Patients with CHD have an increased risk of necrotising enterocolitis, leading to higher mortality compared to infants without necrotising enterocolitis. Current definitions and treatment recommendations are based on premature infants and accepted criteria for diagnosing or treating necrotising enterocolitis in infants with CHD are lacking. We performed a quality improvement project to develop and implement a diagnostic scoring tool and treatment algorithm for necrotising enterocolitis in infants with CHD, aiming to enhance early diagnosis, categorise disease severity, and expedite safe return to enteral feeding.

The scoring tool and algorithm were implemented in children with CHD under six months of age with clinical suspicion of necrotising enterocolitis. Outcome measures included days of nil per os (NPO), duration of antibiotic treatment, time on total parenteral nutrition, and time to full enteral feeding after diagnosis. Balancing measures included progression to surgical necrotising enterocolitis, vasoactive-inotropic score, length of stay, and mortality.

Twenty-seven patients were included (14 preintervention and 13 postintervention) and 39 episodes of necrotising enterocolitis were analysed (19 preintervention and 20 postintervention). In the postintervention group, patients were NPO for fewer days (2 vs. 7 days, p = 0.004), had a shorter duration of antibiotic treatment (3 vs. 7 days, p = 0.02), received total parenteral nutrition for fewer days (0 vs. 20 days, p = 0.01), and returned to full feeds more quickly (8 versus 18 days, p = 0.013) without increased progression to surgical necrotising enterocolitis (3 versus 0, p = 0.11).

Implementation of a novel necrotising enterocolitis scoring tool and treatment algorithm reduced NPO days, antibiotic duration, and time to full feeds without increasing surgical necrotising enterocolitis in infants with CHD.

The rise in interest rates globally in 2022–23 led to improved scheme funding for many defined-benefit pension schemes. Many schemes in the UK now find themselves closer to, or at, a fully funded position on a low-risk basis (annuity buyout or self-sufficiency). Finishing the journey while managing the risk of losses on that journey is highly desirable, but may be difficult to achieve in practice.

However many schemes are not yet sufficiently funded to buy out liabilities in full with an insurer. Others may not wish to, and many who can afford to do so are not yet able to for investment reasons (such as holding illiquid assets) or operational reasons (such as the time needed to resolve member data issues). For schemes that instead look to adopt self-sufficient ongoing management with low dependency on the sponsoring employer, this may be difficult to maintain in practice. In short, there remains a risk that benefits will not be secured in full, which with hindsight could have been avoided.

The addition of capital to pension scheme assets has long been deployed to enhance the security of member benefits e.g., capital from insurers in the case of a buyout or capital from sponsors in the form of contingent assets.

More recently, providers have developed a diverse set of arrangements that draw on external capital to aid trustees and corporates to meet scheme funding ambitions. Capital Backed Funding Arrangements (“CBFA”) are in this context an additional tool in the trustee toolkit for delivering funding strategies.

This paper focusses on the UK-defined benefit market but the dynamics are applicable to other jurisdictions, with CBFAs being developed for wider markets (e.g., Ireland).

In this paper we:

• survey the current scheme funding landscape and consider the need in this environment for arrangements to support scheme funding journeys to deliver benefits in full

• summarise the key features of arrangements in the market that may support these objectives

• set out considerations for trustees and sponsoring companies when assessing these arrangements.

The aim of this paper is educational – to increase awareness of the key issues and potential solutions. Professional advice will always be required prior to any transaction. We welcome feedback from readers on further material that would be beneficial to support consideration of these arrangements.

Galaxy Zoo is an online project to classify morphological features in extra-galactic imaging surveys with public voting. In this paper, we compare the classifications made for two different surveys, the Dark Energy Spectroscopic Instrument (DESI) imaging survey and a part of the Kilo-Degree Survey (KiDS), in the equatorial fields of the Galaxy And Mass Assembly (GAMA) survey. Our aim is to cross-validate and compare the classifications based on different imaging quality and depth. We find that generally the voting agrees globally but with substantial scatter, that is, substantial differences for individual galaxies. There is a notable higher voting fraction in favour of ‘smooth’ galaxies in the DESI+zoobot classifications, most likely due to the difference between imaging depth. DESI imaging is shallower and slightly lower resolution than KiDS and the Galaxy Zoo images do not reveal details such as disc features and thus are missed in the zoobot training sample. We check against expert visual classifications and find good agreement with KiDS-based Galaxy Zoo voting. We reproduce the results from Porter-Temple+ (2022), on the dependence of stellar mass, star formation, and specific star formation on the number of spiral arms. This shows that once corrected for redshift, the DESI Galaxy Zoo and KiDS Galaxy Zoo classifications agree well on population properties. The zoobot cross-validation increases confidence in its ability to compliment Galaxy Zoo classifications and its ability for transfer learning across surveys.

Prior research on self-other differences involving risk have found that individuals make riskier decisions for others than for the self in situations where risk taking is valued. We expand this research by examining whether the direction of self-other differences reverses when risk aversion is valued, as predicted by social values theory (Stone & Allgaier, 2008). Two studies tested for self-other differences in physical safety scenarios, a domain where risk aversion is valued. In Study 1, participants read physical safety and romantic relationship scenarios and selected what they would decide for themselves, what they would decide for a friend, or what they would predict their friend would decide. In Study 2, participants read public health scenarios and either decided or predicted for themselves and for a friend. In keeping with social values theory, participants made more risk-averse decisions for others than for themselves in situations where risk aversion is valued (physical safety scenarios) but more risk-taking decisions for others than for themselves in situations where risk taking is valued (relationship scenarios). Further, we show that these self-other differences in decision making do not arise from incorrectly predicting others’ behaviors, as participants predicted that others’ decisions regarding physical safety scenarios would be either similar (Experiment 1) or more risk taking (Experiment 2) than their own decisions.

This article argues that a holistic approach to documenting and understanding the physical evidence for individual cities would enhance our ability to address major questions about urbanisation, urbanism, cultural identities and economic processes. At the same time we suggest that providing more comprehensive data-sets concerning Greek cities would represent an important contribution to cross-cultural studies of urban development and urbanism, which have often overlooked relevant evidence from Classical Greece. As an example of the approach we are advocating, we offer detailed discussion of data from the Archaic and Classical city of Olynthos, in the Halkidiki. Six seasons of fieldwork here by the Olynthos Project, together with legacy data from earlier projects by the American School of Classical Studies at Athens and by the Greek Archaeological Service, combine to make this one of the best-documented urban centres surviving from the Greek world. We suggest that the material from the site offers the potential to build up a detailed ‘urban profile’, consisting of an overview of the early development of the community as well as an in-depth picture of the organisation of the Classical settlement. Some aspects of the urban infrastructure can also be quantified, allowing a new assessment of (for example) its demography. This article offers a sample of the kinds of data available and the sorts of questions that can be addressed in constructing such a profile, based on a brief summary of the interim results of fieldwork and data analysis carried out by the Olynthos Project, with a focus on research undertaken during the 2017, 2018 and 2019 seasons.

Background: Carbapenem-resistant Enterobacteriaceae (CRE) are endemic in the Chicago region. We assessed the regional impact of a CRE control intervention targeting high-prevalence facilities; that is, long-term acute-care hospitals (LTACHs) and ventilator-capable skilled nursing facilities (vSNFs). Methods: In July 2017, an academic–public health partnership launched a regional CRE prevention bundle: (1) identifying patient CRE status by querying Illinois’ XDRO registry and periodic point-prevalence surveys reported to public health, (2) cohorting or private rooms with contact precautions for CRE patients, (3) combining hand hygiene adherence, monitoring with general infection control education, and guidance by project coordinators and public health, and (4) daily chlorhexidine gluconate (CHG) bathing. Informed by epidemiology and modeling, we targeted LTACHs and vSNFs in a 13-mile radius from the coordinating center. Illinois mandates CRE reporting to the XDRO registry, which can also be manually queried or generate automated alerts to facilitate interfacility communication. The regional intervention promoted increased automation of alerts to hospitals. The prespecified primary outcome was incident clinical CRE culture reported to the XDRO registry in Cook County by month, analyzed by segmented regression modeling. A secondary outcome was colonization prevalence measured by serial point-prevalence surveys for carbapenemase-producing organism colonization in LTACHs and vSNFs. Results: All eligible LTACHs (n = 6) and vSNFs (n = 9) participated in the intervention. One vSNF declined CHG bathing. vSNFs that implemented CHG bathing typically bathed residents 2–3 times per week instead of daily. Overall, there were significant gaps in infection control practices, especially in vSNFs. Also, 75 Illinois hospitals adopted automated alerts (56 during the intervention period). Mean CRE incidence in Cook County decreased from 59.0 cases per month during baseline to 40.6 cases per month during intervention (P < .001). In a segmented regression model, there was an average reduction of 10.56 cases per month during the 24-month intervention period (P = .02) (Fig. 1), and an estimated 253 incident CRE cases were averted. Mean CRE incidence also decreased among the stratum of vSNF/LTACH intervention facilities (P = .03). However, evidence of ongoing CRE transmission, particularly in vSNFs, persisted, and CRE colonization prevalence remained high at intervention facilities (Table 1). Conclusions: A resource-intensive public health regional CRE intervention was implemented that included enhanced interfacility communication and targeted infection prevention. There was a significant decline in incident CRE clinical cases in Cook County, despite high persistent CRE colonization prevalence in intervention facilities. vSNFs, where understaffing or underresourcing were common and lengths of stay range from months to years, had a major prevalence challenge, underscoring the need for aggressive infection control improvements in these facilities.

Funding: The Centers for Disease Control and Prevention (SHEPheRD Contract No. 200-2011-42037)

Disclosures: M.Y.L. has received research support in the form of contributed product from OpGen and Sage Products (now part of Stryker Corporation), and has received an investigator-initiated grant from CareFusion Foundation (now part of BD).

OBJECTIVES/SPECIFIC AIMS: Background: Children with autism spectrum disorder (ASD) show a broad range of unusual responses to sensory stimuli and experiences. It has been hypothesized that early differences in sensory responsiveness arise from atypical neural function and produce “cascading effects” on development across a number of domains, impacting social and communication skill, as well as broader development in children affected by ASD. A primary challenge to confirming these hypotheses is that ASD cannot be definitely diagnosed in the earliest stages of development (i.e., infancy). A potential solution is to prospectively follow infants at heightened risk for ASD based on their status as infant siblings of children who are diagnosed. We examined the developmental sequelae and possible neurophysiological substrates of three different patterns of sensory responsiveness—hyporesponsiveness (reduced or absent responding to sensory stimuli) and hyperresponsiveness (exaggerated responding to sensory stimuli), as well as sensory seeking (craving of or fascination with certain sensory experiences). Infants at high risk (HR) for ASD were compared with a control group of infants at relatively lower risk for ASD (LR; siblings of children with typical developmental histories). Objectives: Research questions included: (a) Do HR infants differ from LR infants in early sensory responsiveness?, (b) Does sensory responsiveness predict future ASD and related symptomatology? and (c) Is sensory responsiveness predicted by resting brain states? METHODS/STUDY POPULATION: Methods: To answer these questions, we carried out a longitudinal correlational investigation in which 20 HR infants and 20 LR controls matched on sex and chronological age were followed over 18 months. At entry to the study, when infants were 18 months old, sensory responsiveness was measured using the Sensory Processing Assessment and the Sensory Experiences Questionnaire, and a number of putative neural signatures of early sensory differences were measured via resting state EEG. When infants were 24 and 36 months of age, ASD and related symptomatology was evaluated in a comprehensive diagnostic evaluation. RESULTS/ANTICIPATED RESULTS: Results: HR infants trended towards increased hyporesponsiveness and hyperresponsiveness and showed significantly elevated levels of sensory seeking relative to LR controls at 18 months of age. Both groups, furthermore, displayed a high degree of heterogeneity in sensory responsiveness. Atypical sensory responsiveness (increased hyperresponsiveness and/or hyporesponsiveness, as well as sensory seeking behavior) predicted several aspects of ASD and related symptomatology, including social, communication, and play skill, and was associated with differences in resting brain state, including metrics of oscillatory power, complexity, and connectivity, as well as hemispheric asymmetry. Moderation analyses revealed that several relations varied according to risk group, such that associations were stronger in magnitude in the HR Versus LR group. DISCUSSION/SIGNIFICANCE OF IMPACT: Conclusion: Findings provide empirical support for the notion that early sensory responsiveness may produce cascading effects on development in infants at heightened risk for ASD. Differences in resting brain states may underlie atypical behavioral patterns of sensory responsiveness. From a clinical standpoint, results suggest that early sensory differences may be useful for predicting developmental trajectories, and be potentially important targets for early preventive intervention, in infants at risk for autism.

Research on the cities of the Classical Greek world has traditionally focused on mapping the organisation of urban space and studying major civic or religious buildings. More recently, newer techniques such as field survey and geophysical survey have facilitated exploration of the extent and character of larger areas within urban settlements, raising questions about economic processes. At the same time, detailed analysis of residential buildings has also supported a change of emphasis towards understanding some of the functional and social aspects of the built environment as well as purely formal ones. This article argues for the advantages of analysing Greek cities using a multidisciplinary, multi-scalar framework which encompasses all of these various approaches and adds to them other analytical techniques (particularly micro-archaeology). We suggest that this strategy can lead towards a more holistic view of a city, not only as a physical place, but also as a dynamic community, revealing its origins, development and patterns of social and economic activity. Our argument is made with reference to the research design, methodology and results of the first three seasons of fieldwork at the city of Olynthos, carried out by the Olynthos Project.

Soil water from plots containing cotton, devil's-claw, cotton with devil's-claw, and bare soil was measured throughout the growing season using a neutron probe and related to weed interference with the crop. Volumetric water content throughout the soil profile to a depth of 180 cm did not differ among treatments before the 5th or 6th week after cotton emergence. Greater water depletion occurred early in the season in plots containing devil's-claw which corresponded to a period of rapid weed growth. In plots containing only cotton, the largest reduction in water content occurred later in the season during peak bloom and early boll formation. Soil water content at depths greater than 105 cm remained unchanged in all plots throughout the season. Interference from devil's-claw reduced cotton lint yield 96% in 1986 and 46% in 1987. Higher rainfall and reduced weed populations in 1987 reduced the impact of weed interference on cotton lint yield.