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This work presents the high-resolution high-accuracy orthophoto map and the Digital Surface Model of Forni Glacier (Italian Alps). These represent the status of the glacier tongue in mid-August 2022 when surveys were carried out with a DJI Phantom 4 RTK drone. The processing was carried out in Leica Infinity, and a 3 cm orthomosaic and a 20 cm Digital Surface Model were generated and made available for analysis of the current status of the glacier, which shows signs of downwasting, with the occurrence of collapsing areas and a rapidly changing proglacial landscape. This work can also be used as a reference to investigate the glacier evolution, also in light of climate change. Accuracy requirements of the deliverables were ensured by combining Post Processed Kinematic and Structure from Motion integrated with bundle block adjustment, and using Ground Control Points and Check Points, to guarantee redundancy and evaluate the geolocation accuracy and precision.

\"Whether you're new to running or experienced in shorter distances, you'll learn how to break down 26.2 miles into achievable daily workouts for a well-executed, life-changing first marathon. Follow training plans specific to your level of experience, plan for race day, and support your running with instruction on nutrition and supplemental training\"--Provided by publisher.

The extracellular matrix (ECM) of the embryonic heart guides assembly and maturation of cardiac cell types and, thus, may serve as a useful template, or blueprint, for fabrication of scaffolds for cardiac tissue engineering. Surprisingly, characterization of the ECM with cardiac development is scattered and fails to comprehensively reflect the spatiotemporal dynamics making it difficult to apply to tissue engineering efforts. The objective of this work was to define a blueprint of the spatiotemporal organization, localization, and relative amount of the four essential ECM proteins, collagen types I and IV (COLI, COLIV), elastin (ELN), and fibronectin (FN) in the left ventricle of the murine heart at embryonic stages E12.5, E14.5, and E16.5 and 2 days postnatal (P2). Second harmonic generation (SHG) imaging identified fibrillar collagens at E14.5, with an increasing density over time. Subsequently, immunohistochemistry (IHC) was used to compare the spatial distribution, organization, and relative amounts of each ECM protein. COLIV was found throughout the developing heart, progressing in amount and organization from E12.5 to P2. The amount of COLI was greatest at E12.5 particularly within the epicardium. For all stages, FN was present in the epicardium, with highest levels at E12.5 and present in the myocardium and the endocardium at relatively constant levels at all time points. ELN remained relatively constant in appearance and amount throughout the developmental stages except for a transient increase at E16.5. Expression of ECM mRNA was determined using quantitative polymerase chain reaction and allowed for comparison of amounts of ECM molecules at each time point. Generally, COLI and COLIII mRNA expression levels were comparatively high, while COLIV, laminin, and FN were expressed at intermediate levels throughout the time period studied. Interestingly, levels of ELN mRNA were relatively low at early time points (E12.5), but increased significantly by P2. Thus, we identified changes in the spatial and temporal localization of the primary ECM of the developing ventricle. This characterization can serve as a blueprint for fabrication techniques, which we illustrate by using multiphoton excitation photochemistry to create a synthetic scaffold based on COLIV organization at P2. Similarly, fabricated scaffolds generated using ECM components, could be utilized for ventricular repair.

\"This book exposes our unconscious selfish motives, those we're reluctant to discuss or even think about. These motives drive our body language, laughter, and conversation, as well as venerated institutions like art, school, charity, medicine, politics, and religion\"-- Provided by publisher.

In March 2013, the American Association of School Administrators (AASA) released a report to Congress recommending the reauthorization of the Individuals with Disabilities Education Act (IDEA), the primary federal statute regulating the provision of services to disabled children by local school districts. The report critiqued the special education due process system of IDEA in scathing terms, stating that \"significant dollars, time, and emotional capitol [sic] . . . continue to be expended on a process that has little, if any, real connection to improving education outcomes.\" Special education due process, the report argues, fails to satisfy the expectations of both parents and school districts, while also hindering the ability of low- and middle-income parents to obtain necessary services for their children.

Differential Effects of Acute and Extended Infusions of Glucagon-Like Peptide-1 on First- and Second-Phase Insulin Secretion in Diabetic and Nondiabetic Humans Shaista Quddusi , MD 1 , Torsten P. Vahl , MD 2 , Kevin Hanson , MD 2 , Ronald L. Prigeon , MD 1 3 and David A. D’Alessio , MD 1 2 1 Department of Medicine, University of Washington, Seattle, Washington 2 Department of Medicine, University of Cincinnati, Cincinnati, Ohio 3 University of Maryland School of Medicine and Geriatric Research Education and Clinical Center (GRECC), Baltimore VA Medical Center, Baltimore, Maryland Abstract OBJECTIVE —The purpose of this study was to determine whether an extended infusion of the incretin hormone glucagon-like peptide 1 (GLP-1) has a greater effect to promote insulin secretion in type 2 diabetic subjects than acute administration of the peptide. RESEARCH DESIGN AND METHODS —Nine diabetic subjects and nine nondiabetic volunteers of similar age and weight were studied in identical protocols. First-phase insulin release (FPIR; the incremental insulin response in the first 10 min after the intravenous glucose bolus) and second-phase insulin release (SPIR; the incremental insulin response from 10–60 min after intravenous glucose) were measured during three separate intravenous glucose tolerance tests (IVGTTs): 1 ) without GLP-1 (control); 2 ) with acute administration of GLP-1 as a square wave starting just before glucose administration; and 3 ) with an extended infusion of GLP-1 for 3 h before and during the IVGTT. RESULTS —In the subjects with diabetes, FPIR was severely impaired—a defect that was only modestly improved by acute administration of GLP-1 (197 ± 97 vs. 539 ± 218 pmol/l · min, P < 0.05), while SPIR was substantially increased (1,952 ± 512 vs. 8,072 ± 1,664 pmol/l · min, P < 0.05). In contrast, the 3-h preinfusion of GLP-1 normalized fasting hyperglycemia (7.9 ± 0.5 vs. 5.2 ± 0.6, P < 0.05), increased FPIR by 5- to 6-fold (197 ± 97 vs. 1,141 ± 409 pmol/l · min, P < 0.05), and augmented SPIR significantly (1,952 ± 512 vs. 4,026 ± 851 pmol/l · min, P < 0.05), but to a lesser degree than the acute administration of GLP-1. In addition, only the 3-h GLP-1 preinfusion significantly improved intravenous glucose tolerance ( K g control 0.61 ± 0.04, acute infusion 0.71 ± 0.04, P = NS; 3-h infusion 0.92 ± 0.08%/min, P < 0.05). These findings were also noted in the nondiabetic subjects in whom acute administration of GLP-1 significantly increased SPIR relative to the control IVGTT (9,439 ± 2,885 vs. 31,553 ± 11660 pmol/l · min, P < 0.001) with less effect on FPIR (3,221 ± 918 vs. 4,917 ± 1,614 pmol/l · min, P = 0.075), while the 3-h preinfusion of GLP-1 significantly increased both FPIR (3,221 ± 918 vs. 7,948 ± 2,647 pmol/l · min, P < 0.01) and SPIR (9,439 ± 2,885 vs. 21,997 ± 9,849 pmol/l · min, P < 0.03). CONCLUSIONS —Extended administration of GLP-1 not only augments glucose-stimulated insulin secretion, but also shifts the dynamics of the insulin response to earlier release in both diabetic and nondiabetic humans. The restitution of some FPIR in subjects with type 2 diabetes is associated with significantly improved glucose tolerance. These findings demonstrate the benefits of a 3-h infusion of GLP-1 on β-cell function beyond those of an acute insulin secretagogue, and support the development of strategies using continuous or prolonged GLP-1 receptor agonism for treating diabetic patients. CRC, clinical research centers FPIR, first-phase insulin release GLP-1, glucagon-like peptide 1 GLP-1-A, GLP-1 acute infusion GLP-1-PI, GLP-1 3-h preinfusion GLP-1-IR, GLP-1 immunoreactivity IVGTT, intravenous glucose tolerance test SPIR, second-phase insulin release Footnotes Address correspondence and reprint requests to D. D’Alessio, MD, Division of Endocrinology, University of Cincinnati, ML 0547, Cincinnati, OH 45267. E-mail: david.d’alessio{at}uc.edu . Received for publication 25 September 2002 and accepted in revised form 6 December 2002. A table elsewhere in this issue shows conventional and Système International (SI) units and conversion factors for many substances. DIABETES CARE

OBJECTIVES/SPECIFIC AIMS: To create a searchable public registry of all Quality Improvement (QI) projects. To incentivize the medical professionals at UF Health to initiate quality improvement projects by reducing startup burden and providing a path to publishing results. To reduce the review effort performed by the internal review board on projects that are quality improvement Versus research. To foster publication of completed quality improvement projects. To assist the UF Health Sebastian Ferrero Office of Clinical Quality & Patient Safety in managing quality improvement across the hospital system. METHODS/STUDY POPULATION: This project used a variant of the spiral software development model and principles from the ADDIE instructional design process for the creation of a registry that is web based. To understand the current registration process and management of quality projects in the UF Health system a needs assessment was performed with the UF Health Sebastian Ferrero Office of Clinical Quality & Patient Safety to gather project requirements. Biweekly meetings were held between the Quality Improvement office and the Clinical and Translational Science – Informatics and Technology teams during the entire project. Our primary goal was to collect just enough information to answer the basic questions of who is doing which QI project, what department are they from, what are the most basic details about the type of project and who is involved. We also wanted to create incentive in the user group to try to find an existing project to join or to commit the details of their proposed new project to a data registry for others to find to reduce the amount of duplicate QI projects. We created a series of design templates for further customization and feature discovery. We then proceed with the development of the registry using a Python web development framework called Django, which is a technology that powers Pinterest and the Washington Post Web sites. The application is broken down into 2 main components (i) data input, where information is collected from clinical staff, Nurses, Pharmacists, Residents, and Doctors on what quality improvement projects they intend to complete and (ii) project registry, where completed or “registered” projects can be viewed and searched publicly. The registry consists of a quality investigator profile that lists contact information, expertise, and areas of interest. A dashboard allows for the creation and review of quality improvement projects. A search function enables certain quality project details to be publicly accessible to encourage collaboration. We developed the Registry Matching Algorithm which is based on the Jaccard similarity coefficient that uses quality project features to find similar quality projects. The algorithm allows for quality investigators to find existing or previous quality improvement projects to encourage collaboration and to reduce repeat projects. We also developed the QIPR Approver Algorithm that guides the investigator through a series of questions that allows an appropriate quality project to get approved to start without the need for human intervention. RESULTS/ANTICIPATED RESULTS: A product of this project is an open source software package that is freely available on GitHub for distribution to other health systems under the Apache 2.0 open source license. Adoption of the Quality Improvement Project Registry and promotion of it to the intended audience are important factors for the success of this registry. Thanks goes to the UW-Madison and their QI/Program Evaluation Self-Certification Tool ( https://uwmadison.co1.qualtrics.com/SE/?SID=SV_3lVeNuKe8FhKc73 ) used as example and inspiration for this project. DISCUSSION/SIGNIFICANCE OF IMPACT: This registry was created to help understand the impact of improved management of quality projects in a hospital system. The ultimate result will be to reduce time to approve quality improvement projects, increase collaboration across the UF Health Hospital system, reduce redundancy of quality improvement projects and translate more projects into publications.

The overall hypersensitivity reaction rate among 14,249 U.S. Marine Corps personnel who received 36,850 doses of an investigational Japanese encephalitis vaccine was 10.3 per 10,000 doses; reaction rates were 16.1 and 10.3 per 10,000 doses for the first two doses, and 2.0 per 10,000 doses for the third. The reaction rate was 26.7 per 10,000 vaccinees. Of 38 reactors, 26 had urticaria and/or angioedema, and 11 had pruritus. Vaccine reaction intervals clustered within 48 hours for dose 1, but the median reaction interval for dose 2 was 96 hours. A history of urticaria or allergic rhinitis was associated with an increased probability of a vaccine reaction.

An assessment was conducted of the impact of infectious diseases on the 697,000 U.S. troops deployed to the Persian Gulf during 1990–1991 in Operations Desert Shield and Desert Storm. The incidence of nonbattle injuries, including infectious diseases, during this conflict was lower than during previous wars involving U.S. military personnel. The major reported causes of morbidity were generally mild cases of acute diarrheal and upper respiratory disease. The most unexpected outcome was the lack of arboviral infections, particularly sandfly fever, and the occurrence among U.S. troops of 12 cases of visceral leishmaniasis due to Leishmania tropica. The fact that infectious diseases were not a major cause of lost manpower, in sharp contrast to the experience among military personnel in World War II, can be attributed to a combination of factors: the presence of a comprehensive infrastructure of medical care, extensive preventive medicine efforts, and several fortuitous circumstances. Beneficial conditions that may not be present in future conflicts in this region include isolation of most combat troops to barren desert locations during the cooler, winter months, which provided the least favorable conditions for transmission of arthropod-borne diseases.