Objectives/Goals: Our main objective was to compare 5-year survival and organ function between patients with sickle cell disease (SCD) who underwent hematopoietic cell transplant (HCT) and those who did not undergo HCT. We hypothesized that organ function would be improved in those with SCD who underwent HCT when compared to those who remained on standard therapy. Methods/Study Population: This IRB-approved, retrospective study includes patients with SCD treated at Children’s Healthcare of Atlanta. Cases underwent HCT between 2010 and 2016. They were randomly matched with 2 patients with SCD who did not undergo HCT. Match criteria included age, sex, disease genotype, and disease severity, which was determined by the number of hospitalizations in the 5 years pre-HCT, prior intensive care unit admission, and prior chronic transfusion therapy. Data extracted included SCD treatment, hospitalizations, emergency department visits, and organ function pre-HCT and 1-, 2-, 3-, and 5-years post-HCT. Organ-specific outcomes and overall survival were compared between the two groups using cumulative incidence curves and Kaplan–Meier analyses. Normal FEV1 and FVC in this analysis were >80% predicted. Results/Anticipated Results: Thirty-seven cases who had undergone HCT were matched with 74 controls who continued with standard medical therapy. The median age was 8 years for both groups and 59% were females. The median disease severity score was 2 in both groups. At baseline, 70.3% of the HCT group completed pulmonary function tests (PFTs) compared to 35.1% of the non-HCT group. Of these, 73% in both groups had a normal FEV1. In terms of FVC, 57.7% of HCT patients and 76.9% of non-HCT patients had a normal FVC pre-HCT. At 5 years post-HCT, 56.8% of the HCT group had PFTs completed compared to 21.6% of the non-HCT group. Among these, 85.7% in the HCT group had a normal FEV1 compared to 75% in the non-HCT group, while 90.6% had a normal FVC in the HCT group compared to 75% in the non-HCT group. Two of 37 in the HCT group and 1 of 74 in the non-HCT group died (p = 0.21). Discussion/Significance of Impact: Our data suggest that post-HCT, the proportion of patients falling in the normal range for FEV1 and FVC increases. This increase is not seen in the non-HCT group, indicating that HCT may improve this organ function. There was no difference in survival between the groups, indicating the risk of HCT mortality may not be greater than the risk of living with SCD.

Autoimmune encephalitis is increasingly recognized as a neurologic cause of acute mental status changes with similar prevalence to infectious encephalitis. Despite rising awareness, approaches to diagnosis remain inconsistent and evidence for optimal treatment is limited. The following Canadian guidelines represent a consensus and evidence (where available) based approach to both the diagnosis and treatment of adult patients with autoimmune encephalitis. The guidelines were developed using a modified RAND process and included input from specialists in autoimmune neurology, neuropsychiatry and infectious diseases. These guidelines are targeted at front line clinicians and were created to provide a pragmatic and practical approach to managing such patients in the acute setting.

Recent studies have shown that the punitive drug laws enacted in the mid-1970s led to a sharp increase in incarceration only in the mid-1980s, when city police departments started policing street-level drug markets much more intensively. The case study of New York City in the wake of the Rockefeller Drug Laws of 1973 presents an explanation. Only when new policing ideas, popular dissatisfaction with street crime, and the revival of the city's fiscal capacity coalesced as part of a larger project to rebuild urban governance in the aftermath of the fiscal crisis of the 1970s did New York turn toward street-level drug enforcement. An examination of the political history of street-level drug enforcement offers a better understanding of the history of New York's war on drugs, as well as a new chronology of the political dynamics of state rebuilding in the 1980s.

Tropical forest regions in equatorial Africa are threatened with degradation, deforestation and biodiversity loss as a result of land-cover change. We investigated historical land-cover dynamics in unprotected forested areas of the Littoral Region in south-western Cameroon during 1975–2017, to detect changes that may influence this important biodiversity and wildlife area. Processed Landsat imagery was used to map and monitor changes in land use and land cover. From 1975 to 2017 the area of high-value forest landscapes decreased by c. 420,000 ha, and increasing forest fragmentation caused a decline of c. 12% in the largest patch index. Conversely, disturbed vegetation, cleared areas and urban areas all expanded in extent, by 32% (c. 400,000 ha), 5.6% (c. 26,800 ha) and 6.6% (c. 78,631 ha), respectively. The greatest increase was in the area converted to oil palm plantations (c. 26,893 ha), followed by logging and land clearing (c. 34,838 ha), all of which were the major factors driving deforestation in the study area. Our findings highlight the increasing threats facing the wider Littoral Region, which includes Mount Nlonako and Ebo Forest, both of which are critical areas for regional conservation and the latter a proposed National Park and the only sizable area of intact forest in the region. Intact forest in the Littoral Region, and in particular at Ebo, merits urgent protection.

The deep ice-sheet coring (DISC) drill consists of four major mechanical drilling subsystems and four subsystems supporting on-surface activities. The mechanical drilling subsystems are a drill sonde, a drill cable, a tower and a winch. The drill sonde is the down-hole portion of the drill system and consists of six distinct sections: (1) the cutter head, (2) the core barrel, (3) the screen section, (4) the motor/pump section, (5) the instrument section and (6) the upper sonde, which includes anti-torques and drill cable terminations. The drill cable not only provides the means of supporting the drill sonde in the borehole, but also provides conduits for electrical power and data transmission. The tower tilts to allow the drill sonde to be serviced in the horizontal position without removing it from the tower. The winch provides a means of quickly raising the sonde from the borehole and providing the fine control necessary for coring operations.

The Deep Ice Sheet Coring (DISC) drill developed by Ice Coring and Drilling Services under contract with the US National Science Foundation is an electromechanical ice-drill system designed to take 122mm ice cores to depths of 4000 m. The new drill system was field-tested near Summit camp in central Greenland during the spring/summer of 2006. Testing was conducted to verify the performance of the DISC drill system and its individual components and to determine the modifications required prior to the system’s planned deployment for coring at the WAIS Divide site in Antarctica in the following year. The experiments, results and the drill crew’s experiences with the DISC drill during testing are described and discussed.

The Deep Ice Sheet Coring (DISC) drill, developed by Ice Coring and Drilling Services (ICDS) under contract with the US National Science Foundation, is an electromechanical drill designed to take 122 mm diameter ice cores to depths of 4000 m. The conceptual design of the DISC drill was developed in 2002/03 based on science requirements written by K. Taylor and the United States ice-coring community and on engineering performance objectives. Detailed design of the drill began in June 2003. Special attention was paid to building safety into the design and operation of the drill system. The drill was designed and manufactured by a team of engineers and technicians from the University of Wisconsin–Madison and various subcontractors with assistance from the science community, the European ice-drilling community and polar logistical support organizations. ICDS successfully tested the drill in Greenland in 2006 and will continue its development to meet the science objectives of the West Antarctic Ice Sheet Divide Ice Core Project.

The middle Wisconsinan Gilman Canyon Formation at the Buzzard's Roost type locality in southwestern Nebraska was investigated to document the stratigraphy and to reconstruct the environmental and climate record. The Gilman Canyon Formation was subdivided into three loess units and three soils, with radiocarbon ages constraining it between about 40 ka and 25 ka. Stable carbon isotope ratios, magnetic susceptibility, and carbon content were used to define and characterize soils within both the Gilman Canyon Formation and underlying Illinoian Loveland Loess. At the height of soil development within the Gilman Canyon Formation, climate was supporting C4-dominated grassland, with July temperatures equal to or exceeding those of today. Soil-forming intervals within the Loveland Loess, including the Sangamon Soil, also exhibited relative increases in C4 biomass. Climate, as recorded in the Gilman Canyon Formation, is corroborated by regional proxy data. The formation accumulated during MIS 3, and concurrent soil formation coincided with a summer insolation maximum.