Introduction Neglected tropical diseases (NTDs) in developing countries like the Caribbean, negatively affect multiple income-generating sectors, including the tourism industry upon which island states are highly dependent. Insect-transmitted NTDs include, but are not limited to, malaria, dengue and lymphatic filariasis. Control measures for these disease, are often ignored because of the associated cost. Many of the developing country members are thus retained in a financially crippling cycle, balancing the cost of prophylactic measures with that of controlling an outbreak. The purpose of the paper is to bring awareness to NTDs transmitted by insects of importance to humans, and to assess factors affecting such control, in the English-speaking Caribbean. Method Comprehensive literature review on reports pertaining to NTDs transmitted by insects in the Caribbean and Latin America was conducted. Data search was carried out on PubMed, and WHO and PAHO websites. Results and conclusion Potential risk factors for NTDs transmitted by arthropods in the English-speaking Caribbean are summarised. The mosquito appears to be the main insect-vector of human importance within the region of concern. Arthropod-vectors of diseases of veterinary importance are also relevant because they affect the livelihood of farmers, in highly agriculture based economies. Other NTDs may also be in circulation gauged by the presence of antibodies in Caribbean individuals. However, routine diagnostic tests for specific diseases are expensive and tests may not be conducted when diseases are not prevalent in the population. It appears that only a few English-speaking Caribbean countries have examined secondary reservoirs of pathogens or assessed the effectivity of their insect control methods. As such, disease risk assessment appears incomplete. Although continuous control is financially demanding, an integrated and multisectoral approach might help to deflect the cost. Such interventions are now being promoted by health agencies within the region and various countries are creating and exploring the use of novel tools to be incorporated in their insect-vector control programmes.
The aquaculture industry accounts for nearly half of the world's fish for consumption. To reduce energy expenditures towards reproductive efforts, hatcheries can induce the process of triploidization in their stock (resulting in altered ploidy from 2N to 3N). This process induces an early life stressor at the egg stage, yet can have several benefits (e.g., greater growth potential, producing sterile fish, and lowered aggression), as well as drawbacks (e.g., compromised immune function, increased stress reactions with lowered behavioural/physiological responsiveness, and greater environmental sensitivities). In this study, implementation of probiotic therapy is examined to determine its viability for overcoming drawbacks of triploidization. By adding probiotics into feed, we expect behavioural changes as well as alterations to the gut‐brain axis, which result in further changes in brain function and neural gene expression. Behaviours and neural transcriptomic profiles of hatchery‐reared Chinook salmon (Oncorhynchus tshawytscha) eight months post‐fertilization are examined following a series of behavioural trials, designed to assess the fish's foraging motivation, competitiveness, sensitivity to stress, and behavioural flexibility. Fish from four treatment groups (2N‐regular feed, 2N‐probiotic feed, 3N‐regular feed, and 3N‐probiotic feed; n=90 per treatment) underwent a behavioural assay consisting of an open‐field, novel‐object, predator‐stimulus and mirror tests. Transcriptional profiles of neural tissues will be examined for genes relating to neural functions (i.e., neurogenesis/synaptic plasticity) to mechanistically examine behavioural flexibility, biomarkers for individual level stress response and development (i.e., growth and appetite). Through a behavioural genomics approach, we will be examining transcriptional expression integrated with behavioural profiles, allowing for determining the role of individual transcriptional variation across different behavioural groups. We will be able to determine how ploidy (specifically triploidization) coupled with probiotic therapies affect the gut‐brain axis via behavioural and transcriptional profiles in an economically important fish species. Ultimately, we will determine whether probiotic therapies are effective for future usage in the aquacultural industry.
OBJECTIVES/GOALS: Lack of diversity within clinical trials is well known, but there is little data on the use of investigational products through other pathways, such as expanded access. This project sought to determine the demographic diversity of patients benefiting from expanded access at Michigan Medicine. METHODS/STUDY POPULATION: Previous quality improvement reviews provided the list of 271 patients for whom a single-patient, expanded access request had been approved by the FDA and University of Michigan IRBMED between 2005 and 2021. Demographic information was collected through the EMERSE tool, including age, legal sex, race, ethnicity, and zip code. These data were cross-referenced with available regulatory documentation on product requested, treatment area, and date of request. Descriptive statistics were performed using Excel. RESULTS/ANTICIPATED RESULTS: Patients who were approved to use an investigational product through expanded access at Michigan Medicine showed a wide geographic distribution, including 48 Michigan counties, 20 states, and 1 province. All age groups were served, with those between 30-49 underrepresented and those under 10 and over 60 overrepresented. Race data generally followed the proportions of the Michigan state census, including 76% white and 14% black or African American (expected: 79% and 14%) and 48% female (expected: 50%). On further breakdown, populations differed by specialty and county. DISCUSSION/SIGNIFICANCE: The distribution of Michigan Medicine patients with approved expanded access requests was similar to the population of Michigan with respect to age, sex, and race. Further research is needed to determine if this reflects equitable use or if these results are generalizable to other institutions.
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