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A national need is to prepare for and respond to accidental or intentional disasters categorized as chemical, biological, radiological, nuclear, or explosive (CBRNE). These incidents require specific subject-matter expertise, yet have commonalities. We identify 7 core elements comprising CBRNE science that require integration for effective preparedness planning and public health and medical response and recovery. These core elements are (1) basic and clinical sciences, (2) modeling and systems management, (3) planning, (4) response and incident management, (5) recovery and resilience, (6) lessons learned, and (7) continuous improvement. A key feature is the ability of relevant subject matter experts to integrate information into response operations. We propose the CBRNE medical operations science support expert as a professional who (1) understands that CBRNE incidents require an integrated systems approach, (2) understands the key functions and contributions of CBRNE science practitioners, (3) helps direct strategic and tactical CBRNE planning and responses through first-hand experience, and (4) provides advice to senior decision-makers managing response activities. Recognition of both CBRNE science as a distinct competency and the establishment of the CBRNE medical operations science support expert informs the public of the enormous progress made, broadcasts opportunities for new talent, and enhances the sophistication and analytic expertise of senior managers planning for and responding to CBRNE incidents.
Immune system markers may predict affective disorder treatment response, but whether an overall immune system marker predicts bipolar disorder treatment effect is unclear.
Bipolar CHOICE (N = 482) and LiTMUS (N = 283) were similar comparative effectiveness trials treating patients with bipolar disorder for 24 weeks with four different treatment arms (standard-dose lithium, quetiapine, moderate-dose lithium plus optimised personalised treatment (OPT) and OPT without lithium). We performed secondary mixed effects linear regression analyses adjusted for age, gender, smoking and body mass index to investigate relationships between pre-treatment white blood cell (WBC) levels and clinical global impression scale (CGI) response.
Compared to participants with WBC counts of 4.5–10 × 109/l, participants with WBC < 4.5 or WBC ≥ 10 showed similar improvement within each specific treatment arm and in gender-stratified analyses.
An overall immune system marker did not predict differential treatment response to four different treatment approaches for bipolar disorder all lasting 24 weeks.
X-ray diffraction is ideal for quantitative crystalline phase determination in solid mixtures. Each phase of the mixture will produce its characteristic lines independent of other phases that may or may not be present when diffracting an X-ray beam and will be “proportional” to the amount of the phase present.
The mental health and social functioning of millions of forcibly displaced individuals worldwide represents a key public health priority for host governments. This is the first longitudinal study with a representative sample to examine the impact of interpersonal trust and psychological symptoms on community engagement in refugees.
Participants were 1894 resettled refugees, assessed within 6 months of receiving a permanent visa in Australia, and again 2–3 years later. Variables measured included post-traumatic stress disorder symptoms, depression/anxiety symptoms, interpersonal trust and engagement with refugees’ own and other communities.
A multilevel path analysis was conducted, with the final model evidencing good fit (Comparative Fit Index = 0.97, Tucker–Lewis Index = 0.89, Root Mean Square Error of Approximation = 0.05, Standardized Root-Mean-Square-Residual = 0.05). Findings revealed that high levels of depression symptoms were associated with lower subsequent engagement with refugees’ own communities. In contrast, low levels of interpersonal trust were associated with lower engagement with the host community over the same timeframe.
Findings point to differential pathways to social engagement in the medium-term post-resettlement. Results indicate that depression symptoms are linked to reduced engagement with one's own community, while interpersonal trust is implicated in engagement with the broader community in the host country. These findings have potentially important implications for policy and clinical practice, suggesting that clinical and support services should target psychological symptoms and interpersonal processes when fostering positive adaptation in resettled refugees.
OBJECTIVES/SPECIFIC AIMS: The serotonin receptor 6 (5-HT6) is a potential therapeutic target given its distribution in brain regions that are important in depression, anxiety, and cognition. This study sought to investigate the effects of age on 5-HT6 receptor availability using 11C GSK215083, a PET ligand with affinity for 5-HT6 in the striatum and 5-HT2A in the cortex. METHODS/STUDY POPULATION: In total, 28 healthy male subjects (age range: 23–52 years) were scanned with 11C-GSK215083 on the HR+PET scanner. Time-activity curves in regions-of-interest were fitted with multilinear analysis-1 method. Binding potentials (BPND) were calculated using cerebellum as the reference region and corrected for partial volume effects. RESULTS/ANTICIPATED RESULTS: In 5-HT6 rich areas, regional 11C-GSK215083 displayed a negative correlation between BPND and age in the caudate (r=−0.41, p=0.03) (14% change per decade), and putamen (r=−0.30, p=0.04) (11% change per decade), but not in the ventral striatum and pallidum. Negative correlation with age was also seen in cortical regions (r=−0.41, p=0.03) (7% change per decade), consistent with the literature on 5-HT2A availability. DISCUSSION/SIGNIFICANCE OF IMPACT: This is the first in vivo study in humans to examine the effect of age on 5-HT6 receptor availability. The study demonstrated a significant age-related decline in 5-HT6 availability (BPND) in the caudate and putamen.
Immunological theories, particularly the sickness syndrome theory, may explain psychopathology in mood disorders. However, no clinical trials have investigated the association between overall immune system markers with a wide range of specific symptoms including potential gender differences.
We included two similar clinical trials, the lithium treatment moderate-dose use study and clinical and health outcomes initiatives in comparative effectiveness for bipolar disorder study, enrolling 765 participants with bipolar disorder. At study entry, white blood cell (WBC) count was measured and psychopathology assessed with the Montgomery and Aasberg depression rating scale (MADRS). We performed analysis of variance and linear regression analyses to investigate the relationship between the deviation from the median WBC, and multinomial regression analysis between different WBC levels. All analyses were performed gender-specific and adjusted for age, body mass index, smoking, race, and somatic diseases.
The overall MADRS score increased significantly for each 1.0×109/l deviation from the median WBC among 322 men (coefficient=1.10; 95% CI=0.32–1.89; p=0.006), but not among 443 women (coefficient=0.56; 95% CI=−0.19–1.31; p=0.14). Among men, WBC deviations were associated with increased severity of sadness, inner tension, reduced sleep, reduced appetite, concentration difficulties, inability to feel, and suicidal thoughts. Among women, WBC deviations were associated with increased severity of reduced appetite, concentration difficulties, lassitude, inability to feel, and pessimistic thoughts. Both higher and lower WBC levels were associated with increased severity of several specific symptoms.
Immune system alterations were associated with increased severity of specific mood symptoms, particularly among men. Our results support the sickness syndrome theory, but furthermore emphasise the relevance to study immune suppression in bipolar disorder. Due to the explorative nature and cross-sectional design, future studies need to confirm these findings.
Branigan & Pickering (B&P) claim that the success of structural priming as a method should “end the current reliance on acceptability judgments.” Structural priming is an interesting and useful phenomenon, but we are dubious that the effect is powerful enough to test many detailed claims about specific points of syntactic theory.
The Arctic marine environment is undergoing a transition from thick multi-year to first-year sea-ice cover with coincident lengthening of the melt season. Such changes are evident in the Baffin Bay-Davis Strait-Labrador Sea (BDL) region where melt onset has occurred ~8 days decade−1 earlier from 1979 to 2015. A series of anomalously early events has occurred since the mid-1990s, overlapping a period of increased upper-air ridging across Greenland and the northwestern North Atlantic. We investigate an extreme early melt event observed in spring 2013. (~6σ below the 1981–2010 melt climatology), with respect to preceding sub-seasonal mid-tropospheric circulation conditions as described by a daily Greenland Blocking Index (GBI). The 40-days prior to the 2013 BDL melt onset are characterized by a persistent, strong 500 hPa anticyclone over the region (GBI >+1 on >75% of days). This circulation pattern advected warm air from northeastern Canada and the northwestern Atlantic poleward onto the thin, first-year sea ice and caused melt ~50 days earlier than normal. The episodic increase in the ridging atmospheric pattern near western Greenland as in 2013, exemplified by large positive GBI values, is an important recent process impacting the atmospheric circulation over a North Atlantic cryosphere undergoing accelerated regional climate change.
Glaciers often advance over proglacial sediments, which then may enhance basal motion. For glaciers with abundant meltwater, thermodynamic considerations indicate that the sediment–ice contact in the direction of ice flow tends toward an angle opposed to and somewhat steeper than the surface slope (by slightly more than 50%). A simple model based on this hypothesis yields the extent of over-ridden sediments as a function of sediment thickness and strength, a result that may be useful in guiding additional fieldwork for hypothesis testing. Sediment-floored as well as rock-floored overdeepenings are common features along glacier flow paths and are expected based on theories of glacier erosion, entrainment, transport and deposition.
Two rain events at Matanuska Glacier illustrate how subglacial drainage system development and snowpack conditions affect hydrologic response at the terminus. On 21 and 22 September 1995, over 56 mm of rain fell in the basin during a period usually characterized by much drier conditions. This event caused an 8-fold increase in discharge and a 47-fold increase in suspended-sediment concentration. Peak suspended-sediment concentration exceeded 20 kg m —3, suggesting rapid evacuation of stored sediment. While water discharge returned to its pre-storm level nine days after the rain ceased, suspended- sediment concentrations took about 20 days to return to pre-storm levels. These observations suggest that the storm influx late in the melt season probably forced subglacial water into a more distributed system. In addition, subglacially transported sediments were supplemented to an unknown degree by the influx of storm-eroded sediments off hillslopes and from tributary drainage basins.
A storm on 6 and 7 June 1997, dropped 28 mm of rain on the basin demonstrating the effects of meltwater retention in the snowpack and englacial and subglacial storage early in the melt season. Streamflow before the storm event was increasing gradually owing to warming temperatures; however, discharge during the storm and the following week increased only slightly. Suspended-sediment concentrations increased only a small amount, suggesting the drainage system was not yet well developed, and much of the run off occurred across the relatively clean surface of the glacier or through englacial channels.
Several different types of laterally extensive debris bands occur along the western terminus region of the Matanuska Glacier, Alaska, U.S.A. An ice-bed process, which to our knowledge has not previously been recognized and described, forms the most common and most prominent type of debris band at Matanuska Glacier’s terminus. The debris bands are composed of one or several millimeter-thick laminations of silt-rich ice having much higher sediment content than that of the surrounding ice. Samples of these bands and their surrounding englacial ice have been analyzed for anthropogenic tritium (3H), oxygen-18 (δ18O), and deuterium (δD).We interpreted the laminated, silt-rich debris bands as basal fractures, along which silt-laden, glaciohydraulically supercooled and pressurized waters flowed, healing the fractures by ice growth. This process is analogous to the inward growth of hydrothermal quartz from the sides of an open fracture.
The numerous debris bands in the terminus region of Matanuska Glacier, Alaska, U.S.A., were formed by injection of turbid meltwaters into basal crevasses. The debris bands are millimeter(s)-thick layers of silt-rich ice cross-cutting older, debris-poor englacial ice. The sediment grain-size distribution of the debris bands closely resembles the suspended load of basal waters, and of basal and proglacial ice grown from basal waters, but does not resemble supraglacial debris, till or the bedload of subglacial streams. Most debris bands contain anthropogenic tritium (3H) in concentrations similar to those of basal meltwater and ice formed from that meltwater, but cross-cut englacial ice lacking tritium. Stable-isotopic ratios (δ18O and δD) of debris-band ice are consistent with freezing from basal waters, but are distinct from those in englacial ice. Ice petrofabric data along one debris band lack evidence of active shearing. High basal water pressures and locally extensional ice flow associated with overdeepened subglacial basins favor basal crevasse formation.
OBJECTIVES/SPECIFIC AIMS: As part of a larger effort to create a longitudinal record of care for patients with chronic kidney disease (CKD) in Delaware, we assessed transitions of care from pediatric to adult care. This study examined the length of time between last pediatric contact and first contact in the adult system in order to determine characteristics associated with delayed transition to adult care. METHODS/STUDY POPULATION: Patients who receive pediatric care at the Nemours/Alfred I. duPont Hospital for Children (Nemours) are transitioned to adult care between the ages of 18 and 21. Our study population consists of all patients seen in the Nephrology unit at Nemours for CKD, hypertension (HTN), or diabetes who turned 21 years old between 2007 and 2013. Records of office visits from Nemours, Christiana Care Health System (CCHS), and Nephrology Associates, P.A. (NAPA) were transformed into the OMOP common data model and merged. Patients who had at least 1 record in the Nemours EHR of pediatric care before age 21 and had at least 1 record in the CCHS or NAPA adult EHRs were considered transitioned. To identify characteristics associated with delayed transition to adult care, we compared gender, race, ethnicity, age, comorbidities, and level of kidney function at the last pediatric visit between patients whose transition gap was less than 1 year and patients whose gap was 1 year or more. Kidney function was estimated by calculating glomerular filtration rate (GFR). Nemours estimates GFR in children using the revised Schwartz equation, which is based on serum creatinine and height. To calculate adult GFR, we used the CKD-Epi equation, which is based on serum creatinine, age, sex, and race and is widely used to derive adult GFR. As kidney function declines, GFR decreases. We used Fisher exact test to compare categorical variables and t-test to compare age and GFR. RESULTS/ANTICIPATED RESULTS: We found only 109 (25%) patients who had records in our adult offices out of the 440 Nemours patients in our data set. Of the 109 transitioned patients, 54 had office visits at CCHS, 37 at NAPA, and 18 at both locations. Examining the office visits of the 109 transitioned patients, 34 (31%) had an overlap in visits defined as an office visit at CCHS or NAPA before the last office visit at Nemours, and 75 (69%) did not have an overlap. The median gap between last pediatric and first adult office visit for the 75 patients without an overlap was 615 days (range 8–3495 d). Only 6 (6%) of the 109 transitioned patients had overlapping GFR measurements from pediatric to adult care, and all of the adult GFR calculations (CKD-Epi) were greater than the pediatric GFR calculations (Schwartz). The difference between child and adult GFR ranged from 8.2 to 87.1 mL/minute per 1.72 m2. DISCUSSION/SIGNIFICANCE OF IMPACT: During the transition from pediatric care to adult care, many young adults with CKD experience declines in health outcomes and comorbidities such as diabetes and HTN complicate self-management. Lack of overlap between pediatric and adult care office visits indicates a delay in executing this transition. In our population of 109 transitioned patients, 69% did not have an overlap in care, and 50% of those without overlap had a gap of more than 615 days (1 y, 8 mo). Our analysis suggests that young adults who are younger at last pediatric office visit are more likely to delay transitioning to adult care. Transitioning from the nurturing environment of pediatric care to adult care is a complex process and could be challenging for young adults with CKD. Transition clinics may be necessary to improve the coordination of care and help these young adults keep their physician appointments.
The Sextans dwarf Spheroidal (dSph) galaxy was discovered recently by Irwin, et al. (1990, M. N. R. A. S., 244, 16p). We report results concerning a number of the global properties of the stellar population of this system. Based on deep CCD photometry obtained with the prime-focus CCD camera on the CTIO 4m telescope, we find that the galaxy is dominated by an old stellar population, similar to that observed in the Draco, Sculptor, and Ursa Minor dwarfs. Some blue stragglers are also present; if these are associated with an intermediate age component, they indicate that only a tiny fraction of the stellar population of Sextans is younger than about 10 Gyr. Based on the apparent magnitude of the predominately red horizontal branch, we conclude that the true distance modulus of Sextans is 19.7 ± 0.3, and the total luminosity of the galaxy is 5.2 × 105L⊙. A complete description of these results is given in Mateo, et al. (1991, A. J., 101, 892).
Synthesis of Ni and Zn substituted nano-greigite,
Fe3S4, is achieved from single source
diethyldithiocarbamato precursor compounds, producing particles typically
50–100 nm in diameter with plate-like pseudohexagonal morphologies. Up to 12
wt.% Ni is incorporated into the greigite structure, and there is evidence
that Zn is also incorporated but Co is not substituted into the lattice. The
Fe L3 X-ray absorption spectra for these materials have a narrow
single peak at 707.7 eV and the resulting main X-ray magnetic circular
dichroism (XMCD) has the same sign at 708.75 eV. All XMCD spectra also have
a broad positive feature at 711 eV, a characteristic of covalent mixing. The
greigite XMCD spectra contrast with the three clearly defined XMCD site
specific peaks found in the ferrite spinel, magnetite. The Fe
L2,3X-ray absorption spectra and XMCD spectra of the
greigite reflect and reveal the high conductivity of greigite and the very
strong covalency of the Fe–S bonding. The electron hopping between
Fe3+ and Fe2+ on octahedral sites results in an
intermediate oxidation state of the Fe in the Oh site of
Fe2.5+ producing an effective formula of [Fe3+
↑]A-site[2Fe2.5+ ↓]B-siteS42–]. The Ni L2,3 X-ray absorption spectra and XMCD reveal substitution on the
Oh site with a strongly covalent character and an
oxidation state <Ni1.5+ in a representative formula
[Fe3+ ↑]A[[(2 – x)Fe2.5+