Precision or “Personalized Medicine” and “Big Data” are growing trends in the biomedical research community and highlight an increased focus on access to larger datasets to effectively explore disease processes at the molecular level versus the previously common one-size-fits all approach. This focus necessitated a local transition from independent lab and siloed projects to a single software application utilizing a common ontology to create access to data from multiple repositories. Use of a common system has allowed for increased ease of collaboration and access to quality biospecimens that are extensively annotated with clinical, molecular, and patient associated data. The software needed to function at an enterprise level while continuing to allow investigators the autonomy and security access they desire. To identify a solution, a working group comprised of representation from independent repositories and areas of research focus across departments was established and responsible for review and implementation of an enterprise-wide biospecimen management system. Central to this process was the creation of a unified vocabulary across all repositories, including consensus around source of truth, standardized field definitions, and shared terminology.

This paper reports the methods and preliminary findings of Germina, an ongoing cohort study to identify biomarkers and trajectories of executive functions and language development in the first 3 years of life. 557 mother-infant dyads (mean age of mothers 33.7 years, 65.2% white, 48.7% male infants) have undergone baseline and are currently collecting data for other timepoints. A linear regression was used to predict baseline Bayley-III using scores derived from data-driven sparse partial least squares utilizing a multiple holdout framework of 15 domains. Significant associations were found between socioeconomic/demographic characteristics (B = 0.29), epigenetics (B = 0.11), EEG theta (B = 0.14) and beta activity (B = 0.11), and microbiome functional pathways (B = 0.08) domains, and infant development measured by the Bayley-III at T1, suggesting potential interventions to prevent impairments.

This collectively authored article argues for a regional turn in the historical study of transnational activism. By considering not only pan-regional movements but also examples of borderland contexts, transregional connections and diasporic understandings of ‘region’, our discussion identifies fresh possibilities for investigating the evolution and functioning of transnational activism. Based on a Royal Historical Society-funded workshop held at and supported by Northumbria University, the article brings together insights from diverse locations and arenas of contestation. The first part considers literatures on three macro-regional settings – South Asia, Western Europe and Latin America – to illustrate the importance of distinctive regional contexts and constructs in shaping transnational activism and its goals. The second part turns to case studies of transnational activism in and beyond Eastern Europe, West Africa, the Caribbean and East Asia. In doing so, it explores very different notions of the regional to identify how transnational activism has both shaped and been shaped by these ideas. Taken together, the two parts highlight the role of regional identities and projects in challenging inequalities and external domination. Our analysis and examples indicate the possibilities of a regionally rooted approach for writing histories of transnational activism.

Background: In November 2020, bamlanivimab received emergency use authorization (EUA) to treat patients with early, mild-to-moderate COVID-19 who are at high risk of progression. Montefiore Medical Center serves an economically underserved community of >1.4 million residents in the Bronx, New York. Montefiore’s antimicrobial stewardship team (AST) developed a multidisciplinary treatment pathway for patients meeting EUA criteria: (1) outpatients and hospital associates and (2) acute-care patients (EDs or inpatient). Methods: The Montefiore AST established a centralized process for screening high-risk COVID-19 patients 7 days a week. Referrals were sent by e-mail from occupational health, primary care practices, specialty practices, emergency departments, and urgent care centers. Patients were screened in real time and were treated in the ED or a newly established infusion center within 24 hours. After infusion, all patients received phone calls from nurses and had an infectious diseases televisit. Demographics, clinical symptoms, subsequent ED visit or hospital admission, and timing from infusion to ED or hospitalization were obtained from the electronic health record. Results: In total, 281 high-risk patients (median age, 62 years; 57% female) received bamlanivimab at the infusion center or in the acute-care setting between December 2, 2020, and January 27, 2021 (Table 1). The number of treated patients increased weekly (Figure 1). Also, 62% were Hispanic or black, and 96% met EUA criteria. Furthermore, 51 (18%) were referred from occupational health, 205 (73%) were referred from the community, and 25 (9%) were inpatients (https://www.fda.gov/media/143605/download). All patients were successfully infused without adverse reactions. In addition, 23 patients (8.2%) were hospitalized and 6 (2.1%) visited EDs within 30 days of treatment. The average number of days between symptom onset and infusion was 4.9. The median age of admitted versus nonadmitted patients was 68 years versus 61.5 years (P = .07). Conclusions: An AST-coordinated bamlanivimab treatment program successfully treated multiple high-risk COVID-19 patients and potentially reduced hospitalizations. However, the effort, personnel, and resources required are significant. Dedicated hospital investment is necessary for maximal success.

Funding: No

Disclosures: None

Table 1.

Figure 1.

The principal aim of this study was to optimize the diagnosis of canine neuroangiostrongyliasis (NA). In total, 92 cases were seen between 2010 and 2020. Dogs were aged from 7 weeks to 14 years (median 5 months), with 73/90 (81%) less than 6 months and 1.7 times as many males as females. The disease became more common over the study period. Most cases (86%) were seen between March and July. Cerebrospinal fluid (CSF) was obtained from the cisterna magna in 77 dogs, the lumbar cistern in f5, and both sites in 3. Nucleated cell counts for 84 specimens ranged from 1 to 146 150 cells μL−1 (median 4500). Percentage eosinophils varied from 0 to 98% (median 83%). When both cisternal and lumbar CSF were collected, inflammation was more severe caudally. Seventy-three CSF specimens were subjected to enzyme-linked immunosorbent assay (ELISA) testing for antibodies against A. cantonensis; 61 (84%) tested positive, titres ranging from <100 to ⩾12 800 (median 1600). Sixty-one CSF specimens were subjected to real-time quantitative polymerase chain reaction (qPCR) testing using a new protocol targeting a bioinformatically-informed repetitive genetic target; 53/61 samples (87%) tested positive, CT values ranging from 23.4 to 39.5 (median 30.0). For 57 dogs, it was possible to compare CSF ELISA serology and qPCR. ELISA and qPCR were both positive in 40 dogs, in 5 dogs the ELISA was positive while the qPCR was negative, in 9 dogs the qPCR was positive but the ELISA was negative, while in 3 dogs both the ELISA and qPCR were negative. NA is an emerging infectious disease of dogs in Sydney, Australia.

The aim of the Avera Twin Register (ATR) is to establish a prospective longitudinal repository of twins, multiples, siblings and family members’ biological samples to study environmental and genetic influences on health and disease. Also, it is our intention to contribute to international genome-wide association study (GWAS) twin consortia when appropriate sample size is achieved within the ATR. The ATR is young compared with existing registers and continues to collect a longitudinal repository of biological specimens, survey data and health information. Data and biological specimens were originally collected via face-to-face appointments or the postal department and consisted of paper-informed consents and questionnaires. Enrollment of the ATR began on May 18, 2016 and is located in Sioux Falls, South Dakota, a rural and frontier area in the Central United States with a regional population of approximately 880,000. The original target area for the ATR was South Dakota and the four surrounding states: Minnesota, Iowa, North Dakota and Nebraska. The ATR has found a need to expand that area based on twin and multiple siblings who live in various areas surrounding these states. A description of the state of the ATR today and its transition to online data collection and informed consent will be presented. The ATR collects longitudinal data on lifestyle, including diet and activity levels, aging, plus complex traits and diseases. All twins and multiples participating in the ATR are genotyped on the Illumina Global Screening Array and receive zygosity results.

Community advisory boards (CABs) are a valuable strategy for engaging and partnering with communities in research. Eighty-nine percent of Clinical and Translational Science Awardees (CTSA) responding to a 2011 survey reported having a CAB. CTSAs’ experiences with CABs are valuable for informing future practice. This study was conducted to describe common CAB implementation practices among CTSAs; document perceived benefits, challenges, and contributions; and examine their progress toward desirable outcomes. A cross-CTSA collaborative team collected survey data from respondents representing academic and/or community members affiliated with CTSAs with CABs. Data representing 44 CTSAs with CABs were analyzed using descriptive statistics. A majority of respondents reported practices reflecting respect for CAB members’ expertise and input such as compensation (75%), advisory purview beyond their CTSA’s Community Engagement program (88%), and influence over CAB operations. Three-quarters provide members with orientation and training on roles and responsibilities and 89% reported evaluating their CAB. Almost all respondents indicated their CTSA incorporates the feedback of their CABs to some degree; over half do so a lot or completely. This study profiles practices that inform CTSAs implementing a CAB and provide an evaluative benchmark for those with existing CABs.

Evidence for changes in human mobility is fundamental to interpretations of transitions in human socioeconomic organization. Showing changes in mobility requires both archaeological proxies that are sensitive to movement and a clear understanding of how different mobility configurations influence their patterning. This study uses computer simulation to explore how different combinations of reduction, selection, transport, and discard of stone artifacts generate patterning in the “cortex ratio,” a geometric proxy used to demonstrate movement at the assemblage level. A case study from western New South Wales, Australia, shows how cortex ratios are used to make inferences about movement. Results of the exploratory simulation show that redundancy in movement between discards reduces variability in cortex ratios, while mean assemblage values can be attributed to the relative proportions of artifacts carried into and out of the assemblages. These results suggest that raw material availability is a potentially crucial factor in determining what kinds of mobility are visible in assemblages, whereby different access to raw material can shift the balance of import and export of stone in an otherwise undirected movement configuration. These findings are used to contextualize distributions of cortex ratios from the raw material–rich study area, prompting suggestions for further fieldwork.

A main objective of this study is to assess the opinions of 50 behavioral health patients on selective control over their behavioral and physical health information. We explored patients' preferences regarding current consent models, what health information should be shared for care and research and whether these preferences vary based on the sensitivity of health information and/or the type of provider involved. The other objective of this study was to solicit opinions of 8 behavioral health providers on patient-driven granular control of health information and potential impact on care.

Electronic surveys were implemented at an outpatient Behavioral Health facility that provides care for behavioral health patients with non-serious mental illnesses. The Patient Survey included questions regarding patients' demographics and about their concerns and preferences for data sharing for care and research. The Provider Survey included questions about their view on the current consent process and perceptions on barriers and facilitators to implement patient-controlled granular consent models.

This novel study provides valuable preliminary data that can help guide future studies to better understand privacy choices of this underrepresented patient group.

Sediments from Rapid Lake document glacial and vegetation history in the Temple Lake valley of the Wind River Range, Wyoming over the past 11,000 to 12,000 yr. Radiocarbon age determinations on basal detrital organic matter from Rapid Lake (11,770 ± 710 yr B.P.) and Temple Lake (11,400 ± 630 yr B.P.) bracket the age of the Temple Lake moraine, suggesting that the moraine formed in the late Pleistocene. This terminal Pleistocene readvance may be represented at lower elevations by the expansion of forest into intermontane basins 12,000 to 10,000 yr B.P. Vegetation in the Wind River Range responded to changing environmental conditions at the end of the Pleistocene. Following deglaciation, alpine tundra in the Temple Lake valley was replaced by a Pinus albicaulis parkland by about 11,300 14C yr B.P. Picea and Abies, established by 10,600 14C yr B.P., grew with Pinus albicaulis in a mixed conifer forest at and up to 100 m above Rapid Lake for most of the Holocene. Middle Holocene summer temperatures were about 1.5°C warmer than today. By about 5400 14C yr B.P. Pinus albicaulis and Abies became less prominent at upper treeline because of decreased winter snowpack and higher maximum summer temperatures. The position of the modern treeline was established by 3000 14C yr B.P. when Picea retreated downslope in response to Neoglacial cooling.

Sediments of Balsam Meadow have produced a 11,000-yr pollen record from the southern Sierra Nevada of California. The Balsam Meadow diagram is divided into three zones. (1) The Artemisia zone (11,000–7000 yr B.P.) is characterized by percentages of sagebrush (Artemisia) and other nonarboreal pollen higher than can be found in the modern local vegetation. Vegetation during this interval was probably similar to the modern vegetation on the east slope of the Sierra Nevada and the climate was drier than that of today. (2) Pinus pollen exceeded 80% from 7000 to 3000 yr B.P. in the Pinus zone. The climate was moister than during the Artemisia zone. (3) Fir (Abies, Cupressaceae, and oak (Quercus) percentages increased after 3000 yr B.P. in the Abies zone as the modern vegetation at the site developed and the present cool-moist climatic regime was established. Decreased fire frequency after 1200 yr B.P. is reflected in decreased abundance of macroscopic charcoal and increased concentration of Abies magnifica and Pinus murrayana needles.