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A case of spontaneous regression of malignant lymphoma of the maxillary gingiva following a biopsy is reported. An 84-year-old man was referred to the hospital with chief complaints of swelling of the anterior maxillary gingiva. A non-tender swelling with an ulcer was observed. There was no abnormal bone resorption in the anterior maxillary region and no swelling of the cervical lymph nodes. A biopsy was performed, and the patient was diagnosed with diffuse large B-cell lymphoma. The lesion regressed spontaneously 3 weeks after the initial biopsy. Two years have passed since the spontaneous regression and no recurrence has been observed. If malignant lymphoma regresses on biopsy, observation is considered to be sufficient.

For the development of electric propulsion aircrafts with light weight, low emission and high efficiency, MW-class fully superconducting synchronous machines operating at liquid nitrogen temperature were conceptually designed with REBa2Cu3O7- δ (REBCO) superconducting tapes in our previous studies. To verify the actualization of the structure and cooling method, a 1 kW-class prototype fully superconducting synchronous motor was designed and constructed in this study. The fixed armature was cooled with subcooled liquid nitrogen at 65 K. The rotor was cooled with helium gas. The pole number was two for the future high speed operation. The applicability of the complicated casing structure with three chambers into fully superconducting motor was also investigated from the viewpoint of thermal insulation. The operations as a motor up to 500 rpm and a generator demonstrated that the designed structure and cooling method were reasonable and effective for cooling the fixed armature and rotating field windings.

International audience; The role of brain dystrophin in muscular dystrophy: Implications for clinical care and translational research, Hoofddorp, the Netherlands, November 29 th-December 1 st 2019

This document updates the previous AMMI Canada Foundation Guidance (2013) on the use of antiviral therapy for influenza.Le présent document est une mise à jour des précédentes directives d’AMMI Canada (2013) sur l’utilisation des antiviraux contre la grippe.

Cable corrosion significantly decreases the ultimate and fatigue strength of cable-stayed bridges. It might lead to lose the cables and may affect to the entire bridge significantly. In this paper, parametric studies with three different span lengths, different corrosion levels and loss of different cables were performed. Whereas the ultimate strength lowered by about 25% as the cross-sectional area decreased due to corrosion. The elongation also decreases due to corrosion. The ultimate strength was found to sharply drop when the elongation became 1.0%. The fatigue strength of stays was studied taking a 500kN heavy lorry as the representative load. The fatigue strength sharply lowers as corrosion progresses and the severely corrode anchor cable becomes less than 4% of the healthy one. The anchor cables showed the most significant effect to the entire bridges.

This paper presents design challenges and solutions for the fifth generation (5G) phased-array transceiver ICs in millimeter-wave (MMW) frequency bands. A 28nm bulk CMOS device technology is selected to integrate multiple RF phased-array elements in a single-chip to achieve a high-level of TX EIRP and RX sensitivity. Several design approaches of gain, P OUT , stability, reliability and linearity enhancement techniques are applied to enable CMOS as a key device solution for 5G applications in MMW frequency bands. A 39GHz band 16-channel CMOS RF phased-array transceiver IC is designed and can support 4T/4R MIMO base-station applications including ×64 RF phased-array ICs (total 1,024 phased-array elements). T/RX paths have gain dynamic ranges of >30/40dB for flexibility and scalability. The TX path shows P OUT /Ch. of >6.0dBm at EVM of -34dB (800MHz) and P DC /Ch. of 105mW. The RX path performs NF of 4.2dB, EVM of -38dB (100MHz) and P DC /Ch. of 39mW. These state-of-the-art results lead to TX EIRP of >55dBm and RX sensitivity of

We provide an update to the Association of Medical Microbiology and Infectious Disease Canada foundation guidance for the upcoming 2020-2021 influenza season in Canada. Important issues for this year include the implications of co-circulation of SARS-CoV-2, the role of diagnostic testing, and a restatement of dosing and administration recommendations for neuraminidase inhibitors in various age groups and underlying health conditions. Although peramivir and baloxivir are now licensed in Canada, neither is currently marketed, so this guidance focuses on further optimizing the use of oseltamivir and zanamivir.Nous actualisons l’information sur les directives de la Fondation de l’Association pour la microbiologie médicale et l'infectiologie Canada en vue de la saison grippale 2020–2021 au Canada. Cette année, les enjeux importants touchent les conséquences de la co-circulation de la maladie à coronavirus 2019, le rôle des tests diagnostiques et la réaffirmation des recommandations relatives aux maladies sous-jacentes ainsi qu’à la posologie et à l’administration des inhibiteurs de la neuraminidase dans divers groupes d’âge. Même si le péramivir et le baloxivir sont désormais homologués au Canada, ces médicaments n’y sont pas encore commercialisés, et c’est pourquoi les présentes directives visent à optimiser l’utilisation de l’oseltamivir et du zanamivir.

Background It is uncertain whether curative surgical treatment or a less radical surgery with adjuvant treatment should be provided to preserve function in patients with vulvar squamous cell carcinoma (SCC) that is adjacent to the urethra, anus, and vagina. The aim of this study was to investigate the surgical margin in patients with vulvar SCC with regard to local recurrence and overall survival. Methods Thirty-four patients were identified as having a diagnosis of vulvar SCC without distant metastasis. They had been treated surgically with curative intent at the Cancer Institute Hospital between May 1992 and January 2019. Clinical data were analyzed retrospectively. Results Rates of 5-year local recurrence-free survival among patients with positive, Conclusion To improve the prognosis, thorough resection with an adequate surgical margin is needed.

Most healthy people fully recover from influenza illness without medical intervention or antiviral treatment However, given the potential for suboptimal VE this season, antiviral therapy may be of particular importance in the management of individuals with suspected influenza illness despite documentation of having received the 2019–2020 influenza vaccine

Increasing demands on high-data-rate and low-latency cellular communications are accelerating the developments of millimeter-wave (mm-wave) systems for 5G NR in 28 and 39GHz bands. In order to provide the 5G communication systems worldwide, high-performance and low-cost RF chipset solutions are required. Recently, 5G mm-wave CMOS/BiCMOS RF phased-array transceivers for the 28GHz band have been reported [1]–[5]. However, there are very limited reports for the 39GHz band [6], which is one of the main frequency bands in the US, Canada, China and other countries. In this paper, we present both a 39GHz 16-channel RF phased-array transceiver IC in 28nm CMOS and a dual-stream IF transceiver IC in 65nm CMOS. These chipsets can be scaled up to >500 RF phased-array elements and support dual-stream (MIMO) in 5G NR base-station applications.

In existing or operating oil fields, enhanced oil recovery (EOR) methods are employed to increase production, which can contribute to meet fossil fuel demand. This research proposes a new EOR method by adding Cu(II) ions into the injected seawater, which shows a significant incremental oil production in carbonate reservoirs. An important remark in this study is the Cu(II) incorporation into the cores, with mineralization of atacamite on the carbonate surface, and copper complexation with the acid fraction of the oil. In addition, we observed oil removal up to the last monolayer on calcite surfaces. Based on these observations and first-principles calculations, we propose an EOR mechanism where the acidic oil desorbs from the rock surface by forming acid-copper complexes that are dragged by the injected fluids. In summary, we propose a simple and cost-effective EOR method with transition metals, which may significantly increase the yield of low-recovery carbonate reservoirs and reduce the environmental impact of exploring new reservoirs.

Influenza vaccine is recommended annually to reduce the influenza-associated disease burden, particularly among those at high risk of serious influenza complications ( 1 ). However, a potential for low vaccine effectiveness (VE) has been identified for the 2017–2018 influenza season. To address that concern, the following antiviral drug recommendations have been revised (see Table 1 , changes in bold) from the AMMI Canada Foundation Document ( 2 ).

Introduction/Background Radiation therapy is an effective treatment for cervical cancer (CC), but remains at a constant rate, and those cases have a poor prognosis. The purpose of this study was to examine the efficacy of adjuvant hysterectomy in local remnant or recurrent (LR) cases of CC after radical radiotherapy (RT). Methodology Between May 2007 and September 2018, 21 patients who underwent hysterectomy for LR CC after RT in our department were included in this study. We retrospectively reviewed their medical records for patient background, clinicopathological factors, complications and prognosis. LR CC was determined based on histopathological and imaging examinations 3 months after the end of treatment. We classified surgical specimens according to the treatment effect (effects 0–3) using histological effect criteria. In addition, we used the Kaplan-Meier and log-rank test for statistical analyses. Results The median patient age was 55 years, and the FIGO stages were IB2, IIB and IIIB in 11, 8 and 2 cases, respectively. Based on the histological type, there were 14 cases of squamous cell carcinoma and 7 of adenocarcinoma. Tumour markers (TM) were re-elevated in five cases. Perioperative complications included intraoperative bladder injury and postoperative pelvic abscess in two cases. The median observation period was 39 months, and there were 10 recurrences. The median progression-free survival (PFS) was 54 months, and the 3-year overall survival (OS) rate was 61.1%. With regard to prognostic factors, the treatment effect (effect 1 vs. effect 2/3) was significantly associated with PFS (p=0.008) and OS (p=0.023) and the re-elevation of TM was significantly associated with PFS (p=0.017). Conclusion Hysterectomy for LR CC after RT might be a tolerable treatment with a long-term prognosis. Histological treatment effect evaluation of surgical specimens might be useful in additional treatment assessment, and TM elevation might be useful in preoperative assessment. Disclosure Nothing to disclose.

Introduction/Background This study aimed to reveal that pre-treatment sarcopenia is really a prognostic factor of outcome with patients undergoing concurrent chemoradiotherapy (CCRT) in cervical cancer. Methodology We retrospectively analyzed pre-treatment CT images of 115 patients with cervical cancer who were treated by same regimen and same irradiation range between 2010 to 2015. All CT images were taken within 30days before radiotherapy. Skeletal muscle index (SMI) was calculated from CT images at the level of third lumbar vertebra, in the range from -29 to +150 Hounsfield Units. We defined sarcopenia as low SMI (less than 38.5cm2/m2). Overall survival (OS) and disease free survival (DFS) were analyzed Kaplan-Meier method and Cox hazard regression model. Results The median follow-up was 46 months(range, 2–104 months). 65 patients (56.5%) was defined pre-treatment sarcopenia. The median DFS was 42 months (range, 0–104 months). Sarcopenia was not poorer prognostic factor for PFS and OS rates (p=0.4915, and p=0.5811). Multivariate analysis showed same results. Conclusion Pre-treatment sarcopenia was not prognostic factor for patients with cervical cancer who treated with CCRT. Disclosure Nothing to disclose.

Introduction/Background A midline block (MB) used in whole pelvic RT (WPRT) hinders accurate interpretation of the treatment outcome due to uncertainty of the RT dose delivered to cervical tumours. Methodology Patients with cervical cancer of FIGO stages IB1-IVA were eligible for this prospective study. The treatment protocol consisted of WPRT (non-IMRT) without a MB (45 Gy/25 fractions) and CT-based high-dose-rate intracavitary brachytherapy (HDR-ICBT; 15 Gy/3 fractions or 20 Gy/4 fractions, prescribed to point A). The total EQD2 to point A was 63 or 69.3 Gy. The HR-CTV was contoured at the time of the present analyses. If optimisation (manual adjustment of the dwell times) was inadequate to meet the organ-at-risk dose constraints, the point A dose was decreased. Graphical optimisation was not performed. Results A total of 40 patients were enrolled. The FIGO stage distribution was IB1, 11; IB2, 13; IIA2, 1: IIB, 11; IIIB, 3; IVA, 1. The median pretreatment tumour diameter was 47 mm (14–81 mm). No patients underwent hybrid ICBT. The point A dose was decreased in 19 of 153 ICBT sessions (12%). Twenty-nine patients received concurrent chemoradiotherapy. After a median follow-up of 33 months, the 2-year pelvic progression-free survival (PPFS), and overall survival rates were 83%, and 85%, respectively. A HR-CTV D90 threshold of 70 Gy was correlated with the PPFS: 93% for patients receiving ≥70 Gy (n=29) versus 64% for those receiving Conclusion Definitive RT consisting of WPRT without a MB and HDR-ICBT was feasible in our cohort of Japanese patients. A low RT dose might be adequate for patients with non-bulky tumours. Proper 3D-IGBT using graphical optimisation and a suitable hybrid technique, based on appropriate HR-CTV contouring, is recommended to improve outcomes further. Disclosure Nothing to disclose.

Nuclear instruments & methods in physics research / A Accelerators, spectrometers, detectors and associated equipment Section A 918, 41 - 53 (2019). doi:10.1016/j.nima.2018.11.060, We have developed a gating foil for the time projection chamber envisaged as a central tracker for the international linear collider experiment. It has a structure similar to the Gas Electron Multiplier (GEM) with a higher optical aperture ratio and functions as an ion gate without gas amplification. The transmission rate for electrons was measured in a counting mode for a wide range of the voltages applied across the foil using an $^{55}$Fe source and a laser in the absence of a magnetic field. The blocking power of the foil against positive ions wasestimated from the electron transmissions., Published by North-Holland Publ. Co., Amsterdam

Micro-Pattern Gaseous Detectors Conference 2019, MPGD2019, La Rochelle, France, 5 May 2019 - 10 May 2019; Journal of physics / Conference Series 1498(1), 012020 (2020). doi:10.1088/1742-6596/1498/1/012020, We have developed a gating foil for the time projection chamber envisaged as a central tracker for the international linear collider experiment. It has a structure similar to the Gas Electron Multiplier (GEM) with a higher optical aperture ratio and functions as an ion gate without gas amplification. The transmission rate for electrons was measured in a counting mode for a wide range of the voltages applied across the foil using an $^{55}$Fe source and a laser in the absence of a magnetic field. The upper limit of the transmission rate for positive ions was estimated to be 3.36 ± 0.05 (stat. only)) × 10$^{−4}$ from the measured electron transmission at a relatively low reverse bias voltage applied to the foil ($ΔV$ =−15.5 V). The blocking power of the gating foil was confirmed to be high enough to suppress the influence of ion backflow., Published by IOP Publ., Bristol

A microwave ion source is a long-life ion source because it has few expendable items. Therefore, it can have various applications in the industrial and medical fields, such as ion implantations in semiconductors and particle therapies. In this paper, we report on the design of new electromagnets that consist of three electromagnets, namely, iron yokes and permanent magnets, to produce highly charged ions and ions from molecules with strong chemical bonds. These electromagnets can generate both the so-called off-resonance and electron-cyclotron resonance conditions by tuning the currents in each coil. Permanent magnets are used to generate cusp magnetic field.

In a multicenter, randomized controlled clinical trial, administration of valacyclovir for 90 days following standard intravenous acyclovir therapy for herpes simplex encephalitis did not improve outcomes, as measured by neuropsychological testing at 12 months.

The AMMI Canada Guidelines document ‘The use of antiviral drugs for influenza: A foundation document for practitioners’, published in the Autumn 2013 issue of the Journal, outlines the recommendations for the use of antiviral drugs to treat influenza. This article, which represents the first of two updates to these guidelines published in the current issue of the Journal, aims to inform health care professionals of the increased risk for influenza in long-term care facilities due to a documented mismatch between the components chosen for this season’s vaccine and currently circulating influenza strains. Adjusted recommendations for the use of antiviral drugs for influenza in long-term care facilities for this season are provided.

Summary The oral appliance (OA) is considered to be an effective treatment modality for obstructive sleep apnoea (OSA). Upper airway enlargement during OA therapy is critical, and lateral cephalometry has been used for the two-dimensional evaluation of upper airway form during this therapy. However, this method cannot provide an accurate three-dimensional (3D) view of upper airway form. To confirm the effects of OA on the upper airway in patients with OSAS, we performed CT in the presence and absence of OA in 15 Japanese patients (12 males, 3 females) who responded to OA therapy. CT in the presence and absence of OA was consecutively performed for each patient, and upper airway cross-sectional area in six arbitrary planes parallel to the palatal plane was measured. Next, 3D image reconstruction was performed; morphological changes in upper airway form were evaluated, and upper airway volume at three levels from the palatal plane to the deepest point of the epiglottis was measured. The cross-sectional area of two planes in the posterior soft palate region significantly increased in the presence of OA compared with that in the absence of OA. In the presence of OA, upper airway cross-sectional area and volume significantly increased in the posterior soft palate region compared with those in the posterior tongue region. 3D CT image reconstruction accurately confirmed morphological changes in the upper airway during OA therapy. Continued use of this 3D evaluation is expected to improve the results of OA therapy in the future.

Summary Herpes simplex virus 1 and 2 (HSV-1 and HSV-2) infections continue to be among the most common and unrecognized sexually transmitted infections in the world. Although treatable, HSV-1 and HSV-2 infections remain incurable. Hence, there is interest in the development of a vaccine to prevent genital herpes. As part of a multicentre, randomized, placebo-controlled trial to test such a vaccine, healthy women 18–30 years were enrolled as volunteers in several Canadian centres between 2005 and 2007. This study reports the seroprevalence of HSV-1 and HSV-2 antibodies in this group. A total of 2694 adult female volunteers in Canada with no known history of herpes simplex were screened for HSV antibodies using Western blot assay (the gold standard for diagnosis of HSV) for potential participation in a randomized, double-blind efficacy field trial of a herpes simplex vaccine. This trial provides a unique opportunity to examine the prevalence of antibodies to HSV-1 and of antibodies to HSV-2 in women with no known history of herpes simplex infection. The prevalence of antibodies to HSV-1 and to HSV-2 is compared with that found in previous Canadian studies that focused on a more general population. The overall seroprevalence of antibody to HSV-1 was 43%; that of HSV-2 was 2.5% and seropositivity to both was 2%. The prevalence of antibody to both HSV-1 and to HSV-2 increased with age. Seronegativity to both HSV-1 and HSV-2 was 56% in participating centres with populations under 250,000 and 46% in participating centres with populations over 250,000. Significant racial differences in seropositivity to HSV-1 and to HSV-2 were noted. The likelihood of participants being seropositive to HSV-1 and to HSV-2 was found to increase with age and to positively correlate with the population of the city in which they resided. Hypotheses are proposed to account for differences in racial seropositivity to HSV-1 and to HSV-2.

In this paper, a finite element (FE) model for a cable-stayed bridge designed according to Australian standards is developed and analysed statically and dynamically with and without geometrical nonlinearities. The dynamic amplification factor ( DAF) and demand-to-capacity ratio ( DCR) in different structural components including cables, towers and the deck are calculated and it is shown that DCR usually remains below one (no material nonlinearity occurs) in the scenarios studied for the bridge under investigation, however, DAF can take values larger than two. Moreover, effects of location, duration and number of cable(s) loss as well as effect of damping level on the progressive collapse resistance of the bridge are studied and importance of each factor on the potential progressive collapse response of the bridgeis investigated.

The purpose of this study was to retrospectively analyze the treatment results of boost external beam radiotherapy (EBRT) to clinically positive pelvic nodes in patients with uterine cervical cancer. The study population comprised 174 patients with FIGO stages 1B1–4A cervical cancer who were treated with definitive radiotherapy (RT) or concurrent chemoradiotherapy (CCRT) and high-dose-rate intracavitary brachytherapy (HDR-ICBT). Patients with positive para-aortic or common iliac nodes (≥10 mm in the shortest diameter, as evaluated by CT/MRI) were ineligible for the study. Fifty-seven patients (33%) had clinically positive pelvic nodes. The median maximum diameter of the nodes was 15 mm (range, 10–60 mm) and the median number of positive lymph nodes was two (range, one to four). Fifty-two of 57 patients (91%) with positive nodes were treated with boost EBRT (6–10 Gy in three to five fractions). The median prescribed dose of EBRT for nodes was 56 Gy. The median follow-up time for all patients was 66 months (range, 3–142 months). The 5-year overall survival rate, disease-free survival rate and pelvic control rate for patients with positive and negative nodes were 73% and 92% (P = 0.001), 58% and 84% (P < 0.001), and 83% and 92% (P = 0.082), respectively. Five of 57 node-positive patients (9%) developed pelvic node recurrences. All five patients with nodal failure had concomitant cervical failure and/or distant metastases. No significant difference was observed with respect to the incidence or severity of late complications by application of boost EBRT. The current retrospective study demonstrated that boost EBRT to positive pelvic nodes achieves favorable nodal control without increasing late complications.

1C INDEX I. PURPOSE II. PROCESS STATEMENT III. GRADING OF RECOMMENDATIONS IV. THE DISEASE A. Influenza viruses B. Clinical aspects C. Clinical diagnosis of influenza illness V. TREATMENT OF INFLUENZA ILLNESS A. Antiviral drugs including off-label use B. Benefits of antiviral treatment C. Considerations in selecting treatments 1. Severity of illness 2. Presence of risk factors or co-morbid medical conditions 3. Interval between onset of illness and initiation of antiviral therapy 4. Likely influenza type(s) causing infection D. Treatment of children E. Treatment of immunocompromised patients F. Treatment of patients with renal impairment G. Treatment of pregnant patients VI. RECOMMENDATIONS FOR TREATMENT A. General principles B. Treatment of non-pregnant adults with mild or uncomplicated influenza C. Treatment of non-pregnant adults with moderate, progressive, severe or complicated illness with or without risk factors D. Treatment of infants, children and youth with mild or uncomplicated influenza illness E. Treatment of infants, children and youth with moderate, progressive, severe or complicated influenza illness with or without risk factors F. Treatment of immunocompromised patients G. Treatment of patients with renal impairment H. Treatment of pregnant women VII. RECOMMENDATIONS FOR CHEMOPROPHYLAXIS VERSUS EARLY THERAPY TABLES 1. Grading of recommendations 2. Clinical signs warranting urgent medical attention in infants, children and youth with suspected or proven influenza 3. At-risk groups and co-morbid medical conditions that predispose to severe influenza 4. Oseltamivir and zanamivir regimens 5. Recommended regimens for treatment of patients with renal impairment or failure 6. Selected surrogate indices of immunocompromised states REFERENCES APPENDICES A. Oseltamivir and zanamivir treatments for mild or uncomplicated influenza in non-pregnant adults B. Oseltamivir and zanamivir treatments for non-pregnant adults with moderate, progressive, severe or complicated illness C. Oseltamivir and zanamivir treatments for influenza in children (

High-Q spiral inductors are described that are embedded in the wafer-level chip-size package (WLP) and suffer from unfavorable two-port asymmetric characteristics. To solve this problem, a novel clip-type inductor is proposed, where an electrode crossover point in multiturn inductor structures is modified from a conventional mirror symmetric point to a novel electrical symmetric point. These novel clip-type inductors are designed and fabricated using the WLP technology. By means of a developed 4 nH novel clip inductor, a Q factor value difference between the two ports can be significantly reduced to 1.4% from 14.8% at 1.4 GHz. The Q factors of developed inductors are evaluated under both a conventional short-circuited load condition and an impedance-matched condition. In addition, a novel evaluation method for inductance values for inductors is also described. By using newly derived formulas, inductance values for a fabricated WLP clip-type inductor and a fabricated meander-type inductor are evaluated. This method represents the inherent nature of inductor devices under test including circuit parasitic elements.

Background: Clinical evidences of inhaled salmeterol/fluticasone propionate combination (SFC) therapy are insufficient in early childhood asthma. Objectives: To examine the effects of SFC50, a combination product of salmeterol xinafoate (50 μg/day) and fluticasone propionate (100 μg/day), in infants and preschool children with asthma. Methods: The study was conducted at 31 sites in Japan. 35 patients (6 months to 5 years old) with asthma insufficiently controlled by inhaled corticosteroids (100 μg/day) were initiated to treat with SFC50 twice a day for 12 weeks with pressurized metered dose inhalers. The efficacy of SFC50 was assessed using nighttime sleep disorder score as the primary endpoint and the other efficacy measurements. The safety measurement included the incidences of adverse event (AE). Results: Mean patient age was 3.1 years, and 94.2% had mild-to-moderate persistent asthma (atopic type: 65.7%). Nighttime sleep disorder scores, assessed by a nighttime sleep diary, significantly decreased after treatment with SFC50 throughout the study period (p Conclusions: SFC50 improved nighttime sleep disorder score and other efficacy outcome measures with no safety concerns. The results suggest that SFC50 treatment is useful to control the mild-to-moderate asthma in infant and preschool-aged children.

A microwave ion source is expected to have a long lifetime, as it has fewer consumables. Thus, we are in the process of developing a microwave ion source for ion implantation applications. In this paper, we report on a newly developed plasma chamber and the extracted P(+) beam currents. The volume of the plasma chamber is optimized by varying the length of a boron nitride block installed within the chamber. The extracted P(+) beam current is more than 30 mA, at a 25 kV acceleration voltage, using PH3 gas.

Aims The aim of this study was to evaluate the time course of changes in parameters of diffusion tensor imaging (DTI) such as fractional anisotropy (FA) and apparent diffusion coefficient (ADC) in patients with symptomatic lumbar disc herniation. We also investigated the correlation between the severity of neurological symptoms and these parameters. Patients and Methods A total of 13 patients with unilateral radiculopathy due to herniation of a lumbar disc were investigated with DTI on a 1.5T MR scanner and underwent micro discectomy. There were nine men and four women, with a median age of 55.5 years (19 to 79). The changes in the mean FA and ADC values and the correlation between these changes and the severity of the neurological symptoms were investigated before and at six months after surgery. Results The mean FA values were significantly lower (p = 0.0005) and mean ADC values were significantly higher (p = 0.0115) in compressed nerves than in intact nerves. Although the FA values increased significantly at six months after surgical treatment (p = 0.020), the ADC values decreased but not significantly (p = 0.498). There were strong correlations between the DTI parameters such as the FA value and the severity of the neurological symptoms as assessed using the Japanese Orthopaedic Association (JOA) score and the Roland-Morris Disability Questionnaire (RDQ). Conclusion This preliminary study suggests that it may be possible to use DTI to diagnose, quantitatively evaluate and follow-up patients with lumbar nerve entrapment. Take home message: DTI is a potential tool for functional diagnosis of lumbar nerve damage. Cite this article: Bone Joint J 2016;98-B:387–94.

Background An earlier cluster randomized controlled trial (RCT) of Hutterite colonies had shown that if more than 80% of children and adolescents were immunized with influenza vaccine there was a statistically significant reduction in laboratory-confirmed influenza among all unimmunized community members. We assessed the impact of this intervention for two additional influenza seasonal periods. Methods Follow-up data for two influenza seasonal periods of a cluster randomized trial involving 1053 Canadian children and adolescents aged 36 months to 15 years in Season 2 and 1014 in Season 3 who received the study vaccine, and 2805 community members in Season 2 and 2840 in Season 3 who did not receive the study vaccine. Follow-up for Season 2 began November 18, 2009 and ended April 25, 2010 while Season 3 extended from December 6, 2010 and ended May 27, 2011. Children were randomly assigned in a blinded manner according to community membership to receive either inactivated trivalent influenza vaccine or hepatitis A. The primary outcome was confirmed influenza A and B infection using RT-PCR assay. Due to the outbreak of 2009 H1N1 pandemic, data in Season 2 were excluded for analysis. Results For an analysis of the combined Season 1 and Season 3 data, among non-recipients (i.e., participants who did not receive study vaccines), 66 of the 2794 (2.4%) participants in the influenza vaccine colonies and 121 of the 2301 (5.3%) participants in the hepatitis A colonies had influenza confirmed by RT-PCR, for a protective effectiveness of 60% (95% CI, 6% to 83%; P = 0.04); among all study participants (i.e., including both those who received study vaccine and those who did not), 125 of the 3806 (3.3%) in the influenza vaccine colonies and 239 of the 3243 (7.4%) in the hepatitis A colonies had influenza confirmed by RT-PCR, for a protective effectiveness of 63% (95% CI, 5% to 85%; P = 0.04). Conclusion Immunizing children and adolescents with inactivated influenza vaccine can offer a protective effect among unimmunized community members for influenza A and B together when considered over multiple years of seasonal influenza. Trial Registration Clinicaltrials.gov NCT00877396

Please cite this paper as: Kim et al. (2012) Characteristics of respiratory viral infections during influenza season in Canadian Hutterite Communities. Influenza and Other Respiratory Viruses DOI:10.1111/irv.12021. Objectives: To determined the pathogen-specific incidence of respiratory virus infection in Hutterite communities occurring over the 2008–2009 influenza season and assess temporal characteristics of respiratory illness related to infection. Methods: 3273 participants community members enrolled in a cluster randomized trial of influenza vaccine were studied. Results: One hundred forty-nine participants had laboratory-confirmed influenza, and 595 had at least one episode of laboratory-confirmed respiratory viral infection other than influenza. Entero/rhinovirus had the highest incidence among children

In the Phase III PATRICIA study (NCT00122681), the human papillomavirus (HPV)-16/18 AS04-adjuvanted vaccine (Cervarix(®), GlaxoSmithKline Biologicals) was highly efficacious against HPV-16/18 infections and precancerous lesions in women HPV-16/18 deoxyribose nucleic acid (DNA) negative and seronegative at baseline. We present further data on vaccine efficacy (VE) against HPV-16/18 in the total vaccinated cohort including women who may have been exposed to HPV-16/18 infection before vaccination. In women with no evidence of current or previous HPV-16/18 infection (DNA negative and seronegative), VE was 90.3% (96.1% confidence interval: 87.3-92.6) against 6-month persistent infection (PI), 91.9% (84.6-96.2) against cervical intraepithelial neoplasia (CIN)1+ and 94.6% (86.3-98.4) against CIN2+ [97.7% (91.1-99.8) when using the HPV type assignment algorithm (TAA)]. In women HPV-16/18 DNA negative but with serological evidence of previous HPV-16/18 infection (seropositive), VE was 72.3% (53.0-84.5) against 6-month PI, 67.2% (10.9-89.9) against CIN1+, and 68.8% (-28.3-95.0) against CIN2+ [88.5% (10.8-99.8) when using TAA]. In women with no evidence of current HPV-16/18 infection (DNA negative), regardless of their baseline HPV-16/18 serological status, VE was 88.7% (85.7-91.1) against 6-month PI, 89.1% (81.6-94.0) against CIN1+ and 92.4% (84.0-97.0) against CIN2+ [97.0% (90.6-99.5) when using TAA]. In women who were DNA positive for one vaccine type, the vaccine was efficacious against the other vaccine type. The vaccine did not impact the outcome of HPV-16/18 infections present at the time of vaccination. Vaccination was generally well tolerated regardless of the woman's HPV-16/18 DNA or serological status at entry.

BACKGROUND AND PURPOSE: DTI can provide valuable structural information that may become an innovative tool in evaluating lumbar foraminal nerve root entrapment. The purpose of this study was to visualize the lumbar nerve roots and to measure their FA in healthy volunteers and patients with lumbar foraminal stenosis by using DTI and tractography with 3T MR imaging. MATERIALS AND METHODS: Eight patients with lumbar foraminal stenosis and 8 healthy volunteers underwent 3T MR imaging. In all subjects, DTI was performed with echo-planar imaging at a b-value of 800 s/mm2 and the lumbar nerve roots were visualized with tractography. Mean FA values in the lumbar nerve roots were quantified on DTI images. RESULTS: In all subjects, the lumbar nerve roots were clearly visualized with tractography. In all patients, tractography also showed abnormalities such as tract disruption, nerve narrowing, and indentation in their course through the foramen. Mean FA values were significantly lower in entrapped roots than in intact roots. CONCLUSIONS: We demonstrated that DTI and tractography of human lumbar nerves can visualize and quantitatively evaluate lumbar nerve entrapment with foraminal stenosis. We believe that DWI is a potential tool for the diagnosis of lumbar nerve entrapment.

High-temperature superconducting (HTS) cables are considered the next generation transmission line because they are compact, lightweight, and demonstrate large capacity and low loss compared to conventional cables. In particular, since a coated conductor (YBCO wire) provides high critical current, high magnetic-field property, low AC loss, and low cost, it is expected to make the HTS cable more attractive than other superconducting wire. In Japan, 66/77 kV HTS cables have developed for about 20 years. We started developing 275 kV class HTS cables three years ago based on 66/77 kV HTS cables. The goal is a 275 kV 3 kA cable with a capacity of 1.5 GVA, the same capacity as a typical overhead transmission line, which serves as the backbone of Japanese power networks. The following technical developments will be carried out: high current and low AC loss cable conductors and high voltage insulation and low dielectric loss cables. Regarding high current and low AC loss cable conductors, 3-kA cables have been fabricated, and AC losses have been measured. We found that using thin YBCO wire reduced AC losses in experiments.

A randomized placebo-controlled double-blind trial of a nasally administered inactivated trivalent influenza vaccine formulated with partially purified meningococcal outer membrane proteins (OMP-TIV) was conducted in 1349 healthy adults aged 18-64 years. Subjects received either vaccine containing 15 μg of haemagglutinin (HA) of each of three influenza strains for the 2003-2004 season on days 0 and 14, or 30 μg on day 0 and saline placebo on day 14, or placebo on days 0 and 14. Vaccination was well tolerated, with similar reactogenicity as placebo. Compared to placebo, statistically significant increases in mean serum haemagglutinin inhibition reciprocal titers and salivary secretory IgA to all 3 antigens were seen on day 28 for both vaccine dose groups. The incidence of culture-positive influenza and fever >37.8°C and cough and one or more of sore throat, runny nose or nasal congestion, muscle or joint ache, headache, fatigue, or chills or culture positive influenza and at least two of these symptoms was low (16/1349; 1.2%). In the intent-to-immunize population too few febrile culture-confirmed illness events (n=4) occurred to perform analysis. Fever occurred infrequently, even in the presence of positive cultures and disabling multi-symptom disease. In participants receiving all doses of either vaccine regimen the incidence of culture-confirmed influenza with respiratory symptoms and with or without fever was 0.77% (7/904) vs. 2.03% (9/443) in placebo recipients (p=0.045, Fisher's exact test; relative risk reduction 62%), despite circulation of a drift variant A/H3N2 that was poorly matched to vaccine. An OMP-TIV vaccine was well tolerated and reduced risk of symptomatic culture confirmed influenza. Vaccine efficacy will need to be validated in a season with a higher attack rate.

We discuss a renal transplant patient with focal segmental glomerulosclerosis (FSGS) treated with plasma exchange and rituximab. A 45-yr-old woman underwent cadaveric renal transplantation in May 2008. She had started hemodialysis support in 1991. Immediately after transplantation, massive proteinuria (1-5 g/d) appeared. Graft biopsy at one h showed minor glomerular abnormalities with partial foot process effacement on electric microscopy. Protocol biopsy at three months after transplantation for persistent proteinuria showed obvious FSGS under light microscopy. Plasma exchange and rituximab administration were subsequently initiated in August 2008, and proteinuria disappeared within a month after starting these treatments. Protocol graft biopsy one yr after transplantation (2009) showed increased global sclerosis and a decrease in segmental sclerosis. In addition, foot process effacement had recovered by one yr after transplantation. Plasma exchange and subsequent rituximab administration led to clinical remission of post-transplant FSGS with improvement in podocyte structure. Rituximab should be considered soon after several sessions of plasmapheresis in transplant patients with recurrent FSGS.

Prophylactic human papillomavirus (HPV) vaccines have to provide sustained protection. We assessed efficacy, immunogenicity, and safety of the HPV-16/18 AS04-adjuvanted vaccine up to 6.4 years.Women aged 15-25 years, with normal cervical cytology, who were HPV-16/18 seronegative and oncogenic HPV DNA-negative (14 types) at screening participated in a double-blind, randomised, placebo-controlled initial study (n=1113; 560 vaccine group vs 553 placebo group) and follow-up study (n=776; 393 vs 383). 27 sites in three countries participated in the follow-up study. Cervical samples were tested every 6 months for HPV DNA. Management of abnormal cytologies was prespecified, and HPV-16/18 antibody titres were assessed. The primary objective was to assess long-term vaccine efficacy in the prevention of incident cervical infection with HPV 16 or HPV 18, or both. We report the analyses up to 6.4 years of this follow-up study and combined with the initial study. For the primary endpoint, the efficacy analysis was done in the according-to-protocol (ATP) cohort; the analysis of cervical intraepithelial neoplasia grade 2 and above (CIN2+) was done in the total vaccinated cohort (TVC). The study is registered with ClinicalTrials.gov, number NCT00120848.For the combined analysis of the initial and follow-up studies, the ATP efficacy cohort included 465 women in the vaccine group and 454 in the placebo group; the TVC included 560 women in the vaccine group and 553 in the placebo group. Vaccine efficacy against incident infection with HPV 16/18 was 95.3% (95% CI 87.4-98.7) and against 12-month persistent infection was 100% (81.8-100). Vaccine efficacy against CIN2+ was 100% (51.3-100) for lesions associated with HPV-16/18 and 71.9% (20.6-91.9) for lesions independent of HPV DNA. Antibody concentrations by ELISA remained 12-fold or more higher than after natural infection (both antigens). Safety outcomes were similar between groups: during the follow-up study, 30 (8%) participants reported a serious adverse event in the vaccine group versus 37 (10%) in the placebo group. None was judged related or possibly related to vaccination, and no deaths occurred.Our findings show excellent long-term efficacy, high and sustained immunogenicity, and favourable safety of the HPV-16/18 AS04-adjuvanted vaccine up to 6.4 years.GlaxoSmithKline Biologicals (Belgium).

High-temperature superconducting (HTS) power cables transmit bulk power with lower loss than conventional cables. Moreover, HTS cables are expected to be constructed as a new underground cable in urban areas at lower cost compared to a high voltage XLPE cable. To put promising HTS cables to practical use, we need (RE)BCO tapes with long length, high critical current, and low cost. Recently many organizations have improved the performance of the (RE)BCO tapes, such as YBCO tapes, or other coated conductor tapes that are made with a variety of different processes. We have fabricated the conductors for the HTS power cable that was constructed of different kinds of (RE)BCO tapes and measured the I c and AC losses. We achieved significantly low AC loss of 0.1 W/m at 1 kA in the HTS conductor using narrow slit tapes that were cut by laser. Moreover, a 20 m long HTS power cable model and a cable intermediate joint were developed. Short circuit current tests were conducted on the cable system that consisted of two 10 m cables, a cable joint, and two terminations. The cables and the joint withstood the short circuit current of 31.5 kA for 2 s without damage.

We discuss a renal transplant patient with recurrent IgA nephropathy (IgAN) before and after tonsillectomy. A 36-year-old man started on hemodialysis support in 1996 due to biopsy-proven IgAN, living related renal transplantation was then performed in 1997. Six years after transplantation, the patient presented with microhematuria and proteinuria. Graft biopsy for these urinary abnormalities showed recurrent IgAN. Tonsillectomy was subsequently performed in December 2003, proteinuria remitted 6 months after the tonsillectomy and microhematuria disappeared three years later. Protocol graft biopsy was subsequently performed twice, at 2 yr after the tonsillectomy (2005) and 4 yr after (2008). Comparing the findings of the pre-tonsillectomy biopsy and the two post-tonsillectomy biopsies, an increase in mesangial cells and matrix in 2005, and an expansion of the mesangial matrix and proliferation of mesangial interposition in 2008. In addition, global sclerosis of glomeruli increased over time, the area of tubulointerstitial damage has extended as well. While the tonsillectomy led to clinical remission of recurrent IgAN, the chronicity progressed on these protocol biopsies. This is the first report of the efficacy and the limitations of tonsillectomy in a case of recurrent IgAN in a transplant patient.

Summary Background The human papillomavirus (HPV)-16/18 AS04-adjuvanted vaccine was immunogenic, generally well tolerated, and effective against HPV-16 or HPV-18 infections, and associated precancerous lesions in an event-triggered interim analysis of the phase III randomised, double-blind, controlled PApilloma TRIal against Cancer In young Adults (PATRICIA). We now assess the vaccine efficacy in the final event-driven analysis. Methods Women (15–25 years) were vaccinated at months 0, 1, and 6. Analyses were done in the according-to-protocol cohort for efficacy (ATP-E; vaccine, n=8093; control, n=8069), total vaccinated cohort (TVC, included all women receiving at least one vaccine dose, regardless of their baseline HPV status; represents the general population, including those who are sexually active; vaccine, n=9319; control, n=9325), and TVC-naive (no evidence of oncogenic HPV infection at baseline; represents women before sexual debut; vaccine, n=5822; control, n=5819). The primary endpoint was to assess vaccine efficacy against cervical intraepithelial neoplasia 2+ (CIN2+) that was associated with HPV-16 or HPV-18 in women who were seronegative at baseline, and DNA negative at baseline and month 6 for the corresponding type (ATP-E). This trial is registered with ClinicalTrials.gov, number NCT00122681. Findings Mean follow-up was 34·9 months (SD 6·4) after the third dose. Vaccine efficacy against CIN2+ associated with HPV-16/18 was 92·9% (96·1% CI 79·9–98·3) in the primary analysis and 98·1% (88·4–100) in an analysis in which probable causality to HPV type was assigned in lesions infected with multiple oncogenic types (ATP-E cohort). Vaccine efficacy against CIN2+ irrespective of HPV DNA in lesions was 30·4% (16·4–42·1) in the TVC and 70·2% (54·7–80·9) in the TVC-naive. Corresponding values against CIN3+ were 33·4% (9·1–51·5) in the TVC and 87·0% (54·9–97·7) in the TVC-naive. Vaccine efficacy against CIN2+ associated with 12 non-vaccine oncogenic types was 54·0% (34·0–68·4; ATP-E). Individual cross-protection against CIN2+ associated with HPV-31, HPV-33, and HPV-45 was seen in the TVC. Interpretation The HPV-16/18 AS04-adjuvanted vaccine showed high efficacy against CIN2+ associated with HPV-16/18 and non-vaccine oncogenic HPV types and substantial overall effect in cohorts that are relevant to universal mass vaccination and catch-up programmes. Funding GlaxoSmithKline Biologicals.

The Japanese Society of Chemotherapy (JSC) conducted the first nationwide surveillance of bacterial respiratory pathogens during the period from January to August 2006. With the cooperation of 32 medical institutions throughout Japan, a total of 924 strains belonging to seven clinically relevant bacterial species were collected from adult patients with well-diagnosed respiratory tract infections (RTIs). Antimicrobial susceptibility testing of the 887 evaluable strains (205 Staphylococcus aureus, 200 Streptococcus pneumoniae, 9 Streptococcus pyogenes, 165 Haemophilus influenzae, 91 Moraxella catarrhalis, 74 Klebsiella pneumoniae, and 143 Pseudomonas aeruginosa) to 42 antibacterial agents was conducted at the Central Laboratory of the Research Center for Anti-infective Drugs of the Kitasato Institute, according to recommendations issued by the Clinical and Laboratory Standards Institute (CLSI). The antibacterial agents employed were 25 beta-lactams, three aminoglycosides, four macrolides (including one azalide and one ketolide), one lincosamide, one tetracycline, two glycopeptides, five fluoroquinolones, and one oxazolidinone. The incidence of methicillin-resistant S. aureus (MRSA) was 63.4%, and the incidences of penicillin-intermediately resistant S. pneumoniae (PISP) and penicillin-resistant S. pneumoniae (PRSP) were 35.0% and 4.0%, respectively. Among H. influenzae, 21.2% of the strains were found to be beta-lactamase-nonproducing ampicillin (ABPC)-intermediately resistant (BLNAI), 29.1% to be beta-lactamase-nonproducing ABPC-resistant (BLNAR), and 4.8% to be beta-lactamaseproducing ABPC-resistant (BLPAR) strains. The incidence of extended-spectrum beta-lactamase-producing K. pneumoniae was 2.7% (2 of 74 strains). Three (2.1%) of the 143 P. aeruginosa strains were found to be metallo-beta-lactamaseproducing, including 1 (0.7%) multidrug-resistant strain. Through the nationwide surveillance, we obtained fundamental antimicrobial susceptibility data of clinically relevant bacterial pathogens in adult RTI to various antibacterial agents. These data will be a useful reference for future periodic surveillance studies, as well as for investigations to control antimicrobial-resistant pathogens.

This paper presents a dynamic predistorter (PD), which linearizes the dynamic AM-AM and AM-PM of a wideband code division multiple access handset power amplifier (PA). The dynamic PD allows an adjacent channel leakage power ratio (ACPR) improvement of 15.7 dB, which is superior to conventional PDs that linearize static AM-AM and AM-PM. The dynamic PD was designed using an HBT generating nonlinearity, a short circuit at the baseband (les4 MHz), and a load circuit for the HBT at the RF fundamental band (ap1.95 GHz). Volterra-series analysis was performed to understand the mechanism of the dynamic PD. The analysis revealed that the short circuit at the baseband enabled the dynamic PD generating third-order intermodulation distortion (IMD3) with opposite phase to the fundamental tone (i.e., antiphase IMD3). The antiphase IMD3 allows dynamic gain compression, which linearizes the dynamic gain expansion of a PA with low quiescent current. The analysis also revealed that the IMD3 amplitude of the dynamic PD can be adjusted by load impedance at the RF fundamental band, which enables the gradient of dynamic AM-AM and AM-PM to be optimized to linearize the PA. The fabricated two-stage InGaP/GaAs HBT PA module with the dynamic PD exhibited an ACPR of -40 dBc and a power-added efficiency of 50% at an average output power of 26.8 dBm with a quiescent current of 20 mA

Purpose To compare the prevalence of visual field loss, the sensitivity distribution, and the size and depth of glaucomatous visual field defects using the standard full threshold (FT) and the Swedish interactive threshold algorithm (SITA) standard (SS) procedures in patients with early or suspected glaucoma. Methods Automated perimetry findings were retrospectively evaluated in 53 patients (105 eyes) with early or suspected glaucoma. Results The number of eyes judged to have glaucomatous visual field loss by SS (48 eyes) was significantly larger than what was found with FT (35 eyes), and 70 eyes were classified as pre-perimetric glaucoma. In these 70 eyes, there were many locations where the sensitivity was significantly higher with SS than with FT (intrasubject difference), and SS had less intersubject variability than FT at most locations. The cumulative decibel scores at the region of glaucomatous defects were larger with SS (206.2±103.3 dB) than with FT (162.1±87.5 dB) (p=0.02), which indicated that the depth of defects measured by SS was shallower than that by FT. The sizes of defects were significantly larger with SS (11.2±5.6) than with FT (9.7±5.1) (pConclusions Glaucomatous defects were measured as being significantly shallower and larger with SS than with FT. In addition, the prevalence of visual field defect was higher with SS according to some of the criteria for glaucomatous visual field defects. These results might be related to the fact that SS strategy has a lower variability and to the Bayesian statistical properties of the SITA algorithm. (Eur J Ophthalmol 2007; 17: 196–202)

This paper presents a nonlinear adaptive torque control method for an interior permanent magnet synchronous motor (IPMSM) with dynamic copper loss minimization based on control Lyapunov function (CLF). A nonlinear torque control for IPMSM with dynamic copper loss minimization based on CLF has been proposed. However, the method does not consider parameter variation of IPMSM. Then, we propose a torque control method for IPMSM considering parameter variation and copper loss minimization. Finally, the effectiveness of the proposed method is demonstrated by computer simulation and experiments.