Aortic arch anomalies are rare congenital cardiovascular malformations. We present a case of a 9-year-old asymptomatic boy with an unusual, unknown arch anomaly.

We describe a new specimen of the aïstopod Oestocephalus from Five Points, Ohio, which preserves much of the posterior braincase. The specimen, the largest aïstopod skull described, preserves the postorbital region to the occiput. The posterior braincase has coossified the basioccipital, exoccipitals, and opisthotic. The parasphenoid is rostrally restricted, toothless, and highly vaulted along the cultriform process. The lateral walls of the cultriform process are further reinforced by large longitudinally running, ventral flanges from the parietals. Two large endochondral ventral projections from the basioccipital, previously interpreted as basal tuberosities for hypaxial muscle insertion, are here instead interpreted as articulations for the branchial skeleton. This interpretation is further supported by traces of vasculature that is consistent with what is seen in gill-bearing species. A model for the reorganisation of the basicranial region on the transition from hyomandibula to stapes is proposed, which suggests that gills, or gill-support skeletal elements, might be further distributed along the tetrapod stem than previously thought. These data further support the placement of aïstopods in the tetrapod stem group and require a reconsideration of our understanding of early tetrapod evolution.

Vegetable and grain amaranths represent a vital source of micronutrients and protein in Asia and Africa. However, various foliar lepidopteran pests and stem-mining weevils hinder amaranth production. Insect-resistant cultivars can enhance the productivity of this crop. Here, we report on the performances of amaranth varieties screened for their resistance to insect pests under the field conditions at The World Vegetable Center stations in Asia and sub-Saharan Africa. We conducted two preliminary screening trials with a total of 263 entries from around the world in Taiwan and a third preliminary screening trial with 49 African-indigenous entries in Tanzania. Promising entries from these preliminary trials were collectively evaluated in an advanced screening trial in Tanzania, to identify lines resistant to foliar and stem-boring pests in East Africa. Four entries exhibited moderate resistance to foliar pests: TZ51 and TZ53 (Amaranthus cruentus), TZ34 (A. dubius) and TZ39 (Amaranthus sp.). Five entries showed moderate resistance to stem weevils: TZ06 and TZ27 (A. cruentus), TZ52 (A. graecizans), TZ59 (A. palmeri) and TZ07 (Amaranthus sp.). Lepidopteran pests affecting leaves were reared to adulthood and identified as Spoladea recurvalis (Crambidae), Spodoptera exigua (Noctuidae) and Spodoptera littoralis (Noctuidae). Stem weevil larvae were also reared and identified as: Neocleonus sannio Herbst, Gasteroclisus pr. rhomboidalis Boheman, Hypolixus pr. haerens Boheman and Baradine sp. (Curculionidae). These results highlight key amaranth pests in East Africa and identify insect-resistant entries that will be useful in breeding programmes and resistance studies.

Strain rates are fundamental measures of ice flow and are used in a wide variety of glaciological applications including investigations of bed properties, calculations of basal mass balance on ice shelves, and constraints on ice rheological models. However, despite their extensive application, strain rates are calculated using a variety of methods and length scales and the details are often not specified. In this study, we compare the results of nominal and logarithmic strain-rate calculations based on a satellite-derived velocity field of the Antarctic ice sheet generated from Landsat 8 satellite data. Our comparison highlights the differences between the two common approaches in the glaciological literature. We evaluate the errors introduced by each approach and their impacts on the results. We also demonstrate the importance of choosing and specifying a length scale over which strain-rate calculations are made, which can strongly influence other derived quantities such as basal mass balance on ice shelves. Finally, we present strain-rate data products calculated using an approximate viscous length-scale with satellite observations of ice velocity for the Antarctic continent.

An internationally approved and globally used classification scheme for the diagnosis of CHD has long been sought. The International Paediatric and Congenital Cardiac Code (IPCCC), which was produced and has been maintained by the International Society for Nomenclature of Paediatric and Congenital Heart Disease (the International Nomenclature Society), is used widely, but has spawned many “short list” versions that differ in content depending on the user. Thus, efforts to have a uniform identification of patients with CHD using a single up-to-date and coordinated nomenclature system continue to be thwarted, even if a common nomenclature has been used as a basis for composing various “short lists”. In an attempt to solve this problem, the International Nomenclature Society has linked its efforts with those of the World Health Organization to obtain a globally accepted nomenclature tree for CHD within the 11th iteration of the International Classification of Diseases (ICD-11). The International Nomenclature Society has submitted a hierarchical nomenclature tree for CHD to the World Health Organization that is expected to serve increasingly as the “short list” for all communities interested in coding for congenital cardiology. This article reviews the history of the International Classification of Diseases and of the IPCCC, and outlines the process used in developing the ICD-11 congenital cardiac disease diagnostic list and the definitions for each term on the list. An overview of the content of the congenital heart anomaly section of the Foundation Component of ICD-11, published herein in its entirety, is also included. Future plans for the International Nomenclature Society include linking again with the World Health Organization to tackle procedural nomenclature as it relates to cardiac malformations. By doing so, the Society will continue its role in standardising nomenclature for CHD across the globe, thereby promoting research and better outcomes for fetuses, children, and adults with congenital heart anomalies.

Glacier sliding is commonly linked with elevated water pressure at the glacier bed. Ice surface motion during a 3 week period encompassing an outburst of ice-dammed Hidden Creek Lake (HCL) at Kennicott Glacier, Alaska, USA, showed enhanced sliding during the flood. Two stakes, 1.2 km from HCL, revealed increased speed in two episodes, both associated with uplift of the ice surface relative to the trajectory of bed-parallel motion. Uplift of the surface began 12 days before the flood, initially stabilizing at a value of 0.25 m. Two days after lake drainage began, further uplift (reaching 0.4 m) occurred while surface speed peaked at 1.2 md–1. Maximum surface uplift coincided with peak discharge from HCL, high water level in a down-glacier ice-marginal basin, and low solute concentrations in the Kennicott River. Each of these records is consistent with high subglacial water pressure. We interpret the ice surface motion as arising from sliding up backs of bumps on the bed, which enlarges cavities and produces bed separation. The outburst increased water pressure over a broad region, promoting sliding, inhibiting cavity closure, and blocking drainage of solute-rich water from the distributed system. Pressure drop upon termination of the outburst drained water from and depressurized the distributed system, reducing sliding speeds. Expanded cavities then collapsed with a 1 day time-scale set by the local ice thickness.

Ice-dammed Hidden Creek Lake, Alaska, USA, outbursts annually in about 2–3 days. As the lake fills, a wedge of water penetrates beneath the glacier, and the surface of this ‘ice dam’ rises; the surface then falls as the lake drains. Detailed optical surveying of the glacier near the lake allows characterization of ice-dam deformation. Surface uplift rate is close to the rate of lake-level rise within about 400 m of the lake, then decreases by 90% over about 100 m. Such a steep gradient in uplift rate cannot be explained in terms of ice-dam flexure. Moreover, survey targets spanning the zone of steep uplift gradient move relative to one another in a nearly reversible fashion as the lake fills and drains. Evidently, the zone of steep uplift gradient is a fault zone, with the faults penetrating the entire thickness of the ice dam. Fault motion is in a reverse sense as the lake fills, but in a normal sense as the lake drains. As the overall fault pattern is the same from year to year, even though ice is lost by calving, the faults must be regularly regenerated, probably by linkage of surface and bottom crevasses as ice is advected toward the lake basin.

We measured the surface velocity field during the summers of 1999 and 2000 on the 7 km long, 185 m thick Bench Glacier, Alaska, USA. In the spring of both years, a short-lived pulse of surface velocity, 2-4 times the annual mean velocity, propagated up-glacier from the terminus at a rate of ~200-250md-1. Displacement attributable to rapid sliding is ~5-10% of the annual surface motion, while the high-velocity event comprised 60-95% of annual basal motion. Sliding during the propagating speed-up event peaked at 6-14 cm d-1, with the highest rates in mid-glacier. Continuous horizontal and vertical GPS measurements at one stake showed divergence and then convergence of the ice surface with the bed as the velocity wave passed, with maximum surface uplift of 8-16 cm. High divergence rates coincided with high horizontal velocities, suggesting rapid sliding on the up-glacier side of bedrock steps. Initiation of the annual speed-up event occurred during the peak in englacial water storage, while the glacier was entirely snow-covered. Basal motion during the propagating speed-up event enlarges cavities and connections among them, driving a transition from a poorly connected hydrologic system to a well-connected linked-cavity system. Sliding is probably halted by the development of a conduit system.

Ice velocities observed in 2005/06 at three GPS stations along the Sermeq Avannarleq flowline, West Greenland, are used to characterize an observed annual velocity cycle. We attempt to reproduce this annual ice velocity cycle using a 1-D ice-flow model with longitudinal stresses coupled to a 1-D hydrology model that governs an empirical basal sliding rule. Seasonal basal sliding velocity is parameterized as a perturbation of prescribed winter sliding velocity that is proportional to the rate of change of glacier water storage. The coupled model reproduces the broad features of the annual basal sliding cycle observed along this flowline, namely a summer speed-up event followed by a fall slowdown event. We also evaluate the hypothesis that the observed annual velocity cycle is due to the annual calving cycle at the terminus. We demonstrate that the ice acceleration due to a catastrophic calving event takes an order of magnitude longer to reach CU/ETH (‘Swiss’) Camp (46 km upstream of the terminus) than is observed. The seasonal acceleration observed at Swiss Camp is therefore unlikely to be the result of velocity perturbations propagated upstream via longitudinal coupling. Instead we interpret this velocity cycle to reflect the local history of glacier water balance.

Nearly 100 days of hourly glacier motion, hydrology and hydrochemistry measurements on Kennicott Glacier, Alaska, USA, demonstrate the complicated relationship between water and motion at the glacier bed. Our observations capture the transient glacier response to seasonal and daily melt cycles, and to a jökulhlaup that prompts a sixfold increase in glacier speed. Sliding is promoted whenever the water inputs to the glacier exceed the capacity of the subglacial hydrologic system to transmit the water. Sensitivity of sliding to daily meltwater inputs varies strongly through the season, implying that the state of the hydrologic system governs the sensitivity of basal sliding. A numerical model constructed to explore these relationships reveals: the roles of the effective pressure; the exponent to which this is taken in the ‘sliding law’ (0.1 <γ< 0.6); glacier macroporosity (φ < 2%); and the ‘cavity-generating capacity’ of the glacier bed, which encapsulates the sizes and spacing of bed roughness elements. Temporal changes in the effective pressure associated with evolution of both water inputs and subglacial water transmission capacity can explain the varying strength of diurnal velocity fluctuations of Kennicott Glacier. Spatial patterns of glacier macroporosity and of basal roughness govern variation in sensitivity of sliding to water inputs.

Medial moraines form striking dark stripes that widen non-linearly, steepen laterally and increase in relief down-glacier from the equilibrium line. Coalescence of these low-ablation-rate features can feed back strongly on the mass balance of a glacier snout. Ablation-dominated medial moraines originate from debris delivered to glacier margins, producing a debris-rich septum between tributary streams of ice below their confluence. Emergence of this ice below the equilibrium line delivers debris to the glacier surface, which then moves down local slopes of evolving morainal topography. A quantitative description of moraine evolution requires specification of the debris concentration field within the glacier, treatment of the melt-rate dependence on debris thickness, and characterization of processes that transport debris once it emerges onto the ice surface. Debris concentration at glacier tributary junctions scales with the erosion rates and the lengths of the tributary-valley walls, and inversely with the tributary ice speeds. Melt rate is damped exponentially by debris, with a ∼10 cm decay scale. Debris flux across the glacier surface scales with the product of debris thickness and local slope. Analytical and numerical results show that medial moraines should develop cross-glacier profiles with parabolic crests and linear slopes, and should widen with age and hence distance down-glacier. Debris should be both thin and uniform over the moraine. Observed faster-than-linear growth of moraine widths with distance reflects the increasing ablation rate down-glacier. Increase in medial moraine cover reduces the local average ablation rate, allowing the glacier to extend further down-valley than meteorology alone would suggest. This feedback is especially effective when moraines merge.

Ice-marginal Hidden Creek Lake, Alaska, USA, outbursts annually over the course of 2–3 days. As the lake fills, survey targets on the surface of the ‘ice dam’ (the glacier adjacent to the lake) move obliquely to the ice margin and rise substantially. As the lake drains, ice motion speeds up, becomes nearly perpendicular to the face of the ice dam, and the ice surface drops. Vertical movement of the ice dam probably reflects growth and decay of a wedge of water beneath the ice dam, in line with established ideas about jökulhlaup mechanics. However, the distribution of vertical ice movement, with a narrow (50–100 m wide) zone where the uplift rate decreases by 90%, cannot be explained by invoking flexure of the ice dam in a fashion analogous to tidal flexure of a floating glacier tongue or ice shelf. Rather, the zone of large uplift-rate gradient is a fault zone: ice-dam deformation is dominated by movement along high-angle faults that cut the ice dam through its entire thickness, with the sense of fault slip reversing as the lake drains. Survey targets spanning the zone of steep uplift gradient move relative to one another in a nearly reversible fashion as the lake fills and drains. The horizontal strain rate also undergoes a reversal across this zone, being compressional as the lake fills, but extensional as the lake drains. Frictional resistance to fault-block motion probably accounts for the fact that lake level falls measurably before the onset of accelerated horizontal motion and vertical downdrop. As the overall fault pattern is the same from year to year, even though ice is lost by calving, the faults must be regularly regenerated, probably by linkage of surface and bottom crevasses as ice is advected toward the lake basin.

OBJECTIVES/SPECIFIC AIMS: More partial nephrectomies are performed every year as a surgical treatment for kidney cancer. However, this procedure remains technically challenging. Surgeons require a substantial number of cases before their performance plateaus. No established practice mode exists; thus, there is a need for training models to simulate real tumor excisions and kidney suturing. In this study, we seek to validate these silicone models using multiple simulations with urologists of different training levels. METHODS/STUDY POPULATION: We created silicone renal tumor models using 3D printed molds of a patient’s kidney with a mass. Medical students, urology residents, fellows, and attending surgeons are recruited to perform simulated partial nephrectomies on these models. Four trials are performed with a da Vinci surgical robot on 2 different days. We are evaluating surgeon performance and improvement using validated measures as well as operation-specific metrics. Operation-specific metrics include renal artery clamp time and surgical margins. Validated measures of self-assessed operative demand (NASA TLX) and reviewer-assessed surgical performance (GEARS) are also recorded across trials. RESULTS/ANTICIPATED RESULTS: The preliminary results of 2 medical students, 10 urology residents, 3 endourology fellows, and 2 attending urologists are reported here. Model face validity was evaluated on a 0–100 sliding scale anchored at unrealistic and realistic. Mean results thus far are 77.7 for overall feel, 82.7 for needle driving, 75.6 for cutting, and 73.2 for visual representation. Between trials 1 and 4 there was a mean reduction of 3.26 minutes in renal artery clamp time, and a 75% reduction in positive margins. There was a reduced incidence of positive surgical margins with advanced training stage. Fellows, residents, and medical students had positive tumor margins in 25%, 50%, and 75% of their trials, respectively. We expect to recruit 15 additional subjects for this study. Upon completion of data acquisition, more robust statistical comparisons and measures will be reported. DISCUSSION/SIGNIFICANCE OF IMPACT: Face validity measures indicate the model adequately represents reality. Preliminary data suggest improved surgical performance over the course of the training and better performance in urologists of higher training levels. This model may have potential for broader application and integration into minimally invasive surgery training programs.

Background: The evidence regarding whether co-morbid obsessive compulsive personality disorder (OCPD) is associated with treatment outcomes in obsessive compulsive disorder (OCD) is mixed, with some research indicating that OCPD is associated with poorer response, and some showing that it is associated with improved response. Aims: We sought to explore the role of OCPD diagnosis and the personality domain of conscientiousness on treatment outcomes for exposure and response prevention for OCD. Method: The impact of co-morbid OCPD and conscientiousness on treatment outcomes was examined in a clinical sample of 46 participants with OCD. Results: OCPD diagnosis and scores on conscientiousness were not associated with poorer post-treatment OCD severity, as indexed by Yale-Brown Obsessive Compulsive Scale (YBOCS) scores, although the relative sample size of OCPD was small and thus generalizability is limited. Conclusion: This study found no evidence that OCPD or conscientiousness were associated with treatment outcomes for OCD. Further research with larger clinical samples is required.

Previous studies of alpine glaciers have demonstrated that as water discharge increases through the summer, the predominant mode of subglacial drainage shifts from a distributed system to a more efficient conduit drainage system. We observed an early-melt-season speed-up and flood event lasting roughly 2 days in a small, uncomplicated Alaskan glacier that appears to have resulted from a sudden shift of the subglacial system in response to a significant accumulation of meltwater within the glacier. Calculated melt-water inputs exceeded discharge before the event; the implied change in storage over this 10 day period was equivalent to roughly 0.13 m averaged over the entire glacier bed. The pattern of discharge and suspended-sediment variations and the appearance of large ice chunks in the stream suggest that the speed-up occurred during a period of establishment of new subglacial conduits. A culminating flood and associated suspended-sediment pulse appear to have marked the final establishment of the new section of subglacial conduit. The flood ended the episode of high sliding velocity, but released water with high solute concentrations that reflect relatively long contact time with sediments. Discharge of stored water, inferred from high solute concentrations and lack of diurnal variation in discharge, continued for at least 3 days. While events such as this must recur through the melt season as the conduit system extends up-glacier and the locus of meltwater inputs shifts, their manifestations in the outlet stream will likely be more subdued later in the season.