ABSTRACT IMPACT: By identifying clear gaps in our knowledge of racial and ethnic disparities in antibiotic-resistant infections, this research is informing the design of (a) community-based interventions and (b) patient-centered research studies that we are currently leading to address these disparities and improve human health. OBJECTIVES/GOALS: Antibiotic resistance (AR) is widely considered to be the next global pandemic. As with COVID-19, the potential for AR to disproportionately impact racial/ethnic minorities is a major concern. Our goal was to identify gaps in knowledge of AR disparities in order to inform the types of interventions that might be most appropriate to address this. METHODS/STUDY POPULATION: We reviewed the literature to examine evidence of racial/ethnic disparities in (a) infections with the most concerning drug-resistant bacteria in the United States, and (b) underlying social-economic or behavioral factors that could contribute to such infections. We searched PubMed and Google Scholar to identify studies published in English between August 1973 - August 2020. We used keywords that included: antibiotic resistance, antibiotic-resistant infections, antibiotic-seeking behavior, prescription/non-prescription antibiotic use, antibiotic education, or health literacy AND race, ethnicity, or socioeconomic status. We screened all abstracts to identify US-based studies that assessed (a) or (b) above. RESULTS/ANTICIPATED RESULTS: We identified 11 studies investigating racial/ethnic disparities for 5 of the 17 drug-resistant bacteria flagged in the CDC’s 2019 Antibiotic Resistance Threats Report. Black, Hispanic, and lower-income individuals were found to be at higher risk of some community-acquired antibiotic-resistant infections. We identified multiple factors that may contribute to disparities in AR-related morbidity and mortality, including reported differences in antibiotic use, higher likelihood of living in crowded/multigenerational homes, more frequent employment in potentially high exposure settings (e.g. slaughterhouses), lower health literacy, and more frequent underlying comorbidities, which increases risks for hospitalization and subsequent acquisition of drug-resistant infections. DISCUSSION/SIGNIFICANCE OF FINDINGS: Given the small number of studies on this topic, educational interventions that aim to raise awareness of this issue must target not only the public but also researchers. Community-based interventions that seek to address disparities in ‘antibiotic resistance literacy’ among minority and underserved groups could be particularly impactful.

As COVID-19 accelerated through spring of 2020 the question became how will schools cope with protracted closure?Devising strategies to engage and educate students through full-time, online learning became a priority.At Tufts CSE we specialize in creating high school biomedical science curricula that foster engagement with science and build scientific and health literacy, however our popular 'Great Diseases' curricula is wholly classroom-based.In response our scientist/teacher co-design team created a new, fully online curriculum: 'The Great Pandemic of 2020'.The materials are targeted to 10th -12th grades and use student-centered and self-paced approaches to learning.It retains our signature format with multiple pedagogical approaches, and extensive scientific reading and math while focusing on both the underlying science and public health measures needed to mitigate COVID-19.Here we describe how we created the curriculum and the challenges we encountered: Which emerging information is reliable?Which topics do we select and how do we keep them current?What constitutes an engaging, effective and seamless online learning experience?How can teachers monitor and assess student work?How can we instill confidence to use the curriculum when teachers may lack the basic information underlying it?How can we evaluate and disseminate it effectively?We also discuss lessons learned in the context of teaching about 21st century biomedical science, and the growing acknowledgement by teachers and students that it is encroaching constantly on daily life.

To broaden participation in science, technology, engineering, and math (STEM), we must understand the factors that shape perspectives and beliefs around career selection. Good measurement of these factors is crucial to quantify how effectively educational interventions impact student attitudes towards STEM. Adolescents are particularly suited for quantifying intervention efficacy because students build their identities during these formative years and make important career choices. To better quantify intervention efficacy at the high school level, we developed an instrument entitled Student Attitudes Surrounding STEM (SASS), which builds upon the social cognitive career theory (SCCT) framework for understanding career selection. Questionnaire responses were collected from 932 high school students and split into samples of 400 for exploratory factor analysis and 532 for confirmatory factor analysis. The 37 questions clustered into six factors: Self-Efficacy-Experience, Self-Efficacy-Academic, Outcome Expectations, Interests, Negative Perceptions of Scientists, and Career Awareness. Adequate construct validity for the factors indicated in the SASS model was suggested by the fit indices and theoretical considerations. Furthermore, the analyses supported criterion validity, internal consistency, and test-retest reliability. This tool represents a novel integration of three latent variables into SCCT: Negative Perceptions of Scientists, Career Awareness, and an experience factor for Self-Efficacy.

: This short paper describes BioScann, a high school STEM inquiry curriculum that uses a CSCL environment to support an interrupted case studies (ICS) method. This technology-enhanced curriculum supports autonomous, sustained student engagement, scientific argumentation, conceptual understanding, and the development of student self-efficacy and career awareness. The BioScann technology platform scaffolds student activities, collects student artifacts, and helps the teacher advance the curriculum through various stages. We discuss how our designs were improved across multiple pilot studies, including two major versions of the curriculum and technology. Each new pilot allowed us to improve the materials and technology environment, as well as student engagement, career awareness, and collaborative data-based decision-making.

OBJECTIVE:To determine the efficacy of a high school biology curriculum focused on promoting nutrition literacy skills.DESIGN:High school students participated in a six-week biology curriculum focused on the three subdomains of nutrition literacy: functional use of factual knowledge (FNL); interactive skills in seeking out information (INL); critical interpretation and analysis (CNL). We used a mixed-methods, change-over-time model that leverages longitudinal aspects of instructor practice and students' development. Pre- and posttest measures of FNL, INL and CNL were administered. Students were also given a retrospective pre-post online survey to measure interactive nutrition literacy and self-efficacy towards learning about nutrition topics.PARTICIPANTS:A total of 111 high school 11th and 12th grade students from four sections of a Biology II course participated.RESULTS:Students' overall NL scores improved (P<0.0001) and they also showed gains in each subdomain (FNL, INL and CNL, P<0.0001). Self-efficacy toward learning about nutrition also increased (P<0.0001). Students reported increased communication about the topics with family and peers who were neither classmates or friends (P<0.0001).CONCLUSIONS:Participation improved nutrition literacy in each of the subdomains, as well as self-efficacy. Self-efficacy was strongly related to increased communication.

Objective:The objective of this 9-mo quasiexperimental study was to examine the impact of gain-and loss-framed messages on nutrition and physical activity (PA) knowledge in 4thgrade students participating in the Shaping Healthy Choices Program (SHCP), a multicomponent nutrition program.Methods: Eight 4th-grade classrooms participating in the University of California CalFresh Nutrition Education Program were recruited and divided into 1 of 3 groups: 1) no messages (2 classrooms, n = 50); 2) loss-framed messages (3 classrooms, n = 76); and 3) gain-framed messages (3 classrooms, n = 67).Students participated in the SHCP and received accelerometers to sync on a tablet in the classroom to view their activity.The gain-and loss-framed groups also viewed a health message on the tablet.Analyses were conducted on data from students who completed both pre-and post-tests.For all outcomes, means and SDs for each group were calculated, and distributions were examined for normality.Change in outcomes was calculated by subtracting pre-from post-scores.Analyses were conducted with STATA 14.0.Paired t tests, ANOVA, and Bonferroni for multiple comparisons were used.Results: Students who participated in the SHCP improved nutrition knowledge in the no message group (+1.3 points, P = 0.04), the loss-framed group (+1.9 points, P = 0.01), and the gain-framed group (+2.6 points, P = 0.01).Improvements in PA knowledge were also demonstrated in the no message group (+1.6 points, P < 0.01), the loss-framed group (+1.3 points, P < 0.01), and the gain-framed group (+2.5 points, P = 0.01).Students who received gain-framed messages significantly improved PA knowledge as compared with students who received loss-framed messages (+1.2 point difference, P = 0.04).Students in the loss-framed group reported a decrease in self-efficacy from pre-to post-test (-1.2, P = 0.05), although this was not observed in the other groups.Conclusions: These results show that the SHCP improves nutrition and PA knowledge, and the positive reinforcement further strengthens some of these improvements, whereas loss-framed messaging can contribute to undesirable outcomes, such as reduced self-efficacy.Incorporating positive reinforcement through gain-framed messages can be a relatively low-cost avenue for supporting beneficial outcomes.

Effective science teaching critically requires content focused professional development (PD), particularly in life sciences where content evolves rapidly. How subject matter knowledge related to teaching (SCK) is most effectively incorporated into PD has not been investigated. We studied how a professional learning community of high school teachers and scientists co-designing a bioscience curriculum produced the accompanying SCK-focused PD. SCK was level-specific but teachers could not generate it alone. Co-designing SCK with scientists was valuable to teachers, as evidenced by significant increases in their cognitive and attitudinal attributes toward the PD, in turn promoting change in practice and student learning gains, both within and outside the initial partnership. Surprisingly, social network analysis of how the collaborators interacted revealed that though the network was cognitively and effectively robust, it was behaviorally much sparser than anticipated for such a high functioning partnership, counter to commonly accepted PD best practices. We suggest that the scientist/educator facilitators who intentionally promoted collaboration in the context of distributed leadership were able to eliminate extraneous interactions, optimizing the process. The results are further evidence that developing content-focused PD relevant to 21st century life sciences requires dismantling the institutionalized segregation between practitioners of science and teaching.

This study reports the secondary analysis of evaluation data from an innovative high school biology curriculum focused on infectious disease (ID) to examine the health literacy implications of teaching claims evaluation, data interpretation, and risk assessment skills in the context of 21st-Century health science. The curriculum was implemented between 2010 and 2013 in Biology II classes held in four public high schools (three in Massachusetts and one in Ohio), plus a private school in Virginia. A quasi-experimental design was used in which student participants (n = 273) were compared to an age-matched, nonparticipant, peer group (N = 125). Participants in each school setting demonstrated increases in conceptual content knowledge (Cohen's d > 1.89) as well as in understanding how to apply scientific principles to health claims evaluation and risk assessment (Cohen's d > 1.76) and in self-efficacy toward learning about ID (Cohen's d > 2.27). Participants also displayed enhanced communication about ID within their social networks relative to the comparison group (p < .05). The data show that integrating the claims evaluation, data interpretation, and risk assessment skills critical for 21st-century health literacy health into high school biology classrooms is effective at fostering both the skills and self-efficacy pertinent to health literacy learning in diverse populations.

Young scientists know that being competitive in the job market requires skills and experience beyond the bench. Given the overproduction of biomedical scientists with PhDs relative to the number of openings for secure academic positions, it is critical that young scientists acquire broad skill sets. Participating in curriculum design partnerships with teachers offers scientists a novel career opportunity. Our collaborative curriculum development team of biomedical scientists has partnered with teachers to build inquiry‐based biomedical curricula focused on “Great Diseases” that impact global health (Infectious Disease, Neurological Disorders, Metabolic Disease and Cancer), and now the scientists are also leading dissemination of the curricula in classrooms nationwide. Teachers often feel unprepared to lead students in formulating questions, designing experiments and interpreting data, a major obstacle to implementation of curricula with novel scientific content or authentic science practice. Interacting directly with scientists helps solve this problem. Scientists work with teachers via one‐on‐one virtual meetings, during which the biomedical scientist offers the teacher structured real‐time mentoring in content and helps devise strategies to implement the material in the classroom, at the same time augmenting their knowledge of effective teaching methods. We have found that when teachers participate in structured mentoring their ability to teach about cutting‐edge biomedical science improves, which is passed on to the high school students, the ultimate beneficiaries.Funded through: NIH Grant: R25OD010953‐04, gift from Boston Scientific and Cubist Pharmaceuticals Grant

This small-scale comparison case study evaluates the impact of an innovative approach to teacher professional development designed to promote implementation of a novel cutting edge high school neurological disorders curriculum. ‘Modeling for Fidelity’ (MFF) centers on an extended mentor relationship between teachers and biomedical scientists carried out in a virtual format in conjunction with extensive online educative materials. Four teachers from different diverse high schools in Massachusetts and Ohio who experienced MFF contextualized to a 6-week Neurological Disorders curriculum with the same science mentor were compared to a teacher who had experienced an intensive in-person professional development contextualized to the same curriculum with the same mentor. Fidelity of implementation was measured directly using an established metric and indirectly via student performance. The results show that teachers valued MFF, particularly the mentor relationship and were able to use it effectively to ensure critical components of the learning objectives were preserved. Moreover their students performed equivalently to those whose teacher had experienced intensive in-person professional development. Participants in all school settings demonstrated large (Cohen's d>2.0) and significant (p<0.0001 per-post) changes in conceptual knowledge as well as self-efficacy towards learning about neurological disorders (Cohen's d>1.5, p<0.0001 pre-post). The data demonstrates that the virtual mentorship format in conjunction with extensive online educative materials is an effective method of developing extended interactions between biomedical scientists and teachers that are scalable and not geographically constrained, facilitating teacher implementation of novel cutting-edge curricula.

In his News & Analysis story “Educators, lawmakers question proposed reorganization” (14 June, p. [1274][1]), J. Mervis discusses our efforts to prevent an end to funding for the Science Education Partnership Award (SEPA) program. The tiny SEPA program and its smaller siblings at the National

Medical schools, although the gatekeepers of much biomedical education and research, rarely engage formally with K-12 educators to influence curriculum content or professional development. This segregation of content experts from teachers creates a knowledge gap that limits inclusion of current biomedical science into high school curricula, affecting both public health literacy and the biomedical pipeline. The authors describe how, in 2009, scientists from Tufts Medical School and Boston public school teachers established a partnership of formal scholarly dialogue to create 11th- to 12th-grade high school curricula about critical health-related concepts, with the goal of increasing scientific literacy and influencing health-related decisions. The curricula are based on the great diseases (infectious diseases, neurological disorders, metabolic disease, and cancer). Unlike most health science curricular interventions that provide circumscribed activities, the curricula are comprehensive, each filling one full term of in-class learning and providing extensive real-time support for the teacher.In this article, the authors describe how they developed and implemented the infectious disease curriculum, and its impacts. The high school teachers and students showed robust gains in content knowledge and critical thinking skills, whereas the Tufts scientists increased their pedagogical knowledge and appreciation for health-related science communication. The results show how formal interactions between medical schools and K-12 educators can be mutually beneficial.

Infection with the trematode parasite Schistosoma mansoni results in distinct heterogeneity of disease severity both in humans and in mice. In the experimental mouse model, severe disease is characterized by pronounced hepatic egg-induced granulomatous inflammation mediated by CD4 Th17 cells, whereas mild disease is associated with reduced hepatic inflammation in a Th2-skewed cytokine environment. Even though the host’s genetic background significantly impacts the clinical outcome of schistosomiasis, specific gene(s) that contribute to disease severity remain elusive. We investigated the schistosome infection in wild-derived mice, which possess a more diverse gene pool than classically inbred mouse strains and thus makes them more likely to reveal novel mechanisms of immune regulation. We now show that inbred wild-derived MOLF mice develop severe hepatic inflammation with high levels of IL-17. Congenic mice with a MOLF locus in chromosome 6, designated Why1, revealed high pathology and enabled the identification of Irak2 as the pathogenic gene. Although IRAK-2 is classically associated with TLR signaling, adoptive transfer of CD4 T cells revealed that IRAK-2 mediates pathology in a CD4 T cell specific manner by promoting Th17 cell development through enhancement of IL-1β-induced activation of transcription factors RORγt and BATF. The use of wild-derived mice unravels IRAK-2 as a novel regulator of IL-1-induced pathogenic Th17 cells in schistosomiasis, which likely has wide-ranging implications for other chronic inflammatory and autoimmune diseases.

The vertebrate immune system has evolved to recognize nucleic acids of bacterial and viral origin. Microbial DNA, as well as synthetic oligonucleotides based on these motifs, activates innate immune pathways mediated by the family of Toll-like receptors (TLR) initiating a cascade of signals in immune cells necessary for responses to pathogens. However, not all of the proteins that participate in TLR-mediated responses have been identified. In studies described herein, we observed significant variation in innate immune responses among selected wild-derived strains of mice. Specifically, we show that mice of MOLF/Ei, Czech/Ei, and MSM/Ms strains are hypo-responsive to polyinosinic-polycytidylic acid (poly(I:C)) because of a mutation in Tlr3. In addition, we discovered a hypo-response to cytosine guanine dinucleotide in MOLF/Ei mice and established that it is not linked to Tlr9, but to another locus. Further inquiry revealed that this hypo-response is transmitted as a monogenic dominant trait that can be mapped and cloned through positional cloning methods. These results suggest the existence of a novel molecule that can alter pro-inflammatory signals or activate additional signal transduction pathways. In addition, they support the wild-derived mouse strain as a forward genetic tool for the identification of novel immunological phenotypes.

Despite significant progress in understanding the origin of soluble CD14 (sCD14), its physiological function remains largely unknown. Recent research has produced contradictory observations suggesting that sCD14 may have either beneficial or detrimental properties in protection against LPS-induced endotoxin shock. To resolve this controversy and to establish a mouse model suitable for elucidation of the functions of human CD14 (hCD14) in vivo, we generated several lines of transgenic mice bearing different copy numbers of the hCd14 transgene on a murine Cd14(-/-) background. The hCD14 was entirely capable of complementing loss of mouse CD14 to mediate cellular responses to LPS. Serum levels of sCD14 in a founder with multiple copies of the transgene were several times higher than in transgenic animals with a single copy of Cd14. Furthermore, mice with high levels of hCD14 were hypo-responsive to LPS and survived a lethal dose of LPS. Further inquiry into the mechanism of the hypo-response to LPS revealed that protection is associated with the higher amounts of circulating LPS. Most of this circulating LPS can be immunoprecipitated with anti-CD14 antibodies. These results suggest that sCD14 blocks circulating LPS by limiting the amount of monocyte-bound LPS and thus reduces inflammatory responses.