OBJECTIVES/GOALS: Supported by the State of Alabama, the Alabama Genomic Health Initiative (AGHI) is aimed at preventing and treating common conditions with a genetic basis. This joint UAB Medicine-HudsonAlpha Institute for Biotechnology effort provides genomic testing, interpretation, and counseling free of charge to residents in each of Alabama’s 67 counties. METHODS/STUDY POPULATION: Launched in 2017, as a state-wide population cohort, AGHI (1.0) enrolled 6,331 Alabamians and returned individual risk of disease(s) related to the ACMG SF v2.0 medically actionable genes. In 2021, the cohort was expanded to include a primary care cohort. AGHI (2.0) has enrolled 750 primary care patients, returning individual risk of disease(s) related to the ACMG SF v3.1 gene list and pre-emptive pharmacogenetics (PGx) to guide medication therapy. Genotyping is done on the Illumina Global Diversity Array with Sanger sequencing to confirm likely pathogenic / pathogenic variants in medically actionable genes and CYP2D6 copy number variants using Taqman assays, resulting in a CLIA-grade report. Disease risk results are returned by genetic counselors and Pharmacogenetics results are returned by Pharmacists. RESULTS/ANTICIPATED RESULTS: We have engaged a statewide community (>7000 participants), returning 94 disease risk genetic reports and 500 PGx reports. Disease risk reports include increased predisposition to cancers (n=38), cardiac diseases (n=33), metabolic (n=12), other (n=11). 100% of participants harbor an actionable PGx variant, 70% are on medication with PGx guidance, 48% harbor PGx variants and are taking medications affected. In 10% of participants, pharmacists sent an active alert to the provider to consider/ recommend alternative medication. Most commonly impacted medications included antidepressants, NSAIDS, proton-pump inhibitors and tramadol. To enable the EMR integration of genomic information, we have developed an automated transfer of reports into the EMR with Genetics Reports and PGx reports viewable in Cerner. DISCUSSION/SIGNIFICANCE: We share our experience on pre-emptive implementation of genetic risk and pharmacogenetic actionability at a population and clinic level. Both patients and providers are actively engaged, providing feedback to refine the return of results. Real time alerts with guidance at the time of prescription are needed to ensure future actionability and value.

The current coronavirus disease (COVID-19) pandemic has placed unprecedented strain on underfunded public health resources in the Southeastern United States. The Memphis, TN, metropolitan region has lacked infrastructure for health data exchange.

This manuscript describes a multidisciplinary initiative to create a community-focused COVID-19 data registry, the Memphis Pandemic Health Informatics System (MEMPHI-SYS). MEMPHI-SYS leverages test result data updated directly from community-based testing sites, as well as a full complement of public health data sets and knowledge-based informatics. It has been guided by relationships with community stakeholders and is managed alongside the largest publicly funded community-based COVID-19 testing response in the Mid-South. MEMPHI-SYS has supported interactive Web-based analytic resources and informs federally funded COVID-19 outreach directed toward neighborhoods most in need of pandemic support.

MEMPHI-SYS provides an instructive case study of how to collaboratively establish the technical scaffolding and human relationships necessary for data-driven, health equity-focused pandemic surveillance, and policy interventions.

Healthcare personnel with severe acute respiratory coronavirus virus 2 (SARS-CoV-2) infection were interviewed to describe activities and practices in and outside the workplace. Among 2,625 healthcare personnel, workplace-related factors that may increase infection risk were more common among nursing-home personnel than hospital personnel, whereas selected factors outside the workplace were more common among hospital personnel.

A thorough understanding of commonly used herbicide application practices and technologies is needed to provide recommendations and determine necessary application education efforts. An online survey to assess ground and aerial herbicide application practices in Arkansas was made available online in spring 2019. The survey was direct-emailed to 272 agricultural aviators and 831 certified commercial pesticide applicators, as well as made publicly available online through multiple media sources. A total of 124 responses were received, of which 75 responses were specific to herbicide applications in Arkansas agronomic crops, accounting for approximately 49% of Arkansas’ planted agronomic crop hectares in 2019. Ground and aerial application equipment were used for 49% and 51% of the herbicide applications on reported hectares, respectively. Rate controllers were commonly used application technologies for both ground and aerial application equipment. In contrast, global positioning system-driven automatic nozzle and boom shut-offs were much more common on ground spray equipment than aerial equipment. Applicator knowledge of nozzles and usage was limited, regardless of ground or aerial applicators, as only 28% of respondents provided a specific nozzle type used, indicating a need for educational efforts on nozzles and their importance in herbicide applications. Of the reported nozzle types, venturi nozzles and straight-stream nozzles were the most commonly used for ground and aerial spray equipment, respectively. Spray carrier volumes of 96.3 and 118.8 L ha−1 for ground spray equipment and 49.6 and 59.9 L ha−1 for aerial application equipment were the means of reported spray volumes for systemic and contact herbicides, respectively. Respondents indicated application optimization was a major benefit of utilizing newer application technologies, herbicide drift was a primary challenge, and research needs expressed by respondents included adjuvants, spray volume efficacy, and herbicide drift. Findings from this survey provided insight into current practices, technologies, and needs of Arkansas herbicide applicators. Research and education efforts can be implemented as a result to address aforementioned needs while providing applied research-based information to applicators based on current practices.