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Objectives/Goals: SARS-CoV-2 infection has been shown to impact multiple organ systems, including the brain, and is associated with increased cognitive decline in vulnerable populations. The gut microbiome may play a significant role in modulating these effects, as shifts in microbiota composition have been linked to inflammation and systemic disease processes. Methods/Study Population: To explore these interactions, we conducted an acute COVID-19 study using 12-week-old C57 mice intranasally inoculated with 1x10^4 PFU of the Mouse Adapted 10 (MA-10) strain of SARS-CoV-2. On day 5 postinfection, we performed 16S ribosomal RNA sequencing on fecal samples, analyzed using QIIME2 and DeSeq2, to assess microbiome alterations and identify changes in metabolic pathways associated with inflammatory responses. Results/Anticipated Results: Analysis revealed notable shifts in the gut microbiome during the acute phase of COVID-19 infection, with significant alterations in metabolic pathways related to inflammation and immune regulation. These changes suggest that early gut microbiome disruptions may contribute to the host response in acute COVID-19. Discussion/Significance of Impact: Our findings indicate that acute SARS-CoV-2 infection leads to rapid alterations in the gut microbiome, which could underlie inflammatory and immune pathways impacting disease progression. These insights highlight the potential for microbiome-targeted therapies to mitigate acute COVID-19 morbidity and warrant further investigation.
Objectives/Goals: Our research goal is to translate medical guidelines for adolescent-centered contraceptive counseling into improved clinical practice. Here, we describe the process of co-designing a training program for adolescent-serving primary care clinicians with teen, caregiver, and clinician advisory boards. Methods/Study Population: We recruited teens, caregivers, and clinicians residing in North Carolina to participate in three virtual advisory boards separated by role. Eligible teen advisors were assigned female at birth and 15–19 years old; eligible clinicians provided care for teen patients; and all groups were purposively sampled to reflect diverse identities and experiences. At each advisor meeting, we used human-centered design techniques to elicit participant priorities, generate training content and engagement strategies, and obtain feedback on the final training program. We conducted a focus group at our final meetings and used rapid qualitative analysis to understand our advisors’ experiences participating in program co-development. Results/Anticipated Results: We partnered with 20 advisors with diverse identities across geographic location, race and ethnicity, sexuality, and experiences with disability. During 15 meetings from January to May 2024 (five with each advisor group), we developed a 3-hour virtual, synchronous training for adolescent-serving primary care providers to improve their contraceptive counseling skills. The curriculum includes five interactive modules and a resource toolkit. Advisors described motivations to participate (e.g., chance to share their perspective, desire to make change), positive experiences with the advisory boards (e.g., opportunities to learn, to connect with others), and opportunities for improvement (e.g., better technology orientation). Discussion/Significance of Impact: We describe developing a successful longitudinal partnership with three community advisory boards and co-creating a training program that incorporates community-led priorities and perspectives, including youth. This approach can be adapted for other clinician training programs seeking to center community voices.
This paper introduces a method for pricing insurance policies using market data. The approach is designed for scenarios in which the insurance company seeks to enter a new market, in our case: pet insurance, lacking historical data. The methodology involves an iterative two-step process. First, a suitable parameter is proposed to characterize the underlying risk. Second, the resulting pure premium is linked to the observed commercial premium using an isotonic regression model. To validate the method, comprehensive testing is conducted on synthetic data, followed by its application to a dataset of actual pet insurance rates. To facilitate practical implementation, we have developed an R package called IsoPriceR. By addressing the challenge of pricing insurance policies in the absence of historical data, this method helps enhance pricing strategies in emerging markets.
Objectives/Goals: The growing burden of hypertension in the USA disproportionately impacts individuals with lower socioeconomic status and those in rural communities. This study aims to investigate specific social determinants of health associated with uncontrolled hypertension among rural, underserved patients residing in Alabama. Methods/Study Population: A retrospective review of electronic health records data from the UAB Selma Family Medicine clinic was conducted. The deidentified data were entered into the Population Health Assessment Engine (PHATE) to render social characteristics and community vital sign (CVS) scores, a social deprivation index, by census tracts. We provide descriptive statistics and compare the stated factors between patients with controlled and uncontrolled hypertension using logistic regression models. We are conducting phone surveys to gather individualized data on social determinants of health to assess the perceived social needs of patients with hypertension. The Protocol for Responding to & Assessing Patients’ Assets, Risks & Experience tool was used to develop the survey, and survey responses will be compared with the PHATE results. Results/Anticipated Results: Among 2129 patients, 375 (17.6%) had uncontrolled hypertension with a mean age of 58.7 ± 14.4 years. Women comprised 66.7% (250) and 65.1% (1142) of the uncontrolled and controlled hypertension populations, respectively. The prevalence of uncontrolled hypertension was 19.1% among Black patients and 8.2% in White patients. Patients with uncontrolled hypertension had a CVS of 82.37 ± 7.31 and 81.81 ± 8.40 patients with controlled hypertension. Patients with uncontrolled hypertension lived in areas where an average of 46 ± 11% were not employed, 36 ± 9% rented, and 28 ± 1% lived below the federal poverty line (FPL). Adjusting for age, race, and sex, a unit increase in the proportion of people below the FPL was associated with 43% higher odds of uncontrolled versus controlled hypertension (OR = 1.43, 95% CI 0.44, 4.64). Discussion/Significance of Impact: Rural, underserved patients with hypertension experience multiple adverse social determinants, such as nonemployment rates, low income, and rental housing. Survey results will allow us to compare assessed and individualized social determinants that may be important to address when caring for this population.
Objectives/Goals: In this project, we set out to supplement our existing grant writing workshops with targeted, learner-centered, multimodal training. This method will assist us in moving toward a more equitable training landscape, reaching a wider variety of learners, by freely disseminating these resources. Methods/Study Population: To increase access and impact of training materials for our career development grant writing workshops, we restructured our pre-workshop training videos. We culled expert advice from lengthy recorded lectures into brief (less than 5 minute) how-to videos that target instruction to writing specific sections of an NIH K grant. We then coupled these how-to videos with easy-to-navigate, open access online courses that further illustrate best practices for writing key sections of NIH K grants. These resources were given to registered workshop attendees and made available through a public Canvas course, the Diamond portal, MICHR website, and U-M Innovation Partnerships to disseminate the materials through multiple channels. Results/Anticipated Results: Four online courses and complementary videos were developed over six months, each focusing on a specific section of the NIH K grant proposal. These resources provide targeted instruction for writing the Specific Aims, Candidate Background, Career Development Plan, Career Goals and Objectives, and Mentor Letter. Learners accessed all four of the online courses. Released in January 2024, we continue to gather data on whether learners believe their knowledge about writing successful K grants has increased after using the resources, if they believe the courses have prepared them to write the section of the grant covered, and whether learners would recommend the courses. We will analyze these results to better understand how learners are using and responding to these new resources. Discussion/Significance of Impact: These how-to videos and online courses provide targeted, learner-centered training and fill an important gap by meeting learners where they are and extending the impact of our training beyond our institution. Widely disseminating online interactive training resources is a model we are applying beyond grant writing to other projects.
Objectives/Goals: Current popular scoring systems for evaluating facial nerve function are subjective and imprecise. This study aims to quantify speech and facial motor changes in patients suffering from facial palsy after cerebellopontine angle (CPA) tumor resection to lay the foundation for a scoring algorithm that is higher resolution and more objective. Methods/Study Population: We will obtain audio and video recordings from 20 adult patients prior to and after surgical resection of unilateral CPA tumors between October 2024 and February 2025. We will obtain preoperative recordings within two weeks prior to surgery and postoperative recordings following a preset schedule starting from the day after surgery up to one year. Audio recordings entail patient readings of standardized passages and phonations while video recordings entail patient performance of standardized facial expressions. We will analyze video data for key distance measurements, such as eye opening and wrinkle size, using DynaFace. We will process audio data using VoiceLab to extract metrics such as prominence and tonality. We will perform statistical tests such as t-tests and ANOVA to elucidate changes across time. Results/Anticipated Results: I expect to obtain 9 sets of audio and video recordings from each of the 20 participants. In terms of speech, I expect average speech duration to increase postoperatively. Similarly, I expect to find increases in time spent breathing, number of breaths taken, and mean breathing duration. In terms of facial movement, I expect nasolabial fold length to decrease postoperatively, as well as eye opening size and left-right symmetry at rest. For both audio and video, I expect these changes to revert towards their preoperative baseline as time passes. I also expect average House-Brackmann and Sunnybrook facial grading scores to increase postoperatively and then decrease with time, correlating strongly with the video and audio findings. I will use trajectory analysis and time point matching to handle any missing data. Discussion/Significance of Impact: This study will validate our analysis platform’s ability to automatically quantify measurable changes that occur to speech and facial movement which correlate strongly with existing scoring systems. Future work will synthesize these data streams to move towards establishing biomarkers for facial nerve function that aid clinical decision-making.
Objectives/Goals: Neuroendocrine malignancies are heterogeneous cancers with varied clinical outcomes, yet the molecular landscape driving this heterogeneity has not been fully characterized. Here, we investigate the gene expression and mutational profiles of neuroendocrine malignancies to better understand the underlying biology and therapeutic targets. Methods/Study Population: Patients with neuroendocrine tumors (NETs) and neuroendocrine carcinomas (NECs) treated at Cleveland Clinic (2000–2022) with molecular profiling (n = 66) were identified. Mutational and gene expression profiles were abstracted from electronic health records (EHR). Clinico-pathological characteristics and overall survival (OS) were obtained from EHR. Statistical analyses were performed by R v.4.0.5 and R package Limma for differential gene expression, as well as Chi-square, Fisher’s exact, and Wilcoxon rank sum tests. Results/Anticipated Results: The cohort consisted of 38 cases with NEC, 18 NET g3, and 10 NET g1/2. EZH2 and cyclin E1 were differentially over-expressed in NEC vs. NET (p < 0.05), while PTEN and MSLN were differentially under-expressed in NEC vs. NET (p < 0.005). Several recurrent alterations co-segregated with aggressive histology (NEC vs. NET): TP53 (p 60. Also, there was no difference in gene expression profiles between the two age groups among NETs or NECs. Discussion/Significance of Impact: This study explores the molecular landscape of NETs and NECs, revealing distinct gene expression and mutation profiles related to clinical outcomes. High expressions of cyclin D1 and EGFR were significantly associated with improved 2-year OS in NECs, highlighting potential therapeutic targets. Future studies are needed to validate these findings.
Objectives/Goals: Pancreatic ductal adenocarcinoma (PDAC) is a deadly disease with a mean survival of only 11 months even with the most advanced treatment to date. The desmoplastic microenvironment of PDA is thought to play a critical role in therapy resistance. One pathway that might be responsible for resistance to immunotherapy is the CXCR4-CXCL12 axis. Methods/Study Population: In this study, we propose to evaluate the effect of CXCR4-CXCL12 inhibition on dual checkpoint inhibition in KPC mouse model of PDAC and patient-derived explants. PDAC mouse models are made with pancreatic cancer cells driven by loss of TP53 and activation of KRAS. These models are treated with PD1 inhibitor Balstilimab and an FC-modified CTLA4 Botensilimab with or without CXCR4 inhibitor BL8040. In addition, we make explants of patient tumors along with their tumors and autologous peripheral blood mononuclear cells and this model is similarly challenged with BOT/BAL and BL8040. Using immunofluorescence and flow cytometry, we quantify and evaluate the spatial relationships between different cell populations. Most notably, we evaluate the relative abundance of CD8+ T cells in control and treated conditions. Results/Anticipated Results: We expect the inhibition of CXCR4-CXCL12 axis, along with two new potent checkpoint blockers, will lead to infiltration of CD8+ T cells in both the mouse and human PDAC models. We also expect this to translate into more tumor cell killing as demonstrated by Caspase activities and tumor shrinkage. Discussion/Significance of Impact: If our hypothesis is proven in both mouse and human PDAC models, this study will serve as a basis for a phase I/II clinical trial testing this combination of drug.
Objectives/Goals: We describe the prevalence of individuals with household exposure to SARS-CoV-2, who subsequently report symptoms consistent with COVID-19, while having PCR results persistently negative for SARS-CoV-2 (S[+]/P[-]). We assess whether paired serology can assist in identifying the true infection status of such individuals. Methods/Study Population: In a multicenter household transmission study, index patients with SARS-CoV-2 were identified and enrolled together with their household contacts within 1 week of index’s illness onset. For 10 consecutive days, enrolled individuals provided daily symptom diaries and nasal specimens for polymerase chain reaction (PCR). Contacts were categorized into 4 groups based on presence of symptoms (S[+/-]) and PCR positivity (P[+/-]). Acute and convalescent blood specimens from these individuals (30 days apart) were subjected to quantitative serologic analysis for SARS-CoV-2 anti-nucleocapsid, spike, and receptor-binding domain antibodies. The antibody change in S[+]/P[-] individuals was assessed by thresholds derived from receiver operating characteristic (ROC) analysis of S[+]/P[+] (infected) versusS[-]/P[-] (uninfected). Results/Anticipated Results: Among 1,433 contacts, 67% had ≥1 SARS-CoV-2 PCR[+] result, while 33% remained PCR[-]. Among the latter, 55% (n = 263) reported symptoms for at least 1 day, most commonly congestion (63%), fatigue (63%), headache (62%), cough (59%), and sore throat (50%). A history of both previous infection and vaccination was present in 37% of S[+]/P[-] individuals, 38% of S[-]/P[-], and 21% of S[+]/P[+] (P<0.05). Vaccination alone was present in 37%, 41%, and 52%, respectively. ROC analyses of paired serologic testing of S[+]/P[+] (n = 354) vs. S[-]/P[-] (n = 103) individuals found anti-nucleocapsid data had the highest area under the curve (0.87). Based on the 30-day antibody change, 6.9% of S[+]/P[-] individuals demonstrated an increased convalescent antibody signal, although a similar seroresponse in 7.8% of the S[-]/P[-] group was observed. Discussion/Significance of Impact: Reporting respiratory symptoms was common among household contacts with persistent PCR[-] results. Paired serology analyses found similar seroresponses between S[+]/P[-] and S[-]/P[-] individuals. The symptomatic-but-PCR-negative phenomenon, while frequent, is unlikely attributable to true SARS-CoV-2 infections that go missed by PCR.
Only little empirical evidence exists on mental health in LGBTIQ+ refugees. In the present study, trauma exposure, experiences of sexual violence and current treatment needs for physical and mental health were investigated in association with symptoms of anxiety, depression, post-traumatic stress disorder (PTSD) and somatic symptom burden in LGBTIQ+ asylum-seekers resettled in Germany and seeking psychosocial support.
Methods
Data was collected in cooperation with a counselling centre for LGBTIQ+ asylum-seekers between Mai 2018 and March 2024, with a total of 120 completed questionnaires of adult clients. The questionnaire (11 different languages) included sociodemographic and flight-related questions as well as standardized instruments for assessing PTSD (PCL-5), depression (PHQ-9), somatic symptom burden (SSS-8), and anxiety (HSCL-25). Prevalence rates were calculated according to the cut-off scores of each questionnaire. Four logistic regression analyses were conducted to test for potential associations between being screened positive for anxiety, depression, somatic symptom burden or PTSD and the number of traumatic events, experiences of sexual violence as well as current treatment needs for physical and mental health.
Results
The great majority, 74.2% (95% CI: 66–82) of the respondents, screened positive for at least one of the mental disorders investigated, with 45% (95% CI: 36–54) suffering from somatic symptom burden, 44.2% (95% CI: 35–53) from depression, 58.3% (95% CI: 50–67) from PTSD, and 62.5% (95% CI: 54–71) from anxiety; 69.5% participants reported having been exposed to sexual violence. Current treatment needs for physical health problems were reported by 47% and for mental health problems by 56.7%. Participants with experiences of sexual violence were more likely to be screened positive for depression (OR: 6.787, 95% CI: 1.45–31.65) and PTSD (OR: 6.121, 95% CI: 1.34–27.95).
Conclusions
The study provides initial insights on mental health and associated factors in a highly burdened and hard-to-reach population. The findings are important for healthcare systems and political authorities in terms of assuring better protection and healthcare for LGBTIQ+ refugees and asylum-seekers.
Objectives/Goals: The Research Education and Community Health (REACH) coalition proposes to develop the infrastructure for continuous and comprehensive collection of community health data to drive programs, education, and funding priorities across municipal agencies, institutions, and nonprofit organizations in Galveston County. Methods/Study Population: The workgroup through REACH will organize and adopt a comprehensive community health needs assessment that 1) accumulates existing, readily available data for shared use (e.g., Center for Health Care Data at the UT School of Public Health, the Texas Department of State Health Services Center for Health Statistics, and Epic Cosmos, a data aggregation tool, used by UTMB and other health systems to improve patient care); 2) utilizes data collected throughout the community (i.e. non-profits, municipal agencies, and law enforcement); and 3) applies qualitative data from focus groups and/or key informant interviews, so we can hear directly from community members about what their needs are. By doing so, we hope all can benefit from having access to current and relevant data to drive our programs, education, and funding. Results/Anticipated Results: This Community Health Needs Assessment is being coordinated by a diverse workgroup including community organizations, researchers, and policy makers who will benefit from access to current and relevant data. The Galveston Youth Risk Student Survey, completed every three years and most recently in 2024, revealed lingering health and mental health effects of the COVID-19 pandemic on County youth. This highlighted the need for community access to current, accurate, and ongoing data to drive programming, interventions, and education. The REACH Coalition, made up of 23 UTMB Centers and Institutes and 39 community organizations, is spearheading this effort as a part of its mission to facilitate collaborative research, service, and educational efforts. Discussion/Significance of Impact: Collected data will be used to establish and support ongoing, coordinated interventions in response to identified needs. Shared ownership of data and project implementation optimizes resources and reduces gaps and/or redundancy in community programming.
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: This scoping review examines common characteristics of Community Engagement Studios, defined as custom panels bringing together community partners with lived experience around a health issue to provide highly tailored feedback to a research team. The authors also identify health service fields that most commonly use community engagement studios. Methods/Study Population: This scoping review will follow procedures outlined in the Joanna Briggs Institute Manual for Evidence Synthesis. Inclusion criteria are limited to peer reviewed manuscripts published between 2010 and 2024. Key word searches for terms related to Community Engagement Studios will be conducted within Embase, MEDLINE, CINAHL, and Web of Science. Experimental, quasi-experimental, observational studies, process and conceptual manuscripts published in English or Spanish meet inclusion criteria. Two reviewers will reach consensus about article inclusion. Data analysis will include content analysis and descriptive statistics. Results/Anticipated Results: The results for studies that meet inclusion criteria will be summarized through descriptive tables of study characteristics, the number of studies excluded at the full-text review stage, and reasons for the exclusion of any studies that met the initial inclusion criteria. The results will also include a summary of common elements in the design of CE studios, the health disciplines for which CE Studios are most frequently conducted, and the aspect/phase of research design for which CE Studios are most frequently requested. Discussion/Significance of Impact: To date, no work exists examining key elements of Community Engagement Studios and the fields within health services using this valuable research tool. This scoping review is a critical first step to develop guidelines, standards, and best practices around consistent procedures and characteristics to include in the design and conduct of CE Studios.
Objectives/Goals: Clinical trial success requires recruiting and retaining diverse participants. The ER&R Certificate Program trains clinical research professionals (CRPs) in equity, diversity, and inclusion (EDI), addressing biases, and integrating regulatory knowledge with practical skills to foster inclusive research practices. Methods/Study Population: An interdisciplinary Steering Committee, supported by Duke CTSI and DOCR, developed and implemented an engagement, recruitment, and retention certificate program (ER&R) for CRPs. With expert-led instruction, including e-learning, group sessions, and hands-on activities, ER&R integrates EDI into participant engagement practices. Participants complete 7 core courses and at least 3 elective courses, reflecting their unique responsibilities. Program evaluation uses the Kirkpatrick model to assess participant learning, competency, and EDI integration into clinical research. Since launch, the program has expanded to include clinical research trainees from Durham Technical Community College. All elements of the program were designed to allow for sharing across academic medical institutions. Results/Anticipated Results: A total of 202 CRPs and trainees have participated since launch (2020), including 17 trainee participants from Durham Technical Community College (2022–2024). Post-program evaluations showed significant growth in recruitment and retention self-efficacy. An early evaluation of the first 2 cohorts (n = 59) included a self-assessment across defined competencies showing marked increases in comfort across all learning objectives, with notable gains in: Community and Stakeholder Engagement, Recruitment on a Shoestring Budget, Community-Engaged Research Initiatives, and Social Marketing. Participants valued the program’s focus on EDI and sought more practical strategies and peer collaboration. 50 additional institutions have engaged with our implementation consultations and program repository. Discussion/Significance of Impact: Barriers to equitable ER&R exist at the individual, study, and system levels. Addressing these requires more intentional engagement practices. The ER&R certificate program is an innovative model for integrating equity principles with practical and required knowledge and skills training for participant-facing research professionals.
Objectives/Goals: Increasingly, women and people of color are earning PhDs. However, historically underrepresented (HU) degree seekers often follow a “nontraditional” track, pursuing their degree part time, at an older age, and balancing work and family with their studies. Over half of the U.S. PhD students are part time, a feature correlated with candidate diversity. Methods/Study Population: To address this need, the Advancing Diversity and Equity in Pre-doctoral Trainees (ADEPT) program was developed for part-time HU students who do not meet the requirements of the NIH-funded NRSA TL1 program but who offer relevant work and life experience. The program provides individualized navigation and tailored support based on individual student need and career goals, flexible training opportunities, and intentional connections to established, dedicated, and well-trained mentors throughout the predoctoral journey. To better understand their unique needs, we conducted thematic analysis on the notes taken during monthly meetings to explore the challenges our students face and how ADEPT provides support in navigating these challenges. Results/Anticipated Results: Students pursuing a PhD on a part-time basis while balancing other responsibilities, such as caretaking or a full-time job, bring a unique perspective to their graduate education. 5 ADEPT students described how their background or clinical work experience played a crucial role in their decision to pursue a PhD. Themes from the monthly meeting and mentor meeting notes include the challenges of balancing full-time jobs with school, and how they do not experience the cohort effect that a traditional, full-time PhD student would have as a resource. The students reflected on how an individualized culturally sensitive approach was instrumental to their success. Discussion/Significance of Impact: It was initially believed that part-time PhD students were rare. Despite this misconception, we easily recruited students. Students reported their experiences do not reflect the experiences of their full-time peers and their difficulty establishing a peer group, demonstrating the clear need for ADEPT.
Objectives/Goals: To evaluate equity in utilization of free initial health evaluation (IHE) services among members of a limited health care program, the World Trade Center (WTC) Health Program (Program), to inform intervention development and provide insights for similar healthcare programs. Methods/Study Population: We included Program members who newly enrolled during 2012–2022, and who had an IHE or were alive for ≥ 1 year after enrollment. Program administrative and surveillance data collected from January 2012 to February 2024 were used. We evaluated two outcomes: timely IHE utilization (proportion of members completing an IHE within 6 months of enrollment) and any IHE utilization (proportion completing an IHE by February 2024). We described IHE utilization by enrollment year and various members’ characteristics and conducted multivariable logistic regression models to estimate adjusted odds ratios for IHE utilizations to identify factors related to potential inequities for the two member types: Responders, who performed support services, vs. Survivors, who did not respond but were present in the New York disaster area. Results/Anticipated Results: A total of 27,379 Responders and 30,679 Survivors were included. Responders were 89% male, 70% 45–64 years old at enrollment and 76% White. Survivors were 46% female, 54% 45–64 years old at enrollment, and 57% White. Timely IHE utilizations remained relatively stable (~65%) among Responders across time and increased from 16% among Survivors who enrolled in 2017 to 68% among Survivors who enrolled in 2021. Timely IHE utilization was lower for younger members (enrolled Discussion/Significance of Impact: This study highlights Program achievements and gaps in providing equitable IHE services. Strategies to improve members’ equitable IHE utilization can include: adopt/expand flexible scheduling; increase non-English language capacity and cultural competency; and facilitate transportation/assistance for members with accessibility barriers.
Objectives/Goals: To facilitate engagement between university researchers and Appalachian Kentucky communities, the UK Rural Research Hub (RRH) promotes Community Engaged Research (CEnR) and academic–community partnerships that have the greatest potential to conduct impactful research to improve health and reduce regional health disparities. Methods/Study Population: Through the UK RRH, a wealth of expertise and a range of services sustain successful CEnR. Hub coordinators provide research consultations, accelerate researchers’ engagement with the community, and facilitate the success of studies through study coordination, assistance with participant recruitment, data collection and interventions, and through dissemination back to the community. Results/Anticipated Results: UK RRH coordinators have supported numerous studies across the region. For example, RRH staff facilitated recruitment of and collected data from 40 Appalachian caregivers of patients with Alzheimer’s disease and related dementias (ADRD) in a study to improve home environments for patient well-being. The study provided pilot data for a successful K23 application. Other examples of supported research include studies to improve cancer screening uptake, self-management of diabetes, and cardiovascular disease risk reduction, resulting in improved care in the community and often providing pilot data leading to larger national grants. Discussion/Significance of Impact: Research addressing the complex health issues that burden Appalachian Kentucky requires community engagement to be successful. The UK RRH is at the heart of successful CEnR that benefits researchers and communities alike.
Bovine mastitis harms milk quality and cattle health. Val-Pro-Pro (VPP) and Ile-Pro-Pro (IPP) are well-known milk-derived bioactive peptides with anti-inflammatory activity. However, the impact of VPP and IPP on mastitis remain unknown. This study aimed to investigate the anti-inflammatory effects and the underlying mechanisms of VPP and IPP in lipopolysaccharide (LPS)-induced inflammation. When cells were treated with LPS (1 µg/mL) for 24 h, the protein levels of pro-inflammatory factors (tumor necrosis factor-α (TNF-α), interleukin(IL)-1β and IL-6)) and chemokine (monocyte chemotactic protein-1 (MCP-1)) were markedly increased, and the protein level of anti-inflammatory cytokine (IL-10) was reduced. Both VPP and IPP with concentrations of 50 and 100 µM reversed these phenomena and further inhibited the protein expression of β-casein induced by LPS. In a mouse mastitis model, different concentrations of VPP and IPP (300, 600 µM/kg) pretreatment alleviated histopathological lesions in the mammary gland and suppressed the mRNA expression of TNFα, IL1β, and IL6 induced by LPS. VPP and IPP also maintained the integrity of the blood–milk barrier in mice. RNA-seq analyses indicated that enriched phosphatidylinositol 3-kinase/protein kinase B (PI3K/AKT) and mitogen-activated protein kinase (MAPK) signaling pathways likely contribute to the changes observed (P < 0.05 and |log2 fold change (FC)| ≥ 1). Notably, fibronectin was identified as an important hub by protein–protein interaction (PPI) analysis and molecular docking combined with molecular dynamics simulation. In summary, VPP and IPP exerted a protective effect on LPS-induced inflammation by regulating PI3K/AKT signaling pathway via fibronectin.
Objectives/Goals: We assessed the feasibility of using a large language model (LLM) to create lay language descriptions of study protocols for recruitment, which has the potential to improve accessibility and transparency of clinical studies and enable participants to make informed decisions. Methods/Study Population: All studies from a clinical research recruitment platform were included, which features human-written lay descriptions and titles for study recruitment. Corresponding protocol summaries in the IRB system were extracted and translated into lay language using a LLM (gpt-35-turbo-0613). A subset was used to develop prompt variations through an iterative process. Prompt strategies evaluated include chain-of-thought and few-shot prompting techniques. LLM-generated and human-written descriptions were compared for readability using Flesch–Kincaid and Simple Measure of Gobbledygook (SMOG) reading grade levels and information completeness using Word Movers’ Distance (WMD). Results/Anticipated Results: A total of 55 study descriptions were included – 10 were used to develop prompts and 45 were used for evaluation. The final LLM instructions included multistep prompts. The LLM was first instructed to produce a two- to three-sentence long description without using scientific jargon and included two pairs of examples. The LLM was then asked to shorten the description and finally to provide an engaging title. LLM-generated and human-written summaries were similar in length (median (IQR) 328 (278.5–360.5) vs. 342 (203–532.5) characters, respectively). LLM-generated summaries had lower Flesch-Kincaid grade level (5.15 vs. 8.28, p Discussion/Significance of Impact: An LLM can be used to generate lay language summaries that are readable at a lower grade level while maintaining semantic similarity. This approach can be used to improve the drafting of summaries for recruitment, thereby improving accessibility to potential participants. Future work includes human evaluation and implementation into practice.
Objectives/Goals: Electronic health record (EHR)-based recruitment can facilitate participation in clinical trials, but is not a panacea to trial accrual challenges. We conducted a root cause analysis to identify EHR-based accrual barriers and facilitators in a pragmatic randomized trial of metformin for those with prostate cancer and glucose intolerance. Methods/Study Population: We quantitatively analyzed enrollment drop-offs among eligible patients who either did not complete a consent (with analysis of EHR-embedded consent process) or who completed a consent but were not enrolled (with analysis of EHR implementation of a Best Practice Alert). We summarized data from the EHR by eligibility, provider encounters, and alerts, and generated CONSORT diagrams and tables to trace the enrollment pathway. We supplemented quantitative findings with a thematic analysis of semi-structured individual interviews with eligible patients (n = 10) and study providers (n = 4) to identify systematic barriers to recruitment and enrollment of eligible patients. Results/Anticipated Results: CONSORT diagram analysis found that 24% of potentially eligible patients (268 of 1130) had an eligible study encounter but were not enrolled. Additionally, BPAs were not triggering for some eligible patients. Interviews revealed that study providers wanted more detailed information about which study arm their patient would be assigned to, and about next steps after enrollment, especially relating to additional lab tests and follow-up care needed. Patient interviews suggested that patients often did not remember completing the consent process and felt overwhelmed with appointments and information; patients expected providers to actively bring up research opportunities during appointments. Discussion/Significance of Impact: While pragmatic EHR-embedded trials are often characterized as lower-burden, these trials still require active engagement by providers, as well as ongoing attention from both research and informatics teams to ensure that EHR-embedded processes are functioning as designed, and that they are effective in recruiting study participants.