OBJECTIVES/GOALS: Physical therapy (PT) is key for treating functional decline that inpatients experience but is a constrained resource in hospital settings. The Activity Measure Post-Acute Care (AM-PAC) score is a mobility measurement tool that has been used to define misallocation of PT. We aim to optimize PT referrals using AM-PAC-based clinical decision support . METHODS/STUDY POPULATION: We conducted a prospective study of patients admitted to University of Chicago Medical Center. AM-PAC scores were assessed by nursing staff every 12 hours. Clinical decision support was designed using validated AM-PAC cutoffs (> 18, a predictor of discharge to home). The tool was embedded in hospital medicine note templates, requiring providers to indicate PT referral status based on current AM-PAC scores. The primary outcome, unskilled consult , was defined as PT referral for patients with AM-PAC > 18. Data were collected for one year prior to implementation and one year after implementation for intervention (hospital medicine) and control (general internal medicine) services. Difference in differences analysis was used to assess the association between the intervention and unskilled consults. RESULTS/ANTICIPATED RESULTS: Between October 2018 and March 2021, 18,241 admissions were eligible for the study. Compared to preintervention, there was a lower rate of referral to PT for patients with high AM-PAC mobility scores in the post-intervention period [18.5% vs 16.6%; X2(1) = 7.02; p < 0.01]. In the postintervention time period, the control group experienced a 2.6% increase in unskilled consults while the intervention group experienced a 2.3% decrease, a difference in differences of 4.9% (95% CI -0.07–-0.03 for difference in differences) controlling for age sex, race, LOS, and change in mobility. Compared to preintervention, there was no statistically significant difference in mean change in mobility score post-intervention for either group. DISCUSSION/SIGNIFICANCE: Our results suggest that clinical decision support can decrease unskilled PT consults. Many functionally independent patients can mobilize with nursing or other mobilization staff. Hospitals should consider mobility score-based decision support to prioritize PT for impaired and at-risk patients.

The uptake of electric vehicles (EVs) and renewable energy technologies is changing the magnitude, variability, and direction of power flows in electricity networks. To ensure a successful transition to a net zero energy system, it will be necessary for a wide range of stakeholders to understand the impacts of these changing flows on networks. However, there is a gap between those with the data and capabilities to understand electricity networks, such as network operators, and those working on adjacent parts of the energy transition jigsaw, such as electricity suppliers and EV charging infrastructure operators. This paper describes the electric vehicle network analysis tool (EVENT), developed to help make network analysis accessible to a wider range of stakeholders in the energy ecosystem who might not have the bandwidth to curate and integrate disparate datasets and carry out electricity network simulations. EVENT analyses the potential impacts of low-carbon technologies on congestion in electricity networks, helping to inform the design of products and services. To demonstrate EVENT’s potential, we use an extensive smart meter dataset provided by an energy supplier to assess the impacts of electricity smart tariffs on networks. Results suggest both network operators and energy suppliers will have to work much more closely together to ensure that the flexibility of customers to support the energy system can be maximized, while respecting safety and security constraints within networks. EVENT’s modular and open-source approach enables integration of new methods and data, future-proofing the tool for long-term impact.

The legal brief is a primary vehicle by which lawyers seek to persuade appellate judges. Despite wide acceptance that briefs are important, empirical scholarship has yet to establish their influence on the Supreme Court or fully explore justices’ preferences regarding them. We argue that emotional language conveys a lack of credibility to justices and thereby diminishes the party’s likelihood of garnering justices’ votes. The data concur. Using an automated textual analysis program, we find that parties who employ less emotional language in their briefs are more likely to win a justice’s vote, a result that holds even after controlling for other features correlated with success, such as case quality. These findings suggest that advocates seeking to influence judges can enhance their credibility and attract justices’ votes by employing measured, objective language.

We provide evidence of a network of information flow between activists and other investors prior to 13D filings. We match EDGAR search activity to investor IP addresses, identifying specific investors who persistently download information on an individual activist’s campaign targets in the days prior to that activist’s 13D disclosures. This outside investor’s knowledge of pending activist campaign plans seems to benefit both parties: the informed investor, unnamed in the 13D, increases its holdings in the targeted stock prior to the price surge upon 13D disclosure, while the activist earns voting support that increases their likelihood of pursuing and winning a proxy fight.

Our understanding of homogeneous vapour bubble growth is currently restricted to asymptotic descriptions of their limiting behaviour. While attempts have been made to incorporate both the inertial and thermal limits into bubble growth models, the early stages of bubble growth have not been captured. By accounting for both the changing inertial driving force and the thermal restriction to growth, we present an inertio-thermal model of homogeneous vapour bubble growth, capable of accurately capturing the evolution of a bubble from the nano- to the macro-scale. We compare our model predictions with: (a) published experimental and numerical data, and (b) our own molecular simulations, showing significant improvement over previous models. This has potential application in improving the performance of engineering devices, such as ultrasonic cleaning and microprocessor cooling, as well as in understanding of natural phenomena involving vapour bubble growth.

The production of meltwater from glacier ice, which is exposed at the margins of land ice during the summer, is responsible for a large proportion of glacier mass loss. The rate of meltwater production from glacier ice is especially sensitive to its physical structure and chemical composition which combine to determine the albedo of glacier ice. However, the optical properties of near-surface glacier ice are not well known since most prior work has focused on laboratory-grown ice or deep cores. Here, we demonstrate a measurement technique based on diffuse propagation of nanosecond-duration laser pulses in near-surface glacier ice that enables the independent measurement of the scattering and absorption coefficients, allowing for a complete description of the processes governing radiative transfer. We employ a photon-counting detector to overcome the high losses associated with diffuse optics. The instrument is highly portable and rugged, making it optimally suited for deployment in remote regions. A set of measurements taken on Crook and Collier Glaciers, Oregon, serves as a demonstration of the technique. These measurements provide insight into both physical structure and composition of near-surface glacier ice and open new avenues for the analysis of light-absorbing impurities and remote sensing of the cryosphere.

OBJECTIVES/GOALS: In a familial case where 10 of 17 members inherited EA/LVNC in an autosomal dominant pattern, we discovered a novel, damaging missense variant in the gene KLHL26 that segregates with disease and comprises an altered electrostatic surface profile, likely decoupling the CUL3-interactome. We hypothesize that this KLHL26 variant is etiologic of EA/LVNC. METHODS/STUDY POPULATION: We differentiated a family trio (a heart-healthy daughter and EA/LVNC-affected mother and daughter) of induced pluripotent stem cells into cardiomyocytes (iPSC-CMs) in a blinded manner on three iPSC clones per subject. Using flow cytometry, immunofluorescence, and biomechanical, electrophysiological, and automated contraction methods, we investigated iPSC-CM differentiation efficiency between D10-20, contractility analysis and cell cycle regulation at D20, and sarcomere organization at D60. We further conducted differential analyses following label-free protein and RNA-Seq quantification at D20. Via CRISPR-Cas9 gene editing, we plan to characterize KLHL26 variant-specific iPSC-CM alterations and connect findings to discoveries from patient-specific studies. RESULTS/ANTICIPATED RESULTS: All iPSC lines differentiated into CMs with an increased percentage of cTnT+ cells in the affected daughter line. In comparison to the unaffected, affected iPSC-CMs had fewer contractions per minute and altered calcium transients, mainly a higher amount of total calcium release, faster rate of rise and faster rate of fall. The affected daughter line further had shorter shortening and relaxation times, higher proliferation, lower apoptosis, and a smaller cell surface area per cardiac nucleus. The affected mother line trended in a similar direction to the affected daughter line. There were no gross differences in sarcomere organization between the lines. We also discovered differential expression of candidate proteins such as kinase VRK1 and collagen COL5A1 from proteomic profiling. DISCUSSION/SIGNIFICANCE: These discoveries suggest that EA/LVNC characteristics or pathogenesis may result from decreased contractile ability, altered calcium transients, and cell cycle dysregulation. Through the KLHL26 variant correction and introduction in the daughter lines, we will build upon this understanding to inform exploration of critical clinical targets.

Perennial grain crops are emerging as a promising addition to sustainable agricultural systems because of their low-input requirements and delivery of ecosystem services. However, adoption of these crops is expected to bring novel management challenges, including those related to plant diseases. In New York, fungal pathogens of annual grains have a significant impact on crop yield and value and are generally controlled through a combination of host resistances, cultural practices and chemical fungicides. Without the availability of crop rotation and soil tillage practices, disease control in perennial grain systems may be problematic, and little is known about perennial grain crop susceptibility to local plant pathogen populations. During 2017 and 2018, ongoing field trials of two perennial grain crops recently introduced in New York, intermediate wheatgrass (IWG; Thinopyrum intermedium) and perennial cereal rye (PCR; Secale cereale), were assessed for the presence of putative fungal pathogens on actively growing plants, overwintered crop residue and harvested grain. A total of nine potential host–pathogen combinations were recorded based on symptomology, pathogen morphology and DNA sequences. Common annual crop pathogens were recovered most frequently, but, at one site, Phyllachora graminis, causal fungus of tar spot and a pathogen not previously reported on crops in New York, was found on IWG. Residue colonization by an important toxigenic pathogen (Fusarium graminearum) was high in both crops, though mycotoxin levels in associated grain were low, indicating either the hosts or environment were unsuitable for disease development. Seed-borne fungal communities differed across crops and locations, and black point, a condition caused by Alternaria and Bipolaris fungi and indicative of compromised grain quality, was prevalent in PCR under some conditions. Growing PCR with intercropped red clover (Trifolium pratense L.) resulted in less Stagonospora colonization of stem residue, and PCR grown with an oat (Avena sativa L.) nurse crop had a reduced incidence of black point. These alternative cultural practices may prove useful for managing disease in perennial grains. Our results suggest that the incorporation of perennial crops into the agricultural landscape will lead to familiar plant disease problems requiring new solutions as well as new problems that may require significant research investments.

The role of weed suppression by the cultivated crop is often overlooked in annual row cropping systems. Agronomic practices such as planting time, row spacing, tillage and herbicide selection may influence the time of crop canopy closure. The objective of this research was to evaluate the influence of the aforementioned agronomic practices and their interaction with the adoption of an effective preemergence (PRE) soil residual herbicide program on soybean canopy closure and yield. A field experiment was conducted in 2019 and 2020 in Arlington, WI, as a 2×2×2×2 factorial in a randomized complete block design, including early (late April) and standard (late May) planting time, narrow (38 cm) and wide (76 cm) row spacing, conventional tillage and no-till, and soil-applied PRE herbicide (yes and no; flumioxazin 150 g ai ha−1 + metribuzin 449 g ai ha−1 + pyroxasulfone 190 g ai ha−1). All plots were maintained weed-free throughout the growing season. In both years, early planted soybeans reached 90% green canopy cover (T90) before (7 to 9 d difference) and yielded more (188 to 902 kg ha−1 difference) than the standard planted soybeans. Narrow-row soybeans reached T90 earlier than wide-row soybeans (4 to 7 d difference), but yield was similar between row spacing treatments. Conventional tillage resulted in a higher yield compared to a no-till system (377 kg ha−1 difference). The PRE herbicide slightly delayed T90 (4 d or less) but had no impact on yield. All practices investigated herein influenced the time of soybean canopy closure but only planting time and tillage impacted yield. Planting soybeans earlier and reducing their row spacing expedites the time to canopy closure. The potential delay in canopy development and yield loss if soybeans are allowed to compete with weeds early in the season would likely outweigh the slight delay in canopy development by an effective PRE herbicide.