Background: Between October 2023 and July 2024, Methodist Hospital Specialty Transplant (MHST, San Antonio TX) experienced a cluster of five infections with Salmonella enterica serotype uganda among hospitalized kidney and liver transplant patients. All patients were symptomatic and specimens included blood, stool and urine. Salmonella enterica serotype uganda is rare with only a few reported outbreaks in the literature with none from healthcare settings. Methods: Investigation focused on two hypotheses: 1) a source within the facility was causing broad exposure but only severely immunocompromised patients were becoming symptomatic or 2) The clinical management of certain transplant patients is creating a risk of reactivation of Salmonella sp. The case definition was any solid organ transplant patient with a positive culture result (any specimen source) for Salmonella enterica serotype uganda post-transplant (no defined time) with or without symptoms who had a hospitalization at MHST after October 2023. The response focused on horizontal control measures (foundational infection prevention practices, water management), vertical control measures (food and nutrition services, patient screening) and epidemiologic descriptive analysis. Findings: Whole genome sequencing identified the five cases to be from an identical species. Cases occurred among kidney and liver transplant patients in roughly the proportion to the underlying census of these patients. No clinical or nutritional product or service was identified that would expose risk to transplant patients exclusively. There were no commonalities among the cases in relation to clinical care, procedures, or type of immunosuppression. Screening was performed for twenty-eight patients (either pre-liver transplant, post liver transplant or post kidney transplant) hospitalized between September and October 2024 with either chronic diarrhea or acute loose stools, none of which were positive for any species of Salmonella. Inspections of the kitchen showed opportunities around staff attire, food handling, food storage and the physical environment. Compliance to infection prevention assessments was 71% initially but improved to above 90% by early October 2024. Hand hygiene by food handlers after the handling of raw meat was low in July and August 2024 at 25% and 37%, respectively. After targeted interventions, compliance increased to 80% by September 2024. Conclusion: Following interventions, no additional healthcare-associated Salmonella sp cases in transplant patients were noted after July 2024. While a common source for these cases was suspected, none was definitely identified. While it was not possible to make a definitive conclusion, evidence suggests that the transplant population had a unique vulnerability to this species of Salmonella.

Wetlands in hypersaline environments are especially vulnerable to loss and degradation, as increasing coastal urbanization and climate change rapidly exacerbate freshwater supply stressors. Hypersaline wetlands pose unique management challenges that require innovative restoration perspectives and approaches that consider complex local and regional socioecological dynamics. In part, this challenge stems from multiple co-occurring stressors and anthropogenic alterations, including estuary mouth closure and freshwater diversions at the catchment scale. In this article, we discuss challenges and opportunities in the restoration of hypersaline coastal wetland systems, including management of freshwater inflow, shoreline modification, the occurrence of concurrent or sequential stressors, and the knowledge and values of stakeholders and Indigenous peoples. Areas needing additional research and integration into practice are described, and paths forward in adaptive management are discussed. There is a broad need for actionable research on adaptively managing hypersaline wetlands, where outputs will enhance the sustainability and effectiveness of future restoration efforts. Applying a collaborative approach that integrates best practices across a diversity of socio-ecological settings will have global benefits for the effective management of hypersaline coastal wetlands.

Herbicide resistance in Palmer amaranth and waterhemp is on the rise and poses a great concern to growers in the United States. A multistate screening was conducted for these two weed species in the United States to assess their sensitivity to glufosinate, dicamba, and 2,4-D. The screening was designed to understand the weed sensitivity landscape and emerging trends in resistance evolution by testing each herbicide at its respective label rate and at half the label rate. A total of 303 weed seed accessions from 21 states representing 162 Palmer amaranth and 141 waterhemp seeds were collected from grower fields in 2019 and screened in greenhouse conditions. Statistical power of different sample sizes and probability of survivors in each accession were estimated for each species and herbicide treatment. Overall, the efficacy of glufosinate, dicamba, and 2,4-D against all these accessions was excellent, with greater than 90% average injury. The variability in herbicide injury, if any, was greater with half the label rate of 2,4-D in some Palmer amaranth accessions, while waterhemp accessions had exhibited variable sensitivity with half the label rate of dicamba and glufosinate. The study highlights the value of monitoring weeds for herbicide sensitivity across broader landscape and the importance of glufosinate, dicamba, and 2,4-D herbicides in managing troublesome weeds as part of a diversified weed control program integrated with other chemical, mechanical and cultural practices.

The application and provision of prehospital care in disasters and mass-casualty incident response in Europe is currently being explored for opportunities to improve practice. The objective of this translational science study was to align common principles of approach and action and to identify how technology can assist and enhance response. To achieve this objective, the application of a modified Delphi methodology study based on statements derived from key findings of a scoping review was undertaken. This resulted in 18 triage, eight life support and damage control interventions, and 23 process consensus statements. These findings will be utilized in the development of evidence-based prehospital mass-casualty incident response tools and guidelines.

Humans operating in extreme environments often conduct their operations at the edges of the limits of human performance. Sometimes, they are required to push these limits to previously unattained levels. As a result, their margins for error in execution are much smaller than that found in the general public. These same small margins for error that impact execution may also impact risk, safety, health, and even survival. Thus, humans operating in extreme environments have a need for greater refinement in their preparation, training, fitness, and medical care. Precision medicine (PM) is uniquely suited to address the needs of those engaged in these extreme operations because of its depth of molecular analysis, derived precision countermeasures, and ability to match each individual (and his or her specific molecular phenotype) with any given operating context (environment). Herein, we present an overview of a systems approach to PM in extreme environments, which affords clinicians one method to contextualize the inputs, processes, and outputs that can form the basis of a formal practice. For the sake of brevity, this overview is focused on molecular dynamics, while providing only a brief introduction to the also important physiologic and behavioral phenotypes in PM. Moreover, rather than a full review, it highlights important concepts, while using only selected citations to illustrate those concepts. It further explores, by demonstration, the basic principles of using functionally characterized molecular networks to guide the practical application of PM in extreme environments. At its core, PM in extreme environments is about attention to incremental gains and losses in molecular network efficiency that can scale to produce notable changes in health and performance. The aim of this overview is to provide a conceptual overview of one approach to PM in extreme environments, coupled with a selected suite of practical considerations for molecular profiling and countermeasures.

The current assays to confirm herbicide resistance can be time- and labor-intensive (dose–response) or require a skill set/technical equipment (genetic sequencing). Stakeholders could benefit from a rapid assay to confirm herbicide-resistant weeds to ensure sustainable crop production. Because protoporphyrinogen oxidase (PPO)-inhibiting herbicides rapidly interfere with chlorophyll production/integrity; we propose a new, rapid assay utilizing spectral reflectance to confirm resistance. Leaf disks were excised from two PPO-inhibiting herbicide-resistant (target-site [TSR] and non–target site [NTSR]) and herbicide-susceptible redroot pigweed (Amaranthus retroflexus L.) populations and placed into a 24-well plate containing different concentrations (0 to 10 mM) of fomesafen for 48 h. A multispectral sensor captured images from the red (668 nm), green (560 nm), blue (475 nm), and red edge (717 nm) wavebands after a 48-h incubation period. The green leaf index (GLI) was utilized to determine spectral reflectance ratios of the treated leaf disks. Clear differences of spectral reflectance were observed in the red edge waveband for all populations treated with the 10 mM concentration in the dose–response assays. Differences of spectral reflectance were observed for the NTSR population compared with the TSR and susceptible populations treated with the 10 mM concentration in the green waveband and the GLI in the dose–response assay. Leaf disks from the aforementioned A. retroflexus populations and two additional susceptible populations were subjected to a similar assay with the discriminating concentration (10 mM). Spectral reflectance was different between the PPO-inhibiting herbicide-resistant and herbicide-susceptible populations in the red, blue, and green wavebands. Spectral reflectance was not distinctive between the populations in the red edge waveband and the GLI. The results provide a basis for rapidly (∼48 h) detecting PPO-inhibiting herbicide-resistant A. retroflexus via spectral reflectance. Discrimination between TSR and NTSR populations was possible only in the dose–response assay, but the assay still has utility in distinguishing herbicide-resistant plants from herbicide-susceptible plants.

OBJECTIVES/GOALS: Nearly all thoracic aortic aneurysm patients suffer from hypertension leading to elevated wall tension and abnormal extracellular matrix remodeling. PTSD patients have higher blood pressure both at rest and in response to stimuli. Although stress is associated with cardiovascular disease, the exact mechanism linking the two is still unknown. METHODS/STUDY POPULATION: Adult C57BL/6 mice underwent a PTSD induction protocol consisting of inescapable foot shock followed by single prolonged stress. The mice were assessed incrementally for their PTSD-like phenotype using specific behavioral tests chosen to assess for each of the human criteria of PTSD according to the DSM-V. Tail cuff blood pressure measurements were taken serially throughout the 16-week protocol. At terminal study, thoracic aortic diameter measurements were obtained through digital microscopy and plasma was harvested for cytokine analysis. Thoracic aortic aneurysms (TAA) were induced through periadventitial application of a calcium chloride solution on the descending thoracic aorta in BPH/2J and BPN/3J adult mice. The thoracic aortic diameter was measured at terminal study through digital microscopy. RESULTS/ANTICIPATED RESULTS: Using our PTSD-like mouse model we have demonstrated that PTSD-like mice have significantly higher systolic blood pressure following a reminder of the traumatic event than control mice recapitulating the human phenotype. They also had increased plasma proinflammatory cytokines and larger thoracic aortic diameters than control mice. Although the increased thoracic aortic diameter is not an aneurysm, it suggests ECM remodeling is occurring predisposing the aorta to aneurysm formation. Finally, we have shown that in neurogenic hypertensive mice, TAA formation was accelerated by 12 weeks with roughly 70% dilation at 4 weeks post-TAA induction surgery as compared to roughly a 20% dilation in control mice. DISCUSSION/SIGNIFICANCE: Altogether, these studies reinforce the link between stress and TAA development, and our mouse model will allow for the underlying mechanism to be elucidated. Better understanding of the mechanism linking PTSD and TAA will allow for the creation of novel therapeutics to treat PTSD symptoms while also delaying TAA progression.

Complaints of control failures with acetolactate synthase (ALS)- and protoporphyrinogen oxidase (PPO)-inhibiting herbicides on redroot pigweed (Amaranthus retroflexus L.) were reported in conventional soybean [Glycine max (L.) Merr.] fields in North Carolina. Greenhouse dose–response assays confirmed that the Camden County and Pasquotank County populations were less sensitive to ALS- and PPO-inhibiting herbicides compared with susceptible A. retroflexus populations, suggesting the evolution of resistance to these herbicides. Sanger sequencing of target genes determined the Camden County population carried a Trp-574-Leu mutation in the ALS gene and an Arg-98-Gly mutation in the PPX2 gene, while the Pasquotank County population carried a His-197-Pro mutation in the ALS gene (first documentation of the mutation in the Amaranthus genus), but no mutation was detected in the PPX2 gene. Single-nucleotide polymorphism (SNP) genotyping assays were developed to enable efficient screening of future control failures in order to limit the spread of these herbicide-resistant populations. In addition, preliminary testing of these assays revealed the three mutations were ubiquitous in the respective populations. These two populations represent the first confirmed cases of PPO-inhibiting herbicide-resistant A. retroflexus in the United States, as well as the first confirmed cases of this particular herbicide-resistance profile in A. retroflexus inhabiting North America. While no mutation was found in the PPX2 gene of the Pasquotank County population, we suggest that this population has evolved resistance to PPO-inhibiting herbicides, but the mechanism of resistance is to be determined.

Glufosinate is an effective postemergence herbicide, and overreliance on this herbicide for weed control is likely to increase and select for glufosinate-resistant weeds. Common assays to confirm herbicide resistance are dose–response and molecular sequencing techniques; both can require significant time, labor, unique technical equipment, and a specialized skillset to perform. As an alternative, we propose an image-based approach that uses a relatively inexpensive multispectral sensor designed for unmanned aerial vehicles to measure and quantify surface reflectance from glufosinate-treated leaf disks. Leaf disks were excised from a glufosinate-resistant and glufosinate-susceptible corn (Zea mays L.), cotton (Gossypium hirsutum L.), and soybean [Glycine max (L.) Merr.] varieties and placed into a 24-well plate containing eight different concentrations (0 to 10 mM) of glufosinate for 48 h. Multispectral images were collected after the 48-h incubation period across five discrete wave bands: blue (475 to 507 nm), green (560 to 587 nm), red (668to 682 nm), red edge (717 to 729 nm), and near infrared (842 to 899 nm). The green leaf index (GLI; a metric to measure chlorophyll content) was utilized to determine relationships between measured reflectance from the tested wave bands from the treated leaf disks and the glufosinate concentration. Clear differences of spectral reflectance were observed between the corn, cotton, and soybean leaf disks of the glufosinate-resistant and glufosinate-susceptible varieties at the 10 mM concentration for select wave bands and GLI. Leaf disks from two additional glufosinate-resistant and glufosinate-susceptible varieties of each crop were subjected to a similar assay with two concentrations: 0 and 10 mM. No differences of spectral reflectance were observed from the corn and soybean varieties in all wave bands and the GLI. The leaf disks of the glufosinate-resistant and glufosinate-susceptible cotton varieties were spectrally distinct in the green, blue, and red-edge wave bands. The results provide a basis for rapidly detecting glufosinate-resistant plants via spectral reflectance. Future research will need to determine the glufosinate concentrations, useful wave bands, and susceptible/resistant thresholds for weeds that evolve resistance.

This research communication evaluates experts’ opinions on the importance and weights of six gait aspects. In 2016, a Qualtrics (Qualtrics LLC., Provo, Utah) survey was distributed to lameness experts. Six gait aspects – general symmetry, tracking, spine curvature, head bobbing, speed and abduction as well as adduction were included. Respondents were asked to rank the gait aspects from 1 (most important) to 6 (least important), and to indicate which weight each gait aspect should receive when assessing lameness. For each gait aspect, frequency (percentage %) was used to describe the distribution of rank, and medians as well as 25th and 75th percentiles were used to summarize assigned weights. Thirty-nine percent of respondents ranked general symmetry first, followed by 32% for tracking, and 19% ranked spine curvature third. Head bobbing ranked fourth with 10% whereas, speed, abduction and adduction were not ranked. The median, 25th and 75th percentiles weight for each gait aspect were: general symmetry (25, 15, and 30), tracking (20, 10, and 30), spine curvature (20, 10, and 21), head bobbing (15, 10, and 20), speed (10, 5, and 20), and abduction and adduction (10, 5, and 10). General symmetry and tracking were deemed the most important gait aspects. A composite gait score can be calculated based on weighted importance of different gait aspects to indicate possible lameness.

We present stable isotope and osteological data from human remains at Paloma, Chilca I, La Yerba III, and Morro I that offer new evidence for diet, lifestyle, and habitual mobility in the first villages that proliferated along the arid Pacific coast of South America (ca. 6000 cal BP). The data not only reaffirm the dietary primacy of marine protein for this period but also show evidence at Paloma of direct access interactions between the coast and highlands, as well as habitual mobility in some parts of society. By locating themselves at the confluence of diverse coastal and terrestrial habitats, the inhabitants of these early villages were able to broaden their use of resources through rounds of seasonal mobility, while simultaneously increasing residential sedentism. Yet they paid little substantial health penalty for their settled lifestyles, as reflected in their osteological markers of stature and stress, compared with their agriculturalist successors even up to five millennia later. Contrasting data for the north coast of Chile indicate locally contingent differences. Considering these data in a wider chronological context contributes to understanding how increasing sedentism and population density laid the foundations here for the emergence of Late Preceramic social complexity.

The loggerhead turtle (Caretta caretta) is a circumglobal species and is listed as vulnerable globally. The North Pacific population nests in Japan and migrates to the Central North Pacific and Pacific coast of North America to feed. In the Mexican Pacific, records of loggerhead presence are largely restricted to the Gulf of Ulloa along the Baja California Peninsula, where very high fisheries by-catch mortality has been reported. Records of loggerhead turtles within the Sea of Cortez also known as the Gulf of California (GC) exist; however, their ecology in this region is poorly understood. We used satellite tracking and an environmental variable analysis (chlorophyll-a (Chl-a) and sea surface temperature (SST)) to determine movements and habitat use of five juvenile loggerhead turtles ranging in straight carapace length from 62.7–68.3 cm (mean: 66.7 ± 2.3 cm). Satellite tracking durations ranged from 73–293 days (mean: 149 ± 62.5 days), transmissions per turtle from 14–1006 (mean: 462 ± 379.5 transmissions) and total travel distance from 1237–5222 km (mean: 3118 ± 1490.7 km). We used travel rate analyses to identify five foraging areas in the GC, which occurred mainly in waters from 10–80 m deep, with mean Chl-a concentrations ranging from 0.28–13.14 mg m−3 and SST ranging from 27.8–34.4°C. This is the first study to describe loggerhead movements in the Gulf of California and our data suggest that loggerhead foraging movements are performed in areas with eutrophic levels of Chl-a.

OBJECTIVES/SPECIFIC AIMS: The study investigated whether adults diagnosed with epilepsy or migraine (a neurological disorder with common features to epilepsy) are at increased risk for developing substance abuse disorders following diagnosis compared to (presumably healthy) adults with lower extremity fracture (LEF). METHODS/STUDY POPULATION: A retrospective cohort analysis was conducted using a subset of surveillance data of hospital admissions, emergency department visits and outpatient visits in South Carolina, USA from January 1, 2000 through December 31, 2011. Individuals aged 18 years or older were identified using the International Classification of Disease, 9th Revision Clinical modification (ICD-9) with a diagnosis of epilepsy (epilepsy-cohort 1; n = 78,547; 52.7% female, mean age [SD] 51.3 years [19.2]), migraine (migraine-cohort 2; n = 121,155; 81.5% female, mean age [SD] 40.0 years [14.5]), or LEF (control cohort; n = 73,911; 55.4% female, mean age [SD] 48.7 years [18.7]). Individuals with substance abuse or dependence diagnosis following epilepsy, migraine, or LEF were identified with ICD-9 codes. Cox proportional hazard regression analyses modelled the time to substance abuse diagnosis comparing epilepsy to LEF and comparing migraine to LEF. RESULTS/ANTICIPATED RESULTS: Adjusting for insurance payer, age and sex, adults with epilepsy are diagnosed with substance abuse disorders at 2.5 times the rate of those with LEF [HR 2.54 (2.43, 2.67)] and adults with migraine are diagnosed with substance abuse disorders at 1.10 times the rate of those with LEF [HR 1.10 (1.04, 1.16)]. An interaction between exposure and insurance payer was found with hazard ratios comparing epilepsy to LEF of 4.56, 3.60, and 1.94 within the commercial payer, uninsured and Medicaid strata, respectively. DISCUSSION/SIGNIFICANCE OF IMPACT: Compared to adults with LEF, adults with epilepsy had a substantially higher hazard of subsequent substance abuse, while adults with migraine showed a small, but still significant, increased hazard of subsequent substance abuse.

Objectives: Caregivers of youth with heavy prenatal alcohol exposure report impaired communication, which can significantly impact quality of life. Using data collected as part of the Collaborative Initiative on Fetal Alcohol Spectrum Disorders (CIFASD), we examined whether cognitive variables predict communication ability of youth with histories of heavy prenatal alcohol exposure. Methods: Subjects (ages 10–16 years) comprised two groups: adolescents with heavy prenatal alcohol exposure (AE) and non-exposed controls (CON). Selected measures of executive function (NEPSY, Delis-Kaplan Executive Function System), working memory (CANTAB), and language were tested in the child, while parents completed communication ratings (Vineland Adaptive Behavior Scales – Second Edition). Separate multiple regression analyses determined which cognitive domains predicted communication ability. A final, global model of communication comprised the three cognitive models. Results: Spatial Working Memory and Inhibition significantly contributed to communication ability across groups. Twenty Questions performance related to communication ability in the CON group only while Word Generation performance related to communication ability in the AE group only. Effects remained significant in the global model, with the exception of Spatial Working Memory. Conclusions: Both groups displayed a relation between communication and Spatial Working Memory and Inhibition. Stronger communication ability related to stronger verbal fluency in the AE group and Twenty Questions performance in the CON group. These findings suggest that alcohol-exposed adolescents may rely more heavily on learned verbal storage or fluency for daily communication while non-exposed adolescents may rely more heavily on abstract thinking and verbal efficiency. Interventions aimed at aspects of executive function may be most effective at improving communication ability of these individuals. (JINS, 2018, 24, 1026–1037)