OBJECTIVES/GOALS: High serum copper (Cu) levels have previously been described in bariatric patients. The kidneys are a target organ for Cu toxic insult but the role of Cu on kidney function (eGFR) is uncertain. This study examines the association between Cu and eGFR in a bariatric population in Southeast Louisiana. METHODS/STUDY POPULATION: Seven hundred fifty patients will be recruited from the Bariatric Center of the University Medical Center in New Orleans. Inclusion criteria include: age ≥ 18 years, clinic visit between June 1, 2018 – May 31st 2024, and having a serum Cu test result. Covariables such as inflammatory markers and hormonal contraception use will be assessed as potential confounders. Blood pressure will be assessed as a potential effect modifier. Data will be obtained from electronic medical records. Two cohorts will be assembled, a pre-surgery cross-sectional cohort and another followed post-surgery. Separate models will be developed stratified by race-ethnicity. RESULTS/ANTICIPATED RESULTS: In a pilot study of bariatric patients 26% had elevated (>155 mcg/dl) serum Cu and pronounced racial differences were noted. Characteristics consisted of a mean BMI of approximately 50 kg/m2; 91% were female and 69% were Black. Black patients had approximately double the prevalence (OR 1.98; 95% CI: 1.15, 3.4) compared to white patients. Due to the dual nature of the kidneys’ involvement in metabolism via excretion and being the target organ for toxic insult, racial differences in exposure, coupled with the disproportionate rates of chronic kidney disease in Black adults, may be an explanation for the association between elevated Cu levels and eGFR in Black adults in this study. DISCUSSION/SIGNIFICANCE: Results from this study will provide insight into the prevalence of Cu and its association with kidney function in a bariatric population. Chronic kidney disease or other forms of renal impairment may result in the need for more conservative guidelines for dietary copper in bariatric medicine.

Abha Arabic is a dialect of Arabic (ISO 693-3: ara), belonging to the Semitic language family group, and spoken primarily in Abha city. Abha Arabic can be broadly classified as a variety of Arabic from the Arabian Peninsula group (Versteegh, 2014), and further sub-classified as a south (-west) Arabian dialect (Ingham, 1982). Abha city is the administrative capital of the province of Asir, in south-west Saudi Arabia (Figure 1). The population of Abha is approximately 290,185 and that of the Asir province is 1,601,725, according to the most recent data on the population (General Authority for Statistics, 2010). The province is named after the Asir tribe, who first inhabited Abha and the surrounding regions. The present day Abha Arabic dialect thus represents a blending of Bedouin and urban dialects. The first settlers to Abha were the Bani-Mghed tribe (an Asir tribe) followed by three additional Asir tribes (Alkam, Rabiah w Rufeda, Bani-Malik) and other nearby tribes such as the Gahtaːn, Bal-lahmir, Bal-lasmir, Shahran, Rejal Alma’, all of which had distinct dialects (Al-Azraqi, 1998). These dialects merged to varying degrees and were further influenced by urban education and mass media, which were and continue to be dominated by Modern Standard Arabic (henceforth MSA) (Al-Azraqi, 1998).1

Youth in the juvenile justice system evince high rates of mental health symptoms, including anxiety and depression. How these symptom profiles change after first contact with the justice system and – importantly – how they are related to re-offending remains unclear. Here, we use latent growth curve modeling to characterize univariate and multivariate growth of anxiety, depression, and re-offending in 1216 male adolescents over 5 years following their first arrest. Overall, the group showed significant linear and quadratic growth in internalizing symptoms and offending behaviors over time such that levels decreased initially after first arrest followed by a small but significant upturn occurring a few years later. Crucially, multivariate growth models revealed strong positive relationships between the rates of growth in internalizing symptoms and offending behaviors such that improvements in mental health related to greater decreases in offending, and vice versa. These results highlight the reciprocal nature of internalizing and externalizing problems in adolescence, underscoring the importance of considering mental health alongside offending in the juvenile justice system.

Hereditary transthyretin-mediated (hATTR) amyloidosis is a progressive disease caused by mutations in the TTR gene leading to multisystem organ dysfunction. Pathogenic TTR aggregation, misfolding, and fibrillization lead to deposition of amyloid in multiple body organs and frequently involve the peripheral nerve system and the heart. Common neurologic manifestations include: sensorimotor polyneuropathy (PN), autonomic neuropathy, small-fiber PN, and carpal tunnel syndrome. Many patients have significant progression due to diagnostic delays as hATTR PN is not considered within the differential diagnosis. Recently, two effective novel disease-modifying therapies, inotersen and patisiran, were approved by Health Canada for the treatment of hATTR PN. Early diagnosis is crucial for the timely introduction of these disease-modifying treatments that reduce impairments, improve quality of life, and extend survival. In this guideline, we aim to improve awareness and outcomes of hATTR PN by making recommendations directed to the diagnosis, monitoring, and treatment in Canada.

Smoking rates in people with depression and anxiety are twice as high as in the general population, even though people with depression and anxiety are motivated to stop smoking. Most healthcare professionals are aware that stopping smoking is one of the greatest changes that people can make to improve their health. However, smoking cessation can be a difficult topic to raise. Evidence suggests that smoking may cause some mental health problems, and that the tobacco withdrawal cycle partly contributes to worse mental health. By stopping smoking, a person's mental health may improve, and the size of this improvement might be equal to taking antidepressants. In this article we outline ways in which healthcare professionals can compassionately and respectfully raise the topic of smoking to encourage smoking cessation. We draw on evidence-based methods such as cognitive–behavioural therapy (CBT) and outline approaches that healthcare professionals can use to integrate these methods into routine care to help their patients stop smoking.

This manuscript describes, defines, and discusses the process of cold sintering, which can consolidate a broad set of inorganic powders between room temperature and 300 °C using a standard uniaxial press and die. This temperature range is well below that needed for appreciable bulk diffusion, indicating immediately the distinction from the well-known and thermally driven analogue, allowing for an unconventional method for densifying these inorganic powders. Sections of this report highlight the general background and history of cold sintering, the current set of known compositions that exhibit compatibility with this process, the basic experimental techniques, the current understanding of physical mechanisms necessary for densification, and finally opportunities and challenges to expand the method more generically to other systems. The newness of this approach and the potential for revolutionary impact on traditional methods of powder-based processing warrants this discussion despite a nascent understanding of the operative mechanisms.

Motivational interviewing has been employed extensively and successfully among people with alcohol and other drug problems in order to enhance involvement in treatment and to reduce substance use. Despite clear commonalities in motivating people with mental health problems to recognise their problem and adhere to treatment, motivational interviewing has not been widely adopted by mental health professionals, largely due to the separation of mental health versus substance use services. The existing evidence for the effectiveness of motivational interviewing in improving engagement in treatment for mental health problems is reviewed. It is recommended that, based on the evidence available, motivational interviewing should be applied to people with mental health problems as well as those with substance-related problems to enhance treatment engagement, retention and response. Guidelines for its application are suggested.

Pathophysiological stress from acute illness causes metabolic disturbance, including altered hepatic glucose metabolism, increased peripheral insulin resistance and hyperglycaemia. Acute hyperglycaemia is associated with increased morbidity and mortality in patients in intensive care units and patients with acute respiratory disease. The present review will consider mechanisms underlying this association. In normal lungs the glucose concentration of airway secretions is approximately 10-fold lower than that of plasma. Low airway glucose concentrations are maintained against a concentration gradient by active glucose transport. Airway glucose concentrations become elevated if normal homeostasis is disrupted by a rise in blood glucose concentrations or inflammation of the airway epithelium. Elevated airway glucose concentrations are associated with and precede increased isolation of respiratory pathogens, particularly methicillin-resistant Staphylococcus aureus, from bronchial aspirates of patients intubated on intensive care. Markers of elevated airway glucose are associated with similar patterns of respiratory infection in patients admitted with acute exacerbations of chronic obstructive pulmonary disease. Glucose at airway concentrations stimulates the growth of respiratory pathogens, over and above the effect of other nutrients. Elevated airway glucose concentrations may also worsen respiratory disease by promoting local inflammation. Hyperglycaemia may thus promote pulmonary infection, at least in part, by an effect on airway glucose concentrations. Therapeutic options, including systemic control of blood glucose and local manipulation of airway glucose homeostasis, will be considered.