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BackgroundThere are currently limited data for the use of specific antiviral therapies for the treatment of Ebola virus disease (EVD). While there is anecdotal evidence that supportive care may be effective, there is a paucity of direct experimental data to demonstrate a role for supportive care in EVD. We studied the impact of ICU-level supportive care interventions including fluid resuscitation, vasoactive medications, blood transfusion, hydrocortisone, and ventilator support on the pathophysiology of EVD in rhesus macaques infected with a universally lethal dose of Ebola virus strain Makona C07.MethodsFour NHPs were infected with a universally lethal dose Ebola virus strain Makona, in accordance with the gold standard lethal Ebola NHP challenge model. Following infection, the following therapeutic interventions were employed: continuous bedside supportive care, ventilator support, judicious fluid resuscitation, vasoactive medications, blood transfusion, and hydrocortisone as needed to treat cardiovascular compromise. A range of physiological parameters were continuously monitored to gage any response to the interventions.ResultsAll four NHPs developed EVD and demonstrated a similar clinical course. All animals reached a terminal endpoint, which occurred at an average time of 166.5 ± 14.8 h post-infection. Fluid administration may have temporarily blunted a rise in lactate, but the effect was short lived. Vasoactive medications resulted in short-lived improvements in mean arterial pressure. Blood transfusion and hydrocortisone did not appear to have a significant positive impact on the course of the disease.ConclusionsThe model employed for this study is reflective of an intramuscular infection in humans (e.g., needle stick) and is highly lethal to NHPs. Using this model, we found that the animals developed progressive severe organ dysfunction and profound shock preceding death. While the overall impact of supportive care on the observed pathophysiology was limited, we did observe some time-dependent positive responses. Since this model is highly lethal, it does not reflect the full spectrum of human EVD. Our findings support the need for continued development of animal models that replicate the spectrum of human disease as well as ongoing development of anti-Ebola therapies to complement supportive care.

Background: The 2014–2016 Ebola outbreak in West Africa recapitulated that nosocomial spread of Ebola virus could occur and that health care workers were at particular risk including notable cases in Europe and North America. These instances highlighted the need for centers to better prepare for potential Ebola virus cases, including understanding how the virus spreads and which interventions pose the greatest risk. Methods: We created a fully equipped intensive care unit (ICU), within a Biosafety Level 4 (BSL4) laboratory, and infected multiple sedated non-human primates (NHPs) with Ebola virus. While providing bedside care, we sampled blood, urine, and gastric residuals, as well as buccal, ocular, nasal, rectal, and skin swabs, to assess the risks associated with routine care. We also assessed the physical environment at end-point. Results: Although viral RNA was detectable in blood as early as three days post-infection, it was not detectable in the urine, gastric fluid, or swabs until late-stage disease. While droplet spread and fomite contamination were present on a few of the surfaces that were routinely touched while providing care in the ICU for the infected animal, these may have been abrogated through good routine hygiene practices. Conclusions: Overall this study has helped further our understanding of which procedures may pose the highest risk to healthcare providers and provides temporal evidence of this over the clinical course of disease.

The yielding brace system (YBS) is a seismic-resistant concentrically braced frame system that provides a fully symmetric hysteretic response via flexural yielding of cast steel triangular ...

This study assessed the potential physiological and perceptual drivers of fluid intake and thirst sensation during intermittent exercise. Ten male rugby players (17 ± 1 years, stature: 179.1 ± 4.2 cm, body mass (BM): 81.9 ± 8.1 kg) participated in six 6-min small-sided games, interspersed with 2 min rest, where fluid intake was ad libitum during rest periods. Pre- and postmeasurements of BM, subjective ratings (thirst, thermal comfort, thermal sensation, mouth dryness), plasma osmolality (POsm), serum sodium concentration (S[Na+]), haematocrit and haemoglobin (to calculate plasma volume change; PV) were taken. Fluid intake was measured during rest periods. BM change was –0.17 ± 0.59% and fluid intake was 0.88 ± 0.38 L. Pre- to post-POsm decreased (–3.1 ± 2.3 mOsm·kg−1; p = 0.002) and S[Na+] remained similar (–0.3 ± 0.7 mmol·L−1, p = 0.193). ΔPV was 5.84 ± 3.65%. Fluid intake displayed a relationship with pre-POsm (r = –0.640, p = 0.046), prethermal comfort (r = 0.651; p = –0.041), ΔS[Na+] (r = 0.816, p = 0.004), and ΔPV (r = 0.740; p = 0.014). ΔThirst sensation displayed a relationship with premouth dryness (r = 0.861, p = 0.006) and Δmouth dryness (r = 0.878, p = 0.004). Yet a weak positive relationship between Δthirst sensation and fluid intake was observed (r = 0.085, p = 0.841). These data observed in an ambient temperature of 13.6 ± 0.9 °C, suggest team-sport athletes drink in excess of fluid homeostasis requirements and thirst sensation in cool conditions; however, this was not influenced by thermal discomfort.

Generation of rhythmic activity in numerous systems has been shown to depend on electrical coupling. Small networks provide a strong advantage for studying electrical coupling because, thanks to the accessibility and limited number of neurons, their role in network activity and even behavior can be determined accurately and rigorously. We discuss the known role of electrical coupling in the generation of rhythmic activity, describing experimental and theoretical work. Interestingly, a large body of work indicates that electrical coupling–based rhythmogenesis may be prevalent during early development. The best known effect of electrical coupling in rhythmic networks is the regulation of synchronization and pattern generation, which we describe in the context of electrical coupling, both rectifying and nonrectifying, and its interactions with chemical synaptic coupling. Finally, we discuss the important issue of neuromodulation of gap junctions and its role in regulation of pattern generation and behavior.

O1 IL-15 primes an mTOR-regulated gene-expression program to prolong anti-tumor capacity of human natural killer cells #### Andreas Lundqvist1, Vincent van Hoef1, Xiaonan Zhang1, Erik Wennerberg2, Julie Lorent1, Kristina Witt1, Laia Masvidal Sanz1, Shuo Liang1, Shannon Murray3, Ola Larsson1

The neuromodulator-gated current ( IMI) found in the crab stomatogastric ganglion is activated by neuromodulators that are essential to induce the rhythmic activity of the pyloric network in this system. One of these neuromodulators is also known to control the correlated expression of voltage-gated ionic currents in pyloric neurons, as well as synaptic plasticity and strength. Thus understanding the mechanism by which neuromodulator receptors activate IMIshould provide insights not only into how oscillations are initiated but also into how other processes, and currents not directly activated by them, are regulated. To determine what specific signaling molecules are implicated in this process, we used a battery of agonists and antagonists of common signal transduction pathways. We found that the G protein inhibitor GDPβS and the G protein activator GTPγS significantly affect IMIamplitude, suggesting that its activation is mediated by G proteins. Interestingly, when using the more specific G protein blocker pertussis toxin, we observed the expected inhibition of IMIamplitude but, unexpectedly, in a calcium-dependent fashion. We also found that antagonists of calcium- and calmodulin-associated signaling significantly reduce IMIamplitude. In contrast, we found little evidence for the role of cyclic nucleotide signaling, phospholipase C (PLC), or kinases and phosphatases, except two calmodulin-dependent kinases. In sum, these results suggest that proctolin-induced IMIis mediated by a G protein whose pertussis toxin sensitivity is altered by external calcium concentration and appears to depend on intracellular calcium, calmodulin, and calmodulin-activated kinases. In contrast, we found no support for IMIbeing mediated by PLC signaling or cyclic nucleotides.NEW & NOTEWORTHY Neuronal rhythmic activity is generated by either network-based or cell-autonomous mechanisms. In the pyloric network of decapod crustaceans, the activation of a neuromodulator-gated pacemaker current is crucial for the generation of rhythmic activity. This current is activated by several neuromodulators, including peptides and acetylcholine, presumably via metabotropic receptors. We have previously demonstrated a novel extracellular calcium-sensitive voltage-dependence mechanism of this current. We presently report that the activation mechanism depends on intracellular and extracellular calcium-sensitive components.

A best evidence topic in cardiothoracic surgery was written according to a structured protocol. The question addressed was: is it safe to stop anticoagulants after successful surgery for atrial fibrillation? Altogether, 177 papers were found using the reported search, of which 14 were selected that represented the best evidence to answer the clinical question. Selection criteria included study relevance, primary outcome, size of study population and length of follow-up. The authors, journal, date and country of publication, patient group studied, study type, relevant outcomes and results of these papers are tabulated. The weight of evidence, including over 10,000 patient-years of follow-up, supports the discontinuation of warfarin following atrial fibrillation correction procedures as being safe, with an associated annual thromboembolic stroke rate of 0-3.8% off warfarin, in studies where warfarin was stopped at a mean of 3.6 months (range 0-8 months) after the procedure. However, the confidence of this conclusion suffers from a paucity of high-quality randomized controlled trials in the field, with the main body of evidence coming instead from observational non-randomized studies. The stroke rate also varies with the exact procedure performed; pulmonary vein isolation procedures are the most extensively evaluated and carry the lowest stroke rate following warfarin discontinuation (0-0.4% per annum when performed as an isolated procedure). By contrast, left atrial appendage occlusion by insertion of a transcatheter device has an associated annual stroke rate of 0-3.8% off warfarin. Thus, discontinuation of warfarin following such transcatheter procedures cannot be recommended at this time. Concomitant heart surgeries, such as mitral valve repair have been shown to increase the thromboembolic rate both unpredictably and dramatically, and this review thus identifies concomitant mitral valve surgery as a potentially substantial risk factor for late thromboembolic stroke in patients undergoing corrective surgeries for atrial fibrillation. This review finds in favour of warfarin discontinuation in selected patients at three months post-procedure, emphasizing consideration of the patient's individual risk-factor profile as paramount. This recommendation is in line with the 2010 guidelines for the management of atrial fibrillation produced by the European Society of Cardiology.

Durch Diagonalen ausgesteifte Rahmentragwerke sind effiziente und gern verwendete Konstruktionen in halbhohen bis niedrigen Stahlbauten. Allerdings sind die Strebenverbindungen immer ein Schwachpunkt, sofern nicht aufwendige Entwurfs- und Herstellungsverfahren eingesetzt werden. Rahmen mit Hohlprofilstreben, die so geschlitzt werden, dass eine zentrische Lasche eingeschweist werden kann, sind insbesondere anfallig fur Verbindungsversagen aufgrund von Spannungsspitzen im Nettoquerschnitt. Um dieses Problem zu vermeiden, wurde an der Universitat von Toronto ein Stahlguss verbindungselement entwickelt, das eine geschraubte Verbindung zwischen einer Rundhohlprofilstrebe und einem typischen Knotenblech ermoglicht. Im Gegensatz zur typischen geschlitzten Hohlprofilverbindung wurde das Stahlgussverbindungselement derart entwickelt, dass ein Versagen durch ortlich begrenzte Lasteinleitung im Strebenelement praktisch ausgeschlossen ist. Auf diese Weise konnen lastige Verstarkungsbleche vermieden werden. Das Verbindungselement wurde mit FE-Analysen auf Basis von Volumenmodellen entwickelt und aus Stahl der Guteklasse ASTM A958 gegossen, welcher den ublichen Baustahlen sehr ahnlich ist. Im folgenden Beitrag werden die Ergebnisse einer Serie von Versuchen an Streben in Originalgrose vorgestellt. Hierbei wurden vier moderat schlanke, kompakte Streben aus kaltverformten Rundhohlprofilen zyklisch bis zum Versagen beansprucht. Die Strebenanordnungen bestanden aus verschiedenen Rundhohlprofil- und Verbindungselementgrosen, wobei das Verbindungselement jeweils mit einem typischen Knotenblech verschraubt wurde. Alle Versuche erfolgten entsprechend der Vorgaben fur knickresistente Streben in den Erdbebenvorschriften des amerikanischen Instituts fur Stahlkonstruktionen (AISC). Alle Streben uberstanden mehrere, uber die Anforderungen hinaus gehende Zyklen und versagten auf Zug in der Strebenmitte. Die Stahlgussverbindungselemente zeigten in samtlichen Versuchen keinerlei Anzeichen von Plastizierungen und illustrierten hiermit, dass die Verwendung dieser Bauelemente ein praktikables Mittel zum Anschluss von Rundhohlprofilstreben in seismischen Anwendungen darstellen kann. Tubular brace members with cast steel connectors under seismic loading. Although concentrically braced frames are an efficient and popular choice for the lateral force resisting systems of mid- to low-rise steel frames, their bracing connections may be prone to premature failure unless complex design and fabrication procedures are undertaken. Frames utilizing Hollow Structural Section (HSS) braces, slotted to receive a concentric welded gusset plate, are particularly susceptible to connection fracture due to stress concentrations arising from the shear lag phenomenon at the net-section. To address this issue, a cast steel connector was developed at the University of Toronto that provides a bolted connection between a circular hollow section (CHS) brace and a typical corner gusset plate. Unlike standard, fabricated, slotted-tube type connections, the cast connector is designed such that shear lag in the brace member is virtually eliminated. Thus, there is no need for cumbersome reinforcing plates in the connection region. The connector was designed using solid modeling software and finiteelement analysis, and cast using ASTM A958 grade steel, which is very similar to most wrought grades. This paper presents the results of a series of full-scale brace tests in which four moderately slender, compact, cold-formed CHS brace assemblies were cyclically loaded to failure. Each of the brace assemblies employed a different size of CHS and cast steel connector, with the latter in turn bolted to a typical corner gusset plate. Each of the tests followed the buckling restrained brace protocol specified in the American Institute of Steel Construction (AISC) Seismic Provisions. All of the braces survived several cycles beyond the protocol and failed in tension at the center of the brace. In each test the cast steel connectors showed no sign of yielding, illustrating that the use of a cast steel connector is a viable means of connecting CHS brace members for seismic applications.

During the past three decades, steel casting technologies and processes have developed significantly, making way for the production of high-quality castings that are capable of meeting the rigorous demands of structural applications. As a result, the use of steel castings in construction is becoming increasingly more accepted and commonplace. This article presents the state-of-the-art uses of steel castings in onshore construction and summarises recent publications to give an overview of the current status of research and use of cast steel in tubular structures in North America, Europe and Asia.

Background In the fall of 2017, the community of Bridgeland approached the City of Calgary with a vision to enhance the space beneath the 4 Avenue Flyover, a key walking connection to the downtown and river pathway network. With the City of Calgary's Pedestrian Strategy approved in 2016, this project aligned with a new way of working with partners as well as to deliver on The City's development of a Tactical Urbanism program. Aim This project involves "hiring" grade six students in a youth-led design project. The community, local school, the University of Calgary Landscape Architecture program and the City of Calgary together will create a safer, more inviting walking corridor. The project will add temporary and permanent active modes, play, LID elements in the summer of 2017. Each of the partners has successfully joined their unique goals to ultimately benefit a community: City of Calgary: deliver on Step Forward, Calgary’s first pedestrian strategy by working closely with partners and creating a Tactical Urbanism program; University of Calgary, Landscape Architecture: offer a relevant and project as part of the Green Infrastructure and Winter City Design graduate course; Bridgeland Riverside Community Association: enhance an underused space beneath the 4 Avenue Flyover. Specifically, creating a gateway, enhancing safety, walking and lighting; Langevin School: deliver the grade-six curriculum around democracy & municipal government, forestry, math and writing in a fun and meaningful way. Method Landscape architecture students develop and refine concepts with input from City staff and community specialists including members of Calgary’s Drop In Centre, local business owners, artists and historians. The City’s provides project coordination and public engagement and will lead construction to temporary and permanent elements in the summer of 2017. Results This project will add shared streets elements, play spaces, lighting, public art, and low impact development. The project is being recognized through the media and other sources on its potential to empower communities. Conclusions The lessons learned through this project will inform Calgary’s tactical urbanism program and show how meaningful it can be to engage on improving walking – especially with the help of a few #flyover kids.

Victoria Square shopping centre is a new £400 million mixed-use development in the centre of Belfast, Northern Ireland. Unlike most traditional shopping centres, its layout is based on the twists and turns of existing street patterns and it also provides open streetscapes with glazed rain screens rather than enclosed malls. This paper describes the design and construction of this 135 000 m2 high-quality urban regeneration scheme, including its extensive three-level basement in water-bearing gravels and the spectacular glazed dome and central ‘lily pad’ viewing and circulation structure.

Quantitative structural activity relationship (QSAR) models are receiving wide use because of new regulations and public scrutiny regarding new compounds entered into commerce. Accordingly, the US Department of Defense (DoD) supported this study to evaluate QSAR modeling for energetic compounds. Four compounds proposed to replace ammonium perchlorate were examined: ammonium di(nitramido)amine (ADNA); 1,3,5,5-tetranitrohexahydropyrimidine (DNNC); 1,3,3,5,7,7-hexanitro-1,5-diazacyclooctane (HCO); and diammonium di(nitramido)dinitroethylene (ADNDNE). Currently used compounds were evaluated as analogues for those under development. Ammonium dinitramide (ADN) was the analogue for ADNA; hexahydro-1,3,5-trinitro-1,3,5-triazine (RDX) for DNNC; octahydro-1,3,5,7-tetranitro-1,3,5,7-tetrazocine (HMX) for HCO; and 1,1-diamino-2,2-dinitroethene (FOX-7) for ADNDNE. QSAR analysis was performed with the US Environmental Protection Agency’s Estimation Program Interface (EPI) Suite™. The comparison of model estimates to literature values ranged from good-to-poor. Results suggested the proposed replacement compounds have low aquatic toxicities and little potential to bioaccummulate, but the uncertainty in the predictions indicates QSAR modeling with EPI Suite™ is only useful for qualitative assessments of these proposed energetic compounds.

Limited data exist on the hydration status of female athletes, with no data available on female rugby players. The objective of this study was to investigate the habitual hydration status on arrival, sweat loss, fluid intake, sweat Na loss, and blood [Na+] during field training and match-play in 10 international female rugby league players. Urine osmolality on arrival to match-play (382 ± 302 mOsmol·kg(-1)) and training (667 ± 260 mOsmol·kg(-1)) was indicative of euhydration. Players experienced a body mass loss of 0.50 ± 0.45 and 0.56 ± 0.53% during match-play and training, respectively. During match-play, players consumed 1.21 ± 0.43 kg of fluid and had a sweat loss of 1.54 ± 0.48 kg. During training, players consumed 1.07 ± 0.90 kg of fluid, in comparison with 1.25 ± 0.83 kg of sweat loss. Blood [Na+] was well regulated (Δ-0.7 ± 3.4 and Δ-0.4 ± 2.6 mmol·L(-1)), despite sweat [Na+] of 47.8 ± 5.7 and 47.2 ± 6.3 mmol·L(-1) during match-play and training. The findings of this study show mean blood [Na+] that seems to be well regulated despite losses of Na in sweat and electrolyte-free fluid consumption. For the duration of the study, players did not experience a body mass loss (dehydration >2%) indicative of a reduction in exercise performance, thus habitual hydration strategies seem adequate. Practitioners should evaluate the habitual hydration status of athletes to determine whether interventions above habitual strategies are warranted.

Objectives This study characterized the performance of the “Classical Mexican Device”, which immunized 4 million children against measles, demonstrating the efficacy of aerosol vaccination. Methods Using plaque-forming units to quantify virus, the particle size distribution (Next Generation Pharmaceutical Impactor) and rate of output coupled with age specific patterns of breathing allowed the calculation of expected pulmonary deposition. Results The estimated immunization dose for infants was 30 pfu's, for small children 50, and for older children and adolescents it was 130 and 225, respectively. Conclusions These performance characteristics can be used to develop newer battery operable devices that are licensable.

The Yielding Brace System is a highly ductile bracing system in which seismic energy is dissipated by the yielding fingers of a specially engineered cast steel connector. When the brace is ...

The VProf Tutor is a computer-based intelligent tutoring system (ITS) that teaches the use and understanding of vertical profile navigation modes to MD-11 pilots. This ITS is a proof-of-concept implementation of GT-ITACS (Georgia Tech-Intelligent Tutoring Architecture for Complex Systems). GT-ITACS is a domain- and platform- independent intelligent tutoring system shell designed to train operators of complex-dynamic systems. This paper introduces the features of GT-ITACS, using the VProf Tutor to illustrate the capabilities of the system.

This paper describes a research program that addresses a variety of issues and problems in training pilots to fly modern, highly sophisticated aircraft First, the paper describes two intelligent tutors developed to teach two important aspects of aviation: a tutor that teaches management of the vertical dimension of the flight management system for pilots in transition training; and a tutor that teaches expert novices, that is, certified pilots, procedures not included in their transition training. Second, both tutors extend GT-ITACS (Georgia Tech-Intelligent Tutoring Architecture for Complex Systems), a computational development environment for intelligent tutors. In general, implementing instructional material in computational form is the most difficult step in developing effective computer-based instruction; this is particularly true for intelligent tutors Computational implementation is so difficult that implementing computer-based training is often cost and time prohibitive—explaining in part the small number of tutors and the abundance of computer-based training that is little more than Power Point presentations GT-ITACS is an computational architecture that is completely file driven That is, configuring a GT-ITACS tutor for a new application requires only reformatting input files. A tutor based on GT-ITACS does not require any additional software development or ‘hard-coding.’ Both tutors described in this paper instantiate GT-ITACS, demonstrating the versatility and power of the development environment. Finally, the paper concludes by describing a method to implement distributed, computer-based training, that is, training any time, any where A description of an easily implemented method, evaluated with both tutors described in this paper, provides users access to training at the place and time of their choice.

Pre-existing immunity to human adenovirus serotype 5 (Ad5) is common in the general population. Bypassing pre-existing immunity could maximize Ad5 vaccine efficacy. Vaccination by the intramuscular (I.M.), nasal (I.N.) or oral (P.O.) route with Ad5 expressing Ebola Zaire glycoprotein (Ad5-ZGP) fully protected naïve mice against lethal challenge with Ebola. In the presence of pre-existing immunity, only mice vaccinated I.N. survived. The frequency of IFN-gamma+ CD8+ T cells was reduced by 80% and by 15% in animals vaccinated by the I.M. and P.O. routes respectively. Neutralizing antibodies could not be detected in serum from either treatment group. Pre-existing immunity did not compromise the frequency of IFN-gamma+ CD8+ T cells (3.9+/-1% naïve vs. 3.6+/-1% pre-existing immunity, PEI) nor anti-Ebola neutralizing antibody (NAB, 40+/-10 reciprocal dilution, both groups). The number of INF-gamma+ CD8+ cells detected in bronchioalveolar lavage fluid (BAL) after I.N. immunization was not compromised by pre-existing immunity to Ad5 (146+/-14, naïve vs. 120+/-16 SFC/million MNCs, PEI). However, pre-existing immunity reduced NAB levels in BAL by approximately 25% in this group. To improve the immune response after oral vaccination, the Ad5-based vaccine was PEGylated. Mice given the modified vaccine did not survive challenge and had reduced levels of IFN-gamma+ CD8+ T cells 10 days after administration (0.3+/-0.3% PEG vs. 1.7+/-0.5% unmodified). PEGylation did increase NAB levels 2-fold. These results provide some insight about the degree of T and B cell mediated immunity necessary for protection against Ebola virus and suggest that modification of the virus capsid can influence the type of immune response elicited by an Ad5-based vaccine.

Previous work has shown that, during the early phases of chronic nerve compression (CNC) injury, axonal pathology is absent while Schwann cells undergo a dramatic process of cellular turnover with marked proliferation. It is known that macrophages may release Schwann cell mitogens, so we sought to explore the role of macrophages in CNC injury by selectively depleting the population of hematogenously derived macrophages in nerves undergoing CNC injury by injecting clodronate liposomes at days 1, 3, and 6 postinjury and evaluating both the integrity of the blood-nerve barrier (BNB) and Schwann cell function. Integrity of the BNB was evaluated by intravenously injecting Evans blue albumin (EBA), and Schwann cell number was determined via stereologic techniques. The BNB was clearly altered by 2 weeks postinjury and continued to disintegrate at later time points. Macrophage depletion attenuated this response at all observed time points. Quantification of Schwann cell nuclei in CNC nerves showed no differences between compressed sections of macrophage-depleted and nondepleted animals. Although macrophages are largely responsible for the increased vascular permeability associated with CNC injury, it is likely that the Schwann cell response to CNC injury is not influenced by macrophage-derived mitogenic signals but rather must be mediated via alternative mechanisms.

Meeting abstracts Extensive studies have demonstrated that the inside-out membrane phospholipid phosphatidylserine (PS) actively drives global immunosuppression in the tumor microenvironment and is a major contributor to tumor resistance to immune checkpoint blockade. We have shown that PS

To better understand the pathogenesis of chronic nerve compression injuries, we investigated the possibility that Schwann cell production of vascular endothelial growth factor (VEGF) is responsible for the increased vascularity and Schwann cell proliferation associated with chronic nerve injury. In situ hybridization was used to evaluate VEGF mRNA production with immunohistochemistry to further localize the production of VEGF and its receptor proteins in an animal model of chronic nerve compression injury. VEGF mRNA and protein expression increased within Schwann cells as early as 2 weeks after compression and peaked by 1 month with a subsequent marked increase in the number of blood vessels. Thus, chronic nerve compression injury induces Schwann cells to increase VEGF production, which may be responsible for changes in neural vasculature secondary to chronic nerve compression injury. With a better understanding of these nerve injuries, more effective treatments may be developed to help patients with these impairments.

Genotyping is an important component of measles surveillance. In this study, we report the genotypes of 30 measles viruses from cases in Canada; 6 of these were collected between 1979 and 1996 and 24 were collected from 1997 through 2002. Many measles virus genotypes were found (C1, C2, D3, D4, D5, D6, D7, D8, E, and H1). These data indicate that the predominant measles virus genotypes detected from 1979 to 1997 in Canada are no longer commonly found. Since the implementation of a routine second dose of measles vaccine and catch-up campaigns in 1996-1997, the wide variety of measles virus genotypes found supports epidemiological data showing that importation of measles is the source of current measles cases in Canada.

Mandibular distraction osteogenesis is a medical procedure for lengthening the mandible bone by stimulating natural bone-healing mechanisms via a mechanical device that exerts a force on the mandible in one or more directions. Many mandibular distraction devices must be placed externally and most rely on the patient to manually actuate the device each day. This project focuses on the design of an automatically actuated, single degree-of-freedom, implantable distraction device that would be minimally visible after installation. Such a device could reduce errors from patient compliance and would be an important first step toward increasing the capability of future devices. A simple motor and leadscrew system was used with a custom designed impact transmission and controller. A test was conducted on a prototype to determine the feasibility of the design and measure the overall system efficiency. The device was able to move the required 70 N load at a rate of about 1 mm per minute. Compared to an equivalent device utilizing a planetary gearhead to amplify the torque, the impact coupling is significantly less efficient. However, the necessary increase in battery size has only a small impact on the total device length. For a system with the same motor and force output, the impact coupling system is shorter than the gearhead-based system due to a 50% reduction in transmission length.Copyright © 2004 by ASME

Background:Rubella virus generally causes a mild fever, rash illness similar in clinical presentation to infections by other viruses including measles and parvovirus B19. Rubella infections in pregnant women in the first trimester carry a high risk of congenital rubella syndrome (CRS) which can result in severe congenital defects in the infants. The goal of rubella immunization programs is therefore to eliminate CRS. The primary test for the laboratory confirmation of rubella is IgM serology. It is therefore important to evaluate currently available commercial rubella IgM immunoassays to ensure high quality rubella diagnostic testing. Study design: In this study, we compared the performance of seven commercial rubella IgM enzyme immunoassays (EIA) (Meddens, Denka Seiken, Behring, Wampole, Captia, Sigma and Abbott Axsym) using well-defined panels of sera from rubella and non-rubella/rash-illness cases. Results: The Meddens, Denka Seiken, Behring and Wampole rubella IgM EIAs all performed similarly for sensitivity (range of 74.1–76.8%) and specificity (range of 93.9–96.1%). Relative to the other assays, the Axsym had a higher sensitivity (78.9%) but lower specificity (86.5%). The Captia assay had the lowest overall sensitivity (66.4%), while the Sigma assay had a lower specificity (85.6%) in relation to the other assays. Conclusions:In conclusion, the Meddens, Denka Seiken, Behring and Wampole rubella IgM EIAs are comparable in their overall performance with respect to sensitivity and specificity. © 2003 Elsevier B.V. All rights reserved.

Cerebral venous sinus thrombosis is a rare but serious cause of headache. In this report, we present a young man with poorly controlled Crohn's disease who presented with a 2-week history of headache and fluctuating left-sided sensory and motor symptoms. CT demonstrated changes consistent with either a subarachnoid haemorrhage or venous sinus thrombosis. The ensuing magnetic resonance venogram confirmed superior sagittal venous sinus thrombosis and an infarct of his right superior frontal lobe. The patient was started on low-molecular weight heparin and steroids. He required multi-disciplinary input from the stroke physicians, neurologists, gastroenterologists, dieticians and physiotherapists. He made a full neurological recovery and is now on long-term azathioprine. The purpose of this report is to highlight the consideration of venous sinus thrombosis in the diagnosis of headache and as a rare extraintestinal complication of Crohn's disease.

Summary We observe fluctuations in human papillomavirus detection and variation in genotyping between sequential cervical cell specimens analyzed by filter in situ hybridization. Furthermore, specimen adequacy for analysis varies. To determine whether these phenomena are correlated with menstrual cycle stage at the time of sampling, we analyzed cervical cell specimens from women with cervical intraepithelial neoplasia. Specimens were categorized on the basis of a 28-day menstrual cycle and were analyzed by hybridization to combined probes for virus types 6 and 11 or types 16 and 18. Specimen adequacy was determined by hybridization to a human Alu I repetitive deoxyribonucleic acid probe. Analysis of data with κ 2 revealed that fluctuations in virus detection and type variation are unrelated to menstrual cycle stage. Specimen adequacy is stage-dependent for women who take oral contraceptives. Whereas specimens can be collected at any time other than the first week of the menstrual cycle, accurate determination of infection status requires multiple assessments. (Am J Obstet Gynecol 1990;162:1037-41.)

This paper describes the Multimodality Acquisition and Review System, (MARS), as an operational digital radiographic image management system. The presentation emphasizes the unifying effect that a digital radiograph management system has on a radiological department and hospital.© (1984) COPYRIGHT SPIE--The International Society for Optical Engineering. Downloading of the abstract is permitted for personal use only.

A workable PACS system consists of several discrete assemblies which are linked together by data communication links for terminal and image data input and output. Two phases of development of a PACS system can be identified and labeled: emulation and enhancement. The latter is characterized by the observation "you do that so well, can you also do this?" Emulation, on the other hand, assures an accepted and working system. One of the key components of a PACS system is the emulation of the classical and ubiquitous "lightbox". This paper presents an emulation of the lightbox using a highspeed digital disk and video display on multiple high resolution monitors capable of 1024 x 1024 or 512 x 512 resolution pixel display. The emulation features are: a) loading and reloading in less than one second, b) access to between 800 and 3200 digital radiographs, and c) highspeed review forward and backward through this list of radiographs at rates up to 30 new images/second. Operation is under manual control both in rate and direction. This stresses the speed. The feature which makes this "lightbox" emulation desirable is the ability to dwell on a presently viewable display of digital radiographs with access to previous and following images in the study. One of the features desired in an emulation is that the components be "off the shelf". This means that existing hardware is used in the emulation. Software can then be generated based on known hardware. The emulation has flexibility of size: multi-image displays ranging from 2 or 3 images side by side to the piano-roll type endless display of an array with 4 images side-by-side and 3 rows visible at any one time. In addition, it has flexibility of resolution: radiographs displayable within a 256 x 256 pixel region to those displayable within a 1024 x 1024 pixel array as well as images which are much larger (4000 pixel by 4000 line chest radiograph scans) using a 1024 pixel by 1024 line window into the radiograph. The emulation of the "lightbox" finds application at both radiology review stations and at locations for consultation with attending physicians.© (1983) COPYRIGHT SPIE--The International Society for Optical Engineering. Downloading of the abstract is permitted for personal use only.

emission, two of the mills were ordered to close by the Pinal-Gila Air Pollution Control District in 1973. Before closing, however, the owner of one of the mill sites was successful in obtaining a rezoning of the property into a residential subdivision. Asbestos mill tailings were used as the primary landfill material before partial covering with topsoil. Before being shut down, this mill continued operations for several weeks as residents moved into the subdivision. The mill buildings, housing asbestos-laden equipment, remained standing in the midst of the mobile homes. The third mill, with its large pile of asbestos mill tailings, continues to operate a few hundred yards upwind from the mobile homes.

The previously described computerized model (Cywinski & Gray) for calculating the cost of film based PACS in radiology departments has been extended to include projected costs of automated PACS. A survey of 17 diagnostic digital imaging facilities was performed. The survey results for each facility were entered into the model. The output of the model was in the form of a series of spreadsheets which illustrated cost comparisons between film and automated PACS in radiology departments. The analysis of cost comparisons indicated that presently available (M/NET) automated PACS are cost effective and actually save operating costs for the radiology facilities performing at least 10,000 diagnostic imaging procedures per year.

Serum Vitamin B12 levels were determined on 378 patients ranging in age from 56 to 104 years with a median age of 77 for both males and females. A radiodilution method was employed for these determinations. This screening procedure identified 26 patients with low serum B12 levels. Nineteen of these patients had no other symptoms and were hematologically normal. The B12 binding proteins, transcobalamins (TC) I, II, and III were quantitated employing QUSO and DEAE cellulose batch separations. The total number of TC II binding/affinity sites for B12 were elevated in both the normal and low B12 elderly groups. About 17% of the total serum B12 was carried by TC II in the control group while only 4% of the total was carried on TC II in both the normal and low B12 elderly. This was accompanied by an increase in unsaturation in TC II for these two groups. The findings suggest that an alteration in the TC II-B12 delivery system has occurred in the elderly.

This paper describes the application of a Realtime Digital Disk (RTDD) with processing capabilities and the increased functionality the RTDD brings to a PACS system. While the display and acquisition of images at 30 frames per second is the obvious advantage of the RTDD in PACS, the image processing and image enhancing functions make its use more effective. Realtime presentations include window and level of greater than 8 bit images, intensity transformation of 8 bit images, shape table and tiling presentation, and subsampling. Movie loop and three dimensional reconstruction sequences are viewed in realtime. Edge enhancement, smoothing, interpolated zoom, unsharp masking and other convolution filtering are near realtime presentations. Compression and decompression, histogram equalization and other transforms are performed in just a few frame times.

The offshore structures of the Forties Field were investigated to determine their static and dynamic response to wave action. The dynamic analysis took into account the nondeterministic nature of waves by representing the sea as a wave spectrum. A comparison of the results of the dynamic response analysis and the static analysis demonstrate that for extreme weather conditions, the static design is adequate.