Objectives/Goals: Highlight the importance of community engagement: Showcase how the involvement of Promotoras de Salud is critical for fostering trust and encouraging participation in clinical trials. Cultural relevance and adaptation: Underline the importance of cultural and contextual relevance in developing and refining clinical research tools. Methods/Study Population: The theater test, an interactive evaluation approach akin to a dress rehearsal in theater, was conducted with approximately 60 Promotoras de Salud at a community center near the US-Mexico border. The Promotoras were divided into four groups, each focusing on one domain of the toolkit and facilitated discussions provided critical feedback on the materials and methods. A community engagement liaison with the University of New Mexico Health Sciences Center played a key role in introducing the EXPLORE team to these community leaders, leveraging long-standing relationships that predate this project. Results/Anticipated Results: Post-testing evaluations showed that 97% of the Promotoras were likely to encourage clinical trials in their communities, and 86% saw significant benefits for their community members. The Promotoras provided key insights and recommendations to enhance the toolkit’s cultural and contextual relevance. The community engagement liaison created a bilingual infographic to share these insights, which was presented at a Promotoras meeting, fostering meaningful discussion about clinical trials. Discussion/Significance of Impact: This project underscores the importance of community voices in research, transforming feedback into actionable insights for public health. Engaging Promotoras through theater testing validated the EXPLORE Toolkit and strengthened ties between clinical research and communities impacted by the opioid crisis.

Objectives/Goals: Here, we utilize deep learning to automate the analysis of dual X-ray absorptiometry (DEXA) scans in the UK Biobank (UKB) imaging dataset to enable a large-scale assessment of lumbar spine disc degeneration, low back pain, and socioeconomic status. Methods/Study Population: Study Population: The UKB is a biomedical database that includes lateral spine DEXA imaging for 50,000 participants. Deep Learning Model Development: A computer vision model was developed that receives a DEXA scan as input and outputs a quadrilateral that corresponds to the corners of 5 lumbar vertebral bodies. The model is a deep, fully convolutional, encoder–decoder network using DeepLabV3. Statistical Analysis: To determine our preliminary model accuracy, we used the intersection over union (IoU) metric.We analyzed data using an ordinal regression model to determine the relationship between income/ neighborhood level multiple deprivation index (MDI) and low back pain (LBP), as well as a mixed effects model to estimate the relationship between income/MDI and disc height index (DHI). Results/Anticipated Results: Our model predicted vertebral body quadrilaterals in training and unseen test data (train IoU  =  0.96, test IoU  = .91) and was used to infer data for 10,440 participants. Confirming previous studies, there were significant relationships (p0.05) between income or MDI and DHI (Figure 2). Discussion/Significance of Impact: Low back pain is the world’s leading cause of disability, and socioeconomic factors play an important role. We found no relationship between disc height index and socioeconomic status. Thus, disc degeneration may not be a factor in this low back pain phenotype.

Objectives/Goals: Children with chronic respiratory technology needs (CRTN) are becoming a dominant patient group in pediatric intensive care units (ICUs). However, little is known about patient-level, long-term outcomes in this population. The lack of such knowledge may lead to inadequate ICU therapies, interventions, or follow-up care. Methods/Study Population: This project will deploy a set of ecological momentary assessment (EMA) modules measuring real-time functioning as well as standardized instruments to measure child and family outcomes including health care utilization, physical functioning, and health-related quality of life following pediatric critical illness in children with CRTN. EMA has particular strength in assessing conditions where individual-level characteristics vary over time, as after critical illness. EMA’s recurrent measurements allow for evaluation of the variables’ temporal course and limit the potential for bias associated with recall surveys. Pulmonary function in children with CRTN in this study will be monitored over time using standardized pulmonary metrics and information from home respiratory machines. Results/Anticipated Results: This work tests the central hypothesis that long-term functional outcomes in children with CRTN are predicted by multimodal data obtained during and shortly after critical illness. To date, 17 families (of a planned 70) have been enrolled. Adherence to EMA modules is high, with 80% completion. Following serial data collection at 3, 6, and 9 months after hospital discharge, phenotypes of recovery (including improvement, stability, or deterioration) will be described. This will include 1) describing the patient demographic and clinical features associated with each long-term outcome trajectory and 2) identifying subgroups with similar outcome trajectories using patient demographics, features of the clinical illness, and EMA data using both traditional biostatistical and causal analysis techniques. Discussion/Significance of Impact: This project will provide important insights into the long-term outcomes following critical illness of children with CRTN while utilizing an innovative methodology. This proposal will provide the necessary information to drive future clinical trials assessing potential interventions at a number of different points to improve outcomes.

Considerable progress continues to be made with regards to the value and use of disease associated polygenic scores (PGS). PGS aim to capture a person’s genetic liability to a condition, disease, or a trait, combining information across many risk variants and incorporating their effect sizes. They are already available for clinicians and consumers to order in Australasia. However, debate is ongoing over the readiness of this information for integration into clinical practice and population health. This position statement provides the viewpoint of the Human Genetics Society of Australasia (HGSA) regarding the clinical application of disease-associated PGS in both individual patients and population health. The statement details how PGS are calculated, highlights their breadth of possible application, and examines their current challenges and limitations. We consider fundamental lessons from Mendelian genetics and their continuing relevance to PGS, while also acknowledging the distinct elements of PGS. Use of PGS in practice should be evidence based, and the evidence for the associated benefit, while rapidly emerging, remains limited. Given that clinicians and consumers can already order PGS, their current limitations and key issues warrant consideration. PGS can be developed for most complex conditions and traits and can be used across multiple clinical settings and for population health. The HGSA’s view is that further evaluation, including regulatory, implementation and health system evaluation are required before PGS can be routinely implemented in the Australasian healthcare system.

The spatial distribution of in situ sessile organisms, including those from the fossil record, provides information about life histories, such as possible dispersal and/or settlement mechanisms, and how taxa interact with one another and their local environments. At Nilpena Ediacara National Park (NENP), South Australia, the exquisite preservation and excavation of 33 fossiliferous bedding planes from the Ediacara Member of the Rawnsley Quartzite reveals in situ communities of the Ediacara Biota. Here, the spatial distributions of three relatively common taxa, Tribrachidium, Rugoconites, and Obamus, occurring on excavated surfaces were analyzed using spatial point pattern analysis. Tribrachidium have a variable spatial distribution, implying that settlement or post-settlement conditions/preferences had an effect on populations. Rugoconites display aggregation, possibly related to their reproductive methods in combination with settlement location availability at the time of dispersal and/or settlement. Additionally, post-settlement environmental controls could have affected Rugoconites on other surfaces, resulting in lower populations and densities. Both Tribrachidium and Rugoconites also commonly occur as individuals or in low numbers on a number of beds, thus constraining possible reproductive strategies and environmental/substrate preferences. The distribution of Obamus is consistent with selective settlement, aggregating near conspecifics and on substrates of mature microbial mat. This dispersal process is the first example of substrate-selective dispersal among the Ediacara Biota, thus making Obamus similar to numerous modern sessile invertebrates with similar dispersal and settlement strategies.

Paromomyidae are one of several families of plesiadapiforms that flourished during the Paleocene in North America soon after the extinction of non-avian dinosaurs some 66 million years ago. Although they are often among the best-represented plesiadapiforms in mammalian faunas in both North America and Europe, the early history of paromomyids is poorly understood, and their fossil record at higher latitudes is comparatively depauperate. We report here on the discovery of two new species of paromomyids from Paleocene deposits in southwestern Alberta: Edworthia greggi new species is the second known species of the basal paromomyid Edworthia Fox, Scott, and Rankin, 2010 whereas Ignacius glenbowensis new species is among the most abundantly represented species of Ignacius Matthew and Granger, 1921. These new discoveries document, for the first time, parts of the upper dentition of Edworthia, and the new species of Ignacius represents the first new, pre-Clarkforkian species of the genus to be described in nearly 100 years. A comprehensive phylogenetic analysis of nearly all known paromomyid taxa (including the new species described herein) recovered both species of Edworthia near the base of the paromomyid tree in a polytomy with Paromomys depressidens Gidley, 1923 and a paraphyletic Ignacius. The new paromomyids from Alberta not only increase the known taxonomic diversity of Edworthia and Ignacius but also add significantly to knowledge of the dental anatomy of these poorly known genera and further add to a uniquely Canadian complement of Paleocene plesiadapiforms.

UUID: http://zoobank.org/a2f31cfe-09b9-4168-b09f-9d0c3d0af342

This systematic literature review aimed to provide an overview of the characteristics and methods used in studies applying the disability-adjusted life years (DALY) concept for infectious diseases within European Union (EU)/European Economic Area (EEA)/European Free Trade Association (EFTA) countries and the United Kingdom. Electronic databases and grey literature were searched for articles reporting the assessment of DALY and its components. We considered studies in which researchers performed DALY calculations using primary epidemiological data input sources. We screened 3053 studies of which 2948 were excluded and 105 studies met our inclusion criteria. Of these studies, 22 were multi-country and 83 were single-country studies, of which 46 were from the Netherlands. Food- and water-borne diseases were the most frequently studied infectious diseases. Between 2015 and 2022, the number of burden of infectious disease studies was 1.6 times higher compared to that published between 2000 and 2014. Almost all studies (97%) estimated DALYs based on the incidence- and pathogen-based approach and without social weighting functions; however, there was less methodological consensus with regards to the disability weights and life tables that were applied. The number of burden of infectious disease studies undertaken across Europe has increased over time. Development and use of guidelines will promote performing burden of infectious disease studies and facilitate comparability of the results.

Structural racism in the USA has roots that extend deep into healthcare and medical research, and it remains a key driver of illness and early death for Black, Indigenous, People of Color (BIPOC). Furthermore, the persistence of racism within academic medicine compels an interrogation of education and research within this context. In the spirit of this interrogation, this article highlights a unique model of community-engaged education that integrates cultural humility. As an individual and institutional stance, cultural humility denotes lifelong learning and self-critique, the mitigation of power imbalances, and accountability. The integration of cultural humility emphasizes that when space is created for BIPOC communities to lead the way, education regarding healthcare and research can be effectively reimagined. Demonstrating this effectiveness, six community partners led the development and implementation of a five-module Structural Racism in Healthcare and Research course. Using a cohort model approach, the pilot course enrolled 12 community members and 12 researchers. The curriculum covered topics such as history of racism in healthcare and research, and introduced participants to a cultural resilience framework. Evaluation results demonstrated a significant increase in participants’ knowledge and ability to identify and take action to address inequities related to racism in healthcare and research.

We compared experiences with The Multifaceted Intervention to Improve Prescribing for Acute Respiratory Infection for Adult and Children in Emergency Department and Urgent Care Settings versus Choosing Wisely to evaluate inappropriate antimicrobial prescribing in ambulatory care. Both identified the same clinics, diagnoses, and antibiotics for high-yield antibiotic stewardship interventions.