Background: Cerebral venous thrombosis (CVT)most commonly affects younger women. Diagnosis may be delayed due to its distinct presentation and demographic profile compared to other stroke types. Methods: We examined delays to diagnosis of CVT in the SECRET randomized trial and TOP-SECRET parallel registry. Adults diagnosed with symptomatic CVT within <14 days were included. We examined time to diagnosis and number of health care encounters prior to diagnosis and associations with demographics, clinical and radiologic features and functional and patient-reported outcomes (PROMS) at days 180&365. Results: Of 103 participants, 68.9% were female; median age was 45 (IQR 31.0-61.0). Median time from symptom onset to diagnosis was 4 (1-8) days. Diagnosis on first presentation to medical attention was made in 60.2%. The difference in time to diagnosis for single versus multiple presentations was on the order of days (3[1-7] vs. 5[2-11.75], p=0.16). Women were likelier to have multiple presentations (OR 2.53; 95% CI1.00-6.39; p=0.05) and longer median times to diagnosis (5[2-8]days vs. 2[1-4.5] days; p=0.005). However, this was not associated with absolute or change in functional, or any patient reported, outcome measures (PROMs) at days 180&365. Conclusions: Diagnosis of CVT was commonly delayed; women were likelier to have multiple presentations. We found no association between delayed diagnosis and outcomes.

A variety of applications from insulation to catalytic supports can benefit from lightweight, high surface area, mesoporous materials, which maintain their mesoporous structure to temperatures of 900–1200 °C. Silica aerogels begin to densify by 700 °C. Alumina aerogels are capable of higher temperature exposure than their silica counterparts, but undergo successive phase transformations to form transitional aluminas prior densifying to α-alumina. The present study characterizes the phase transitions of aluminosilicate aerogels derived from Boehmite powders to elucidate the role of time and temperature on phase transitions, surface area, and morphology. Aerogel compositions stable to 1200 °C for periods of 24 h have been demonstrated.

This paper examines the changing role aerodynamictechnology plays in the design and development ofmodern combat aircraft. It reviews several aspectsof aerodynamics which contribute to aircraftperformance and handling characteristics. Itconsiders the importance of a range of technologies,the contribution each makes to the final integratedsolution and comments on the compromises necessarythrough the design cycle to optimise the overallweapon system, sometimes to the cost of one of thecomponent technologies. The technologies discussedare in no way exhaustive but attempt to encapsulatethe breadth of the subject, to illustrate itsdiversity and to point the way for the futuredevelopment if aerodynamic technology is to continueto make an important contribution to the design ofcombat aircraft.

Each of the component technologies are discussed interms of the contribution it makes, the tools andtechniques used to predict, analyse and interpretthe technology contribution, and the requirementsfor the direction of the development of thetechnology for the future.

Before considering the technologies themselves it isimportant to understand the environment in whichthey will be used, which increasingly conditions themanner in which they are employed and suggests thedirection for their development.

This paper begins, therefore, by briefly reviewing thechanges to the environment in which the fighterpilot operates and the manner by which hisrequirements, and therefore the specification of theaircraft, are defined before going on to look at theoverall contribution each technology makes in thedesign process.

Listeria monocytogenes is a foodborne pathogen that can cause bacteraemia, meningitis, and complications during pregnancy. In July 2012, molecular subtyping identified indistinguishable L. monocytogenes isolates from six patients and two samples of different cut and repackaged cheeses. A multistate outbreak investigation was initiated. Initial analyses identified an association between eating soft cheese and outbreak-related illness (odds ratio 17·3, 95% confidence interval 2·0–825·7) but no common brand. Cheese inventory data from locations where patients bought cheese and an additional location where repackaged cheese yielded the outbreak strain were compared to identify cheeses for microbiological sampling. Intact packages of imported ricotta salata yielded the outbreak strain. Fourteen jurisdictions reported 22 cases from March–October 2012, including four deaths and a fetal loss. Six patients ultimately reported eating ricotta salata; another reported eating cheese likely cut with equipment also used for contaminated ricotta salata, and nine more reported eating other cheeses that might also have been cross-contaminated. An FDA import alert and US and international recalls followed. Epidemiology-directed microbiological testing of suspect cheeses helped identify the outbreak source. Cross-contamination of cheese highlights the importance of using validated disinfectant protocols and routine cleaning and sanitizing after cutting each block or wheel.

Toxoplasma antibodies were absent from the sera of 32 adult Hong Kong women and were present in only two of 35 adult males and five of 46 meat workers, an overall incidence of 6·2%. This is the lowest incidence recorded in a large tropical city and lower than the incidence reported for most areas of the world, whether rural or urban. The reasons for this are unknown. Of 31 sera from swine imported from China and slaughtered in Hong Kong, 22 (71%) were positive for toxoplasma antibodies.