3 relative to GT-1 (ORadj 1.75), route of infection through blood products relative to injecting drug use (ORadj 1.40), and lower odds were associated with black ethnicity (ORadj 0.31) relative to white ethnicity. A small proportion of unexplained variation was attributed to differences between hospital centres and local health authorities. Our study provides a baseline measure of historic risk factor prevalence and potential geographical variation in healthcare provision, to support ongoing monitoring of HCV-related disease burden and the design of risk prevention measures.

Scholars have recently investigated the efficacy of applying globalisation models to ancient cultures such as the fourth-millennium BC Mesopotamian Uruk system. Embedded within globalisation models is the ‘complex connectivity‘ that brings disparate regions together into a singular world. In the fourth millennium BC, the site of Çadır Höyük on the north-central Anatolian plateau experienced dramatic changes in its material culture and architectural assemblages, which in turn reflect new socio-economic, sociopolitical and ritual patterns at this rural agro-pastoral settlement. This study examines the complex connectivities of the ancient Uruk system, encompassing settlements in more consistent contact with the Uruk system such as Arslantepe in southeastern Anatolia, and how these may have fostered exchange networks that reached far beyond the Uruk ‘global world‘ and onto the Anatolian plateau.

OBJECTIVES/SPECIFIC AIMS: Central neuropathic pain is a severely disabling consequence of conditions that cause tissue damage in the central nervous system (CNS) such as multiple sclerosis (MS) and neuromyelitis optica (NMO). It impacts mood, mobility and quality of life, but is often refractory to common treatments. Scrambler Therapy is an emerging non-invasive pain modifying technique that utilizes transcutaneous electrical stimulation of nociceptive fibers with the intent of re-organizing maladaptive signaling pathways. It has been examined for treatment of peripheral neuropathy with favorable safety and efficacy outcomes, but its use in central neuropathic pain has not been reported. We aim to explore acceptability and safety of Scrambler Therapy through a Phase II sham-controlled trial in NMO, and describe its use to date in central neuropathic pain. METHODS/STUDY POPULATION: Two patients with longstanding central neuropathic pain who failed multiple drug trials were treated as proof-of-concept, supporting the recent launch of a Phase II randomized controlled trial in NMO where patients receive 10 daily Scrambler treatments versus sham. Safety and acceptability from those recruited to date will be reported. Acceptability is measured by adherence and responses to patient surveys. RESULTS/ANTICIPATED RESULTS: We plan to recruit 22 patients, randomized 1:1 into experimental and sham arms. We will present acceptability and safety data for Scrambler use in patients with NMO who have been recruited by the time of this conference, as well as effectiveness data from two cases that have been completed outside of the trial. One case involved a 65-year-old woman with a 4-year history of central neuropathic pain following a C3-C5 TM. Her numerical rating scale (NRS) pain score was reduced to 0/10 from a baseline score of 5/10. The second case involved a 52-year-old woman with a 13-year history of pain following a medullary cavernoma bleed. Her baseline NRS pain score was 9/10, which was reduced to 0.5/10 post-treatment. No adverse events were reported. Pain relief was sustained at 30 days’ post-treatment. DISCUSSION/SIGNIFICANCE OF IMPACT: We are investigating the acceptability and efficacy of Scrambler Therapy for central neuropathic pain treatment in NMO. Proof-of-concept was supported by two patients whose pain scores improved considerably more in response to this treatment than with previous pharmacologic and non-pharmacologic interventions. Results from this trial may support future investigation in other disorders that cause damage in the CNS, including MS and TM.

Discovery of strongly-lensed gravitational wave (GW) sources will unveil binary compact objects at higher redshifts and lower intrinsic luminosities than is possible without lensing. Such systems will yield unprecedented constraints on the mass distribution in galaxy clusters, measurements of the polarization of GWs, tests of General Relativity, and constraints on the Hubble parameter. Excited by these prospects, and intrigued by the presence of so-called “heavy black holes” in the early detections by LIGO-Virgo, we commenced a search for strongly-lensed GWs and possible electromagnetic counterparts in the latter stages of the second LIGO observing run (O2). Here, we summarise our calculation of the detection rate of strongly-lensed GWs, describe our review of BBH detections from O1, outline our observing strategy in O2, summarize our follow-up observations of GW170814, and discuss the future prospects of detection.

The western Antarctic Peninsula (WAP) region has experienced a statistically significant warming trend during the past half-century. In addition, a statistically significant anticorrelation between air temperatures and sea-ice extent, as determined from satellite passive-microwave data during the past two decades, has been observed for this region. Consistent with this strong coupling, sea-ice extent in the WAP area has trended down during this period of satellite observations. Further, much of the variability in both air temperature and sea ice in the WAP region has been shown to be influenced by contrasting maritime (warm, moist) and continental (cold, dry) climate regimes. As part of the Palmer Long Term Ecological Research program, the ecological influence of these trends and variability is being studied, and effects have already been demonstrated at all trophic levels. Here we extend earlier observations to include the past decade and focus on the annual cycles of air temperature and sea-ice extent for the past few years, with the aim of placing these recent observations within the context of changes seen in the longer-term records. The more recent years have seen an increasing maritime influence in the WAP region, with corresponding effects on the marine ecosystem.

The Community Emergency Response Team (CERT) concept was initially developed for adult members of the community to help prepare for disasters and minimize damage when disasters occur. CERTs also served as a tool for building community capacity and self-sufficiency by supporting a diverse group of people working together in dealing with challenges affecting their communities. The novel approach to CERTs described here sought to involve high-risk youth from low-socioeconomic status communities in CERTs and first aid and cardiopulmonary resuscitation (CPR) training to help them build ties with communities, stay off the streets, and become leaders in the community. It also helped to provide different perspectives on life, while building more resilient communities better prepared to minimize damage when a disaster strikes. After the successful launch of the first high-risk teen CERT cohort in Watts (27 CERT-trained and 14 first aid/CPR-trained), the project was expanded to other community groups and organizations. Seven additional cohorts underwent CERT and first aid/CPR training in 2013 through 2014. This initiative increased CERT visibility within South Los Angeles. New partnerships were developed between governmental, nongovernmental, and community-based organizations and groups. This model can be used to expand CERT programs to other communities and organizations by involving high-risk teens or other high-risk groups in CERT training. (Disaster Med Public Health Preparedness. 2017;11:605–609)

Non-invasive survey in the Stonehenge ‘Triangle’, Amesbury, Wiltshire, has highlighted a number of features that have a significant bearing on the interpretation of the site. Geophysical anomalies may signal the position of buried stones adding to the possibility of former stone arrangements, while laser scanning has provided detail on the manner in which the stones have been dressed; some subsequently carved with axe and dagger symbols. The probability that a lintelled bluestone trilithon formed an entrance in the north-east is signposted. This work has added detail that allows discussion on the question of whether the sarsen circle was a completed structure, although it is by no means conclusive in this respect. Instead, it is suggested that it was built as a façade, with other parts of the circuit added and with an entrance in the south.