OBJECTIVES/GOALS: The goal of this study is to leverage a national database to see if autologous reconstruction rates differ in patient and clinical characteristics, readmission rates, and overall survival (OS) compared to other forms of reconstruction. Autologous reconstruction has not been looked at in this way before. METHODS/STUDY POPULATION: • Aim 1: Use the National Cancer Data Base to construct three patient cohorts for women under 70 and above 18 treated surgically for breast cancer with A) mastectomy only, B) implant-based reconstruction, and C) autologous breast reconstruction. • Aim 2: Examine receipt rates of surgical intervention in Cohorts A vs. B vs. C based on clinical and patient demographic/socioeconomic characteristics. • Aim 3: Compare readmission and overall survival (OS) rates for Cohorts A vs. B vs. C while controlling for age and other key variables. RESULTS/ANTICIPATED RESULTS: Based on the literature, we expect rates of autologous reconstruction (Cohort C) to be lower for patients of minority backgrounds compared to white individuals. In addition, we do not expect overall survival to differ between implant-based (Cohort B) and Cohort C reconstruction. Still, we expect mastectomy-only (Cohort A) survival to vary from the two cohorts even when adjusting for different clinical factors, as similar but smaller studies have shown. Finally, we expect readmission rates to be higher for Cohort C, compared to Cohorts A & B, as it is a more complicated procedure typically done in academic institutions with skilled surgeons. DISCUSSION/SIGNIFICANCE: Autologous reconstruction is now considered the gold standard due to its ability to restore the breast shape with higher patient satisfaction and superior long-term outcomes. Multiple studies have documented ongoing racial disparities in post-mastectomy breast reconstruction and autologous reconstruction, with lower rates and referrals.

Preterm birth has been associated with insulin resistance and beta-cell dysfunction, a hallmark characteristic of type 2 diabetes. However, studies investigating the relationship between a personal history of being born preterm and type 2 diabetes are sparse. We sought to investigate the potential association between a personal history of being born preterm and risk for type 2 diabetes in a racially and ethnically diverse population. Baseline and incident data (>16 years of follow-up) from the Women’s Health Initiative (n = 85,356) were used to examine the association between personal history of being born preterm (born 1910–1940s) and prevalent (baseline enrollment; cross-sectional) or incident (prospective cohort) cases of type 2 diabetes. Logistic and Cox proportional hazards regression models were used to estimate odds and hazards ratios. Being born preterm was significantly, positively associated with odds for prevalent type 2 diabetes at enrollment (adjOR = 1.79, 95% CI 1.43–2.24; P < 0.0001). Stratified regression models suggested the positive associations at baseline were consistent across race and ethnicity groups. However, being born preterm was not significantly associated with risk for incident type 2 diabetes. Regression models stratified by age at enrollment suggest the relationship between being born preterm and type 2 diabetes persists only among younger age groups. Preterm birth was associated with higher risk of type 2 diabetes but only in those diagnosed with type 2 diabetes prior to study enrollment, suggesting the association between preterm birth and type 2 diabetes may exist at earlier age of diagnosis but wane over time.

This study aimed to articulate the roles of social support and coping strategies in the relation between childhood maltreatment (CM) and subsequent major depressive disorder (MDD) with a comprehensive exploration of potential factors in a longitudinal community-based cohort. Parallel and serial mediation analyses were applied to estimate the direct effect (DE) (from CM to MDD) and indirect effects (from CM to MDD through social support and coping strategies, simultaneously and sequentially). Sociodemographic characteristics and genetic predispositions of MDD were considered in the modeling process. A total of 902 participants were included in the analyses. CM was significantly associated with MDD (DE coefficient (β) = 0.015, 95% confidence interval (CI) = 0.002∼0.028). This relation was partially mediated by social support (indirect β = 0.004, 95% CI = 0.0001∼0.008) and negative coping (indirect β = 0.013, 95% CI = 0.008∼0.020), respectively. Social support, positive coping, and negative coping also influenced each other and collectively mediated the association between CM and MDD. This study provides robust evidence that although CM has a detrimental effect on later-on MDD, social support and coping strategies could be viable solutions to minimize the risk of MDD. Intervention and prevention programs should primarily focus on weakening negative coping strategies, then strengthening social support and positive coping strategies.

User-defined higher-order rewrite rules are becoming a standard in proof assistants based on intuitionistic type theory. This raises the question of proving that they preserve the properties of beta-reductions for the corresponding type systems. In a series of papers, we develop techniques based on van Oostrom’s decreasing diagrams that reduce confluence proofs to the checking of various forms of critical pairs for higher-order rewrite rules extending beta-reduction on pure lambda-terms. As shown in a previous paper of the two middle authors, confluence of a terminating set of left-linear rewrite rules is obtained when their critical pairs are joinable, beta-rewrite steps being disallowed. The present paper concentrates on the case where arbitrary beta-rewrite steps are allowed for joining critical pairs. The rewrite relation used for analyzing confluence may rewrite arbitrarily many non-overlapping redexes in a single step. This relation gives rise to critical pairs that overlap both horizontally, as with parallel rewriting, but also vertically, forming chains of successive overlaps. Practical examples of use of this technique are analyzed.

This paper investigates what drives countries to legislate presumed consent – making citizens organ donors by default unless they opt out – instead of explicit consent. Results reveal the following: First, civil law predicts presumed consent, which uncovers a mechanism by which an institution that long pre-dates transplantation medicine has an impact on current health outcomes. This is in line with previous research that has found that civil law regimes tend to be more comfortable with a centralized and activist government than common law ones. Second, Catholicism predicts presumed consent. This is consistent with previous research that shows Catholicism generally relies on more hierarchical structures and is less likely to encourage social responsibility among its members. Last, higher pro-social behavior decreases the likelihood of presumed consent. This could be explained by policy-makers trying not to discourage donations where pro-social behavior is high by making it look a requirement rather than an altruistic act. The implications of the findings are discussed, with a particular focus on policy-switches in organ donations.

In 2018, the Alliance for Open Media (AOMedia) finalized its first video compression format AV1, which is jointly developed by the industry consortium of leading video technology companies. The main goal of AV1 is to provide an open source and royalty-free video coding format that substantially outperforms state-of-the-art codecs available on the market in compression efficiency while remaining practical decoding complexity as well as being optimized for hardware feasibility and scalability on modern devices. To give detailed insights into how the targeted performance and feasibility is realized, this paper provides a technical overview of key coding techniques in AV1. Besides, the coding performance gains are validated by video compression tests performed with the libaom AV1 encoder against the libvpx VP9 encoder. Preliminary comparison with two leading HEVC encoders, x265 and HM, and the reference software of VVC is also conducted on AOM's common test set and an open 4k set.

A novel solid-clad-by-liquid method was developed to form a 10-m long by 10-mm wide by 80-μm thick Ni–5 at.% W/Ni–9.3 at.% W/Ni–5 at.% W composite tape. Three deformation routes (cold rolling, cold rolling with intermediate annealing, and cold rolling combined with warm rolling) have been investigated in short Ni–5 at.% W/Ni–9.3 at.% W/Ni–5 at.% W composite substrate. To optimize the dynamic continuous annealing parameters for the long composite substrates, air-cooled and furnace-cooled annealing procedures were compared in short Ni–5 at.% W/Ni–9.3 at.% W/Ni–5 at.% W composite substrates. Improved cube texture of 98.7% in a 10-m long by 10-mm wide by 80-μm thick Ni–5 at.% W/Ni–9.3 at.% W/Ni–5 at.% W composite substrate was achieved via warm rolling deformation at 550 °C and two-step dynamic continuous annealing (750 °C for 1 h followed by 1200 °C for 1 h). The yield strength, Curie temperature, and saturation magnetization of 176 MPa, 324 K, and 18 emu/g, respectively, were obtained.

Based on the data from the Next Generation Virgo cluster Survey (NGVS), we statistically study the photometric properties of globular clusters (GCs), ultra-compact dwarfs (UCDs) and dwarf nuclei in the Virgo core (M87) region. We found an obvious negative color (g - z) gradient in GC system associate with M87, i.e. GCs in the outer regions are bluer. However, such color gradient does not exist in UCD system, neither in dwarf nuclei system around M87. In addition, we found that many UCDs are surrounded by extended, low surface brightness envelopes. The dwarf nuclei and UCDs show different spatial distributions from GCs, with dwarf nuclei and UCDs (especially for the UCDs with visible envelopes) lying at larger distances to the Virgo center. These results support the view that UCDs (at least for a fraction of UCDs) are more tied to dwarf nuclei than to GCs.

The epitaxial integration of III–V optoelectronic devices on silicon will be the enabling technology for full-scale deployment of silicon photonics and the key to improving communication systems. Silicon photonics also offer new opportunities for the realization of ultracompact and fully integrated sensing systems operating in the mid-infrared (MIR) regime of the spectrum. In this article, we review recent developments, through several approaches, in the direct metamorphic epitaxial growth of various III–V materials-based lasers on silicon substrates. We show that GaAs-based 1.3-μm III–V quantum dot lasers and GaSb-based MIR quantum-well lasers grown on silicon substrates can operate with low threshold current density and high operating temperature, which hold promise for the future.

Background: Schema Theory proposes that the development of maladaptive schemas are based on a combination of memories, emotions and cognitions regarding oneself and one's relationship to others. A cognitive model of psychosis suggests that schemas are crucial to the development and persistence of psychosis. Little is known about the impact that schemas may have on those considered to be at clinical high risk (CHR) of developing psychosis. Aims: To investigate schemas over time in a large sample of CHR individuals and healthy controls. Method: Sample included 765 CHR participants and 280 healthy controls. Schemas were assessed at baseline, 6 and 12 months using the Brief Core Schema Scale (BCSS). Baseline schemas were compared to 2-year clinical outcome. Results: CHR participants evidenced stable and more maladaptive schemas over time compared to controls. Schemas at initial contact did not vary amongst the different clinical outcome groups at 2 years although all CHR outcome groups evidenced significantly worse schemas than healthy controls. Although there were no differences on baseline schemas between those who later transitioned to psychosis compared to those who did not, those who transitioned to psychosis had more maladaptive negative self-schemas at the time of transition. Associations between negative schemas were positively correlated with earlier abuse and bullying. Conclusions: These findings demonstrate a need for interventions that aim to improve maladaptive schemas among the CHR population. Therapies targeting self-esteem, as well as schema therapy may be important work for future studies.

Discovery of ultra-compact dwarfs (UCDs) in the past 15 years blurs the once thought clear division between classic globular clusters (GCs) and early-type galaxies. The intermediate nature of UCDs, which are larger and more massive than typical GCs but more compact than typical dwarf galaxies, has triggered hot debate on whether UCDs should be considered galactic in origin or merely the most extreme GCs. Previous studies of various scaling relations, stellar populations and internal dynamics did not give an unambiguous answer to the primary origin of UCDs. In this contribution, we present the first ever detailed study of global dynamics of 97 UCDs (rh ≳ 10 pc) associated with the central cD galaxy of the Virgo cluster, M87. We found that UCDs follow a different radial number density profile and different rotational properties from GCs. The orbital anisotropies of UCDs are tangentially-biased within ~ 40 kpc of M87 and become radially-biased with radius further out. In contrast, the blue GCs, which have similar median colors to our sample of UCDs, become more tangentially-biased at larger radii beyond ~ 40 kpc. Our analysis suggests that most UCDs in M87 are not consistent with being merely the most luminous and extended examples of otherwise normal GCs. The radially-biased orbital structure of UCDs at large radii is in general agreement with the scenario that most UCDs originated from the tidally threshed dwarf galaxies.

Transparent conducting aluminum-doped and undoped ZnO thin films have been deposited by direct current (DC) sputtering technique from ZnO target onto glass substrate at room temperature and 400 °C. X-ray diffraction analysis shows that all films have a preferential growth along the c-axis of the hexagonal structure. The average grain size increases with the increasing deposition temperature and the doping of thin films. Analysis with AFM shows an improvement of the surface with the doping of thin films and deposition temperature. The root main square (RMS) surface roughness increases with deposition temperature. Al-doped ZnO (AZO) thin films have a lower electrical resistivity than that of ZnO thin films. 1/f noise measurement shows that ZnO thin film is more homogeneous than that of AZO.