Single ventricle patients undergoing comprehensive stage II palliation have higher incidence of severe acute kidney injury compared to the bidirectional Glenn palliation; however, the optimal method for early detection remains unknown. Several urinary biomarkers are increased in other patient populations with postoperative kidney injury. We explored the kinetics of these biomarkers in this high-risk population.

We conducted prospective, observational study of 20 patients with single ventricle physiology who underwent second stage palliation (July 2019–December 2021). Acute kidney injury was defined by Kidney Diseases Improving Global Guidelines, based on peak serum creatinine value and urine output. Urine samples were collected pre-operatively and at 1-, 6-, and 24-hours post-surgery. Urinary biomarkers neutrophil gelatinase-associated lipocalin, interleukin-18, liver fatty acid-binding protein, kidney injury molecule-1, and cystatin C were quantified by enzyme linked immunosorbent assay, normalised to urinary creatinine, and shown as median [interquartile range].

Four patients (50%) undergoing comprehensive stage II and 1 patient (8%) undergoing bidirectional Glenn palliation developed stage ≥ 2 acute kidney injury. Comprehensive stage II compared to bidirectional Glenn group had higher median neutrophil gelatinase-associated lipocalin (1769 [1309–1961] versus 91[18–1120] ng/mg) and liver fatty acid-binding protein (12,836 [5016–19798] versus 1272 [220–5172] ng/mg) that peaked 1-hour post-surgery. Kidney injury molecule-1 was significantly greater at 1-, 6-, and 24-hours (greatest) post-surgery in comprehensive stage II than bidirectional Glenn (24h: 11[9–23]) versus 2 [1–6] ng/mg).

Elevated urinary neutrophil gelatinase-associated lipocalin, liver fatty acid-binding protein, and kidney injury molecule-1 may be useful biomarkers for early detection of acute kidney injury in children following comprehensive stage II palliation.

Following the recent report of strongyloidiasis caused by Strongyloides fuelleborni within a semi-captive colony of baboons in a UK safari park, we investigated the genetic relationships of this isolate with other Strongyloides isolates across the world. Whole-genome sequencing data were generated with later phylogenetic analysis of mitochondrial (mt) cytochrome oxidase subunit 1 (cox1) and nuclear ribosomal 18S sequences against 300 published Strongyloides reference genotypes. The putative African origin of the UK S. fuelleborni was confirmed and full-length mt genome sequences were assembled to facilitate a more detailed phylogenetic analysis of 14 mt coding regions against all available Strongyloides species. Our analyses demonstrated that the UK isolate represented a novel African lineage not previously described. Additional complete mt genomes were assembled for several individual UK safari park worms to reveal a slightly altered mt genome gene arrangement, allowing clear separation from Asian S. fuelleborni. Furthermore, these UK worms possessed expanded intergenic regions of unknown function that increase their mt genome size to approximately 24 kilobases (kb) as compared with some 16 kb for Asian S. fuelleborni; this may have arisen from unique populational founder and genetic drift effects set within the peculiar mixed species baboon and drill ancestry of this semi-captive primate colony. A maximum likelihood phylogeny constructed from 14 mt coding regions also supported an evolutionary distinction between Asian and African S. fuelleborni.

The Department of Veterans Affairs (VA) does not have system-wide standardized policies or procedures for ultraviolet-C (UV-C) use. Qualitative researchers performed content analysis of VAV UV-C guidance documents. We observed that lack of specificity and uniformity across guidance documents is a potential barrier to UV-C implementation and future quality control.

Nick Cunningham of Oil Price.com has written a timely article summarizing the World Cup's gargantuan energy consumption and carbon footprint. The World Cup soccer competition underway in Brazil is held quadrennially, and is apparently the most watched sporting event of all. This year's games are to culminate in the July 17 finale in Rio de Janeiro. The games appear likely to set both a viewing record as well as a record for energy consumption and carbon emissions. An estimated 900 million watched the opening ceremonies of London's 2012 Olympics. But the World Cup governing body FIFA's research suggests 909.6 million viewers watched at least a minute of the 2010 World Cup, and Cunningham tells us there may be as many as 3 billion viewers for this event in 2014. Moreover, broadcasting's technical innovations are proceeding apace. Ultra-high definition broadcasts (expected to become standard in 2017) are being used for three of this year's matches, taking advantage of the event's eyeball-dense economics. The official match ball is the Adidas Brazuca, one of which has its own twitter account and micro-cameras studding its surface.

At first glance, the handful of Tokyo rightists who created a furor about a graphic scene of the Nanjing Massacre in two September issues of the popular manga magazine Young Jump Weekly are a surprisingly tolerant lot. They restricted their complaint to technical issues in “My Country is Burning” (Kuni ga moeru!) by Motomiya Hiroshi, the only remotely educational series in a popular weekly comic book, and ignored 400 pages of gratuitous sex, violence, scatology and gore that dominates this illustrated publication with a reported circulation of 2 million.

Clashing views about Thailand's future are being played out on the streets of Bangkok, taking the form of forceful demonstrations, contentious commemorations and populist grandstanding by red shirted and yellow shirted rivals. Behind the searing rhetoric and policy clashes are battles of personality, in which patron-client links coalesce, regroup and solidify, rewarding loyalty with a top-down sharing of power and spoils.

What follows is an account of a return visit to Tiananmen Square in commemoration of the 25th anniversary of the peaceful demonstrations and violent crackdown that I witnessed in Beijing in 1989.

Initially I had planned to go to Hong Kong, as I had been invited to join the well-publicized commemoration in Victoria Park where the people of Hong Kong have held a candlelight vigil for the lost souls and lost dreams of 1989 on an annual basis for a quarter of a century now. In past years I have marched with the conscientious objectors of Hong Kong, lit candles in the warm tropical air and drawn strength from the distant but principled and persistent expression of solidarity with the uprising at Tiananmen.

The sniper shooting of Seh Daeng, Maj. Gen. Khattiya Sawasdipol, on May 13, 2010 by an unknown assailant while chatting with foreign reporters has brought to rupture the standoff between Reds and Yellows in the heart of Bangkok and signals a new stage in the movement and its repression. Seh Daeng, whose nickname means “red commander”, was the reddest of the red shirts. His daughter, who sat at his bedside in the hospital until he succumbed to his grievous wounds on May 17, 2010, has been a staunch supporter of the yellow shirts, illustrative of the convoluted politics of the era. To better put in context the convoluted color-coded politics of the present day, and to identify some of the key heroes and villains and historic reference points being talked about on both sides of the barricades in Bangkok, a brief review of Thai political activism over the years will follow.

“Ladies and gentlemen, your attention please. We have just experienced an earthquake. Please move away from the buildings to an open area…We will provide more detailed information as soon as possible…”

The polite but authoritative “we” was the voice of the Tokyo DisneySea theme park in this instance, but similar, oddly reassuring warnings of peril were being echoed across Japan, mostly following the lead of television broadcaster NHK.

Objectives/Goals: One in 14 individuals have a substance use disorder (SUD). We suggest that a trait of poor impulse control, or high impulsivity, may predict relapse risk. We explore how changes in brain structure linked to decision-making and reward might drive high impulsivity, helping create a “biosignature” to identify those most at risk and guide treatment choices. Methods/Study Population: Male rats were phenotyped as high impulsive (HI) or low impulsive (LI) based on premature responses on the one-choice serial reaction time (1-CSRT) task. Rats then received an intracranial infusion of a retrograde virus (AAVr2) in the nucleus accumbens (NAc) to trace corticoaccumbens neurons back to the medial prefrontal cortex (mPFC). After impulsivity phenotyping (ITI8), another cohort of animals performed cocaine self-administration followed by 30 days of abstinence. Cue reactivity, a measure of relapse-like behaviors, was performed on abstinence day 30. Analyses of microtubule-associated protein 2 (MAP2), a cytoskeletal marker of dendrites, spines, and somas was performed with western blotting and fluorescent images of brain slices after phenotyping and cocaine abstinence. Results/Anticipated Results: HI rats made greater premature responses, a marker of impulsive action vs. LI rats at baseline (p Discussion/Significance of Impact: Poor inherent impulse control and drug cues heighten relapse risk. We found high impulsivity linked to brain structure differences and lower protein markers of synaptic (units supporting signaling) strengthening. Future investigations into brain-behavior links with impulsivity may further identify a SUD relapse vulnerability biosignature.

Objectives/Goals: The gut microbiome and its metabolites, such as short-chain fatty acids (SCFA), are dysregulated in rheumatoid arthritis (RA); however, the significance of this observation and its implications in pathogenesis and therapeutics is unclear. Here, we explore the role of the SCFA, butyrate, in treatment efficacy in new-onset rheumatoid arthritis. Methods/Study Population: We designed a proof-of-principle study to determine the effects of butyrate supplementation in new-onset RA (NORA) patients that fulfilled 2010 ACR/EULAR RA criteria. We evaluated the effects of methotrexate (MTX) plus butyrate in NORA (n = 17; 1 gm butyrate, 3 times daily) compared to MTX alone (n = 19) over 4 months. MTX responders were defined by a change in disease activity score (DAS)-28 ESR of > 1.8 at 4 months. Fecal samples were collected at baseline and followed up for 16s rRNA sequencing and metabolite quantification by 1H NMR spectroscopy. Unpaired-t, paired-t, Wilcox and Fisher’s exact test were performed as appropriate. Results/Anticipated Results: MTX responders in the MTX-only group had a higher concentration of fecal butyrate than nonresponders at baseline (p = 0.045). Fecal butyrate concentration decreased over time in treatment responders in MTX group (p = 0.05), whereas butyrate concentration remained similar in MTX/butyrate group. Prior to treatment, both MTX and MTX/butyrate groups demonstrated similar levels of gut bacterial alpha diversity (Shannon index), yet only the MTX/butyrate group demonstrated a significant increase in alpha diversity by 4 months (p = 0.022). LefSe analysis demonstrated increased abundances of Bacteroides, Clostridium, and Phascolarctobacterium in responders in the MTX/butyrate group by 4 months. Ten (52.6%) patients in MTX and 11 (64.7%) in MTX/butyrate group were considered MTX responders by 4 months (p = 0.516). Discussion/Significance of Impact: Butyrate supplementation increased gut microbial diversity in patients and led to increased abundance of Bacteroides, which has been implicated in efficacy of methotrexate, a first line medication in rheumatoid arthritis. Butyrate may have implications for the maximization of therapeutic effectiveness in rheumatoid arthritis.

A retrospective tour of the haunts and hideouts of the 1989 Tiananmen student uprising would not be complete without a visit to Beijing University, known simply as Beida. Arguably the most prestigious university in China, Beida has long been home to creative thinkers and intellectual ferment ever since the days a young Mao Zedong worked in its associated library and literati such as Hu Shih and Lu Xun graced its grounds.

In 1989 Beida was the fount of discussion and discontent that spread to other campuses. Among Beijing colleges, it was the most distant from Tiananmen, but the Beida contingent always seemed to show up first.