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OBJECTIVES/GOALS: We sought to examine: 1) variability in center acceptance patterns for heart allografts offered to the highest-priority candidates, 2) impact of this acceptance behavior on candidate survival, and 3) post-transplantation outcomes in candidates who accepted first rank offer vs. previously declined offer. METHODS/STUDY POPULATION: In this retrospective cohort study, the US national transplant registry was queried for all match runs of adult candidates listed for isolated heart transplantation between 2007-2017. We examined center acceptance rates for heart allografts offered to the highest-priority candidates and accounted for covariates in multivariable logistic regression. Competing risks analysis was performed to assess the relationship between center acceptance rate and waitlist mortality. Post-transplantation outcomes (patient survival and graft failure) between candidates who accepted their first-rank offers vs those who accepted previously declined offers were compared using Fine-Gray subdistribution hazards model. RESULTS/ANTICIPATED RESULTS: Among 19,703 unique organ offers, 6,302 (32%) were accepted for first-ranked candidates. After adjustment for donor, recipient, and geographic covariates, transplant centers varied markedly in acceptance rates (12%-62%) of offers made to first-ranked candidates. Lowest acceptance rate centers (<25%) associated with highest cumulative incidence of waitlist mortality. For every 10% increase in adjusted center acceptance rate, waitlist mortality risk decreased by 27% (SHR 0.73, 95% CI 0.67-0.80). No significant difference was observed in 5-year adjusted post-Tx survival and graft failure between hearts accepted at the first-rank vs lower-rank positions. DISCUSSION/SIGNIFICANCE OF IMPACT: Wide variability in heart acceptance rates exists among centers, with candidates listed at low acceptance rate centers more likely to die waiting. Similar post-Tx survival suggests previously declined allografts function as well as those accepted at first offer. Center-level decision is a modifiable behavior associated with waitlist mortality.
Minor motor and sensory deficits or neurological soft signs (NSS) are frequently found in individuals suffering from schizophrenia at any stage of their illness. The basal ganglia and the thalamus are accepted as being important for both motor control and integration of sensory input. However, whether NSS are related to structural alterations of these brain regions remains controversial.
20 patients with a first-episode psychosis were investigated using high-resolution magnetic resonance imaging (MRI) at 3 Tesla. NSS were examined on the Heidelberg Scale after remission of acute symptoms and correlated with volume and shape of striatum, pallidum and thalamus by using sophisticated MRI analyses, namely VBM-DARTEL (volume) and FSL-FIRST (shape).
Results NSS scores in patients with schizophrenia were significantly associated with volumetric changes and surface alterations in all investigated areas. Associations remained significant when controlling for age, gender, education, medication and intracranial volume.
Our findings lend further support for an involvement of the basal ganglia and the thalamus in NSS.
Minor motor and sensory deficits or neurological soft signs (NSS) are frequently found in patients with schizophrenia at any stage of their illness. Numerous structural magnetic resonance imaging (MRI) studies repeatedly revealed accentuated thinning of cortical mantle in schizophrenia. However, whether NSS are related to alterations of cortical thickness has so far remained mostly unexplored.
Whole brain high-resolution MRI at 3 Tesla was used to investigate cortical thickness in twenty five patients with recent-onset schizophrenia. Cortical reconstruction was performed with the Freesurfer image analysis suite. NSS were examined on the Heidelberg Scale after remission of acute symptoms and related to cortical thickness. Age, education, medication and duration of illness were considered as potential confounders.
Higher NSS scores were associated with decreased cortical thickness in multiple areas. Significant correlations were found in somatosensory and primary motor cortex, pre-motor area and temporal lobe. Our results confirm the hypothesis of significant relationship between alterations of cortical thickness and the extent of NSS in schizophrenia.
Our findings provide new insights into the association of NSS with brain morphometric alterations and an involvement of cortical thickness in schizophrenia.
We report a novel approach to the instantaneous photoinitiated synthesis of mixed anatase-rutile nanocrystalline TiO2 thin films with a three-dimensional nanostructure through pulsed white light irradiation of photosensitive Ti-organic precursor films. Pulsed photoinitiated pyrolysis accompanied by instantaneous self-assembly and crystallization occurred to form graphitic oxides-coated TiO2 nanograins. Subsequent pulsed light irradiation working as in situ pulsed photothermal treatment improved the crystalline quality of TiO2 film despite its low attenuation of light. The non-radiative recombination of photogenerated electrons and holes in TiO2 nanograins, coupled with inefficient heat dissipation due to low thermal conductivity, produces enough heat to provide the thermodynamic driving force for improving the crystalline quality. The graphitic oxides were reduced by pulsed photothermal treatment and can be completely removed by oxygen plasma cleaning. This photoinitiated nanofabrication technology opens a promising way for the low-cost and high-throughput manufacturing of nanostructured metal oxides as well as TiO2 nanocrystalline thin films.
It is well documented that global warming is unequivocal. Dairy production systems are considered as important sources of greenhouse gas emissions; however, little is known about the sensitivity and vulnerability of these production systems themselves to climate warming. This review brings different aspects of dairy cow production in Central Europe into focus, with a holistic approach to emphasize potential future consequences and challenges arising from climate change. With the current understanding of the effects of climate change, it is expected that yield of forage per hectare will be influenced positively, whereas quality will mainly depend on water availability and soil characteristics. Thus, the botanical composition of future grassland should include species that are able to withstand the changing conditions (e.g. lucerne and bird's foot trefoil). Changes in nutrient concentration of forage plants, elevated heat loads and altered feeding patterns of animals may influence rumen physiology. Several promising nutritional strategies are available to lower potential negative impacts of climate change on dairy cow nutrition and performance. Adjustment of feeding and drinking regimes, diet composition and additive supplementation can contribute to the maintenance of adequate dairy cow nutrition and performance. Provision of adequate shade and cooling will reduce the direct effects of heat stress. As estimated genetic parameters are promising, heat stress tolerance as a functional trait may be included into breeding programmes. Indirect effects of global warming on the health and welfare of animals seem to be more complicated and thus are less predictable. As the epidemiology of certain gastrointestinal nematodes and liver fluke is favourably influenced by increased temperature and humidity, relations between climate change and disease dynamics should be followed closely. Under current conditions, climate change associated economic impacts are estimated to be neutral if some form of adaptation is integrated. Therefore, it is essential to establish and adopt mitigation strategies covering available tools from management, nutrition, health and plant and animal breeding to cope with the future consequences of climate change on dairy farming.
The Dawn spacecraft orbited Asteroid (4) Vesta for a year, and returned disk-resolved images and spectra covering visible and near-infrared wavelengths at scales as high as 20 m/pix. The visible geometric albedo of Vesta is ~ 0.36. The disk-integrated phase function of Vesta in the visible wavelengths derived from Dawn approach data, previous ground-based observations, and Rosetta OSIRIS observations is consistent with an IAU H-G phase law with H=3.2 mag and G=0.28. Hapke's modeling yields a disk-averaged single-scattering albedo of 0.50, an asymmetry factor of -0.25, and a roughness parameter of ~20 deg at 700 nm wavelength. Vesta's surface displays the largest albedo variations observed so far on asteroids, ranging from ~0.10 to ~0.76 in geometric albedo in the visible wavelengths. The phase function of Vesta displays obvious systematic variations with respect to wavelength, with steeper slopes within the 1- and 2-micron pyroxene bands, consistent with previous ground-based observations and laboratory measurement of HED meteorites showing deeper bands at higher phase angles. The relatively high albedo of Vesta suggests significant contribution of multiple scattering. The non-linear effect of multiple scattering and the possible systematic variations of phase function with albedo across the surface of Vesta may invalidate the traditional algorithm of applying photometric correction on airless planetary surfaces.
We propose a generalization of proper orthogonal decomposition (POD) for optimal flow resolution of linearly related observables. This Galerkin expansion, termed ‘observable inferred decomposition’ (OID), addresses a need in aerodynamic and aeroacoustic applications by identifying the modes contributing most to these observables. Thus, OID constitutes a building block for physical understanding, least-biased conditional sampling, state estimation and control design. From a continuum of OID versions, two variants are tailored for purposes of observer and control design, respectively. Firstly, the most probable flow state consistent with the observable is constructed by a ‘least-residual’ variant. This version constitutes a simple, easily generalizable reconstruction of the most probable hydrodynamic state to preprocess efficient observer design. Secondly, the ‘least-energetic’ variant identifies modes with the largest gain for the observable. This version is a building block for Lyapunov control design. The efficient dimension reduction of OID as compared to POD is demonstrated for several shear flows. In particular, three aerodynamic and aeroacoustic goal functionals are studied: (i) lift and drag fluctuation of a two-dimensional cylinder wake flow; (ii) aeroacoustic density fluctuations measured by a sensor array and emitted from a two-dimensional compressible mixing layer; and (iii) aeroacoustic pressure monitored by a sensor array and emitted from a three-dimensional compressible jet. The most ‘drag-related’, ‘lift-related’ and ‘loud’ structures are distilled and interpreted in terms of known physical processes.
14C and δ13C values of C-containing species in cave drip waters are mainly controlled by the C isotope composition of karst rock and soil air, as well as by soil carbon dynamics, in particular the amount of soil CO2 in the unsaturated soil zone and the process of calcite dissolution. Here, we investigate soil carbon dynamics by analyzing the 14C activity and δ13C values of C dissolved in cave drip water. Monthly over a 2-yr period, we collected drip water from 2 drip sites, one fast and one relatively slow, within the shallow Grotta di Ernesto Cave (NE Italy). The 14C data reveal a pronounced annual cycle. In contrast, the δ13C values do not show an annual pattern and only small interannual variability compared to the δ13C values of soil waters. The annual 14C drip-water cycle is a function of drip-rate variability, soil moisture, and ultimately hydrology.
Foods containing plant sterol or stanol esters can be beneficial in lowering LDL-cholesterol concentration, a major risk factor for CVD. The present study examined whether high dietary intake of rapeseed oil (RSO) derived plant sterol and stanol esters is associated with increased levels of these components in brain tissue of homozygous and heterozygous Watanabe rabbits, an animal model for familial hypercholesterolemia. Homozygous animals received either a standard diet, RSO stanol or RSO sterol ester while heterozygous animals were additionally fed with 2 g cholesterol/kg to the respective diet form for 120 d (n 9 for each group). Concentrations of cholesterol, its precursor lathosterol, plant sterols and stanols in brain and additionally in liver and plasma were determined by highly sensitive GC–MS. High-dose intake of RSO derived plant sterols and stanols resulted in increased levels of these components in plasma and liver. In brain a limited uptake of plant sterols and stanols was proven, indicating that these compounds passed the blood–brain barrier and may be retained in the brain tissue of Watanabe rabbits. Plant stanol ester feeding lowered plant sterol levels in brain, liver, and plasma. Cholesterol synthesis in brain, indicated by lathosterol, a local surrogate cholesterol synthesis marker, does not seem to be affected by plant sterol or stanol ester feeding. We conclude that high dose intake of plant sterol and stanol esters in Watanabe rabbits results in elevated concentrations of these components not only in the periphery but also in the central nervous system.