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OBJECTIVES/GOALS: High serum copper (Cu) levels have previously been described in bariatric patients. The kidneys are a target organ for Cu toxic insult but the role of Cu on kidney function (eGFR) is uncertain. This study examines the association between Cu and eGFR in a bariatric population in Southeast Louisiana. METHODS/STUDY POPULATION: Seven hundred fifty patients will be recruited from the Bariatric Center of the University Medical Center in New Orleans. Inclusion criteria include: age ≥ 18 years, clinic visit between June 1, 2018 – May 31st 2024, and having a serum Cu test result. Covariables such as inflammatory markers and hormonal contraception use will be assessed as potential confounders. Blood pressure will be assessed as a potential effect modifier. Data will be obtained from electronic medical records. Two cohorts will be assembled, a pre-surgery cross-sectional cohort and another followed post-surgery. Separate models will be developed stratified by race-ethnicity. RESULTS/ANTICIPATED RESULTS: In a pilot study of bariatric patients 26% had elevated (>155 mcg/dl) serum Cu and pronounced racial differences were noted. Characteristics consisted of a mean BMI of approximately 50 kg/m2; 91% were female and 69% were Black. Black patients had approximately double the prevalence (OR 1.98; 95% CI: 1.15, 3.4) compared to white patients. Due to the dual nature of the kidneys’ involvement in metabolism via excretion and being the target organ for toxic insult, racial differences in exposure, coupled with the disproportionate rates of chronic kidney disease in Black adults, may be an explanation for the association between elevated Cu levels and eGFR in Black adults in this study. DISCUSSION/SIGNIFICANCE: Results from this study will provide insight into the prevalence of Cu and its association with kidney function in a bariatric population. Chronic kidney disease or other forms of renal impairment may result in the need for more conservative guidelines for dietary copper in bariatric medicine.
OBJECTIVES/GOALS: Adoption of the Observational Medical Outcomes Partnership (OMOP) common data model promises to transform large-scale observational health research. However, there are diverse challenges for operationalizing OMOP in terms of interoperability and technical skills among coordinating centers throughout the US. METHODS/STUDY POPULATION: A team from the Critical Path Institute (C-Path) collaborated with the informatics team members at Johns Hopkins to provide technical support to participating sites as part of the Extract, Transform, and Load (ETL) process linking existing concepts to OMOP concepts. Health systems met regularly via teleconference to review challenges and progress in ETL process. Sites were responsible for performing the local ETL process with assistance and securely provisioning de-identified data as part of the CURE ID program. RESULTS/ANTICIPATED RESULTS: More than twenty health systems participated in the CURE ID effort.Laboratory measures, basic demographics, disease diagnoses and problem list were more easily mapped to OMOP concepts by CURE ID partner institutions. Outcomes, social determinants of health, medical devices, and specific treatments were less easily characterized as part of the project. Concepts within the medical record presented very different technical challenges in terms of representation. There is a lack of standardization in OMOP implementation even among centers using the same electronic medical health record. Readiness to adopt OMOP varied across the institutions who participated. Health systems achieved variable level of coverage using OMOP medical concepts as part of the initiative. DISCUSSION/SIGNIFICANCE: Adoption of OMOP involves local stakeholder knowledge and implementation. Variable complexity of health concepts contributed to variable coverage. Documentation and support require extensive time and effort. Open-source software can be technically challenging. Interoperability of secure data systems presents unique problems.
In 1821 Bishop Carey conducted a visitation of the clergy of Devon and Cornwall, asking about the state of their parishes. This volume, along with DCRS New Series volume 4, presents the answers for Devon, and they tell us much about religious life in the county, including the state of parishes, the activities of the clergy, and the relationship between dissenters and the ordinary life of the parish.
THIS volume is intended to continue the previous volume issued in this series, in which the replies to queries for Cornwall were published. In the introduction to that volume will be found an account of the procedure of, and records left by, episcopal visitations and some notes on the interpretation of the several queries. All those matters apply equally to this volume. Here it should be added that the 1821 replies to queries are the last of a series of four in the Devon Record Office (Exeter Diocesan Records), dated 1744, 1765, 1779 and 1821. Fragments for other years also exist. In the earlier introduction there was also given a brief survey of conditions existing in Cornwall in 1821, as illustrated by the text of the replies to queries. What follows is an attempt to provide the same kind of survey for the county of Devon.
There are 387 replies from Devon clergy, covering 415 parishes or chapelries. The exact number of clergy to whom the queries were originally sent is now impossible to determine. Altogether the replies from about 48 were ei ther not sent in, or were subsequently mislaid by the registrar. Gaps in the records have been filled in as far as possible by printing the entries in the bishop's summary books. This has produced some information, chiefly on the residence of the clergy, for a further 19 parishes. The total of parishes covered is therefore brought up to 434. There remain perhaps 29 unaccounted for.
DEVON IN 1821
The Parishes
The 1821 census figures for Devon provide an admirable survey of the county, and a background against which to read the story of the accompanying replies. Exeter and Plymouth distinguish themselves as two greaturban areas, Exeter wi th a population of 23,459, Plymouth (the three parishes of Charles, St Andrew and Stoke Damarel) with 55,582. These two areas differed from each other markedly in the character of their parochial organization. Exeter, the ancient cathedral city, had about a score of churches and a closely entangled web of parochial boundaries, but it contained both tiny decayed parishes and large unwieldy over populated ones also.
INTENDING, by God's Assistance, to hold my Primary Visitation in the Summer of the present Year, I submit the following QUERIES to your Consideration, desiring you, after due Inquiry, to give PLAIN and DISTINCT ANSWERS to them, that I may become better acquainted with the present State of my Diocese, and, consequently, be the better enabled to provide for the due Administration of it.
I request you to return the Answers, signed with your Name and Direction, at length, to the Register of your Arch deaconry at the ensuing Archidiaconal Visitation, who will forward them to my Secretary, at Exeter. I heartily commend you to the Blessing of Almighty God, and remain,
REVEREND SIR,
Your Affectionate Brother,
W. Exeter.
N.B. It is desired that these Queries may be understood as addressed to the Incumbent of the Living, and not to the Curate, who should forward them to the Incumbent, in case he is not resident, accompanied by such Information as the Curate may think necessary, to enable the Incumbent to answer the several Enquiries; but, if it should happen that the Curate be uninformed of the Incumbent's Residence, or if he should, by Age or Infirmity, be disabled from giving the necessary Answers: in either of these Cases, they may be given by the Curate.
I. Twelve.* II. There are no papists or dissenters.* III. I do not Reside there being no House of Residence or Glebe. IV. I have a Curate who resides within two miles of the church, Edmund Herring Rector of Newton St Petrock: his salary is £43. Is. 0d. V. I have the perpetual Curacy of Frithelstoke served by the Revd Denys Yonge who is licensed. He resides at Torrington about two miles from the Church, there being no House of Residence or Glebe. His salary £61. 0. 0. VI. I am incapable of performing Service. VII. Divine Service is performed three Sundays in every month, two Sundays in the forenoon, and one in the afternoon.* VIII. There is a reading & writing school kept in the parish. IX. The youth of the parish are catechised on three Sundays in the afternoon during the summer. X. The Sacrament is administer’d four times in the year. The number of communicants is generally about fifteen.* XI. No Benefactions. XII. None. XIII. No House of Residence. The Church & Chancel are in good repair, the churchyard is well kept and all things are decent for divine service. XIV. There are no Houses or Glebe lands. XV. No chapel. XVI. Date of Licence 1803 Novr 1st. Date of Priests orders 1786 June 11th. John Phillipps, Mambury near Torrington.
ABBOTSHAM
I. About fifty. II. No Papists. Few Methodists occasionally visited by Teachers no Teacher resident. I imagine the Teachers are licensed. The[y] have a small Meeting House licensed. III. I do not because I reside on my Rectory of Bideford. IV. I have a Curate not resident he is licensed his Salary is thirty pounds per Annum. No Lecturer. V. Bideford served by myself. VI. I perform the Service of Bideford. VII. Once a Day alternately with a Sermon at eleven & three. VIII. The Methodists instruct a few Children. There is a small school for private Instruction. IX. My Curate catechises the children at Easter & at other Times. X. Four Times a year—About 25. XI. None whatever. XII. There are Alms houses in which Paupers reside. No Hospital. No Library. XIII. The House is in good Repair so is the Church & Chancel—The Church Yard well kept & all Things decent for divine Service. XIV. There is a Terrier. XV. No Chapel.
While loss of insight into one’s cognitive impairment (anosognosia) is a feature in Alzheimer’s disease dementia, less is known about memory self-awareness in cognitively unimpaired (CU) older adults or mild cognitive impairment (MCI) or factors that may impact self-awareness. Locus of control, specifically external locus of control, has been linked to worse cognitive/health outcomes, though little work has examined locus of control as it relates to self-awareness of memory functioning or across cognitive impairment status. Therefore, we examined associations between locus of control and memory self-awareness and whether MCI status impacted these associations.
Participants and Methods:
Participants from the Advanced Cognitive Training for Independent and Vital Elderly (ACTIVE) study (mean age=73.51; 76% women; 26% Black/African American) were classified as CU (n=2177) or MCI (amnestic n=313; non-amnestic n=170) using Neuropsychological Criteria. A memory composite score measured objective memory performance and the Memory Functioning Questionnaire measured subjective memory. Memory self-awareness was defined as objective memory minus subjective memory, with positive values indicating overreporting of memory difficulties relative to actual performance (hypernosognosia) and negative values indicating underreporting (hyponosognosia). Internal (i.e., personal skills/attributes dictate life events) and external (i.e., environment/others dictate life events) locus of control scores came from the Personality in Intellectual Aging Contexts Inventory. General linear models, adjusting for age, education, sex/gender, depressive symptoms, general health, and vocabulary examined the effects of internal and external locus of control on memory self-awareness and whether MCI status moderated these associations.
Results:
Amnestic and non-amnestic MCI participants reported lower internal and higher external locus of control than CU participants. There was a main effect of MCI status on memory self-awareness such that amnestic MCI participants showed the greatest degree of hyponosognosia/underreporting, followed by non-amnestic MCI, and CU participants slightly overreported their memory difficulties. While, on average, participants were fairly accurate at reporting their degree of memory difficulty, internal locus of control was negatively associated with self-awareness such that higher internal locus of control was associated with greater underreporting (ß=-.127, 95% CI [-.164, -.089], p<.001). MCI status did not moderate this association. External locus of control was positively associated with self-awareness such that higher external locus of control was associated with greater hypernosonosia/overreporting (ß=.259, 95% CI [.218, .300], p<.001). Relative to CU, amnestic, but not non-amnestic, MCI showed a stronger association between external locus of control and memory self-awareness. Specifically, higher external locus of control was associated with less underreporting of cognitive difficulties in amnestic MCI (ß=.107, 95% CI [.006, .208], p=.038).
Conclusions:
In CU participants, higher external locus of control was associated with greater hypernosognosia/overreporting. In amnestic MCI, the lower external locus of control associations with greater underreporting of objective cognitive difficulties suggests that perhaps reduced insight in some people with MCI may result in not realizing the need for external supports, and therefore not asking for help from others. Alternatively, in amnestic participants with greater external locus of control, perhaps the environmental cues/feedback translate to greater accuracy in their memory self-perceptions. Longitudinal analyses are needed to determine how memory self-awareness is related to future cognitive declines.
Adult patients who triggered an electronic sepsis alert in the emergency department (ED), received ≥2 doses of vancomycin or an antipseudomonal beta-lactam, and were discharged with an ICD-10 sepsis code.
Methods:
We assessed the prevalence of delays in second doses of antibiotics by ≥25% of the recommended dose interval and conducted multivariate regression analyses to assess for risk factors for delays and in-hospital mortality.
Results:
The cohort included 449 patients, of whom 123 (27.4%) had delays in second doses. In-hospital death occurred in 31 patients (25.2%) in the delayed group and 71 (21.8%) in the non-delayed group (p = 0.44). On multivariate analysis, only location in a non-ED unit at the time second doses were due was associated with delays (OR 2.75, 95% CI 1.20–6.32). In the mortality model, significant risk factors included malignant tumor, respiratory infection, and elevated Sequential Organ Failure Assessment (SOFA) score but not delayed second antibiotic doses (OR 1.19, 95% CI 0.69–2.05). In a subgroup analysis, delayed second doses were associated with higher mortality in patients admitted to non-intensive care units (ICUs) (OR 4.10, 95% CI 1.32–12.79).
Conclusions:
Over a quarter of patients with sepsis experienced delays in second doses of antibiotics. Delays in second antibiotic doses were not associated with higher mortality overall, but an association was observed among patients admitted to non-ICUs.
Interventions in environmental conservation are intended to make things better, not worse. Yet unintended and unanticipated consequences plague environmental conservation; key is how uncertainty plays out. Insights from the intellectual humility literature offer constructive strategies for coming to terms with uncertainty. Strategies such as self-distancing and self-assessment of causal complexity can be incorporated into conservation decision-making processes. Including reflection on what we know and do not know in the decision-making process potentially reduces unintended and unanticipated consequences of environmental conservation and management decisions. An important caution is not to have intellectual humility legitimate failing to act in the face of uncertainty.
Herbicide-resistant annual bluegrass (Poa annua L.) has become a problem in non-arable land areas. In arable fields, P. annua is frequently of lower priority in weed control program due to the variety of control options available and the relatively modest impact on crop yield compared with other species. In Ireland, postemergence herbicides are not primarily intended for P. annua control, but some herbicides, including the acetolactate synthase (ALS) inhibitor mesosulfuron-methyl + iodosulfuron-methyl, exhibit P. annua activity. In this study, a suspected P. annua population (POAAN-R) that survived mesosulfuron-methyl + iodosulfuron-methyl at 0.75 of the field recommended rate was sampled from a wheat (Triticum aestivum L.) field in County Dublin, Ireland. Single-dose testing confirmed that the suspected POAAN-R had evolved resistance to mesosulfuron-methyl + iodosulfuron-methyl and, additionally, to pyroxsulam (not registered in Ireland for P. annua control), but was sensitive to clethodim, glyphosate, pendimethalin, and flufenacet. Dose–response experiments indicated that POAAN-R was more resistant (GR50 resistance index) to both mesosulfuron-methyl + iodosulfuron-methyl (47.8 times) and pyroxsulam (38.0 times) than sensitive POAAN-S, and this was associated with the mutation at Trp-574 in the ALS protein. Malathion (a cytochrome P450 [P450] inhibitor) pretreatment did not reverse POAAN-R resistance to mesosulfuron-methyl + iodosulfuron-methyl or pyroxsulam at the field rate or above. The natural inherent mutation at Ile-1781 in acetyl-CoA carboxylase protein had no effect on both POAAN-R and POAAN-S sensitivity to clethodim. The glyphosate sensitivity of POAAN-R also corresponded with no known mutation in 5-enolpyruvylshikimate-3-phosphate synthase protein. Based on field histories, poor early-season weed control coupled with intensive use of mesosulfuron-methyl + iodosulfuron-methyl (often at reduced rates) has unintentionally selected for ALS inhibitor–resistant POAAN-R. This is the first report to characterize resistance in P. annua to ALS-inhibiting herbicides mesosulfuron-methyl + iodosulfuron-methyl and pyroxsulam in an arable setting. There is an opportunity to effectively control POAAN-R using herbicides, but this needs a wide-ranging and varied approach, coupled with cultural/nonchemical practices.
Animal welfare encompasses all aspects of an animal's life and the interactions between animals. Consequently, welfare must be measured across a variety of factors that consider aspects such as health, behaviour and mental state. Decisions regarding housing and grazing are central to farm management. In this study, two beef cattle systems and their herds were compared from weaning to slaughter across numerous indicators. One herd (‘HH’) were continuously housed, the other (‘HG’) were housed only during winter. Inspections of animals were conducted to assess body condition, cleanliness, diarrhoea, hairlessness, nasal discharge and ocular discharge. Hair and nasal mucus samples were taken for quantification of cortisol and serotonin. Qualitative behaviour assessments (QBA) were also conducted and performance monitored. Physical health indicators were similar between herds with the exception of nasal discharge which was more prevalent in HH (P < 0.001). During winter, QBA yielded differences between herds over PC1 (arousal) (P = 0.032), but not PC2 (mood) (P = 0.139). Through summer, there was a strong difference across both PC1 (P < 0.001) and PC2 (P = 0.002), with HG exhibiting more positive behaviour. A difference was found in hair cortisol levels, with the greatest concentrations observed in HG (P = 0.011), however such a pattern was not seen for nasal mucus cortisol or for serotonin. Overall, providing summer grazing (HG) appeared to afford welfare benefits to the cattle as shown with more positive QBA assessments, but also slightly better health indicators, notwithstanding the higher levels of cortisol in that group.
In 1821 Bishop Carey conducted a visitation of the clergy of Devon and Cornwall, asking about the state of their parishes. This volume, along with DCRS New Series Volume 4, presents the answers for Devon, and they tell us much about religious life in the county, including the state of parishes, the activities of the clergy, and the relationship between dissenters and the ordinary life of the parish.
The aim of this study was to determine if there was an association between the presence of cytoplasmic strings (CS) and their characteristics, with blastocyst quality, development and clinical outcome in human blastocysts. This two-centre cohort study was performed between July 2017 and September 2018 and involved a total of 1152 blastocysts from 225 patients undergoing in vitro fertilization (IVF) and intracytoplasmic sperm injection (ICSI). All embryos were cultured in Embryoscope+ and were assessed for CS using time-lapse images. A single assessor examined all blastocysts and reviewed videos using the EmbyroViewer® Software. Blastocyst quality was assessed on day 5 of embryo development. The number of CS, location and duration of their activity was recorded on days 5/6. A positive association between the presence of CS in human blastocysts with blastocyst quality was identified. Blastocysts with a higher number of CS present, were of higher quality and were in the more advanced stages of development. Top quality blastocysts had CS activity present for longer, as well as having a higher number of vesicles present travelling along the CS. Blastocysts that had CS present, had a significantly higher live birth rate. This study has confirmed that a higher number of CS and vesicles in human blastocysts is associated with top quality blastocysts and is not a negative predictor of development. They had a higher number of CS present that appeared earlier in development and, although ceased activity sooner, had a longer duration of activity. Blastocysts with CS had a significant increase in live birth rate.
OBJECTIVES/GOALS: Use an easily accessible medium to educate life science researchers and academic innovators interested in the commercialization of academic research at the University of Michigan (UM). METHODS/STUDY POPULATION: Life science research investigators and academic innovators interested in research commercialization and technology development from across the state of Michigan were invited to attend the Idea to Impact: The Translation & Commercialization of Academic Research webinar series, presented by Fast Forward Medical Innovation at the University of Michigan. The webinar series outlined the significance and critical milestones of developing novel therapeutics, medical devices, diagnostics, and digital health innovations, as well as essential collaborations with industry partners to translate a research-based idea into a product of impact. RESULTS/ANTICIPATED RESULTS: 113 investigators and innovators from 28 different institutions, organizations, and companies, registered for the webinar series. Results (N=24) of an evaluation immediately following each webinar revealed that 100% of respondents strongly agreed or agreed that the series was effective in helping them to identify and describe commercialization resources, including funding, education, and mentorship, available at the University of Michigan and within the state. Participants stated that they “loved the practical information” “shared” and that the series was a “great overview that inspired a lot more questions.” The Fast Forward Medical Innovation team was then able to consult with participants to connect them with additional resources. DISCUSSION/SIGNIFICANCE: The data suggests that easily accessible and digestible commercialization education can make navigating the academic entrepreneurial ecosystem easier for investigators and innovators. The recorded webinar series, Idea to Impact: The Translation & Commercialization of Academic Research, serves this purpose.
Colleges and universities around the world engaged diverse strategies during the COVID-19 pandemic. Baylor University, a community of ˜22,700 individuals, was 1 of the institutions which resumed and sustained operations. The key strategy was establishment of multidisciplinary teams to develop mitigation strategies and priority areas for action. This population-based team approach along with implementation of a “Swiss Cheese” risk mitigation model allowed small clusters to be rapidly addressed through testing, surveillance, tracing, isolation, and quarantine. These efforts were supported by health protocols including face coverings, social distancing, and compliance monitoring. As a result, activities were sustained from August 1 to December 8, 2020. There were 62,970 COVID-19 tests conducted with 1435 people testing positive for a positivity rate of 2.28%. A total of 1670 COVID-19 cases were identified with 235 self-reports. The mean number of tests per week was 3500 with approximately 80 of these positive (11/d). More than 60 student tracers were trained with over 120 personnel available to contact trace, at a ratio of 1 per 400 university members. The successes and lessons learned provide a framework and pathway for similar institutions to mitigate the ongoing impacts of COVID-19 and sustain operations during a global pandemic.