Section 106 of the National Historic Preservation Act requires US federal agencies and their applicants to consider historic properties affected by their proposed actions. Guided principally by architectural historians and archaeologists throughout the 1980s, Section 106 reviews focused on identifying discrete structures and sites and then evaluating them in terms of dominant society aesthetics, histories, and sciences. By the 1990s, Section 106 participation by consulting Tribes and other cultural resource stewards obliged federal agencies to address a broader spectrum of historic properties and values. Agencies soon began using cultural landscape studies and other research and consultation tools to “match” historic property identification and assessment processes to the scale and complexity of proposed undertakings. The Section 106 review for the SunZia interstate transmission line (2009–2024) shows that the federal government has yet to consistently meet mandates to identify and assess elements other than archaeological/architectural historic properties. Our surveys of historic preservation professionals and available cultural landscape studies underscore disconnections between practitioner preferences for and the federal agency conduct of cultural landscape studies. They also highlight standards to use in evaluating the adequacy of cultural landscape studies. We recommend six attributes as essential to all cultural landscape study designs, methods, and applications in the Section 106 process.

Objectives/Goals: Substantial evidence supports the use of community engagement in CTS. Yet, there is a lack of empirical basis for recommending a particular level of community engagement over others. We aimed to identify associations between level of community involvement and study process outcomes, focusing on procedures to promote enrollment and inclusion. Methods/Study Population: Using manifest content analysis, we analyzed community engagement (CEn) strategies of studies indexed in ClinicalTrials.gov, focusing on studies 1) associated with 20 medical schools located in 8 southern states in the Black Belt, 2) conducted in 2015–2019, and 3) on 7 topics: cancer, depression, anxiety, hypertension, substance use disorder, cardiovascular disease, and HIV/AIDS. Data source was the ClinicalTrials.gov entry and publication for each study. We categorized each study on level of community involvement as described by the study protocol CTSA Consortium Community Engagement Key Function Committee Task Force on the Principles of Community Engagement continuum. Outcomes included recruitment and representativeness. Other codes included funder type, study phase, study status, and time to enrollment. Results/Anticipated Results: Of 890 studies that met inclusion criteria, only 493 had published findings. 286 studies (58%) met enrollment targets. Only 9 studies described any level of CEn (1 outreach, 3 consult, 1 involvement, 3 collaboration, and 1 shared leadership). Time to enrollment for these 9 studies (mean 28.78 mos.) was shorter than for studies without CEn (mean 37.43 months) (n.s.). CEn studies reached significantly higher enrollment (CEn mean  = 2395.11, non-CEn mean  = 463.93), p Discussion/Significance of Impact: Results demonstrate the substantial effect of CEn on enrollment and inclusion in clinical studies. However, the infinitesimal number of studies that reported CEn did not allow comparisons of level of engagement on the outcomes. Findings highlight ethical questions surrounding the lack of publishing incomplete studies.

Background: High volumes, ill patients, and steep learning curves can make neurosurgical rotations challenging for medical students. Furthermore, existing rotations often lack neurosurgery-specific orientation materials and level-appropriate pre-reading resources reducing the educational yield of short rotations. This is compounded by the lack of mandatory neurosurgical rotations across medical schools. We hypothesized that a “Neurosurgery Clerkship Manual” covering key orientation, knowledge, and practical topics would enhance educational experiences and generate sustained knowledge retention. Methods: Students rotating through neurosurgery at three hospitals were randomized to receive(intervention) or not receive(control) free access to the manual before their rotation. Participants completed surveys before, immediately after, and 4-weeks after the rotation assessing expectations, experiences, and clinically-relevant knowledge. Results: 61 participants were randomized between 2014 and 2017 with 43(70.5%) completing all three questionnaires. Baseline demographics, characteristics, and experiences were not significantly different. Those receiving the manual reported increased rotation enjoyment(p=0.02), decreased stress levels (p=0.05), and a greater feeling of being “part of the team”(p=0.01). There were also reductions in feeling like they were “not learning” (p=0.01). Finally, those receiving the manual demonstrated significantly better knowledge after the rotation (91.6%vs80.9%;p=0.04) which was sustained at 4-weeks post-rotation (89.2%vs79.0%;p=0.05). Conclusions: A simple and inexpensive clerkship manual can improve the neurosurgery rotation experience and knowledge retention for medical students.

The goal of this research was to identify, summarize, and evaluate pediatric disaster preparedness resources in the United States and to identify areas that need improvement or further development. Using standard literature, gray literature and website reviews, relevant resources were identified and the 50 most relevant resources were studied in depth. Each resource was given a grade of A, B, or C based on content, format, quality, and thoroughness. These resources were divided into 3 categories: (1) hospital resources, (2) school resources, and (3) training/education resources. Half of the 50 resources (25) were given a grade of A, indicating the highest level of quality and thoroughness, with pertinent information presented in a clear format. Sixteen of the resources were given a rating of B, while 9 of the resources were given a rating of C. Over 60% of the resources did not contain culturally sensitive information and more than 60% of the resources did not contain preparedness information for children with disabilities. Resources specific to hospitals and schools were limited in number and quality available, while training/education resources were widely available. In addition, 60% of resources were not specific to schools, children’s hospitals, or to certain occupations (ie, nurses, doctors, teachers, principals). Based on these results, gaps in cultural sensitivity were identified and limitations in resources for children with disabilities and for schools and hospitals currently exist. All these areas require further development in the field of pediatric disaster preparedness (Disaster Med Public Health Preparedness. 2019;13:330–337)

Laboratory and greenhouse studies were conducted to determine the effect of several environmental factors on seed germination and seedling emergence of the invasive weed Pueraria lobata (kudzu). Germination occurred over a range of alternating temperatures from 15/6 to 35/25 C. Seed germinated equally well in alternating light/darkness and continuous darkness. At all temperature regimes, percentage germination was much greater for hand-scarified seed (95 to 100%) than for nonscarified seed (7 to 17%), indicating that P. lobata seed possesses physical dormancy. Germination exceeded 51% in solutions with pH 5 to 9. Maximum germination (99%) was observed in distilled water at pH 5.4. Germination was greatly reduced in solutions with osmotic potentials below −0.4 MPa (28% at −0.6 MPa, and 13% at −0.9 MPa); no germination was observed at −1.3 MPa. Percentage emergence was greater than 45% at burial depths in soil of 0.5 to 10 cm, with maximal emergence (72 to 85%) at depths of 0.5 to 4 cm. Seed sown on the soil surface had low seedling emergence (< 13%). No seedlings emerged when seed was exposed to flooding for 7 d or more. Pueraria lobata seed is capable of germinating in a variety of climatic and edaphic conditions, but flooding may severely limit establishment of stands by seed.

Laboratory and greenhouse studies were conducted to determine the effect of temperature, solution pH, water stress, and planting depth on cutleaf eveningprimrose germination and emergence. Field studies were conducted to measure growth parameters of cutleaf eveningprimrose throughout the fall season. When treated with constant temperature, cutleaf eveningprimrose germinated over a range of 15 to 32 C, with the optimum germination occurring at 24 C. Onset, rate, and total germination were greatest in an alternating 20/35 C temperature regime. Germination decreased as solution pH increased, with greatest germination occurring at solution pH of 4. Germination decreased when cutleaf eveningprimrose seed was subjected to increased water stress. Emergence was optimum when seed were buried at depths of 0.5 cm. Germination decreased with increasing burial depth, and no seed emerged from a depth of 10 cm. Cutleaf eveningprimrose control was maximized when 2,4-D was applied in mixture with glyphosate or paraquat. These data suggest that cutleaf eveningprimrose can germinate and gain biomass from early March to late October. These attributes could contribute to poor control before cotton planting if preplant control applications are delayed after early March.

The US Naval Research Laboratory (NRL) is developing technologies that will enable Navy-relevant missions with the smallest practical Micro Air Vehicles (MAVs). The NRL Micro Tactical Expendable (MITE) air vehicle is a result of this research. MITE is a hand-launched, dual-propeller, fixed-wing air vehicle, with a 25cm chord and a wingspan of 25–47cm, depending on payload weight. Vehicle gross weight is 130–350g. Miniature autopilot systems, based on visual imaging techniques, are being developed for MITE. These will be used in conjunction with conventional autopilot sensors to allow the MITE to fly autonomously. This paper provides an overview of the MITE development, including aerodynamic design considerations, electric propulsion, and vision-based autopilot research. Also presented is a rationale for the development of control laws that can direct the behavior of large groups of MAVs or other vehicle agents. Dubbed ‘physicomimetics,’ this process can bring about the self-assembly of complex MAV formations, though individual MAVs have minimal onboard processing power and limited local sensing capabilities.

Background: CAS is reported to have higher complication rates in elderly compared to younger patients. This effect may be a surrogate for unfavourable anatomy (tortuosity, arch/access vessel atheroma burden) for endovascular treatment. We report our experience with 42 highly selected patients with favourable anatomy in spite of age. Methods: From a cohort of 217 consecutive patients undergoing CAS at St Michael’s Hospital from 2010-2016, stroke and a composite outcome of stroke, MI or death at 30 days post procedure was recorded. We compared outcomes in patients below and above the age of 75. Results: In 217 patients, 175 (80.7%) were below and 42 (19.3%) were above age 75 years. The stroke rate was 1.7% (n=3) and 2.4% (n=1), for patients below and above age 75 years respectively (p=0.58). The composite outcome rate was 4.0% (n=7) and 4.8% (n=2) for patients below and above age 75 years respectively (p=0.69). Conclusions: Patients without high-risk anatomic features were selected for CAS treatment. In this selected group, outcomes for those older than 75 years are comparable to the younger age category. Complication rates were comparable to the results in major randomized symptomatic carotid trials.

Background: On imaging, thrombosed aneurysms can be mistaken for tumor with potentially disastrous consequences. Methods: We present two cases of aneurysms mimicking tumor. Results:Patient 1 (6 months of left-sided facial weakness): MRI demonstrated a 3.3 cm, T1-isotense, T2-hypertense heterogeneous enhancing mass favored to represent a CPA schwannoma. Biopsy revealed a thrombosed aneurysm. DSA subsequently revealed an area of contrast penetration, treated by parent artery (AICA) obliteration. Two-year follow-up revealed stable occlusion with reduced mass effect. Patient 2 (1 year of headaches): Imaging demonstrated an extra-axial T1-mixed, T2-hyperintense heterogeneously enhancing mass in the left CPA adjacent to the vertebral artery, enlarging from 1.7 cm to 3.2 cm over 2 years. DSA revealed slow, crescentic filling with suggestion of arborisation distally. Patient deteriorated due to mass effect requiring a VP shunt and passed away from SAH 3 months later. Imaging review revealed crescentic filling of the remnant lumen on CE-MRA and signal voids on T2 in both cases, which may suggest the aneurysm diagnosis. However our cases did not have other features such as lamellated thrombus or pulsation artifact. Conclusions: Central contrast enhancement does not necessarily preclude the diagnosis of thrombosed aneurysm. The possibility of revascularization or penetration of contrast through the thrombus in giant aneurysms needs to be considered.

Background: The CREST trial remains the most influential study regarding choice of treatment modality for carotid revascularization in the modern era. The effect of the CREST trial on patient outcomes and changes to clinical practice are yet to be fully elucidated. Methods: We report a cohort of 217 consecutive symptomatic average risk patients undergoing CAS at St. Michael’s Hospital, between 2010 and 2016. Outcome measures were stroke, MI and death at 30 days post procedure. Of the 217 patients, 42 were above the age of 75 (19%). Results: The 30-day combined stroke, MI and death outcome for all patients was 4.1%. One death occurred (0.46%) in a patient who suffered an MI. One disabling stroke (0.46%) and 3 mild strokes (1.38%) with full recovery by 6 months occurred. Overall 4 patients suffered an MI (1.84%). Conclusions: As a result of the CREST trial in our single institutional experience there has been a clear migration to treating average risk patients using CAS, a treatment previously reserved for high risk patients. In this average risk cohort we report favourable outcomes when compared to the CREST trial as well as the firmly established benchmarks for CEA complications derived from the NASCET trial.

Parkinson's disease is a neurodegenerative disorder that affects about 1% of Canadians between the ages of fifty and seventy. The medical management for these patients consists of drug therapy that is initially effective but has limited long term benefits and does not alter the progressive course of the disease. The recalcitrance of longstanding Parkinson's disease to medical management has prompted the use of alternative surgical therapies. Many neurosurgical procedures have been utilized in order to improve the disabling symptoms these patients harbour. Although most of the current procedures involve making destructive lesions within various basal ganglia nuclei, neural transplantation attempts to reconstitute the normal nigrostriatal pathway and restore striatal dopamine. The initial success of neural transplantation in the rodent and primate parkinsonian models has led to its clinical application in the treatment of parkinsonian patients. Currently, well over one hundred patients throughout the world have been grafted with fetal tissue in an effort to ameliorate their parkinsonian symptoms. Although the results of neural transplantation in clinical trials are promising, a number of issues need to be resolved before this technology can become a standard treatment option. This review focuses on the current status of neural transplantation in Parkinson's disease within the context of other surgical therapies in current use.

Growth and propagation of fish-infecting microsporidians within cell culture has been more difficult to achieve than for insect- and human-infecting microsporidians. Fish microsporidia tend to elicit xenoma development rather than diffuse growth in vivo, and this process likely increases host specificity. We present evidence that the fish microsporidian, Loma salmonae, has the capacity to develop xenomas within a rainbow trout gill epithelial cell line (RTG-1). Spore numbers increased over a 4 weeks period within cell culture flasks. Xenoma-like structures were observed using phase contrast microscopy, and then confirmed using transmission electron microscopy. Optimization of the L. salmonae-RTG-1 cell model has important implications in elucidating the process of xenoma development induced by microsporidian parasites.