Antimicrobial resistance (AMR) is a major global public health threat which disproportionately affects low- and middle-income countries. It intersects with other public health issues including climate change and its impact is compounded by existing socio-economic inequities. In the South Asian setting, persistent gender and caste-based discrimination create differences in infection susceptibility, health-seeking behaviours, accessibility and affordability to essential antibiotics, and quality health care and appropriate diagnosis by healthcare providers, resulting in disparities in healthcare access and outcomes. We report on the deliberations from a cross-disciplinary workshop held in Bengaluru, India, focusing on the Indian context of AMR and its intersections with gender, caste, and climate change—contexts that often apply to the rest of South Asia. The two-day workshop brought together healthcare professionals, public health experts, gender experts, climate experts, researchers, activists, and community members to explore institutional and community-level issues in AMR, gender, caste, and climate change. We also present a conceptual framework to understand how caste-based discrimination influences antibiotic use and AMR in India and other South Asian countries. Finally, we discuss the key recommendations highlighted by the experts to address the gender and caste blind spots in existing data collection methods, surveillance, and policy measures related to AMR.

This investigation examined pathways connecting dysfunctional conflict (parent and family aggression, parental psychological control) in adolescents’ families of origin to parenting of the next generation across two studies. Study 1 included 184 Generation 2 (G2) adolescents (58% White, 29% Black, 13% other identities; 99 females, 85 males) who provided data on their Generation 1 (G1) parents. A subset of 72 G2s later became parents and reported on their parenting of Generation 3 (G3) children. Study 2 included three generations: mothers and fathers (G1; N = 193), adolescents who later became parents (G2; N = 266; 63.5% White, 29.7% Latinx, 6.8% other identities; 96 males, 170 females), and their offspring (G3; N = 385). In both studies, participants reported on either their parental aggression or family aggression, parents’ psychological control, and substance use problems. In adulthood, G2s reported on their punitive responses to G3 children’s distress (Study 1); G3s reported on G2s’ inconsistent parental discipline (Study 2). Across both studies, results revealed heterotypic continuity from G1 dysfunctional family conflict to G2 dysfunctional parenting responses (βs = 0.23–0.33), as well as paths from dysfunctional family conflict to adolescent substance use problems (βs = 0.14–0.25), which subsequently predicted greater next-generation dysfunctional parenting responses (βs = 0.24–0.33).

Objectives/Goals: Clinical trial recruitment needs innovative strategies to increase efficiency. Participant-driven recruitment (PDR) strategies are an advancement of snowball sampling that have been tested in observational studies (e.g., as respondent-driven sampling) but are infrequently used in clinical trials. Methods/Study Population: In preparation for testing participant-driven recruitment as a clinical trial innovation, we conducted interviews with experts (principal investigators, project managers, and methodologists (e.g., biostatisticians)) involved in ongoing trials. The expert’s trials included behavioral, screening, and pharmaceutical therapies. We described the PDR concept to our experts and asked what sorts of trials might be amenable to the approach. We asked experts to discuss when in the course of trial workflow would be ideal for engaging current participants to identify and refer others who might be interested and eligible; and what methods concerns might result from using PDR. Results/Anticipated Results: Experts (n = 10) noted studying disease prevention or screening, or focused on a common condition (e.g., diabetes, hypertension) was most amenable to PDR, whereas rare disease trials would be challenging. Opinions differed regarding when in the enrollment process might be best to engage participants to refer others (time of consent versus after completion of active intervention). From a methods standpoint, common concerns were contamination (if socially connected individuals were randomized to different arms) and that participant-referred individuals would not be independent, thus requiring special statistical considerations. Most experts (8 of 10) expressed interest in learning best practices for PDR (e.g., incentivizing referrals, setting referral quotas and timelines) and implementing the process. Discussion/Significance of Impact: PDR has the potential reduce the time to complete enrollment, and early reports suggest, as referral chains spread through social networks, the heterogeneity and representativeness of the sample increases. Integrating PDR into trials requires a tailored approach.

This study examined adolescent–family relationship predictors of adult-era resilience in the face of the COVID pandemic, considering both mental and physical health outcomes. Adolescents (99 female, 85 male; 107 White, 53 African American, 15 mixed race/ethnicity, 9 from other minority groups) were followed from age 18 to 38 utilizing both observational and self-report assessments. After accounting for levels of functioning pre-COVID, adolescents who demonstrated a capacity to handle disagreements without becoming engaged in relatedness-undermining hostile behavior in mother-adolescent dyads went on as adults to experience relatively fewer depressive symptoms and better physical health quality post-COVID onset (Direct β’s = 0.28 and −0.17, respectively). Follow-up analyses suggested these effects were potentially mediated by maternal reports of adult-era quality of the mother-participant relationship, by level of ongoing maternal contact, and by lower levels of loneliness. Evidence was also found that maintaining contact with fathers in adulthood predicted better health outcomes post-pandemic. Results are taken as supporting a systems approach to understanding resilience, as Luthar has suggested, and identifying the mother–adolescent relationship as a potential long-term protective factor well into mid-adulthood.

Many non-profit organizations rely on volunteers to further their mission, but volunteer rates linger at only 25% of the population. Increasing the volunteer rate can positively impact society in a myriad of ways, including benefits to for-profit organizations. One potential way to increase volunteerism rates is by aligning volunteering with work-related outcomes of interest to employers, since many volunteers are employed. Following recovery theory, we use responses to a survey of working adults to investigate whether volunteers are more engaged and engage in more organizational citizenship behaviors (OCBs) than those who do not volunteer. We found that the meaningfulness and type of volunteer activity relate to both employee engagement and OCBs at work. Implications of these findings as well as opportunities for both practice and future research are discussed.

Data quality is a key input in efforts to link individuals across census records. We examine the extreme case of low data quality by identifying US census enumerators who fabricated entire families. We provide clear evidence of fake people included in the 1920 US Census for Homestead, Pennsylvania. We use the features of this case study to identify other places where information in the census may have been falsified. We develop an automated approach that identifies census sheets that have much lower match rates to other census records than would be expected, given the characteristics of the people recorded on each sheet. We perform a hand-check on the suspicious sheets using standard genealogy tools and identify at least 90 sheets where the entire census sheet appears to have been fabricated.

We present the first results from the COS-EDGES survey, targeting the kinematic connection between the interstellar medium and multi-phase circumgalactic medium (CGM) in nine isolated, near-edge-on galaxies at $z\sim0.2$, each probed along its major axis by a background quasar at impact parameters of $D=13-38$ kpc. Using VLT/UVES and HST/COS quasar spectra, we analyse Mgi, Mgii, Hi, Cii, Ciii, and Ovi absorption relative to galaxy rotation curves from Keck/LRIS and Magellan/MagE spectra. We find that low ionisation absorption for 8/9 galaxies lies below the halo escape velocity, indicating bound inflow or recycling gas, while 6/9 galaxies have high ionisation gas reaching above the halo escape velocity, suggesting some unbound material. We find that at lower $D/R_{\textrm{vir}}$ ($0.12\leq D/R_{\textrm{vir}} \leq0.20$), over 80% of absorption in all ions lies on the side of systemic velocity matching disk rotation, and the optical-depth–weighted median velocity ($v_{abs}$) is consistent with the peak rotation speed. At higher $D/R_{\textrm{vir}}$ ($0.21\leq D/R_{\textrm{vir}} \leq0.31$), the kinematics diverge by ionisation state: For the low ionisation gas, the amount of co-rotating absorption remains above 80%, yet $v_{abs}$ drops to roughly 60% of the galaxy rotation speed. For the high ionisation gas (Ovi), only 60% of the absorption is consistent with co-rotation and $v_{abs}$ drops to 20% of the galaxy rotation speed. Furthermore, the velocity widths, corresponding to 50% of the total optical depth ($\Delta v_{50}$) for low ionisation gas is up to 1.8 times larger in the inner halo than at larger radii, while for Ciii and Ovi $\Delta v_{50}$ remains unchanged with distance. The 90% optical-depth width ($\Delta v_{90}$) shows a modest decline with radius for low ionisation gas but remains constant Ciii and Ovi. At high $D/{R}_{\textrm{vir}}$, both $\Delta v_{50}$ and $\Delta v_{90}$ increase with ionisation potential. These results suggest a radially dependent CGM kinematic structure: the inner halo hosts cool, dynamically broad gas tightly coupled to disk rotation, whereas beyond $\gtrsim 0.2 R_{\textrm{vir}}$, particularly traced by Ovi and Hi, the CGM shows weaker rotational alignment and lower relative velocity dispersion. Therefore, low-ionisation gas likely traces extended co-rotating gas, inflows and/or recycled accretion, while high-ionisation gas reflects a mixture of co-rotating, lagging, discrete collisionally ionised structures and volume-filling warm halo, indicating a complex kinematic stratification of the multi-phase CGM.

Current evidence underscores a need to transform how we do clinical research, shifting from academic-driven priorities to co-led community partnership focused programs, accessible and relevant career pathway programs that expand opportunities for career development, and design of trainings and practices to develop cultural competence among research teams. Failures of equitable research translation contribute to health disparities. Drivers of this failed translation include lack of diversity in both researchers and participants, lack of alignment between research institutions and the communities they serve, and lack of attention to structural sources of inequity and drivers of mistrust for science and research. The Duke University Research Equity and Diversity Initiative (READI) is a program designed to better align clinical research programs with community health priorities through community engagement. Organized around three specific aims, READI-supported programs targeting increased workforce diversity, workforce training in community engagement and cultural competence, inclusive research engagement principles, and development of trustworthy partnerships.

Objectives/Goals: Cerebral amyloid angiopathy (CAA) characterized by the accumulation of amyloid-beta in the cerebrovasculature, affects blood vessel integrity leading to brain hemorrhages and an accelerated cognitive decline in Alzheimer’s disease patients. In this study, we are conducting a genome-wide association study to identify genetic risk factors for CAA. Methods/Study Population: We genotyped 1253 additional AD cases using and curated existing genome-wide genotype data from 110 AD and 502 non-AD donors from the Mayo Clinic Brain Bank. We performed QC and imputation of all datasets. We conducted GWAS in AD only (N =  1,363), non-AD only, as well as the combined cohort (N = 1,865) by testing imputed variant dosages for association with square root transformed CAA using linear regression, adjusting for relevant covariates. To assess associations in the context of major CAA risk factors, we performed interaction analysis with APOEe4 presence and sex; and pursued stratified analyses. We collected peripheral gene expression measures using RNA isolated from 188 PAXgene tube samples of 95 donors collected across multiple time points. More than 1/3 of these participants have MRI measures collected. Results/Anticipated Results: Variants at the APOE locus were identified as the most significant in our study. In addition, several other variants with suggestive association were found under the main model adjusting for AD neuropathology (Braak and Thal). LINC-PINT splice variant remained associated with lower CAA scores in AD cases without the APOEe4 risk allele. To enhance the robustness of our findings, we are pursuing further expansion of our study cohort. In the periphery, we expect to identify expression changes associated with neuroimaging indicators of CAA and determine if variants and genes discovered via GWAS are implicated in these changes. Discussion/Significance of Impact: We expect this study will provide further insight into the genetic architecture underlying risk for CAA both in the context of significant AD pathology and without. Characterization of genetic variants and functional outcomes in the context of neuropathology may lead to new avenues of research aimed at identifying biomarkers and therapies to treat CAA