We postulate that the arteriovenous shunting resulted in arterial steal and chronic hypoxia which could be a pathophysiological mechanism for symptomatic DVAs. CTP and 4D CTA are effective non invasive tools to study DVAs. A classification is proposed.
Allergy immunotherapy (AIT) is the only disease-modifying therapy for the treatment of allergic diseases. Although its efficacy and utility are well-established, the potential for serious adverse events, cumbersome and lengthy treatment protocols, and variability of natural allergen preparations have limited its widespread application. Recent advances in recombinant technology have opened new avenues for the development of AIT vaccines. The purpose of this review is to highlight recent evidence on the use of novel recombinant vaccines and review the mechanisms, efficacy, safety, and limitations of AIT. Emerging evidence suggests that recombinant vaccines may provide a viable treatment alternative that improves on the limitations of natural extract therapy while maintaining efficacy.
<p>The cable-stayed bridge for the New Champlain Bridge Project (the “Project”) is the signature crossing. The asymmetrical structure features a 124 m back span and a 240 m main span. The 170 m high single-pylon consists of a tuning-fork configuration of twin masts. Inclined concrete tower legs and “W” shaped steel pier caps supporting the deck define the unique aesthetics of this bridge.</p><p>The focus of this paper is to provide a detailed description of the bridge including a discussion of the superstructure, main span tower, supporting piers and cable-stay system. It also describes the erection techniques used. Working alongside the Contractor, the design team made innovative use of pre-casting, modular segments, and non-traditional erection sequencing to meet the Project’s fast-track schedule of only 42 months, while overcoming the severe winters in Montréal.</p>
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