Objectives/Goals: With qualitative interviews we aim to 1-Describe barriers and facilitators for post-transplant lymphoproliferative disease (PTLD) survivors’ access to late effects (LE) care. 2-Investigate clinicians’ perceptions of current and ideal PTLD LE care. Our long-term goal is to develop and pilot implementation strategies to standardize PTLD LE care. Methods/Study Population: Study population: We will recruit 20–25 PTLD survivors or their caregivers and 10–15 health care workers (HCW) from oncology, LE, and solid organ transplant (SOT) teams at St. Louis Children’s Hospital (SLCH). PTLD is a lymphoma-like cancer that occurs in solid organ transplant (SOT) recipients. PTLD survivors experience LE from cancer, yet many do not receive LE care. Research strategy: We will conduct qualitative semi-structured interviews based on the Consolidated Framework for Implementation Research (CFIR). A preliminary codebook will be based on CFIR and refined through transcript review. Team-based coding includes double coding and checking for intercoder reliability. We will generate coding reports to understand themes and identify barriers and facilitators of LE care. Results/Anticipated Results: We hypothesize survivors, caregivers, and HCWs will identify actionable factors to inform future studies to optimize LE care. We will examine the CFIR inner setting (resources, communication, and structural characteristics), outer setting (local attitudes and external pressures), innovation domain (adaptability, evidence base, and relative advantage), individuals domain (need, opportunity, and motivation), and implementation process domain. Our contribution will be novel. 1-This is the first assessment of barriers and facilitators for LE care in pediatric PTLD survivors. 2-We will consider input from HCWs across various disciplines delivering care to PTLD survivors. 3-We anticipate identifying unique contextual factors in PTLD survivors that will influence implementation of evidence-based LE care. Discussion/Significance of Impact: Pediatric cancer survivors experience LE. Coordinated care mitigates LE. PTLD survivors experience a high burden of LE, but less than 10% of PTLD survivors at SLCH follow in LE clinic. No studies have evaluated ideal delivery of LE care for PTLD survivors. Our findings will inform an implementation trial to improve delivery of LE care for PTLD survivors.

Studies of the popularity of Hallyu concentrate almost exclusively upon Northeast Asian nations, disregarding their popularity within Southeast Asia, an area still defined as ‘Asian’ yet often ignored in favor of the more economically prominent East Asian nations. This article attempts to expand discussions of Hallyu through an analysis of the reception of South Korean television dramas among different consumers in Thailand. It draws upon evidence gathered from qualitative interviews with Thai fans to illustrate how diverse consumers use these foreign products as a means to assess and critique their own position within contemporary Thailand and actively engage with changing constructions of Koreanness, Thainess and Asianness as a means to do so.

We investigate cooperation using an incremental investment game in which the first-mover has the ability to make small, but increasing incremental investments in their counterpart. Our experiment is designed to test whether establishing trust in small increments is more effective than alternatives, including a one-shot investment game, a decrease only condition where the amount the first-mover sends to the second-mover must be less than the amount previously sent, and an unrestricted condition where the first-mover is not restricted by the amount previously sent. Although results were mixed, broadly, iteration affords greater cooperation than one-shot games and, when given the choice, participants seem to prefer to build trust gradually. Implications for institutional design are discussed.

To say that managers should be accountable to the market only begins the analysis. The problematic downside to this glib norm is that a volatile market can be a fickle master who may regularly override the superior judgment of his manager-servant. Thus, the central question from a public law perspective is how much accountability is too much.

John C Coffee, Jr

The last two decades of corporate law scholarship in the United States have been marked by the ascendancy of law-and-economics research, the centrepiece of which is the contractarian theory of the corporation and the corporate law. Contractarians seek to explain the corporation as the focal point for a process of contracting between various constituencies. Contractarians explain corporate law as a corpus of “default rules” which fills gaps where these contracts are less than fully specified, but which can be excluded by the parties.

Clinical translational neuroscience (CTN) is positioned to generate novel discoveries for advancing treatments for mental health disorders, but it is held back today by the siloing of bioethical considerations from critical consciousness. In this article, we suggest that bioethical and critical consciousness can be paired to intersect with structures of power within which science and clinical practice are conducted. We examine barriers to the adoption of neuroscience findings in mental health from this perspective, especially in the context of current collective attention to widespread disparities in the access to and outcomes of mental health services, lack of representation of marginalized populations in the relevant sectors of the workforce, and the importance of knowledge that draws upon multicultural perspectives. We provide 10 actionable solutions to confront these barriers in CTN research, as informed by existing frameworks such as structural competency, adaptive calibration models, and community-based participatory research. By integrating critical consciousness with bioethical considerations, we believe that practitioners will be better positioned to benefit from cutting-edge research in the biological and social sciences than in the past, alert to biases and equipped to mitigate them, and poised to shepherd in a robust generation of future translational therapies and practitioners.

When a simple sum or number-correct score is used to evaluate the ability of individual testees, then, from an accountability perspective, the inferences based on the sum score should be the same as the inferences based on the complete response pattern. This requirement is fulfilled if the sum score is a sufficient statistic for the parameter of a unidimensional model. However, the models for which this holds true are known to be restrictive. It is shown that the less restrictive nonparametric models could result in an ordering of persons that is different from an ordering based on the sum score. To arrive at a fair evaluation of ability with a simple number-correct score, ordinal sufficiency is defined as a minimum condition for scoring. The monotone homogeneity model, together with the property of ordinal sufficiency of the sum score, is introduced as the nonparametric Rasch model. A basic outline for testable hypotheses about ordinal sufficiency, as well as illustrations with real data, is provided.

The emergence of computer-based assessments has made response times, in addition to response accuracies, available as a source of information about test takers’ latent abilities. The development of substantively meaningful accounts of the cognitive process underlying item responses is critical to establishing the validity of psychometric tests. However, existing substantive theories such as the diffusion model have been slow to gain traction due to their unwieldy functional form and regular violations of model assumptions in psychometric contexts. In the present work, we develop an attention-based diffusion model based on process assumptions that are appropriate for psychometric applications. This model is straightforward to analyse using Gibbs sampling and can be readily extended. We demonstrate our model’s good computational and statistical properties in a comparison with two well-established psychometric models.

This paper discusses the issue of differential item functioning (DIF) in international surveys. DIF is likely to occur in international surveys. What is needed is a statistical approach that takes DIF into account, while at the same time allowing for meaningful comparisons between countries. Some existing approaches are discussed and an alternative is provided. The core of this alternative approach is to define the construct as a large set of items, and to report in terms of summary statistics. Since the data are incomplete, measurement models are used to complete the incomplete data. For that purpose, different models can be used across countries. The method is illustrated with PISA’s reading literacy data. The results indicate that this approach fits the data better than the current PISA methodology; however, the league tables are nearly identical. The implications for monitoring changes over time are discussed.

In this paper it is demonstrated how statistical inference from multistage test designs can be made based on the conditional likelihood. Special attention is given to parameter estimation, as well as the evaluation of model fit. Two reasons are provided why the fit of simple measurement models is expected to be better in adaptive designs, compared to linear designs: more parameters are available for the same number of observations; and undesirable response behavior, like slipping and guessing, might be avoided owing to a better match between item difficulty and examinee proficiency. The results are illustrated with simulated data, as well as with real data.

This abstract was presented as the Nutrition and Optimum Life Course Theme Highlight.

The n-3 polyunsaturated fatty acids (n-3 PUFA), eicosapentaenoic acid (EPA; 20:5n-3) and docosahexaenoic acid (DHA; 22:6n-3), are known for their beneficial roles in regulating inflammation(1). The omega 3 index (O3I) refers to the percentage of EPA+DHA within the erythrocyte membrane with respect to total fatty acids and is a recognised biomarker for cardiovascular disease(2). An O3I >8% is proposed to confer the greatest level of cardioprotection(2). Fish is the richest dietary source of n-3 PUFAs and has been noted as one of the main predictors of a higher O3I(3). Current UK dietary guidelines recommend the consumption of two portions of fish per week; albeit the efficacy of these recommendations in raising the O3I is unknown(4). The aim of this study was to investigate the influence of consuming two portions of fish per week on the O3I amongst low fish consuming women of childbearing age.

Data were analysed from the iFish study(5), an 8-week randomised controlled trial where low fish consuming women, were randomly assigned to consume either no fish (n = 18) or 2 portions of tuna (n = 8) or sardines (n = 9) per week. Total n-3 PUFA concentrations of the fish provided in the intervention were 6.47g/100g for sardines and 4.57g/100g for tuna. Fasting blood samples were collected at baseline and post-intervention. The O3I was determined in red blood cells in the control and two portions of fish groups by OmegaQuant Europe. Analysis of covariance, adjusting for age, BMI, and baseline O3I, examined the effect of the fish intervention on the O3I. Chi-square test was used to compare the O3I between groups when categorised as at risk (<4%), intermediate risk (48%) and low risk (>8%).

Participants had a mean ± SD age of 25.5 ± 6.4 years. Baseline median (IQR) O3I of the cohort was 5.7 (5.2, 6.7) %. There was no significant difference in the O3I between treatment groups at baseline. Consumption of two portions of fish significantly increased the O3I when compared to the consumption of no fish [6.73 (5.41, 7.38) % vs 5.58 (5.12, 6.49) %, respectively, p = 0.034]. Those consuming two portions of sardines, an oily fish high in n-3 PUFAs, had a significantly greater O3I when compared to those consuming two portions of tuna [7.38 (6.83, 8.37) % vs 5.61 (5.29, 6.79) %, respectively, p<0.001]. Post-intervention, the proportion of participants in the low risk O3I category (>8%) was greater in the two portions of fish group when compared to the control group; albeit this did not reach statistical significance (p = 0.104).

In support of the current dietary guidelines, increasing fish consumption of low consumers to two portions of any fish per week will increase the O3I. Future research should determine the potential cardioprotective properties of a higher O3I as a result of consuming fish.

Dietary intake can influence immune function indirectly by affecting the gut microbiota composition and metabolism(1). Fish consumption has been shown to positively regulate the gut microbiota in humans(2,3);albeit in those studies fish was consumed in high amounts (500-750g/week) and immune function was not investigated. This study investigated the effect of consuming the UK dietary recommendation for fish(4) (2 portions [140-280g/week], one of which is oily) on the gut microbiota alpha diversity. Further, we examined if changes (pre- to post-intervention) in the gut microbiota composition were associated with changes in immune cytokine concentrations.

An 8-week randomised controlled trial in low fish consuming women of childbearing age (n = 41; median age 23y) investigated the effect of consuming 1 or 2 portions of fish (tuna or sardines)/week compared to not consuming fish. A blood sample was collected to measure inflammatory cytokines (tumour necrosis factor-a, interleukin [IL]-1b, IL-5, IL-6, IL-17A and IL-22) pre-and post-intervention. Faecal samples were collected at both timepoints and extracted DNA was used to determine gut microbiota compositional profiles using 16S metagenomic sequencing (Illumina, USA). Statistical analysis investigated significant differences in changes in gut microbiota alpha diversity and compositional relative abundances between fish intervention (N = 26) and control (N = 15), then secondary analysis stratified by portion size (1 vs 2 portions) and type of fish (tuna vs sardines). Differences in cytokines between fish intervention and control were assessed by Mann-Whitney U. Spearman rank coefficient assessed associations between the changes in gut microbiota relative abundances with cytokine changes in fish and control groups.

Fish consumption increased gut microbiota alpha diversity indices (Chao1 [7.37±41.23], Simpson [0.003±0.163], Shannon [0.07±0.33], phylogenetic diversity [0.35±2.59], observed species [9.00±40.06]), albeit this was not significant compared to the control group (p>0.05). Consumption of fish, specifically sardines, for 8 weeks significantly reduced Bacteroidetes (-4.77±4.88%) when compared to control (+4.15±7.58%) (p<0.01). No significant differences were observed between the change in relative abundances of gut microbiota at genus-level taxa or inflammatory cytokines between the fish intervention and control. In the fish intervention group, increases in IL-17A, IL-22 and IL-6 concentrations were positively correlated with changes in Alistipes, Rhodococcus, Haemophilus, Barnesiella and Akkermansia relative abundances (p<0.05).

Although not statistically significant, consistent findings suggest that fish intake, in line with dietary guidelines, may have favourable impact on gut microbiota. Sardines, oily fish rich in n-3 polyunsaturated fatty acids, may have health benefits in disease states where Bacteroidetes is elevated; nevertheless, further research is required in a larger cohort over a longer period.

Metabolic dietary patterns, including the Empirical Dietary Index for Hyperinsulinaemia (EDIH) and Empirical Dietary Inflammatory Pattern (EDIP), are known to impact multiple chronic diseases, but the role of the colonic microbiome in mediating such relationships is poorly understood. Among 1,610 adults with faecal 16S rRNA data in the TwinsUK cohort, we identified the microbiome profiles for EDIH and EDIP (from food frequency questionnaires) cross-sectionally using elastic net regression. We assessed the association of the dietary pattern-related microbiome profile scores with circulating biomarkers in multivariable-adjusted linear regression. In addition, we used PICRUSt2 to predict biological pathways associated with the enriched microbiome profiles, and further screened pathways for associations with the dietary scores in linear regression analyses. Microbiome profile scores developed with 32 (EDIH) and 15 (EDIP) genera were associated with higher insulin and homeostatic model assessment of insulin resistance. Six genera were associated with both dietary scores: Ruminococcaceae_UCG-008, Lachnospiraceae_UCG-008, Defluviitaleaceae_UCG-011 Anaeroplasma, inversely and Negativibacillus, Streptococcus, positively. Further, pathways in fatty acid biosynthesis, sugar acid degradation, and mevalonate metabolism were associated with insulinaemic and inflammatory diets. Dietary patterns that exert metabolic effects on insulin and inflammation may influence chronic disease risk by modulating gut microbial composition and function.

The Magellanic Stream (MS), a tail of diffuse gas formed from tidal and ram pressure interactions between the Small and Large Magellanic Clouds (SMC and LMC) and the Halo of the Milky Way, is primarily composed of neutral atomic hydrogen (HI). The deficiency of dust and the diffuse nature of the present gas make molecular formation rare and difficult, but if present, could lead to regions potentially suitable for star formation, thereby allowing us to probe conditions of star formation similar to those at high redshifts. We search for $\text{HCO}^{+}$, HCN, HNC, and C$_2$H using the highest sensitivity observations of molecular absorption data from the Atacama Large Millimeter Array (ALMA) to trace these regions, comparing with HI archival data from the Galactic Arecibo L-Band Feed Array (GALFA) HI Survey and the Galactic All Sky Survey (GASS) to compare these environments in the MS to the HI column density threshold for molecular formation in the Milky Way. We also compare the line of sight locations with confirmed locations of stars, molecular hydrogen, and OI detections, though at higher sensitivities than the observations presented here.

We find no detections to a 3$\sigma$ significance, despite four sightlines having column densities surpassing the threshold for molecular formation in the diffuse regions of the Milky Way. Here we present our calculations for the upper limits of the column densities of each of these molecular absorption lines, ranging from $3 \times 10^{10}$ to $1 \times 10^{13}$ cm$^{-2}$. The non-detection of $\text{HCO}^{+}$ suggests that at least one of the following is true: (i) $X_{\text{HCO}^{+}{}, \mathrm{MS}}$ is significantly lower than the Milky Way value; (ii) that the widespread diffuse molecular gas observed by Rybarczyk (2022b, ApJ, 928, 79) in the Milky Way’s diffuse interstellar medium (ISM) does not have a direct analogue in the MS; (iii) the HI-to-$\text{H}_{2}$ transition occurs in the MS at a higher surface density in the MS than in the LMC or SMC; or (iv) molecular gas exists in the MS, but only in small, dense clumps.