Nipah virus (NiV) outbreak occurred in Kozhikode district, Kerala, India in 2018 with a case fatality rate of 91% (21/23). In 2019, a single case with full recovery occurred in Ernakulam district. We described the response and control measures by the Indian Council of Medical Research and Kerala State Government for the 2019 NiV outbreak. The establishment of Point of Care assays and monoclonal antibodies administration facility for early diagnosis, response and treatment, intensified contact tracing activities, bio-risk management and hospital infection control training of healthcare workers contributed to effective control and containment of NiV outbreak in Ernakulam.

A 64-year-old man with treated hypertension presented with acute left arm and leg weakness. A brain magnetic resonance imaging (MRI) and neck magnetic resonance angiography (MRA) were performed. There was restricted diffusion in the right internal capsule posterior limb consistent with an acute lacunar infarct. The MRA demonstrated aplastic bilateral cervical vertebral arteries (V1 and V2 segments). bilaterally, a variant artery arose from the external carotid just above its origin, extended superiorly then medially, and forming the vertebral artery (V3 and V4 segments). bilaterally, the occipital artery arose from the variant artery at the juncture where it turned medially. The right variant artery terminated intracranially in the right posterior inferior cerebellar artery. The left variant artery continued intracranially to supply the basilar. The appearance was consistent with bilateral persistent proatlantal intersegmental arteries (PPIA) type II.

Summary

Background and objective: For use in a magnetic resonance (MR) scanning room infusion pumps must be MR safe and compatible. This study tested two commonly used infusion pumps (Alaris P6000 and Alaris Asena-GH) to determine if they met these criteria.

Methods: The pumps underwent testing within the scanning room of a 3 T MR scanner. Pump infusion rates were tested at up to 100 Gauss magnetic field strength, with and without radio frequency signals present. The effect of the pumps on image quality was assessed. The occlusion pressure alarm of the pumps was tested at up to 100 Gauss. The projectile risk was assessed by measuring the force exerted upon the pumps at the entrance to the scanner.

Results: The maximum mean flow rate errors at 100 Gauss were 2.18% for the Alaris P6000 and 1.42% for the Alaris Asena-GH, both within our accepted limits. Radio frequency signals had no effect on flow rate. The pumps produced no discernable artefacts on the acquired images. The maximum mean occlusion pressure error was 204 mmHg higher for the Alaris P6000 pump and 99 mmHg lower for the Alaris Asena-GH (P-values < 0.001) at 100 Gauss compared to testing outside the scanner. Both pumps were subject to significant attractive force at the entrance to the scanner.

Conclusions: Whilst the pumps cannot strictly be termed MR safe or compatible at 100 Gauss we have demonstrated that flow rates are unchanged and that, for the Alaris Asena-GH, the effect on the occlusion pressure alarm is unlikely to have patient safety implications.

Alternate layers of pure copper and gold were vapor deposited on a sodium chloride substrate, the average concentration of the films being Cu-16at% Au and the layering periodicity (modulation wavelength) being 3.31 nm. The composition modulation gives rise to satellite diffraction peaks around the (200) Bragg reflections. Synchrotron radiation at SSRL was able to detect up to third order satellite intensity the evolution of which was measured as a function of annealing time at 515 K. Although the first order satellite intensity decayed as expected exponentially with time, intensities of both second and third order satellites decreased very rapidly at first, then increased before decaying exponentially. These results are in conformity with theoretical models of satellite evolution during annealing in a onedimensional modulated system governed by a nonlinear diffusion equation.