Background: Several case series describe patients with refractory acetylcholine receptor antibody-positive (AChR) myasthenia gravis (MG) treated with hematopoietic stem cell transplant (HSCT). In this report, we describe four patients with anti-muscle-specific kinase (MuSK)MG treated with HSCT. Methods: We reviewed the records of all patients undergoing HSCT for MG in the Alberta Blood and Bone Marrow Transplant Program and identified 4 patients with anti-MuSK MG. Results: All 4 patients had severe disease (Myasthenia Gravis Foundation of America score IVb-V) and were refractory to multiple treatments, including rituximab. 3 patients improved with no clinical manifestations or mild symptoms and remained as such for 2, 3.5, and 5.5 years. In these 3 patients, adverse events ranged from treatable infections and transient dyspnea to persistent fatigue and premature menopause. The average worst Myasthenia Gravis Activities of Daily Living (MG-ADL) scores improved from 14.7 before to 0.3 after HSCT while their mean worst Myasthenia Gravis Quality of Life Questionnaire (MG-QoL15) scores improved from 26.7 to 0. The fourth patient developed pneumonia and passed away from respiratory failure 8 weeks post-transplant. Conclusions: In patients with severe refractory anti-MuSK MG, it may be reasonable to consider HSCT but with an appreciation of the associated risks.

Opposition control of artificially initiated turbulent spots in a laminar boundary layer was carried out in a low-turbulence wind tunnel with the aim to delay transition to turbulence by modifying the turbulent structure within the turbulent spots. The timing and duration of control, which was carried out using wall-normal jets from a spanwise slot, were pre-determined based on the baseline measurements of the transitional boundary layer. The results indicated that the high-speed region of the turbulent spots was cancelled by opposition control, which was replaced by a carpet of low-speed fluid. The application of the variable-interval time-averaging technique on the velocity fluctuation signals demonstrated a reduction in both the burst duration and intensity within the turbulent spots, but the burst frequency was increased.

An experimental investigation was carried out in a low-turbulence wind tunnel to study the early development of artificially initiated turbulent spots in a laminar boundary layer over a flat plate. The reproducibility of the experiments allowed us to observe fine structural details that have not been observed previously. Initial velocity disturbances quickly developed into hairpin-like structures that multiplied downstream, which increased the width, length and height of the incipient turbulent spots. Only those disturbances that were greater than a threshold value developed into turbulent spots while the others decayed. The rate of development was also affected by the duration of the initial disturbances. We found that the behaviour of turbulence generation within a turbulent spot is similar to the burst events in the turbulent boundary layer, where ejection events are followed by sweep events.

A primary barrier to translation of clinical research discoveries into care delivery and population health is the lack of sustainable infrastructure bringing researchers, policymakers, practitioners, and communities together to reduce silos in knowledge and action. As National Institutes of Healthʼs (NIH) mechanism to advance translational research, Clinical and Translational Science Award (CTSA) awardees are uniquely positioned to bridge this gap. Delivering on this promise requires sustained collaboration and alignment between research institutions and public health and healthcare programs and services. We describe the collaboration of seven CTSA hubs with city, county, and state healthcare and public health organizations striving to realize this vision together. Partnership representatives convened monthly to identify key components, common and unique themes, and barriers in academic–public collaborations. All partnerships aligned the activities of the CTSA programs with the needs of the city/county/state partners, by sharing resources, responding to real-time policy questions and training needs, promoting best practices, and advancing community-engaged research, and dissemination and implementation science to narrow the knowledge-to-practice gap. Barriers included competing priorities, differing timelines, bureaucratic hurdles, and unstable funding. Academic–public health/health system partnerships represent a unique and underutilized model with potential to enhance community and population health.

A new mineral, nukundamite, from a Fijian kuroko deposit is described. It has been referred to as idaite, Cu5FeS6, or Cu5.5xFexS6.5x. Electron-probe analyses gave Cu 56.51, Fe 9.64, and S 33.51, total with traces of Ag and As is 99.79%. Hexagonal with a 3.782, c 11.187 Å, Z = 1. Empirical formula Cu3.37, Fe0.66, S3.97 on the basis of eight atoms. Copper-coloured, metallic lustre, cleavage {0001} perfect. Density (g cm−3) 4.53 (calc), 4.30 (meas). Strongly pleochroic from reddish orange (Ro) to pale grey (Re). Parallel extinction. Very strong anisotropy with pale green-grey rotation colours. Reflectance values and quantitative colour values in air and oil are given. Similarities with the covelline structure are indicated.

An attempt to fully describe idaite from the Ida mine was unsuccessful. The description of the type material therefore remains inadequate.

A mineral closely resembling eudialyte in single crystal X-ray pattern and chemistry has been found in one granite block from the 5 Mile Post area on Ascension Island. To our knowledge, eudialyte has not previously been recognized in this suite of granites although they contain two other rare zirconium silicates, dalyite and vlasovite. Textural evidence suggests that the eudialyte, which is remarkable for its high yttrium and REE content, crystallized from very late-stage magmatic fluids. Rare-earth patterns are only slightly fractionated (CeN/YN = 1.8–2.5) compared with those of allanites and sphenes from Skye granites which presumably have similar parageneses. In contrast, the whole-rock REE pattern shows greater enrichment of light REE (CeN/YN ∼ 10). This difference in REE pattern is considered to be due to the effects of REE and other element complexing related to the peralkalinity of the granite liquid.

Two new species of Oreocharis, O. tribracteata and O. rufescens, are described and a key to the species in Vietnam is provided. The new species have distinct features not previously, or rarely, observed in the genus, both showing the partial fusion of the calyx lobes into a tube, and the presence of three bracts in Oreocharis tribracteata.

This work is motivated by the need for low-order aerodynamic models to predict accurately the effect on profile drag of controlling attachment line transition. Head's entrainment method(1), a rapid integral boundary layer technique used for design studies on swept wings, suffers from the governing swept-tapered turbulent integral boundary layer equations being ill-posed in the vicinity of the attachment line. This singularity has been treated using crude extrapolations of the attachment-line similarity solution for over half a century, but this approach is unlikely to deliver accurate predictions of the effect of changes in the attachment line flow on profile drag. An experimental study has been carried out to explore the nature of the turbulent flow in the vicinity of a highly swept swept attachment line and has revealed a quite complex, non-monotonic development of the momentum thickness in this region. It has also revealed lower levels of twist in the boundary layer velocity profiles than anticipated from the highly curved character of the inviscid flow streamlines. These observations have prompted an alternative approach to the modelling of the flow in this region which not only successfully eliminates the lack of robustness in the swept-tapered equations but which also matches the experimental results to within ±5%.

The aim of this study was to retrospectively assess the value of whole genome sequencing (WGS) compared to conventional typing methods in the investigation and control of an outbreak of Shigella sonnei in the Orthodox Jewish (OJ) community in the UK. The genome sequence analysis showed that the strains implicated in the outbreak formed three phylogenetically distinct clusters. One cluster represented cases associated with recent exposure to a single strain, whereas the other two clusters represented related but distinct strains of S. sonnei circulating in the OJ community across the UK. The WGS data challenged the conclusions drawn during the initial outbreak investigation and allowed cases of dysentery to be implicated or ruled out of the outbreak that were previously misclassified. This study showed that the resolution achieved using WGS would have clearly defined the outbreak, thus facilitating the promotion of infection control measures within local schools and the dissemination of a stronger public health message to the community.

Extended abstract of a paper presented at Microscopy and Microanalysis 2011 in Nashville, Tennessee, USA, August 7–August 11, 2011.

A recently discovered synthetic route to new kinetically stable [(MSe)y]m[TSe2]n layered intergrowths has been applied to prepare several different compositions (M = Pb or Sn, T = Ta, Nb, Mo, or W) with m = n = 1, in thin film form. Scanning transmission electron microscopy and synchrotron X-ray diffraction show the nanostructure of these materials is characterized by a combination of in-plane component crystallinity with misregistration and rotational mis-orientation between adjacent layers. Extremely low cross-plane thermal conductivity as low as 0.1 W m-1 K-1 are attributed to the turbostratic nanostructure. By appropriate choice of M and T, we demonstrate that a range of electrical transport properties are possible, from metallic to semiconducting. Annealing (PbSe)0.99WSe2 and (PbSe)1.00MoSe2 specimens in a controlled atmosphere of PbSe or WSe2 is observed to systematically influence carrier properties, and is interpreted in terms of reduction of the concentration of electrically active defects. Considering these observations and the large composition and structural space that can be explored in such [(MSe)y]m[TSe2]n intergrowths, these materials are of interest for further investigation as potential thermoelectric materials.

In November and December 1992, an outbreak of parvovirus B19 infection occurred among patients and staff on an adult mixed surgical ward at a large hospital in London. Three patients and 15 staff members were serologically confirmed as acute cases. The attack rate among susceptible members of staff was 47%. In those infected, arthralgia (80%) and rash (67%) were the most common symptoms. Of six susceptible in-patients on the ward, three became infected. One of the in-patients who had carcinoma of the mouth was viraemic for more than 10 days with marrow suppression resulting in the postponement of chemotherapy until intravenous immunoglobulin was given and he was no longer viraemic. Control measures taken included closure of the ward to new admissions, transfer of only immune staff to the ward, and restriction of the ward nursing staff to working only on that ward. Although no specific exposure was conclusively identified as a risk factor, there was a suggestion of an increased risk of acquiring parvovirus B19 infection among those staff who did not adopt strict hand washing procedures after each physical contact with a patient (RR = 2·33; P = 0·07). Knowledge of parvovirus B19 among interviewed health care workers was poor: only 42% reported knowing about parvovirus B19 and only 38% could name a patient category at risk of a severe outcome following infection. This is the first report of a nosocomial outbreak affecting an adult ward and of possible transmission of parvovirus B19 infection from staff to in-patients. Hospital control of infection teams should include parvovirus B19 in their outbreak containment plans.

Shelford and Gail (1922) first used photo-electric cells for submarine photometry in the Puget Sound. Poole (1925) produced an apparatus which was suitable for use on small ships in the open sea. This apparatus was used near Plymouth by Poole and Atkins (1926, 1928, 1929) with various minor alterations in design which rendered it more reliable and less subject to errors due to electrical leakage. The object of these researches was to study illumination in relation to photosynthesis, but Russell perceived their bearing on his own work on the phototropic movements of the zooplankton. When considering the research programme of the Atlantis, Dr. George L. Clarke decided that it would be of value to carry out photo-electric measurements of submarine illuminations in connection with his work on vertical distribution of the plankton. A request was accordingly made by Dr. H. B. Bigelow, Director of the Wood's Hole Oceanographic Institute, that such an apparatus should be assembled under our direction. The apparatus here described has been constructed closely upon the lines of H. H. Poole's original apparatus as modified in 1928. Special attention, however, has been given to the elimination of electrical leakage. Furthermore, J. H. J. Poole (1928) devised an apparatus in which rate of flash of a neon lamp was used to measure light. This rate of flash method is one of integration and not an instantaneous measurement as is that of H. H. Poole. The value of the neon lamp method lies in the fact that light under the water is extremely variable near the surface owing to the motion of the waves. This method of measuring under-water illumination was used in Lough Bray, Co. Dublin, by J. H. J. and H. H. Poole (1930), and has since been used at sea by Poole and Atkins (1931). It seemed advisable to include a neon lamp photometer in the outfit so that errors in determining the loss of light on entering the water might be minimised.

There has been growing public concern with regard to the effects of heavy metals excreted by animals on the environment. Heavy metals can be lost from manure and slurry to ground and surface waters, and subsequently affect water quality (Van Horn et al., 1996). In regions of high domestic livestock production, farmers are therefore seeking means to reduce the quantity of heavy metals excreted by animals and subsequently onto the land (Van Horn et al., 1996). The objective of this study was to establish the effect of two levels of dietary Zn inclusion in two different forms (organically chelated vs. inorganic) on apparent absorption and retention in dairy cattle.