Background: Intravenous Immunoglobulin (IVIg) use for Central Nervous System (CNS) conditions has increased over the last decade. In many CNS disorders, robust evidence for IVIg efficacy is still lacking. Building on the success of the British Columbia (BC) Neuromuscular IVIg utilization initiative, Guidelines for IVIg use in CNS conditions were developed. A provincial screening program was launched in 2023. Methods: For CNS IVIg, requests, diagnosis, dosing, consultation letters and treatment questionnaires were reviewed. Patient management was compared to provincial guidelines. A letter was sent to the ordering physician with the results of the review and treatment recommendations when management differed significantly from guidelines. Review of the first year’s cases was conducted. Results: Over the first 11 months of the program, 79 IVIg renewal requests were reviewed. The most common diagnoses were antibody mediated autoimmune encephalitis, severe drug resistant non-surgical epilepsy and Susac’s syndrome. Recommendations included dose reduction, discontinuation of IVIg, or initiation of alternative therapies for many of the requests. Conclusions: IVIg may be effective in the management of some CNS inflammatory conditions. A physician-led utilization program in BC with targeted education to ordering physicians promotes best practice. Review of year one data will inform a quality improvement cycle to optimize the guidelines.

Background: Our aim was to develop a National Quality Indicators Set for the Care of Adults Hospitalized for Neurological Problems, to serve as a foundation to build regional or national quality initiatives in Canadian neurology centres. Methods: We used a national eDelphi process to develop a suite of quality indicators and a parallel process of surveys and patient focus groups to identify patient priorities. Canadian content and methodology experts were invited to participate. To be included, >70% of participants had to rate items as critical and <15% had to rate it as not important. Two rounds of surveys and consensus meetings were used identify and rank indicators, followed by national consultation with members of the Canadian Neurological Society. Results: 38 neurologists and methodologists and 56 patients/caregivers participated in this project. An initial list of 91 possible quality indicators was narrowed to 40 indicators across multiple categories of neurological conditions. 21 patient priorities were identified. Conclusions: This quality indicators suite can be used regionally or nationally to drive improvement initiatives for inpatient neurology care. In addition, we identified multiple opportunities for further research where evidence was lacking or patient and provider priorities did not align.

This study examined the comminution of fresh herbage, subsequent nutrient release, and the characteristics of swallowed boli from three physically and chemically contrasting forages during ingestive mastication by dairy cows. The extent and pattern of nutrient release will determine their availability to rumen microflora, and potentially influence their efficiency of use. The forages evaluated were perennial ryegrass (ryegrass, Lolium perenne L., cv Alto AR37), lucerne (Medicago sativa L., cv Torlesse) and chicory (Cichorium intybus L., cv Choice). Experimental design was a 3×3 cross-over with three forages and three consecutive 1-day measurement periods, conducted twice. Six non-lactating, pregnant, multiparous Holstein-Friesian×Jersey cows (Bos taurus) were used, with the first cross-over applied to three mature (10.1±0.61 years old; BW 631±64 kg) cows, and the second to three young (4.8±0.02 years; BW 505±19 kg) cows. Fresh cut forage was offered to the cows following partial rumen evacuation. Swallowed boli were collected directly at the cardia at the commencement, middle and end of the first feeding bout of the first meal of the day. Forage species did not affect the fresh weight of ingested boli (mean 169 g, P=0.605) but the proportion of saliva in boli varied between forage. Boli of chicory contained the greatest amount of herbage material and least amount of saliva, whereas ryegrass boli were the opposite. Boli fresh weight tended to increase as time in the meal progressed, but the age of the cow was not shown to affect any boli characteristics or nutrient release. Particle size reduction was affected by forage, with 31%, 38% and 35% of chicory, lucerne and ryegrass herbage reduced to <2 mm. There was little evidence of relationship between comminution and any physical or chemical characteristic of the forage, except in ryegrass where extent of comminution was moderately correlated with herbage strength. Proportional release of herbage soluble carbohydrate exceeded that of N during mastication. Differences in loss of N were moderately correlated with the amount of N in the herbage (R2=0.53) but herbage comminution was not strongly correlated with release of either N or carbohydrate. These findings illustrate the complex animal×forage interactions that occur during mastication, and that it is not possible to infer nutrient loss from herbage based on herbage characteristics as the driver for this differ between species.

We report on the analysis of virtual powder-diffraction patterns from serial femtosecond crystallography (SFX) data collected at an X-ray free-electron laser. Different approaches to binning and normalizing these patterns are discussed with respect to the microstructural characteristics which each highlights. Analysis of SFX data from a powder of Pr0.5Ca0.5MnO3 in this way finds evidence of other trace phases in its microstructure which was not detectable in a standard powder-diffraction measurement. Furthermore, a comparison between two virtual powder pattern integration strategies is shown to yield different diffraction peak broadening, indicating sensitivity to different types of microstrain. This paper is a first step in developing new data analysis methods for microstructure characterization from serial crystallography data.

The rice leaf roller, Cnaphalocrocis medinalis (Guenée), is a serious insect pest of rice with a strong migratory ability. Previous studies on the migration of C. medinalis were mostly carried out in tropical or subtropical regions, however, and what the pattern of seasonal movements this species exhibits in temperate regions (i.e. Northern China, where they cannot overwinter) remains unknown. Here we present data from an 11-year study of this species made by searchlight trapping on Beihuang Island (BH, 38°24′N; 120°55′E) in the centre of the Bohai Strait, which provides direct evidence that C. medinalis regularly migrates across this sea into northeastern agricultural region of China, and to take advantage of the abundant food resources there during the summer season. There was considerable seasonal variation in number of C. medinalis trapped on BH, and the migration period during 2003–2013 ranged from 72 to 122 days. Some females trapped in June and July showed a relatively higher proportion of mated and a degree of ovarian development suggesting that the migration of this species is not completely bound by the ‘oogenesis-flight syndrome’. These findings revealed a new route for C. medinalis movements to and from Northeastern China, which will help us develop more effective management strategies against this pest.

People wounded during bombings or other events resulting in mass casualties or in conjunction with the resulting emergency response may be exposed to blood, body fluids, or tissue from other injured people and thus be at risk for bloodborne infections such as hepatitis B virus, hepatitis C virus, human immunodeficiency virus, or tetanus. This report adapts existing general recommendations on the use of immunization and postexposure prophylaxis for tetanus and for occupational and nonoccupational exposures to bloodborne pathogens to the specific situation of a mass casualty event. Decisions regarding the implementation of prophylaxis are complex, and drawing parallels from existing guidelines is difficult. For any prophylactic intervention to be implemented effectively, guidance must be simple, straightforward, and logistically undemanding. Critical review during development of this guidance was provided by representatives of the National Association of County and City Health Officials, the Council of State and Territorial Epidemiologists, and representatives of the acute injury care, trauma, and emergency response medical communities participating in the Centers for Disease Control and Prevention’s Terrorism Injuries: Information, Dissemination and Exchange project. The recommendations contained in this report represent the consensus of US federal public health officials and reflect the experience and input of public health officials at all levels of government and the acute injury response community. (Disaster Med Public Health Preparedness. 2008;2:150–165)

Ultra-luminous infrared galaxies (ULIRGs; L > 1012 L⊙) are quite rare in the local universe, but seem to dominate the co-moving energy density at z > 2. Many are optically-faint, dust-obscured galaxies that have been identified only relatively recently by the detection of their thermal dust emission redshifted into the sub-mm wavelengths. These submm galaxies (SMGs) have been shown to be a massive objects (M* ~ 1011 M⊙) undergoing intense star-formation(SFRs ~ 102 − 103 M⊙ yr−1) and the likely progenitors of massive ellipticals today. However, the AGN contribution to the far-IR luminosity had for years remained a caveat to these results. We used the Spitzer Infrared Spectrograph (IRS) to investigate the energetics of 24 radio-identified and spectroscopically-confirmed SMGs in the redshift range of 0.6 < z < 3.2. We find emission from Polycyclic Aromatic Hydrocarbons (PAHs) – which are associated with intense star-formation activity – in >80% of our sample and find that the median mid-IR spectrum is well described by a starburst component with an additional power-law continuum representing < 32% AGN contribution to the far-IR luminosity. We also find evidence for a more extended distribution of warm dust in SMGs compared to the more compact nuclear bursts in local ULIRGs and starbursts, suggesting that SMGs are not simple high-redshift analogs of local ULIRGs or nuclear starbursts, but have star formation which resembles that seen in less-extreme star-forming environments at z ~ 0.

An experiment to measure the variation in the phenological and apical development ofwinter wheat (cv. Avalon) in England and Scotland is described. Ten sites which ranged from Aberdeen (57·2° N), the most northerly, to Newton Abbot (50·6° N), the most southerly, were included in the survey, and at each site seed was hand-sown in mid-September, October and November 1983. Developmental stages and sampling procedures were precisely defined to ensure uniformity in scoring by the observers at each site. Temperatures during the growing season were in line with the long-term means, though spring was cooler at all sites and summer warmer at most. The range of monthly-mean temperatures between sites was about the same as the difference between consecutive months. The method of analysis of development rates and durations was in terms of thermal time, modified by sensitivity to photoperiod and a vernalization requirement that slowed early development until a number of days of low temperatures had been experienced. In general, crops at northern sites developed more slowly than those in the south and particularly the south-west of England. There was less variation in the timing of apical stages for later sowings. Developmental rates responded linearly to temperature and photoperiod, with the base temperature increasing for later phases of development. The effect of photoperiod in modifying the rate of development was apparent for all developmental phases from emergence to anthesis, longer days accelerating development, but there was no effect on the duration of the grain-filling period. Vernalization exerted its effect solely within the phase from emergence to double ridge, and had a major influence on the variation between sites only for the first sowing.

The initiation of leaf and spikelet primordia was studied at sites ranging in latitude from Newton Abbot (50·6°N) to Aberdeen (57·2°N) in crops sown in the middle of September, October and November 1983. The rate of primordium initiation tended to decrease from south to north but there were also marked differences between quite close sites.

The rate of leaf initiation increased with temperature but photoperiod had little effect; the rate of spikelet initiation was affected both by temperature and by photoperiod. There were differences in the total number of leaves initiated which were only partlyexplained by differences in vernalization.

Expressing leaf and spikelet initiation rates in terms of thermal and photo-thermal time respectively showed a constant rate of leaf initiation and a constant and more rapid rate of spikelet initiation.

The English HCV lookback programme has identified some individuals with transfusion-transmitted HCV infection. The path from the collection of donations from HCV-infected donors to the identification of infected recipients was constructed. The probability of different outcomes at each branch was derived from data collected during this programme. This path of probabilities was then used to produce a complete estimate of the number of recipients infected by blood transfusions (dead and alive at the end of 1995) by re-entry of blood components that fell out of the lookback at various steps prior to recipient testing, and entry of components from HCV-infected donations that were never identified for lookback. Less than 14 000 recipients were estimated to have been infected with HCV during the decade prior to the start of donation testing. Over 60% of these were expected to have died by the end of 1995. Transfusion has infected a large group of individuals. However, this group constitutes a very small, and declining, proportion of all HCV infections in the population.

Pupillary response to noxious stimulation was investigated in men (n = 11) and women (n = 9). Subjects experienced repeated trials of noxious electrical fingertip stimulation at four intensities, ranging from faint to barely tolerable pain. Measures included pupil dilation response (PDR), pain report (PR), and brain evoked potentials (EPs). The PDR began at 0.33 s and peaked at 1.25 s after the stimulus. Multivariate mixed-effects analyses revealed that (a) the PDR increased significantly in peak amplitude as stimulus intensity increased, (b) EP peaks at 150 and 250 ms differed significantly in both amplitude and latency across stimulus intensity, and (c) PR increased significantly with increasing stimulus intensity. Men demonstrated a significantly greater EP peak amplitude and peak latency at 150 ms than did women. With sex and stimulus intensity effects partialled out, the EP peak latency at 150 ms significantly predicted PR, and EP peak amplitude at 150 ms significantly predicted the PDR peak amplitude.

The period covered by this report, 1984 July to 1987 June, was of extraordinary importance for the progress of cometary physics. For the first time in the history, special space probes were launched to comets. Vega 1, Vega 2 and Giotto encountered P/Halley, providing us with the first close-up pictures of a cometary nucleus, its surface features, and with the first in situ measurements of the matter escaping from it. ICE, Suisei and Sakigake carried out measurements relevant to P/Giacobini-Zinner and P/Halley in interplanetary space. Unprecedented worldwide campaigns of ground-based observations, with the participation of about 1000 professional and 2000 amateur astronomers, were coordinated in 8 sections of the International Halley Watch. Additional measurements were made from artificial satellites, sounding rockets, and highflying airplanes. The wealth of data collected in this way, to a major extent thanks to an excellent international cooperation, represents a milestone in cometary astronomy. Another important step was the progress in processing the extensive 1983 IRAS observations of minor planets and comets, including the discovery of asteroid dust bands and cometary dust trails.

In the Chitwan valley, Nepal, Chilo partellus preferred maize and sorghum over rice, teosinte, finger millet and sugar-cane. Infestation on young maize plants produced “dead hearts” and on older plants reduced growth and sometimes prevented cob formation. The yield reduction in some maize cultivars reached 60% and stem infestation levels reached 98%. Borers produced “dead hearts” in young and “whiteheads” in older rice plants.

The egg, larval and pupal periods from April through September lasted 4–5, 16–41 and 4–8 days, respectively. A complete generation took 28–48 days under summer field conditions and 192–233 days from October to May. Of the one egg, four larval and two pupal parasitoids, all hymenopterans, which were reared from C. partellus, the two most important were Trichogramma chilonis (70% egg parasitism) and Apanteles flavipes (30% larval parasitism).

The last three years have witnessed a growing interest in the physical properties of the small bodies in the solar system. Perhaps the most significant impetus to research on small bodies has been the imminent arrival of Comet Halley in the inner solar system. This famous comet, which was recovered in autumn 1982, has been the object of intense study during the past year as it has approached the sun and developed a tail. Much of the international, ground-based astronomical research on Halley has been coordinated through the International Halley Watch program. Spacecraft from several nations have been successfully launched (or soon will be, we hope) and are on their way to intercept the comet and make close-up observations and in situ measurements. The commencement of spacecraft study of small bodies marks a new era in comet/asteroid science and, in coordination with ground-based and Earth-orbital observations, will result in unprecedented new knowledge about the origin of the solar system and about solar system processes. Although Halley is receiving the most attention, interest is also high in Comet Giacobini-Zinner, the vicinity of which will be probed by a diverted American spacecraft in September 1985. Upcoming spacecraft studies of comets through 1986 are described at the end of the comet section of this report. Asteroid exploration by spacecraft is also anticipated to begin in the near future. The trajectory of the NASA Gailieo Mission to Jupiter has been changed to permit close-encounter observations of the large main-belt asteroid 29 Amphitrite in December 1986; these observations will be conducted on a “best effort” basis only a few months after launch of Galileo. Interest is also high in Europe, the Soviet Union, and the United States in possible spacecraft missions to additional comets and asteroids during the 1990’s. If these efforts are pursued, there will be a concomitant ground-based effort. The last three years have also witnessed extremely productive efforts to observe small bodies from Earth orbit. For example, the Infrared Astronomical Satellite discovered a comet in 1983, which made the closest approach to the Earth of any comet in centuries. IRAS made important discoveries and measurements of other comets and also assembled an immense database on infrared brightnesses of thousands of numbered and unnumbered asteroids. The planned launch of the Hubble Space Telescope next year highlights the continuing potential for applying extremely powerful instrumental techniques to the study of comets and asteroids from above the Earth’s atmosphere.