Coronary artery compression by a dilated pulmonary artery is a rare complication in patients with tetralogy of Fallot with absent pulmonary valve. We present a case in which this condition manifested at two months of age, with ventricular fibrillation as the initial symptom of myocardial ischaemia. It is important to recognise that this potentially fatal complication can occur in early infancy.

Mental health services in Japan are fully integrated into the broader healthcare system, and patients have access to a wide range of services and specialists. In addition, psychiatry services are part of comprehensive mental healthcare that provides social support to address the whole person's needs. However, there are still challenges in the mental health system in Japan, including overuse of hospital beds and coercive practices such as involuntary admission, restraint and seclusion. This article will explore the current state of mental health services, the challenges the country still faces and the efforts being made to address these challenges.

This paper focuses on people's attitudes towards democracy and authoritarian regimes in Myanmar and whether the extent to which they prefer democracy is moderated by the severity of the coronavirus disease-2019 (COVID-19) pandemic. If people view the authoritarian regime's capacity to take swift action favourably, their opposition to it may be lower. We explored this hypothesis by conducting a survey of 756 individuals in Myanmar in June 2022 that incorporated a vignette experiment. A hypothetical scenario of Myanmar society in 2023 was presented with a two-by-two design – the conditions of the government (election is restored or not) and the pandemic situation (good or bad) were randomly varied, and the respondents were asked to report their favourability of the hypothetical scenario. The results reveal: (1) regardless of the pandemic condition, respondents prefer democracy to authoritarian regimes by a wide margin; and (2) the extent to which democracy is preferred is lower when the COVID-19 condition is more severe. Similar results were obtained from supplementary analyses using a conjoint experiment.

The current study aimed to investigate the effects of ageing on oral immunity using β-defensin (DEFB) 1/2 as a marker and evaluate the effects of curcumin (CUR) on these processes. The study sample included thirty male C57BL/6J mice divided into three groups based on the treatment method used. The young control (YC) and old control (OC) groups received 0·5 % methylcellulose-400 (CUR vehicle) orally for 5 days, whereas the CUR group of older mice received a CUR solution suspended in 0·5 % methylcellulose-400 (dose: 3·0 mg/kg body). DEFB1/2 and immune indicator levels were measured in the saliva and salivary glands post-treatment. The saliva volume and protein content were significantly reduced in the OC group compared with the YC group. CUR administration restored these parameters, decreased DEFB1 expression in the salivary gland and increased DEFB1/2 secretion and DEFB2 expression. These findings were supported by epigenetic gene regulation and partial cytokine activation from changes in WD40 repeat protein 5, TNF alpha and IL-1beta. CUR can partially restore age-related changes in oral immune responses and promote oral health, thereby preventing frailty in the older population through a nutritional therapeutic pathway.

OBJECTIVES/GOALS: Our objective is to develop a Telenephrology dashboard for the 150,000 Veterans that obtain care through the Iowa City Veterans Affairs Health Care System. Our goal is to create a comprehensive and user-friendly tool for monitoring kidney health and facilitating remote nephrology consultations. METHODS/STUDY POPULATION: We structured our intervention according to the five stages of human-centered design: (1) Empathize, (2) Define, (3) Ideate, (4) Prototype and (5) Test. During the empathy stage, the principal investigator spent 10 hours immersed in the clinical setting observing how nephrologists approach a remote nephrology consultation. These observations were augmented by unstructured interviews with clinicians and patients to better understand the process and dynamics. Following this, a rapid ideation workshop was convened to generate creative solutions that balance technical requirements with the needs of clinicians and patients. These led to rapid prototyping and testing to identify what elements of the prototypes worked and which needed improvement. RESULTS/ANTICIPATED RESULTS: Through the empathy and define stages, three needs were identified: (1) clarity in visualizing data, (2) accuracy of information, and (3) balancing standardization with individualization. During the rapid ideation workshop, the concept of a four-frame dashboard was settled upon. This led to the creation of five prototypes, which were tested. These were reconciled and modified to make a final product. This final product, the Telenephrology Dashboard, contains 5 elements that support nephrologists and supporting staff: (1) a graph of kidney function over time, (2) tables synthesizing lab data, (3) options to drill down events to specific times, (4) customization of views, and (5) integration of kidney disease progression models. DISCUSSION/SIGNIFICANCE: A Telenephrology dashboard was created to facilitate remote nephrology consultations through a Human-Centered Design process. Our next steps include determining if this dashboard may improve end-user satisfaction, referring clinician satisfaction, access to specialist care, and patient outcomes.

The dissolution behavior of five noncrystalline oxides, montmorillonite, kaolinite, chlorite, and sepiolite in a basic tiron solution was studied at pH 10.5 and 80°C. The results show that for montmorillonite the concentrations of Al and Fe ions dissolved in the treating solution were diminished because of cation-exchange reactions of the sample in the suspension. To explain these observations, a mass-balance equation for the specified cation in solution was formulated, which consisted of both a dissolution term and an ion-exchange term. The several parameters of this differential equation were fitted to allow the calculated results to represent the experimental findings. Using these values, an equation lacking an ion-exchange term was also solved numerically. Thus, a dissolution curve was described, which would have been obtained had no cation exchange taken place. From these equations, the error resulted from the cation-exchange capacity of samples in chemical dissolution methods can be evaluated. According to this estimation, and assuming the value for a 1-hr treatment, an error of about 15% was determined for the amount of noncrystalline components contained in the specimen in this investigation.

Monitoring herbicide-resistant weeds makes it possible to study the evolution and spread of resistance, which provides important information for their management. The objective of this study was to map fleabane accessions in the states of Paraná (PR) and Mato Grosso do Sul (MS), Brazil, to identify herbicide-resistant accessions and their response to soybean preplant chemical burndown management strategies. Fleabane seeds were collected in agricultural areas in PR and MS in 2018, 2019, and 2020. Initial screening was performed for glyphosate, chlorimuron, paraquat, 2,4-D, saflufenacil, and glufosinate efficacy. Subsequently, dose-response experiments were conducted. Field experiments were carried out in three locations, where accessions of multiple herbicide–resistant Sumatran fleabane were identified. Herbicides were used in single or sequential applications at three plant heights (<5 cm, 5 to 10 cm, and >10 cm). After preliminary screening, accessions were classified as putative resistant (<80% control for all four replicates), segregated (<80% control for one to three replicates), or susceptible (>80% control for all four replicates). There was no evidence of resistance to glufosinate or saflufenacil in any of the 461 accessions, while 65 demonstrated possible resistance or segregation to glyphosate only, 235 to glyphosate + chlorimuron, 79 to glyphosate + chlorimuron + paraquat, 59 to glyphosate + chlorimuron + 2,4-D, and 23 with four-way resistance (glyphosate, chlorimuron, paraquat, and 2,4-D). Of these 23 accessions, seven were analyzed using dose-response curves (F2 generation), all from PR, confirming four-way resistance to glyphosate, chlorimuron, paraquat, and 2,4-D. To control resistant Sumatran fleabane, an application should prioritize smaller plants. Despite resistance to 2,4-D, double mixtures containing this herbicide were among the most effective treatments in plants <5 cm in height. If a sequential application is needed for plants >5 cm in height, we recommend glyphosate + synthetic auxin followed by glufosinate or glyphosate + saflufenacil.

Smectites synthesized from experiments at 5.5 GPa and 1500°C are of high quality, crystals are large at >10 μm, and the 2:1 layers may have a homogeneous charge distribution. Smectite was exchanged with various cations (Na+, Li+, K+, Ca2+, and Mg2+) and the hydration behavior of each sample was observed by an in situ powder X-ray diffraction method under precisely controlled relative humidity (RH). The smectite showed distinct stepwise (discontinuous) hydration versus RH. During the transition between two hydration states, the coexistence of the two states was observed. Randomly interstratified structures with one and two planes of H2O are time-dependent phenomena and relate to hydration and dehydration processes.

The effect of cooling rate on the formation of smectite crystals with high crystallinity was investigated using two different types of high-pressure and high-temperature apparatus, a modified belt type and a uniaxial split-sphere type. The cooling rate was changed after a treatment of the sample at 5.5 GPa and 1500°C. Smectite crystals were obtained at faster cooling rate, coexisting with coesite, kyanite, jadeite, corundum and/or glass. In the slowly cooled process, no smectite crystals were obtained but coesite, kyanite, jadeite and clinoenstatite were formed. These results indicate that smectite crystals are formed metastably during the quenching of the high-pressure and high-temperature hydrous silicate melt.

Hydration behavior of Na-smectite crystals synthesized at a pressure of 5.5 GPa and temperatures of 1400°–1500°C was examined by X-ray powder diffraction at various relative humidities (RH) in the range of 0–100%. The basal spacing of the Na-smectite crystal increased stepwise with increase in RH. The reflections observed were only normal reflections of a single or dual hydration states of smectite. No irrational, intermediate, or asymmetrical reflections were observed. The simple hydration behavior, not known for natural smectite with fine particle sizes and low crystallinity, indicates that the Na-smectite crystals are as perfect as common inorganic crystals with an ordered structure.

Smectite single crystals of superior quality were synthesized at high pressures and temperatures using a modified belt type high pressure apparatus. Pressure-temperature conditions were established for smectite formation by quenching experiments in the pressure range from 2–5.5 GPa and temperatures of 700°–1000°C. Smectite crystals with extraordinary quality were formed beyond 3 GPa and 1000°C with coexisting phases of coesite, kyanite, jadeite, and in some cases with mica and glass. Smectite was confirmed from the XRD taken after intercalation of ethylene glycol. The smectite crystals were considered to be quenched crystals metastably from the hydrous silicate melts formed at high pressures and temperatures.

Transformation of montmorillonite was experimentally investigated using a model system of montmorillonite-alanine at 100 MPa and up to 500°C. Sodium-montmorillonite changed to a mixed layer mineral of sodium- and ammoniumn-montmorillonites (Na/NH4-Mnt) in the temperature range from 150 to 400°C. Ammonium ions were the decomposition product of alanine above 150°C. The Na/NH4-Mnt transformed to regularly and randomly interstratified minerals of NH4-montmorillonite and NH4-mica (o. NH4-Mnt/NH4-Mic and d. NH4-Mnt/NH4-Mic) at 400°C. These mixed layered minerals transformed to ammonium-mica at 500°C. Ammonium-analcime appeared and coexisted with the smectites at temperatures over 200°C, and with albite for those over 400°C.

In comparison with the results of previous experiments in which there was no organic component, the present results revealed that (1) some uncommon mineral phases appeared by replacement of sodium ions in montmorillonite with ammonium ions, i.e., NH4-Mic, o. and d. NH4-Mnts, o. and d. NH4-Mnt/NH4-Mics, and (2) ammonium-analcime appeared. The mineral assemblages and alteration sequences correspond better with those observed in the natural system than those known from experimental results in aluminosilicate-water system.

A glass in the intermediate composition of montmorillonite and beidellite, 50/50 in mole ratio, was treated under a hydrothermal pressure of 100 MPa, in the temperature range from 250 to 500°C and durations from 2 to 129 days. The phases identified in the products were plotted in a time-temperature-transformation (TTT) diagram. The TTT diagram showed that the regularly interstratified montmorillonite-beidellite (r.i.M-B) was a metastable phase above the temperature of 350°C and changed to the assemblage of Na-rectorite + saponite + quartz, through the intermediate assemblage of beidellite + saponite + quartz. The TTT diagram suggested also that the r.i.M-B might be a stable clay mineral below the temperature of 300°C in the middle region of montmorillonite-beidellite pseudo-binary system, although the laboratory confirmation of the mineral stability was not easy for the sluggish reaction.

A series of hydrothermal experiments were performed to determine the phase relations on the beidellite-saponite pseudo-binary join. Quenched glasses with stoichiometric dehydrated compositions of an Na-rich smectite on the join were heated at 250–500°C for durations of 1–151 d at 100 MPa. Time-temperature diagrams showed that immiscibility occurs between dioctahedral smectite (beidellite) and trioctahedral smectite (saponite) below 400°C. Thus, smectite with intermediate chemical composition was considered as metastable in this system. Above 400°C the assemblage of regularly interstratified saponite-chlorite, quartz, and feldspar was recognized in the intermediate chemical compositional region of this join. On the beidellite side of this join, beidellite and mixed-layer phases of smectite and a regular interstratification of montmorillonite-beidellite, are possible phases that occur at <300°C. They readily reacted to form a mixture of dioctahedral rectorite plus quartz at 300°C. This assemblage then reacted to a dioctahedral “mica”, which can expand with glycol and quartz. On the saponite side of this join, a single phase, saponite, existed at <400°C, and transformed to saponite plus trioctahedral rectorite with aging and increasing temperature of synthesis. The alteration was affected strongly by the chemical composition of the binary system.

Maternal prenatal and postnatal psychological distress, including depression and anxiety, may affect children’s cognitive development. However, the findings have been inconsistent. We aimed to use the dataset from the Japan Environment and Children’s Study, a nationwide prospective birth cohort study, to examine this association. We evaluated the relationship between the maternal six-item version of the Kessler Psychological Distress Scale (K6) scores and cognitive development among children aged 4 years. K6 was administered twice during pregnancy (M-T1; first half of pregnancy, M-T2; second half of pregnancy) and 1 year postpartum (C-1y). Cognitive development was assessed by trained testers, using the Kyoto Scale of Psychological Development 2001. Multiple regression analysis was performed with the group with a K6 score ≤ 4 for both M-T1 and M-T2 and C-1y as a reference. Records from 1,630 boys and 1,657 girls were analyzed. In the group with K6 scores ≥ 5 in both M-T1 and M-T2 and C-1Y groups, boys had significantly lower developmental quotients (DQ) in the language-social developmental (L-S) area (partial regression coefficient: −4.09, 95% confidence interval: −6.88 – −1.31), while girls did not differ significantly in DQ for the L-S area. Among boys and girls, those with K6 scores ≤ 4 at any one or two periods during M-T1, M-T2, or C-1y did not have significantly lower DQ for the L-S area. Persistent maternal psychological distress from the first half of pregnancy to 1 year postpartum had a disadvantageous association with verbal cognitive development in boys, but not in girls aged 4 years.

Citrate is distributed widely in the Earth’s surface environments as a biological product released by microbes and plants. Citrate is also often used as a chelating agent for the selective dissolution of iron coatings and free iron oxides in soils. Adsorption experiments of Cs+ and IO3− before and after the complexation of citrate with the pseudoboehmite surface were conducted to evaluate the effects of citrate on the adsorption of these ions on the surface of pseudoboehmite. Additional adsorption experiments of Cs+ and IO3− after the decomposition of citrate adsorbed on the pseudoboehmite surface were also performed to confirm the recovery of the original surface properties. Citrate decomposition was carried out by means of 10% H2O2 treatments at 75°C and pH 5, 7, and 9. The results indicated that citrate complexation decreased remarkably the adsorption of both Cs+ and IO3− in the pH range 3–10, which was due to a decrease in the number of active charged sites available for adsorption of these ions. Decomposition of citrate adsorbed on the pseudoboehmite surface was found to be complete after three rounds of treatment with 10% H2O2 at 75°C and pH > 7. After the decomposition of citrate adsorbed on the pseudoboehmite surface, the adsorption of both Cs+ and IO3− was restored completely to the initial amounts before citrate complexation, and the inhibition effect of citrate on the adsorption of these ions disappeared under all pH conditions.