OBJECTIVES/SPECIFIC AIMS: Background: Delirium is a well described form of acute brain organ dysfunction characterized by decreased or increased movement, changes in attention and concentration as well as perceptual disturbances (i.e., hallucinations) and delusions. Catatonia, a neuropsychiatric syndrome traditionally described in patients with severe psychiatric illness, can present as phenotypically similar to delirium and is characterized by increased, decreased and/or abnormal movements, staring, rigidity, and mutism. Delirium and catatonia can co-occur in the setting of medical illness, but no studies have explored this relationship by age. Our objective was to assess whether advancing age and the presence of catatonia are associated with delirium. METHODS/STUDY POPULATION: Methods: We prospectively enrolled critically ill patients at a single institution who were on a ventilator or in shock and evaluated them daily for delirium using the Confusion Assessment for the ICU and for catatonia using the Bush Francis Catatonia Rating Scale. Measures of association (OR) were assessed with a simple logistic regression model with catatonia as the independent variable and delirium as the dependent variable. Effect measure modification by age was assessed using a Likelihood ratio test. RESULTS/ANTICIPATED RESULTS: Results: We enrolled 136 medical and surgical critically ill patients with 452 matched (concomitant) delirium and catatonia assessments. Median age was 59 years (IQR: 52–68). In our cohort of 136 patients, 58 patients (43%) had delirium only, 4 (3%) had catatonia only, 42 (31%) had both delirium and catatonia, and 32 (24%) had neither. Age was significantly associated with prevalent delirium (i.e., increasing age associated with decreased risk for delirium) (p=0.04) after adjusting for catatonia severity. Catatonia was significantly associated with prevalent delirium (p<0.0001) after adjusting for age. Peak delirium risk was for patients aged 55 years with 3 or more catatonic signs, who had 53.4 times the odds of delirium (95% CI: 16.06, 176.75) than those with no catatonic signs. Patients 70 years and older with 3 or more catatonia features had half this risk. DISCUSSION/SIGNIFICANCE OF IMPACT: Conclusions: Catatonia is significantly associated with prevalent delirium even after controlling for age. These data support an inverted U-shape risk of delirium after adjusting for catatonia. This relationship and its clinical ramifications need to be examined in a larger sample, including patients with dementia. Additionally, we need to assess which acute brain syndrome (delirium or catatonia) develops first.

Pyroxasulfone (KIH-485) is a seedling growth-inhibiting herbicide developed by Kumiai America that has the potential to control weeds in sunflower. However, little is known about how this herbicide will interact with various soil types and environments when combined with sulfentrazone. The objective of this research was to evaluate sunflower injury and weed control with pyroxasulfone applied with and without sulfentrazone across the Great Plains sunflower production area. A multisite study was initiated in spring 2007 to evaluate sunflower response to pyroxasulfone applied PRE at 0, 167, 208, or 333 g ai ha−1. In 2008, pyroxasulfone was applied alone and in tank mixture with sulfentrazone. In 2007, no sunflower injury was observed with any rate of pyroxasulfone at any location except Highmore, SD, where sunflower injury was 17%, 4 wk after treatment (WAT) with 333 g ha−1. In 2008, sunflower injury ranged from 0 to 4% for all treatments. Adding sulfentrazone did not increase injury. Sunflower yield was only reduced in treatments in which weeds were not effectively controlled. These treatments included the untreated control and pyroxasulfone at 167 g ha−1. Sunflower yield did not differ among the other treatments of pyroxasulfone or sulfentrazone applied alone or in combination. The addition of sulfentrazone to pyroxasulfone improved control of foxtail barley, prostrate pigweed, wild buckwheat, Palmer amaranth, and marshelder, but not large crabgrass or green foxtail. The combination of pyroxasulfone and sulfentrazone did not reduce control of any of the weeds evaluated.

In North America, terrestrial records of biodiversity and climate change that span Marine Oxygen Isotope Stage (MIS) 5 are rare. Where found, they provide insight into how the coupling of the ocean–atmosphere system is manifested in biotic and environmental records and how the biosphere responds to climate change. In 2010–2011, construction at Ziegler Reservoir near Snowmass Village, Colorado (USA) revealed a nearly continuous, lacustrine/wetland sedimentary sequence that preserved evidence of past plant communities between ~140 and 55 ka, including all of MIS 5. At an elevation of 2705 m, the Ziegler Reservoir fossil site also contained thousands of well-preserved bones of late Pleistocene megafauna, including mastodons, mammoths, ground sloths, horses, camels, deer, bison, black bear, coyotes, and bighorn sheep. In addition, the site contained more than 26,000 bones from at least 30 species of small animals including salamanders, otters, muskrats, minks, rabbits, beavers, frogs, lizards, snakes, fish, and birds. The combination of macro- and micro-vertebrates, invertebrates, terrestrial and aquatic plant macrofossils, a detailed pollen record, and a robust, directly dated stratigraphic framework shows that high-elevation ecosystems in the Rocky Mountains of Colorado are climatically sensitive and varied dramatically throughout MIS 5.

Ninety plant macrofossil taxa from the Ziegler Reservoir fossil site near Snowmass Village, Colorado, record environmental changes at high elevation (2705 m asl) in the Rocky Mountains during the Last Interglacial Period. Present-day vegetation is aspen forest (Populus tremuloides) intermixed with species of higher (Picea, Abies) and lower (Artemisia, Quercus) elevations. Stratigraphic units 4–13 contain montane forest taxa found near the site today and several species that today generally live at lower elevations within (Abies concolor, Lycopus americanus) and outside Colorado (Najas flexilis). These data suggest near-modern climatic conditions, with slightly warmer summer and winter temperatures. This montane forest period was succeeded by a shorter treeless interval (Unit 14) representing colder and/or drier conditions. In units 15–16, conifer trees reoccur but deciduous and herb taxa are lacking, suggesting a return to warmer conditions, although cooler than during the earlier forest period. Comparison of these inferred paleoclimatic changes with the site's geochronologic framework indicates that the lower interval of sustained warmth correlates with late MIS 6–early 5b (~138–94 ka), the cold interval with MIS 5b (~94–87 ka), and the uppermost cool assemblages with MIS 5a (~87–77 ka).

The fossil record displays remarkable stasis in many species over long time periods, yet studies of extant populations often reveal rapid phenotypic evolution and genetic differentiation among populations. Recent advances in our understanding of the fossil record and in population genetics and evolutionary ecology point to the complex geographic structure of species being fundamental to resolution of how taxa can commonly exhibit both short-term evolutionary dynamics and long-term stasis.

People wounded during bombings or other events resulting in mass casualties or in conjunction with the resulting emergency response may be exposed to blood, body fluids, or tissue from other injured people and thus be at risk for bloodborne infections such as hepatitis B virus, hepatitis C virus, human immunodeficiency virus, or tetanus. This report adapts existing general recommendations on the use of immunization and postexposure prophylaxis for tetanus and for occupational and nonoccupational exposures to bloodborne pathogens to the specific situation of a mass casualty event. Decisions regarding the implementation of prophylaxis are complex, and drawing parallels from existing guidelines is difficult. For any prophylactic intervention to be implemented effectively, guidance must be simple, straightforward, and logistically undemanding. Critical review during development of this guidance was provided by representatives of the National Association of County and City Health Officials, the Council of State and Territorial Epidemiologists, and representatives of the acute injury care, trauma, and emergency response medical communities participating in the Centers for Disease Control and Prevention’s Terrorism Injuries: Information, Dissemination and Exchange project. The recommendations contained in this report represent the consensus of US federal public health officials and reflect the experience and input of public health officials at all levels of government and the acute injury response community. (Disaster Med Public Health Preparedness. 2008;2:150–165)