The anterior segment of the vertebrate eye includes the cornea, iris, ciliary body, trabecular meshwork, and lens. Although malformations of these structures have been implicated in many human eye diseases, little is known about the molecular mechanisms that control their development. To identify genes involved in anterior segment formation, we developed a large-scale in situ hybridization screen and examined the spatial and temporal expression of over 1000 genes during eye development. This screen identified 62 genes with distinct expression patterns in specific eye structures, including several expressed in novel patterns in the anterior segment. Using these genes as developmental markers, we tested for the presence of inductive signals that control the differentiation of anterior segment tissues. Organ culture recombination experiments showed that a chick lens is capable of inducing the expression of markers of the presumptive iris and ciliary body in the developing mouse neural retina. The inducing activity from the lens acts only over short ranges and is present at multiple stages of eye development. These studies provide molecular evidence that an evolutionarily conserved signal from the lens controls tissue specification in the developing optic cup.

Objective To reduce pathogen exposure, conserve personal protective equipment, and facilitate health care personnel work participation in the setting of the COVID-19 pandemic, three affiliated institutions rapidly and independently deployed inpatient telemedicine programs during March 2020. We describe key features and early learnings of these programs in the hospital setting. Methods Relevant clinical and operational leadership from an academic medical center, pediatric teaching hospital, and safety net county health system met to share learnings shortly after deploying inpatient telemedicine. A summative analysis of their learnings was re-circulated for approval. Results All three institutions faced pressure to urgently standup new telemedicine systems while still maintaining secure information exchange. Differences across patient demographics and technological capabilities led to variation in solution design, though key technical considerations were similar. Rapid deployment in each system relied on readily available consumer-grade technology, given the existing familiarity to patients and clinicians and minimal infrastructure investment. Preliminary data from the academic medical center over one month suggested positive adoption with 631 inpatient video calls lasting an average (standard deviation) of 16.5 minutes (19.6) based on inclusion criteria. Discussion The threat of an imminent surge of COVID-19 patients drove three institutions to rapidly develop inpatient telemedicine solutions. Concurrently, federal and state regulators temporarily relaxed restrictions that would have previously limited these efforts. Strategic direction from executive leadership, leveraging off-the-shelf hardware, vendor engagement, and clinical workflow integration facilitated rapid deployment. Conclusion The rapid deployment of inpatient telemedicine is feasible across diverse settings as a response to the COVID-19 pandemic.

(PACE 2005; 28:1189-1197 ventricular arrhythmias, sudden cardiac death, T-wave alternans, premature ventricular contraction, electrophysiologic study, autonomic tone

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RATIONALE: Inaccurate beta-lactam allergy (BLA) labeling is associated with worse clinical outcomes due to over-avoidance of beta-lactam antibiotics. Although BLA de-labeling with penicillin skin testing (PST) can increase beta-lactam use, it is not readily available at many hospitals. There is a need to assess beta-lactam administration patterns at hospitals without readily available PST to identify potential areas for improvement. METHODS: Admission records of 282 patients with listed BLA who required antibiotics during hospitalization between June 2017 and July 2018 at a safety-net hospital with limited access to inpatient PST were reviewed retrospectively. RESULTS: Full doses of beta-lactams were administered without reaction in 73.0% [157/215] of patients with documented penicillin allergy (PA). Penicillin antibiotics were administered in 15.8% [34/215], 1st-generation cephalosporins in 11.6% [25/215], 2nd-generation cephalosporins in 0% [0/215], 3rd-generation cephalosporins in 26.5% [57/215], and 4th-generation cephalosporins in 20.0% [43/215]. The 34 patients who received penicillin antibiotics had the following documented reactions: other 50.0% [17/34], hives 17.6% [6/34], rash 17.6% [6/34], anaphylaxis 5.9% [2/34], shortness of breath and swelling 2.9% [1/34], not documented 2.9% [1/34], and fatigue 2.9% [1/34]. Conversely, of 13 patients with documented allergy to 3rd/4th/5th-generation cephalosporins, 38.5% [5/13] received full doses of a penicillin antibiotic without reaction.CONCLUSIONS: Beta-lactam administration was higher than expected, with full doses of penicillin and cephalosporin antibiotics administered without reaction in many patients with documented PA, including patients with documented penicillin anaphylaxis. Further investigation is needed into provider beliefs surrounding BLA cross-reactivity and the role of PST at this hospital, and their impact on beta-lactam administration practices. Abstracts AB31 SATURDAY