Partial anomalous venous connection with sinus venosus atrial septal defect is repaired with different approaches including the Warden procedure. Complications include stenosis of the superior caval vein and pulmonary venous baffle; however, cyanosis is rarely seen post-operatively. We report a patient presenting with cyanosis 5 years after a Warden, which was treated with a transcatheter approach.

This paper describes the results from a project to obtain radiocarbon determinations from Early Bronze Age log coffin burials. Log coffins have been recognised as a burial tradition since antiquarian excavations uncovered the first examples. However, comparatively few are associated with radiocarbon determinations and many old determinations are very imprecise. To address this, seven log coffin burials were identified across England, and 11 samples from these were submitted for radiocarbon dating. The dates from the project were reviewed with previously obtained reliable determinations to reconsider the origins and development of the log coffin burial by region. The resulting study indicates that the earliest log coffins were associated with Beaker burials but that regional variations involving different rites soon developed.

In May 1954, the story broke internationally of Marta Olmos, recipient of the first widely known, male-to-female sex reassignment conducted in Mexico. Her doctor, Rafael Sandoval Camacho, claimed that homosexuality could be cured and that, through transitions, queer Mexicans could be made into ‘socially useful’ citizens. While initially celebrated as a scientific triumph placing Mexico among elite nations, and receiving support from individuals close to the Ruiz Cortines administration, opinions soured as critics – physicians, politicians, cartoonists and clerics – condemned Marta for renouncing manhood through a fraudulent cure that threatened the binary sex/gender order underpinning Mexican nationalism. Sex reassignment, understood through foreigners including Christine Jorgensen and associated with ‘anti-social’ queer Mexicans, thus exemplified misplaced priorities during a period in which the state sought to ‘modernise patriarchy’. While self-affirming for Marta and permitted unofficially through state indifference, sex reassignment became seen as anti-Mexican. Thus, Marta's case illuminated how the state reconciled development with policing its patriarchal order.

Experiencing mental health stigma during adolescence can exacerbate mental health conditions, reduce quality of life and inhibit young people’s help-seeking for their mental health needs. For young people, education and contact have most often been viewed as suitable approaches for stigma reduction. However, evidence on the effectiveness of these anti-stigma interventions has not been consistent. This systematic review evaluated the effectiveness of interventions to reduce mental health stigma among youth aged 10–19 years. The review followed Cochrane and PRISMA guidelines. Eight databases were searched: PubMed, PsycINFO, MEDLINE, Web of Science, Scopus, EMBASE, British Education Index and CNKI. Hand searching from included studies was also conducted. Randomised controlled trials and experimental designs that included randomised allocation to interventions and control groups were included in the review. Narrative synthesis was employed to analyse the results. A meta-analysis was conducted to determine the effectiveness of included interventions. Twenty-two studies were included in the review. Eight studies reported positive effects, 11 studies found mixed effects and 3 studies reported no effect on indicators of mental health stigma among youth. Seven of the effective studies were education-based. Eleven studies were suitable for meta-analysis, and the multivariate meta-analytic model indicated a small, significant effect at post-intervention (d = .21, p < .001), but not at follow-up (d = .069, p = .347). Interventions to reduce stigma associated with mental health conditions showed small, short-term effects in young people. Education-based interventions showed relatively more significant effects than other types of interventions.

Background: What is the number and size of motor units, and axonal excitability profile in the early stages of muscle weakness in ALS compared to controls? Methods: We enrolled ALS patients with APB manual strength testing rated four or four-minus (ALS:4-arm) and four-plus (ALS:4+ arm) and control participants >35 years-old from the University of Toronto, University of Alberta and Universidade Federal de Sao Paulo. Mean±SD, one-way ANOVA and ANCOVA of ALSFRS-R, PUMN Score, MUNIX, MUSIX, and nerve-excitability testing using QTRAC TROND protocol were reported. Results: Twenty-five ALS patients and 63 controls were included. Mean MUNIX was significantly lower (p<0.0001) and MUSIX was significantly higher (p<0.001) in both ALS groups compared to controls. Mean strength-duration time constant in the ALS:4- arm (0.50ms±0.11; p<0.05) and superexcitability in both ALS groups (ALS:4- -29.05%±9.24, ALS:4+ -27.67%±8.03; p<0.05) were relatively increased, supporting axonal hyperexcitability. Conclusions: Significant motor unit loss measured by MUNIX is already present at the earliest detection of muscle weakness in ALS. Increased MUSIX and altered axonal physiology are associated with axonal sprouting and geometry change(1), along with ion channel dysfunction(2). Future trials targeting muscle weakness in ALS should consider the altered neuronal physiology during early disease stages and utilize neurophysiological biomarkers only in normal-to-mildly weak muscles.

Background: The incidence of drug resistant epilepsy (DRE) is around 30% patients with epilepsy. Vagus nerve stimulation (VNS) is offered to patients who are not candidates for epilepsy resective surgery, however the results of lesional cases has not been explored previously Methods: The study was a retrospective cohort study that involved patients with DRE implanted with VNS at the Epilepsy program at Western University, Ontario. We classified our VNS cohort based on brain imaging of lesional (L) and nonlesional (NL) epilepsy. Results: The median age was 31.8 years, 70.69% were females. The VNS-L group average age was 31.8 years and the NL 35.2 years. The most common abnormality was nodular heterotropias 31.34% (n=9). 16 patients underwent palliative procedures before the VNS implantation, 12 in VNS-L and 4 in VNS-NL. The median period of follow-up was 69.97 months. 62% of the VNS-L group had a seizure reduction of 50% or greater, compared to 41.38% in the VNS-NL group. Seizure freedom was 10.34% in VNS-L, compared to 6.99% in VNS-NL. Conclusions: This is the first study reporting the outcome of VNS in lesional cases. Our results suggest that VNS in lesional cases is effective. However, a large multicenteric study is needed.

In Southeast Greenland, summer melt and high winter snowfall rates give rise to firn aquifers: vast stores of meltwater buried beneath the ice-sheet surface. Previous detailed studies of a single Greenland firn aquifer site suggest that the water drains into crevasses, but this is not known at a regional scale. We develop and use a tool in Ghub, an online gateway of shared datasets, tools and supercomputing resources for glaciology, to identify crevasses from elevation data collected by NASA's Airborne Topographic Mapper across 29000 km2 of Southeast Greenland. We find crevasses within 3 km of the previously mapped downglacier boundary of the firn aquifer at 20 of 25 flightline crossings. Our data suggest that crevasses widen until they reach the downglacier boundary of the firn aquifer, implying that crevasses collect firn-aquifer water, but we did not find this trend with statistical significance. The median crevasse width, 27 meters, implies an aspect ratio consistent with the crevasses reaching the bed. Our results support the idea that most water in Southeast Greenland firn aquifers drains through crevasses. Less common fates are discharge at the ice-sheet surface (3 of 25 sites) and refreezing at the aquifer bottom (1 of 25 sites).

It is known that the water entry of a body with a recessed, cupped nose can suppress the splash and air cavity typically observed for solid body entry (Mathai, Govardhan & Arakeri, Appl. Phys. Lett., vol. 106, 2015, 064101). However, the interplay between the captive gas in the cup, the cavity and the splash is quite subtle and has not been thoroughly explored. Here we study the cavity and splash dynamics associated with the vertical water entry of cups and find a variety of regimes over a range of Weber numbers ($We_D$) and dimensionless cup depths. Our parameter space spans a transition between slow-developing cavities with long closure times (low $We_D$) to fast-sealing cavities (high $We_D$). An important dynamic event is the evacuation of trapped gas from within the cup, which drives the ensuing cavity and splash behaviour. Through modelling, we predict the conditions for which the evacuating gas inflates a cavity that opens to the atmosphere versus inflating a submerged cavity that suppresses air entrainment from above the surface. We also compare our cup water entry findings to the impact phenomena observed for flat disks, which entrap gas on the front surface similar to cups. In doing so, we reveal the sensitivity of disk splash and cavity behaviour to impact angle, and show that disks share a common regime with cups, in which a thin splash quickly seals on the body. We deduce the mechanisms by which increasing cup depth delays the cavity seal time in this regime. These findings reveal that cups may in fact promote or suppress cavity growth, depending on the cup depth and impact conditions.

We describe the design, validation, and commissioning of a new correlator termed ‘MWAX’ for the Murchison Widefield Array (MWA) low-frequency radio telescope. MWAX replaces an earlier generation MWA correlator, extending correlation capabilities and providing greater flexibility, scalability, and maintainability. MWAX is designed to exploit current and future Phase II/III upgrades to MWA infrastructure, most notably the simultaneous correlation of all 256 of the MWA’s antenna tiles (and potentially more in future). MWAX is a fully software-programmable correlator based around an ethernet multicast architecture. At its core is a cluster of 24 high-performance GPU-enabled commercial-off-the-shelf compute servers that together process in real-time up to 24 coarse channels of 1.28 MHz bandwidth each. The system is highly flexible and scalable in terms of the number of antenna tiles and number of coarse channels to be correlated, and it offers a wide range of frequency/time resolution combinations to users. We conclude with a roadmap of future enhancements and extensions that we anticipate will be progressively rolled out over time.

OBJECTIVES/GOALS: We have designed an analogue of the Vitamin E tocotrienols called tocoflexol, which improves their pharmacokinetic limitations to make it an effective radiation medical countermeasure. Our goal is to demonstrate that tocoflexol is an effective radiomitigator in vivo when administered after exposure to lethal doses of total body irradiation. METHODS/STUDY POPULATION: Tocoflexol was designed using computational techniques to improve binding to ATTP, the key transporter that reduces the rate of elimination of tocols. In vitro studies compared the antioxidant and cell uptake properties to conventional tocotrienols. Next, we used a mouse model of lethal total body irradiation to evaluate its radioprotection efficacy (treating before radiation). To determine the optimal administration route for radiomitigation (treating after radiation), we will test oral and subcutaneous dosing. Mouse survival will be monitored for 30 days after irradiation. Sample tissues will be taken to evaluate the ability of tocoflexol to protect key organs from acute radiation syndrome. The bioavailability of tocoflexol will be evaluated in a rodent model. RESULTS/ANTICIPATED RESULTS: Known Results: Results show that tocoflexol has potent antioxidant properties and high cell uptake. When tocoflexol was administered 24 hours before exposure to lethal doses of radiation, tocoflexol-treated mice showed 100% survival. Anticipated Results: Because of its improved bioavailability and pharmacokinetic properties, we expect that tocoflexol will show radiomitigation efficacy when administered 24 hours after radiation, improving survival and protecting key organ systems from acute radiation syndrome. DISCUSSION/SIGNIFICANCE: There is an unmet need for safe and effective radiomitigators that can offer multi-organ protection and be rapidly administered in the event of nuclear emergencies. Demonstration of radiomitigation efficacy will position tocoflexol as a prime candidate to be developed into a nuclear medical countermeasure and stockpiled for emergencies.