Approximately 40% of cancers in the UK are attributable to modifiable, lifestyle risk factors such as overweight and obesity and low dietary fibre intake(1). The WCRF and AICR published ten lifestyle- based Cancer Prevention Recommendations with the aim of reducing the risk of cancer and other non-communicable diseases(2). In the UK Biobank cohort, we have found reduced risk of cancer overall and of breast and colorectal cancers with greater adherence to these Cancer Prevention Recommendations (i.e., healthier lifestyles). The present study aimed to investigate whether the magnitude of these associations is modified by the presence of co-morbidities, such as diabetes and cardiovascular disease, at baseline.

We used data from 94,778 participants (53% female, mean age 56 years) from the UK Biobank prospective cohort study, recruited between 2006 and 2010 and free from cancer at baseline. Adherence to the 2018 WCRF/AICR Cancer Prevention Recommendations was calculated from dietary, physical activity, and body composition data using a standardised score(3). Multimorbidity (list of 43 chronic diseases) was self-reported at baseline and categorised into: 0, 1, 2, or 3+ chronic illnesses. Incident cancer cases were identified using population-based cancer registries available until July 2019 for England and Wales and October 2015 for Scotland. Participants were categorised into approximate score tertiles, and the lowest tertile (lowest adherence, 0-3.5 points) was used as the reference category. Cox proportional hazard models were used to investigate associations between total score and incidence of cancer, adjusting for confounders, and to test for an interaction between total score and multimorbidity.

55,191 (58%) participants had one chronic illness at baseline and 8,430 (9%) had ≥3. Mean total 2018 WCRF/AICR score was 3.8 (SD 1.0) points, and participants with the presence of chronic illnesses had a significantly lower total score (mean for ≥3 illnesses = 3.58 points vs 3.96 points for participants without chronic illness, p<0.001). During a median follow-up of 8 years, 3,303 individuals developed cancer. When investigating associations between score tertiles and the risk of cancer overall, there was a significant interaction between the total score and multimorbidity (HR for interaction: 1.59, p=0.002). There was also evidence for an interaction between total score and multimorbidity with breast cancer risk (HR for interaction: 1.23, p=0.030), but no evidence of an interaction between total score and multimorbidity for risk of colorectal cancer.

We found stronger associations between total adherence score and the risk of cancer in participants with ≥3 chronic illnesses. This suggests that the chemoprotective effects of greater adherence to the 2018 WCRF/AICR Cancer Prevention Recommendations may be particularly beneficial for individuals with multimorbidity.

ABSTRACT IMPACT: Current practice guidelines offer a variety of treatment options for sternal reconstruction but complications and infections remain a serious surgical problem. This work seeks to provide a comprehensive picture of the com-morbidities and reconstructive methods that lead to success and improve patient outcomes. OBJECTIVES/GOALS: Patients that undergo cardiac surgery via the median sternotomy approach are at risk of wound complications that require repair. We seek to evaluate how outcomes of sternal reconstruction are influenced by patient comorbidities, flap usage and internal mammary artery grafts and methods of sternal closure. METHODS/STUDY POPULATION: We identified patients between 2005 and 2020 who underwent sternotomy followed by debridement and flap coverage at our institution. Comorbidities, method of reconstruction, demographic data, surgical history, and other factors pertaining to mortality and morbidity were collected. The data will then be analyzed to identify population characteristics using logistic regression variables to determine univariate and adjusted multivariable measures of association with mortality. We present the pre-liminary data analyzed using chi-square and one-way anova in R. RESULTS/ANTICIPATED RESULTS: In this study we present a preliminary characterization of one institution’s sternal reconstruction patient outcomes with a variety of reconstruction methods including pectoralis advancement flaps, omental flaps and latissumus dorsi flaps. Notable preoperative comorbidities include 50% of patients > age 60, 18% with diabetes mellitus, 18 % with diagnosed hypertension, 18% with COPD, and 9% with a smoking history DISCUSSION/SIGNIFICANCE OF FINDINGS: In an evolving cardiothoracic landscape, clinical characteristics of patients being treated for sternal reconstructive surgery present a moving target. Understanding current risk factors, preoperative management and timing for aggressive surgical treatment offers an opportunity to update treatment protocol and maximize successful outcomes.

This paper provides specific guidelines for the neurodevelopmental evaluation of children aged birth through 5 years with complex congenital heart disease. There is wide recognition that children with congenital heart disease are at high risk for neurodevelopmental impairments that are first apparent in infancy and often persist as children mature. Impairments among children with complex congenital heart disease cross developmental domains and affect multiple functional abilities. The guidelines provided are derived from the substantial body of research generated over the past 30 years describing the characteristic developmental profiles and the long-term trajectories of children surviving with complex congenital heart conditions. The content and the timing of the guidelines are consistent with the 2012 American Heart Association and the American Academy of Pediatrics scientific statement documenting the need for ongoing developmental monitoring and assessment from infancy through adolescence. The specific guidelines offered in this article were developed by a multidisciplinary clinical research team affiliated with the Cardiac Neurodevelopmental Outcome Collaborative, a not-for-profit organisation established to determine and implement best neurodevelopmental practices for children with congenital heart disease. The guidelines are designed for use in clinical and research applications and offer an abbreviated core protocol and an extended version that expands the scope of the evaluation. The guidelines emphasise the value of early risk identification, use of evidence-based assessment instruments, consideration of family and cultural preferences, and the importance of providing multidimensional community-based services to remediate risk.

Determination of antibodies against ToRCH antigens at the beginning of pregnancy allows assessment of both the maternal immune status and the risks to an adverse pregnancy outcome. Age-standardised seroprevalences were determined in sera from 1009 women of childbearing age residing in Mexico, Brazil, Germany, Poland, Turkey or China using a multiparametric immunoblot containing antigen substrates for antibodies against Toxoplasma gondii, rubella virus, cytomegalovirus (CMV), herpes simplex viruses (HSV-1, HSV-2), Bordetella pertussis, Chlamydia trachomatis, parvovirus B19, Treponema pallidum and varicella zoster virus (VZV). Seroprevalences for antibodies against HSV-1 were >90% in samples from Brazil and Turkey, whereas the other four countries showed lower mean age-adjusted seroprevalences (range: 62.5–87.9%). Samples from Brazilian women showed elevated seroprevalences of antibodies against HSV-2 (40.1%), C. trachomatis (46.8%) and B. pertussis (56.6%) compared to the other five countries. Seroprevalences of anti-T. gondii antibodies (0.5%) and anti-parvovirus B19 antibodies (7.5%) were low in samples from Chinese women, compared to the other five countries. Samples from German women revealed a low age-standardised seroprevalence of anti-CMV antibodies (28.8%) compared to the other five countries. These global differences in immune status of women in childbearing age advocate country-specific prophylaxis strategies to avoid infection with ToRCH pathogens.

Climate change can cause geographic displacement of the ecological niche of a species, so that similar species that previously did not coexist could begin to face new interactions. Such geographic displacement and increased competition can also be exacerbated by anthropic intervention. Until less than 100 years ago, Vultur gryphus and Coragyps atratus did not coexist. Nowadays, possibly as a result of climate change, changes in the distributions of both species created areas where they are now sympatric. Through ecological niche modeling, we evaluated the possible effects that future scenarios of climate change and human influence would have on the distribution and sympatry between the two species. Our models predict that the current distribution of V. gryphus will be reduced between 18% and 24% by 2050 and between 21% and 32% by 2070. Additionally, they predict that the distribution of C. atratus will be reduced by 31–52% by the year 2050 and 15–60% by 2070. The two algorithms predict a reduction in the areas of sympatry. However, for the northern Andes the overlap between the two species will increase, reaching up to 70% in the year 2070. The distribution of C. atratus will move towards higher areas in the altitudinal gradient, and this will generate an increase in the current sympatry between both species. No clear trend was observed on the effect of human influences on the areas of overlap between the scenarios evaluated. The possible effects of climate change and anthropic intervention in future scenarios found in this study highlight the need to include these effects in future analyses and conservation programs of V. gryphus and other threatened vultures.

The start of Child and Adolescent attention to gender dysphoria is very recent. In our Unit, it has objectified a growing increase in such demand over recent years.

As a typical example would be a patient of 13 years following gender dysphoria begins to present school failure and behavior problems at home with emotional instability.

According to the recommendations of the Group Identity and Sexual Differentiation (GIDSEEN) after early detection is to guide parents towards a comprehensive treatment at a specialized interdisciplinary teams and a psychosocial approach to improve the quality of life, decrease mental comorbidity and gender dysphoria own. Having no such care in our community has been necessary to make a referral to another community to attend this demand.

Currently it is giving adequate attention to these cases, but except for referral to another community. However, as we are seeing progression care in our area in the future could be feasible. Therefore, we consider as a first step dysphoria quantify each case in our area.

Catastrophism is a variable of great importance in the study of pain. Catastrophism refers to a negative and exaggerated compared to the experience of pain, both real and anticipated mental perception (Sullivan, Bishop and Pivik, 1995; Sullivan et al., 2001). The current study to compare the levels of catastrophism in patients with and without fibromialgia. This study is cross-cutting and comparative. Twenty participants (M: 47.20; SD: 12.11) distributed as the following way:

– group 1: patients with fibromyalgia previously diagnosed through the American College of Rheumatology criteria (n = 10);

– group 2: Clinical depression, defined according to the DSM-5 (n = 5);

– group 3: healthy patients (n = 5) paired by age with the group of Fibromyalgia.

The PCS, a self-administered, was used to measure Catastrophism. Responses were summed to yield three different subscales: Rumination, Magnification and Helplessness. This instrument is validated in both experimental and clinical population (Van Damme, Crombez, Bijttebier, Gouber and Van Houdenhove, 2002; Edwards et al., 2006). A comparison among the three groups was established using one-way factor ANOVA. The results point out that patients with fibromyalgia have higher levels of magnification controls with depression and healthy group (P < 0.05). In contrast, although the average level of Catastrophism total presented a greater tendency in fibromyalgia patients no statistically significant differences were found. This is discussed in relation to the literature, a higher level of magnification to explain pain and maintaining the chronicity of the disease. It is important to consider the component catastrophism to have a multidimensional view of pain.

OBJECTIVES/SPECIFIC AIMS: Explain the difference between creative and critical thinking. Practice and enhance the critical thinking skills. Display innovative thinking through creative solutions and insights. Critically evaluate evidence in research. Think imaginatively, actively seeking out new points of view. METHODS/STUDY POPULATION: Offer an online course in Critical and Creative Thinking to junior researchers to improve their capacity to think and transforms their ideas in research questions and aims that bring new option to the field of clinical and translational research. Evaluate their improvement through evaluation forms and exercises that show their process to think imaginatively. RESULTS/ANTICIPATED RESULTS: The Scholars will understood the importance of critical and creative thinking in their careers, believed they could apply the insights and knowledge from the course in their grant and paper writing, recognized that they don’t always consider if they are being critical or creative in their thinking and actions. DISCUSSION/SIGNIFICANCE OF IMPACT: The course helped the participants to improve their capacity to think and saw a need to develop a more systematic thought processes in their life and work. The junior research will understand the difference between opinion, reasoned, judgment and fact and they will be able to judge the credibility of an information source using criteria such as authorship, currency and potential bias that can improve their grant submission and scientific writing skills.

Salmonella is a leading cause of bacterial foodborne illness. We report the collaborative investigative efforts of US and Canadian public health officials during the 2013–2014 international outbreak of multiple Salmonella serotype infections linked to sprouted chia seed powder. The investigation included open-ended interviews of ill persons, traceback, product testing, facility inspections, and trace forward. Ninety-four persons infected with outbreak strains from 16 states and four provinces were identified; 21% were hospitalized and none died. Fifty-four (96%) of 56 persons who consumed chia seed powder, reported 13 different brands that traced back to a single Canadian firm, distributed by four US and eight Canadian companies. Laboratory testing yielded outbreak strains from leftover and intact product. Contaminated product was recalled. Although chia seed powder is a novel outbreak vehicle, sprouted seeds are recognized as an important cause of foodborne illness; firms should follow available guidance to reduce the risk of bacterial contamination during sprouting.

Free-living amoebae belonging to the genus Acanthamoeba are the causative agents of infections such as amoebic keratitis (AK), granulomatous amoebic encephalitis (GAE) and cutaneous lesions. The mechanisms involved in the establishment of infection are unknown. However, it is accepted that the initial phase of pathogenesis involves adherence to the host tissue. In this work, we analysed surface molecules with an affinity for epithelial and neuronal cells from the trophozoites of Acanthamoeba castellanii. We also investigated the cellular mechanisms that govern the process of trophozoite adhesion to the host cells. We first used confocal and epifluorescence microscopy to examine the distribution of the A. castellanii actin cytoskeleton during interaction with the host cells. The use of drugs, as cytochalasin B (CB) and latrunculin B (LB), revealed the participation of cytoskeletal filaments in the adhesion process. In addition, to identify the proteins and glycoproteins on the surface of A. castellanii, the trophozoites were labelled with biotin and biotinylated lectins. The results revealed bands of surface proteins, some of which were glycoproteins with mannose and N-acetylglucosamine residues. Interaction assays of biotinylated amoebae proteins with epithelial and neuronal cells showed that some surface proteins had affinity for both cell types. The results of this study provide insight into the biochemical and cellular mechanisms of the Acanthamoeba infection process.

The performances of organic photovoltaic cells based on the layer couple electron donor/electron acceptor (ED/EA) are significantly improved when an exciton blocking layer (EBL) is inserted between the organic acceptor and the cathode. A new material, the (Z)-5-(4-chlorobenzylidene)-3-(2-ethoxyphenyl)-2-thioxothiazolidin-4-one, that we called (CBBTZ), has been synthesized, characterized and probed as EBL. The energy levels corresponding to the highest occupied molecular orbital (HOMO) and the lowest unoccupied molecular orbital (LUMO) of the CBBTZ have been determined from the first oxidation and reduction potential respectively, using cyclic voltametric (CV) measurements. From CV curves, CBBTZ in dichloromethane showed a one electron reversible reduction and oxidation waves. The values of its HOMO and LUMO have been estimated to be 6.42 eV and 3.42 eV respectively. Such values show that CBBTZ could be probed as EBL in organic solar cells based on the ED/EA couple copper phthalocyanine(CuPc)/fullerene (C60). The photovoltaic solar cells have been obtained by sequential deposition under vacuum of the different films. The different thin film thicknesses were measured in situ by a quartz monitor. Multilayer solar cells ITO/Au/CuPc/C60/EBL/Al have been probed, where EBL is the aluminium tris(8-hydroxyquinoline) (Alq3), the CBBTZ, the 2-(4-byphenylyl)-5-(4-tert-buthylphenyl)-1,3,4-oxadiazole (butyl PBD) or the bathocuproine (BCP). The optimum film thickness is 8–9 nm whatever the EBL used. When obtained in the same run, the averaged efficiency of the cells using the CBBTZ is of the same order of magnitude than that obtained with BCP and higher than that achieved with Alq3 or butyl PBD. It is shown by XPS study that some aluminium of the cathode is present in the buffer layer. This aluminium could justify the ability of the electrons to cross the insulating exciton blocking layer thick of 9 nm.

We report the progress in our measurement of the 3-D kinematics in several low foreground extinction windows of the Galactic Bulge. In order to complete the 3-D kinematics of as many stars as possible, proper motions and radial velocities have been obtained using HST WFPC2-ACS and VLT VIMOS respectively. Our preliminary results for fields close to the galactic minor axis show a significant vertex deviation, which can be directly related to a signature of triaxility. This is one of the strongest proofs to date of the presence of the stellar bar in the galactic bulge.