Arterial oxygen saturation in single ventricle patients is dependent on systemic cardiac output. Here, we describe a case of a newborn with single ventricle physiology and an unusual mechanism to explain poor cardiac output and cyanosis. This case highlights the importance of identifying and considering ventricular morphology and ventricular-ventricular interactions to understand clinical challenges.

Dimethylselenoxide (DMSeO) forms three structurally resolvable intercalates with kaolinite (d(001) = 10.95, 11.26, and 11.38 Å). The 11.26-Å kaolinite: DMSeO intercalate is structurally analogous to the 3-D ordered kaolinite: DMSO intercalate (d(001) = 11.22 Å). Infrared and solid-state 77Se nuclear magnetic resonance data indicate that all DMSeO molecules are equivalent in the structure and, therefore, that the 11.26-Å kaolinite: DMSeO intercalate structure is C-face centered. Structural model refinement from X-ray powder diffraction (XRD) data further support this conclusion (Pl, a = 5.195(2), b = 8.990(4), c = 11.946(5) Å, α = 91.33(2)°, β = 109.39(2)°, γ = 89.77(2)°). The kaolinite: DMSO intercalate structure was subsequently re-refined from the XRD profile in C-face centered Pl. The derived orientation of the DMSO and DMSeO molecules with respect to the basal plane of their respective intercalates is in agreement with polarized infrared measurements of the angles with ab of S=O (40.3°) and Se=O (38.8°) for the 11.26-Å intercalate. The locations of the organic molecules also agree with observed infrared band splittings and perturbations. Interatomic distances calculated from the band shifts agree with those for the XRD derived structures.

The 11.38-Å kaolinite: DMSeO intercalate is closely related to the 11.26-Å intercalate, the main differences being a 2-fold disorder in the orientation of the DMSeO molecule and less penetration of the kaolinite ditrigonal cavity by that molecule. The 10.95-Å kaolinite: DMSeO intercalate, displaying disorder parallel to [110], was obtained from the 11.26- or 11.38-Å intercalates by removal of some DMSeO.

Soil formation usually results in an increase in magnetic susceptibility. The magnetic properties of the products of transformation of ferrihydrite, a typical precursor of other soil Fe oxides, were examined in the present work. Synthetic 2-line ferrihydrite was aged at two temperatures (25 and 50°C) and two different relative humidities (80 and 100%) in the presence of silicate, phosphate, citrate, and tartrate as adsorbed ligands (molar anion/Fe ratio = 1–3%). The ligands delayed or prevented the transformation of ferrihydrite to hematite. The magnetic susceptibility of the ferrihydrite transformation products increased with aging, the rate of increase depending on the type of ligand added and its concentration. The largest increase in magnetic susceptibility, sixfold, was obtained with ferrihydrite in a citrate/Fe ratio of 1%, after 1500 days. The resulting magnetic products exihibited superparamagnetic behavior at room temperature and high coercivity at 5 K. The formation of an intermediate ferrimagnetic phase in the ferrihydrite-to-hematite transformation might explain the magnetic enhancement observed in many aerobic soils lacking other sources of magnetic minerals.

The Food and Drug Administration (FDA) warned against administering over-the-counter cough and cold medicines to children under 2. This study evaluated whether experienced parents show poorer adherence to the FDA warning, as safe experiences are predicted to reduce the impact of warnings, and how adherence can be improved. Participants included 218 American parents (mean age: 29.98 (SD = 6.16), 82.9% female) with children age ≤ 2 who were aware of the FDA warning. We compared adherence among experienced (N=142; with other children > age 2) and inexperienced parents (N=76; only children ≤2). We also evaluated potential moderating variables (amount of warning-related information received, prevalence of side effects, trust in the FDA, frequency of coughs and colds, trust in drug packaging) and quantified the impact of amount of information. Logistic regression assessed the ability of experience alone, and experience combined with amount of information, to predict adherence. 53.3% of inexperienced but 28.4% of experienced parents were adherent (p = 0.0003). The groups did not differ on potential moderating variables. Adherence was 39.5% among experienced parents receiving “a lot of information”, but 15.4% for those receiving less (p = 0.002); amount of information did not affect adherence in inexperienced parents (p = 0.22) but uniquely predicted adherence compared to a model with experience alone (p = 0.0005). Experienced parents were also less likely to mistrust drug packaging (p = 0.03). Targeting FDA information to experienced parents, particularly via drug packaging, may improve their adherence.

ABSTRACT IMPACT: Use of this novel murine model of inflammatory bowel disease (IBD) and C. difficile infection (CDI) will aid in developing new clinical approaches to predict, diagnose, and treat CDI in the IBD population. OBJECTIVES/GOALS: IBD is associated with intestinal inflammation and alterations of the gut microbiota, both of which can diminish colonization resistance to C. difficile. Here, we sought to determine if IBD is sufficient to render mice susceptible to C. difficile colonization and infection in the absence of other perturbations, such as antibiotic treatment. METHODS/STUDY POPULATION: C57BL/6 IL-10-/- mice were colonized with Helicobacter hepaticus to trigger colonic inflammation akin to human IBD. Control mice, not colonized with H. hepaticus, were pretreated with the antibiotic cefoperazone to render the gut microbiota susceptible to CDI. Mice were then gavaged with spores of the toxigenic C. difficile strain VPI 10463 and monitored for C. difficile colonization and disease. The fecal microbiota at the time of C. difficile exposure was profiled by 16S rRNA gene sequencing and analyzed using mothur. Statistical analyses were performed using R. RESULTS/ANTICIPATED RESULTS: Mice with IBD harbored significantly distinct intestinal microbial communities compared to non-IBD controls at the time of C. difficile spore exposure (14 days post-IBD trigger). Mice with IBD were susceptible to persistent C. difficile colonization, while genetically identical non-IBD controls were resistant to C. difficile colonization. Concomitant IBD and CDI was associated with significantly worse clinical and intestinal disease than unaccompanied IBD. DISCUSSION/SIGNIFICANCE OF FINDINGS: Patients with IBD who develop concurrent CDI experience increased morbidity and mortality. These studies in a novel mouse model of IBD and CDI emphasize the dual importance of host responses and alterations of the gut microbiota in susceptibility to C. difficile colonization and infection in the setting of IBD.

We assessed the recovery-orientation of the Pavia Rehabilitation Services using an Italian Version of the DREEM (Developing Recovery Enhancing Environment Measure). A preliminary Italian Version of the DREEM was translated by the first author (MB) and a back-translation was carried out by a trained translator (MT). A third member of the research team (JS) resolved disagreements between the two versions by discussion and consensus with MB and MT. The final version was administered to the patients of the rehabilitation services of Pavia. 15 patients out of a possible 21 (71.4%) participated in the first interview. Demographic information including gender (53% male, 47% female), age range (26-35 years: 27%, 36-45 years: 33%, 46-55 years: 27%, 56-65 years: 6%, 66 years and over: 7%), ethnicity (Italian: 100%) was collected. 20% had been using mental health services for between 5 and 10 years, and 80% for more than 10 years. The section “elements of recovery and recovery enhancing services” scored 1.2 for “importance ratings for recovery elements” and 2.4 for “staff performance”, with a performance gap of 1.2. Mean scores for “organizational climate” and “recovery markers” were 2.3 in both sections. The mean score of 1.2 on the importance ratings shows that patients have a good understanding of recovery elements. The other scores reveal a fairly good recovery orientation of the service, but with a wide margin for improvements as indicated by the performance gap. The Italian version of the DREEM is useful; the results can promote reflections, discussion and learning within the staff.

Approximately 50,000–11,000 years ago many species around the world became extinct or were extirpated at a continental scale. The causes of the late Pleistocene extinctions have been extensively debated and continue to be poorly understood. Several extinction models have been proposed, including two nutritionally based extinction models: the coevolutionary disequilibrium and mosaic-nutrient models. These models draw upon the individualistic response of plant species to climate change to present a plausible scenario in which nutritional stress is considered one of the primary causes for the late Pleistocene extinctions.

In this study, we tested predictions of the coevolutionary disequilibrium and mosaic-nutrient extinction models through the study of dental wear and enamel hypoplasia of Equus and Bison from various North American localities. The analysis of the dental wear (microwear and mesowear) of the samples yielded results that are consistent with predictions established for the coevolutionary disequilibrium model, but not for the mosaic-nutrient model. These ungulate species show statistically different dental wear patterns (suggesting dietary resource partitioning) during preglacial and full-glacial time intervals, but not during the postglacial in accordance with predictions of the coevolutionary disequilibrium model. In addition to changes in diet, these ungulates, specifically the equid species, show increased levels of enamel hypoplasia during the postglacial, indicating higher levels of systemic stress, a result that is consistent with the models tested and with other climate-based extinction models. The extent to which the increase in systemic stress was detrimental to equid populations remains to be further investigated, but suggests that environmental changes during the late Pleistocene significantly impacted North American equids.

Let $E$ be an elliptic curve over a field $k$. Let $R:=\operatorname{End}E$. There is a functor $\mathscr{H}\!\mathit{om}_{R}(-,E)$ from the category of finitely presented torsion-free left $R$-modules to the category of abelian varieties isogenous to a power of $E$, and a functor $\operatorname{Hom}(-,E)$ in the opposite direction. We prove necessary and sufficient conditions on $E$ for these functors to be equivalences of categories. We also prove a partial generalization in which $E$ is replaced by a suitable higher-dimensional abelian variety over $\mathbb{F}_{p}$.

Oxygen isotope stage 3 (OIS3), an interstade between approximately 60,000 and 25,000 yr B.P., presents an ideal opportunity to compare high-resolution climate simulations with the geologic record. To facilitate this comparison, the results of a mesoscale climate model (RegCM2) embedded in the GENESIS GCM are utilized to drive a vegetation model (BIOME 3.5). The BIOME output is then compared with OIS3 compilations derived from pollen. The simulated biomes agree well with the pollen-based biomes in southern Europe; however, disagreements occur in the northern part of the domain. The most striking mismatch involves the distribution of tundra. The models fail to have tundra extend to its observed position as far south as 50°N in central Europe during OIS3. The model also fails to have permafrost extend southward to its observed position between 50°N and 55°N in western Europe during OIS3. A variety of sensitivity experiments are performed to investigate these mismatches. These experiments demonstrate the importance of annual and summer temperatures and the length of the winter season in creating improved matches between the model results and the inferred distributions of vegetation and permafrost in northern Europe.

Pineal gland tumors in adults account for about 0.4 to 1 % of all intracranial tumors. A wide variety of tumors can occur in the pineal gland. The most common are the pineal parenchymal tumors (pineocytomas, pineoblastomas, and pineal parenchymal tumors of intermediate differentiation), germ cell tumors, and glial tumors. Uncommonly in the pineal gland one may encounter a metastatic tumor, a meningioma or a melanoma.

We here report a case of primary pineal gland melanoma with prolonged survival of 56 weeks after radiotherapy alone. To our knowledge, this is the first reported case of prolonged survival after radiotherapy alone, without surgical intervention or chemotherapy. Contrary to previous reports, our case demonstrates that a pineal melanoma with leptomeningeal dissemination can still yield a better survival with radiation treatment only.

We describe the results of carbapenem-resistant Enterobacteriaceae (CRE) screening as part of an outbreak investigation of New Delhi metallo-β-lactamase–producing CRE at a tertiary care university teaching hospital. The manual method for CRE screening was useful for detecting patients with asymptomatic CRE carriage but was time-consuming and costly.