Hospital food service quality significantly impacts patient satisfaction with overall care(1) and can influence food intake, thereby increasing the risk of malnutrition(2). By contrast, meals tailored to patients’ needs result in lower complications and hospitalisation costs(3). With Australia’s ageing population and projected increases among racial and ethnic minority migrants, service delivery must adapt to promote equity and inclusion in the healthcare system. However, data is lacking on the lived experience, preferences, and acceptance of hospital food service and meal quality among older patients from culturally and linguistically diverse (CALD) backgrounds. This study aimed to bridge this gap by investigating the differences in hospital food services related to cultural and ethnic backgrounds. Semi-structured qualitative interviews were planned among 15 Australian-born and 15 CALD-background patients, aged 65 years or over, admitted to the Department of General Medicine at Flinders Medical Centre. Patients admitted with a highly contagious infectious disease (e.g., COVID-19), those referred for palliative care, receiving parenteral or enteral nutrition, or on nil-by-mouth orders were excluded. Translators were available to participants upon request. With participants’ consent, all interviews were audio recorded and transcribed verbatim. Transcripts were analysed thematically using Braun and Clarke’s six-phase process(4). Data was inductively coded with a phenomenological perspective to explore participants’ experiences with hospital food services. Similar codes were grouped together and further developed into themes through iterative discussions with the research team. The current analysis involved six participants from each group to present preliminary results. Among the 12 participants, the mean age was 82 years, ranging from 72–92 in the Australian-born group and 68–92 in the CALD group. Five primary themes emerged: (1) No Complaints—participants did not want to complain about their meals, preferring staff to focus on their healthcare. This attitude was compounded for CALD participants who lacked the language to voice complaints; (2) Food and Identity—CALD participants viewed themselves separately from Australian-born patients, with the lack of culturally familiar food contributing to a feeling of being the minority; (3) Acceptance—the food service was viewed in the context of the overall hospital system, with participants accepting that meals may not suit their preference; (4) Experiences of the Food Service—influenced by participant’s individual preferences for meal quality, menu options, and staff interactions; and (5) Nutrition and Health—All participants had a preference for smaller portions due to their perception of reduced nutritional needs, yet meals were also valued for enjoyment. These preliminary results indicate that hospital food services should offer culturally familiar options, improve patient-staff communication, and provide personalised, smaller portions to enhance patient experience. Addressing the enablers and barriers to meeting cultural and individual dietary needs in hospitals will promote equity, diversity, and inclusion in healthcare.

The use of home video recordings (HVRs) may aid in the diagnosis of neurological disorders. However, this practice remains underutilized. Through an anonymous survey, we sought to understand the perspectives of healthcare providers regarding the sharing of HVRs alongside referrals for responsive and economical pediatric neurology care. This was timely given COVID-19 has worsened wait times for diagnosis and consequently treatment. Most providers agree that sharing of HVRs improves patient care (93.1%: 67/73) and prevents both additional investigations (67%: 49/73) and hospital admissions (68.5%: 50/73). However, a minority of providers (21.9 %: 16/73) currently share HVRs alongside their referrals.

OBJECTIVES/GOALS: Wild-type transthyretin amyloid (ATTRwt) deposits have been found to deposit in the ligamentum flavum (LF) of spinal stenosis patients prior to systemic and cardiac amyloidosis, and is implicated in LF hypertrophy. Currently, no precise method of quantifying amyloid deposits exists. Here, we present our machine learning quantification method. METHODS/STUDY POPULATION: Images of ligamentum flavum specimens stained with Congo red are obtained from spinal stenosis patients undergoing laminectomies and confirmed to be positive for ATTRwt. Amyloid deposits in these specimens are classified and quantified by TWS through training the algorithm via user-directed annotations on images of LF. TWS can also be automated through exposure to a set of training images with user- directed annotations, and then application to a set of new images without additional annotations. Additional methods of color thresholding and manual segmentation are also used on these images for comparison to TWS. RESULTS/ANTICIPATED RESULTS: We develop the use of TWS in images of LF and demonstrate its potential for automated quantification. TWS is strongly correlated with manual segmentation in the training set of images with user-directed annotations (R = 0.98; p = 0.0033) as well as in the application set of images where TWS was automated (R = 0.94; p = 0.016). Color thresholding was weakly correlated with manual segmentation in the training set of images (R = 0.78; p = 0.12) and in the application set of images (R = 0.65; p = 0.23). DISCUSSION/SIGNIFICANCE: Our machine learning method correlates with the gold standard comparator of manual segmentation and outperforms color thresholding. This novel machine learning quantification method is a precise, objective, accessible, high throughput, and powerful tool that will hopefully pave the way towards future research and clinical applications.

Child labourers are at risk of poorer mental health and once rescued require urgent mental health interventions to ameliorate the long-term impact. In our review, only two published scientific studies evaluated custom-made interventions; other programmes were obtained from non-governmental organisations (NGOs), which need rigorous trial evaluation. We also sought the viewpoints of stakeholders working directly with rescued young people, as well as consulting young people with lived experiences of child labour. We propose that psychoeducational interventions aimed at employees working directly with young people could represent a fruitful approach for low- and middle-income countries in the Asia-Pacific region but also more generally.

We discuss theoretical and numerical aspects of gyrokinetics as a Lagrangian field theory when the field perturbation is introduced into the symplectic part. A consequence is that the field equations and particle equations of motion in general depend on the time derivatives of the field. The most well-known example is when the parallel vector potential is introduced as a perturbation, where a time derivative of the field arises only in the equations of motion, so an explicit equation for the fields may still be written. We will consider the conceptually more problematic case where the time-dependent fields appear in both the field equations and equations of motion, but where the additional term in the field equations is formally small. The conceptual issues were described by Burby (J. Plasma Phys., vol. 82 (3), 2016, 905820304): these terms lead to apparent additional degrees of freedom to the problem, so that the electric field now requires an initial condition, which is not required in low-frequency (Darwin) Vlasov–Maxwell equations. Also, the small terms in the Euler–Lagrange equations are a singular perturbation, and these two issues are interlinked. For well-behaved problems the apparent additional degrees of freedom are spurious, and the physically relevant solution may be directly identified. Because we needed to assume that the system is well behaved for small perturbations when deriving gyrokinetic theory, we must continue to assume that when solving it, and the physical solutions are thus the regular ones. The spurious nature of the singular degrees of freedom may also be seen by changing coordinate systems so the varying field appears only in the Hamiltonian. We then describe how methods appropriate for singular perturbation theory may be used to solve these asymptotic equations numerically. We then describe a proof-of-principle implementation of these methods for an electrostatic strong-flow gyrokinetic system; two basic test cases are presented to illustrate code functionality.

Utilization of low-input feed resources rich in plant bioactive compounds is a promising strategy for modulating the fatty acid profile in ruminant products. They manipulate microbes involved in rumen biohydrogenation and increase the accumulation of desirable fatty acids at the tissue level. Therefore, the present study was undertaken to assess the effect of dietary supplementation of aniseed straw and eucalyptus leaves on growth performance, carcass traits and fatty acid profile of finisher lambs. Thirty-six Malpura hogget were divided into three treatment groups of 12 each, reared individually in pen (1.6 m × 1.1 m) and fed ad libitum complete feed blocks made up of 55 parts concentrate, 5 parts molasses and 40 parts roughage. Roughage in control (Con) was 20 parts each of ardu (Ailanthus excelsa) leaves and oat (Avena sativa) straw. In test diets, that is, Con-as and Con-el, 10% aniseed (Pimpinella anisum) straw and Eucalyptus rudis leaves, respectively, were added by replacing 5% each of oat straw and eucalyptus leaves. The lambs were weighed weekly; and at the end of 3 months of feeding trial, the lambs were slaughtered to study the carcass traits, composition and product evaluation. Average daily gain (ADG) and DM intake (DMI) was higher (P < 0.05) in Con-as compared to Con and Con-el, while ADG and feed conversion ratio decreased (P < 0.05) by 29.4% and 36.4%, respectively, in Con-el compared to Con. Carcass traits showed lower (P < 0.05) loin eye area and chilling loss in the Con-el group compared to the Con-as and Con, and the total carcass fat compared to Con-as. However, the keeping quality of meat improved in both Con-as and Con-el which was reflected by lower (P < 0.05) thiobarbituric acid-reactive substances values. Nuggets prepared from Con and Con-as meat had superior (P < 0.05) sensory attributes with an overall palatability. Fatty acid profile of longissimus thoracis muscle showed lower (P < 0.05) atherogenic and thrombogenic indices in Con-as and higher (P < 0.05) in Con-el group. Moreover, in Con-as group, the proportion of C16:0 was lower (P < 0.05) and C18:3n-3 was higher (P < 0.05), but no effect was observed on the amount of conjugated linoleic acid (CLA; C18:2 c9t11). In case of adipose tissue, the content of CLA was higher (P < 0.05), and the ratio of n-6:n-3 was more nearer to desirable levels in Con-as group. Therefore, it can be concluded that aniseed straw is a promising feed supplement compared to eucalyptus leaves for improving meat quality and fatty acid profile in lambs.

Background: Pediatric craniocerebral gunshot wounds occur in the context of both accidental and intentional trauma. Unique physiologic factors merited research into prognostic factors and treatment priorities in the pediatric population. Methods: A systematic search of MEDLINE, EMBASE, Web of Science, LILACS, Cochrane Registered Trials and Systematic Reviews, ISRCTN, and ClinicalTrials.gov was conducted. Selection criteria included all studies published in any language since 2000 which described intracranial isolated gunshot wounds in a civilian individual or population of pediatric age. Post-mortem and epidemiological studies were excluded. Screening was conducted through Covidence. Results: Initial database search revealed 349 unique studies for abstract and title screening. Fifty studies were selected for full text screening. Nine studies were included in the final review. Study quality was assessed with the Newcastle-Ottawa Scale. Case series noted bullet migration, pituitary deficiency, neurovascular and neuropsychological concerns. Three single-center retrospective studies of 71, 30, and 48 pediatric patients suggested multiple negative prognostic signs on initial presentation. Early aggressive surgical treatment was recommended by some authors. Conclusions: This systematic review analyzed the best current understanding of evidence for prognostic factors and treatment considerations of intracranial gunshot wounds in the pediatric neurotrauma context. Areas for future research with larger multi-center studies were highlighted.

These remarks approach the panel topic of investor-state dispute settlement (ISDS) at the crossroads, by reflecting on the ongoing discussions on ISDS reform that are taking place at the United Nations Commission on International Trade Law (UNCITRAL). There are three sets of factors likely to inform how ISDS is being transformed.

Added surfactant and high relative humidity enhanced penetration of 4-amino-3,5,6-trichloropicolinic acid (picloram) into leaves of Canada thistle (Cirsium arvense (L.) Scop.). Leaves and roots of Canada thistle readily absorbed picloram after which it was translocated in both phloem and xylem. Picloram tended to accumulate in young, growing leaves following both foliar and root uptake. In field-grown plants, injury symptoms appeared in young shoots as far as 1 m from treated shoots. The results are in harmony with a “source-to-sink” pattern of picloram translocation in the phloem. Leaves, but not roots, retained a substantial portion of the picloram absorbed. Following foliar application, small amounts of picloram were exuded by the roots into surrounding soil.

The State of Qatar experienced a sandstorm on the night of April 1, 2015, lasting approximately 12 hours, with winds of more than 100 km/h and average particulate matter of approximately 10 μm in diameter. The emergency department (ED) of the main tertiary hospital in Qatar managed 62% of the total emergency calls and those of higher triage order. The peak load of patients during the event manifested approximately 6 hours after the onset. The Major Emergency Command Centre of the hospital ensured the department was maximally organized in terms of disaster management, and established protocols were brought into action. Multiple timely meetings were convened in efforts to effectively execute plans that included rapid emergency medical services handover time, resourcing staff, maximizing bed space, preventing dust entry in the ED, bypassing certain administrative processes, canceling day-surgeries that did not affect inpatient morbidity, and procuring additional respiratory equipment. Patients arrived mainly with exacerbations of asthma and respiratory distress, ophthalmic emergencies, and vehicular trauma; surprisingly, the incidence of pedestrian injuries did not vary. (Disaster Med Public Health Preparedness. 2017;11:227–238)

In search of a suitable resource conservation technology under pigeonpea (Cajanus cajan L.)–wheat (Triticum aestivum L.) system in the Indo-Gangetic Plains, the effects of conservation agriculture (CA) on crop productivity and water-use efficiency (WUE) were evaluated during a 3-year study. The treatments were: conventional tillage (CT), zero tillage (ZT) with planting on permanent narrow beds (PNB), PNB with residue (PNB + R), ZT with planting on permanent broad beds (PBB) and PBB + R. The PBB + R plots had higher pigeonpea grain yield than the CT plots in all 3 years. However, wheat grain yields under all plots were similar in all years except for PBB + R plots in the second year, which had higher wheat yield than CT plots. The contrast analysis showed that pigeonpea grain yield of CA plots was significantly higher than CT plots in the first year. However, both pigeonpea and wheat grain yields during the last 2 years under CA and CT plots were similar. The PBB + R plots had higher system WUE than the CT plots in the second and third years. Plots under CA had significantly higher WUE and significantly lower water use than CT plots in these years. The PBB + R plots had higher WUE than PNB + R and PNB plots. Also, the PBB plots had higher WUE than PNB in the second and third years, despite similar water use. The interactions of bed width and residue management for all parameters in the second and third years were not significant. Those positive impacts under PBB + R plots over CT plots were perceived to be due to no tillage and significantly higher amount of estimated residue retention. Thus, both PBB and PBB + R technologies would be very useful under a pigeonpea–wheat cropping system in this region.

The goal of this work is to study the properties of magnetically aligned CNT/PC nanocomposites towards the development of hydrogen gas separation membranes. A fraction (0.1 weight %) of synthesized carbon nanotubes (CNTs) have been dispersed homogeneously throughout polycarbonate (PC) matrix by ultrasonication. The alignment of CNT in PC matrix has been accomplished by applying an external magnetic field of 1200 Gauss. These nanocomposites have been studied by gas permeation using H2, N2 and Co2 electrical and dielectric constant measurements. Experimental results of gas permeability measurements exhibit here that H2 is more selective than N2 and Co2 in magnetically aligned nanocomposite membranes which can be used as good hydrogen separating media. I-V characteristics show the electron hopping like behavior and dielectric constant shows the enhancement in permittivity of these nanocomposites.

The treatment by states, at the 69th session of the UNGA, of the ILC’s work on the responsibility of international organizations, the effects of armed conflicts on treaties, and the expulsion of aliens, offer some interesting points for reflection, particularly about the role of states in international law-making. This paper situates the UNGA’s consideration of the draft articles before it within the context of the recent trends of the UNGA’s commending of the ILC’s draft articles to the attention of governments, and of its use of technical roll-overs. In this regard, the paper questions whether the UNGA’s approach to the draft articles on the expulsion of aliens signals a reawakening of the UNGA. Against this backdrop, the paper also discusses the past practice of the UNGA when considering the draft articles of the ILC.