Abstract
Background
Comparative long-term trends in fatal accident rates in the UK’s most hazardous occupations have not been reported.
Aims
To compare trends in fatal accident rates in six of the ...most hazardous occupations (the three armed forces, merchant shipping, sea fishing and coal mining) and the general British workforce during peacetime years since 1900.
Methods
Examinations of annual mortality reports, returns, inquiry files and statistics. The main outcome measure was the fatal accident rate per 100 000 population employed.
Results
These six occupations accounted for ~40% of all fatal accidents in the British workforce. Fatal accident rates were highest in merchant shipping to 1914 (400–600 per 100 000) and in the Royal Air Force and sea fishing by the early 1920s (around 300 per 100 000). Since the 1950s sea fishing has remained the most hazardous occupation (50–200). Widespread reductions in fatal accident rates for each occupation have been greatest in recent years in the three armed forces and merchant shipping. Compared with the general workforce, relative risks of fatalities have increased in recent decades in all these occupations except shipping.
Conclusions
All six occupations still have high fatal accident rates. The greatly increased fatalities in sea fishing generally and in the Royal Air Force during its early years reflect, for different reasons, cultures of extreme risk-taking in these two sectors. Reductions in fatality rates in the armed forces over the last 20 years are due largely to decreases in land transport accidents.
Aim
To quantify the insulin requirement for a high‐protein meal compared with a low‐protein meal, controlling for carbohydrate and fat content.
Methods
In this crossover study, young people with Type ...1 diabetes were randomized to consume a high‐ (60 g) or low‐protein meal (5 g), each containing 30 g carbohydrate and 8 g fat. A variation of the insulin clamp technique was used to determine the insulin requirements to maintain euglycaemia for the following 5 h.
Results
A total of 11 participants (mean ± sd age 16.5 ± 2.7 years, HbA1c 52 ± 8.7 mmol/mol 6.9 ± 0.8%, diabetes duration 6.9±5.1 years) completed the study. The mean insulin requirements for the high‐protein meal were higher than for the low‐protein meal 10.3 (CI 8.2, 12.57) vs 6.7 units (CI 4.7, 8.8); P=0.001, with inter‐individual requirements ranging from 0.9 to six times the low‐protein meal requirement. Approximately half the additional insulin 1.1 units/h (CI 0.5, 1.8; P=0.001) was given in the first 2 h, compared with an additional 0.5 units/h (CI –0.2, 1.2; P=0.148) in the second 2 h and 0.1 units (CI –0.6, 0.8; P=0.769) in the final hour.
Conclusions
A high‐protein meal requires ~50% more insulin to maintain euglycaemia than a low‐protein meal that contains the same quantity of carbohydrate. The majority is required within the first 2 h. Inter‐individual differences exist in insulin requirements for dietary protein.
What's new?
This is the first study to quantify the additional insulin and the delivery required for a high‐protein vs a low‐protein meal, controlled for carbohydrate and fat content.
This was achieved using a novel variation of the insulin clamp technique to maintain euglycaemia throughout the study period.
A mean of 50% additional insulin was required for the high‐protein meal compared with the low‐protein meal.
The majority (60%) of the additional insulin required for the high‐protein meal was needed in the first 2 hours after meal consumption.
Large inter‐individual variation in the quantity of additional insulin required for the high‐protein meal was seen (–1.3 to 9.4 units), indicating the need for individual insulin to protein ratios to be calculated.
Imprinted genes are expressed monoallelically depending on their parental origin. High expression of the majority of imprinted genes tested to date has been demonstrated in extraembryonic tissues; ...placenta and yolk sac. Several mouse models where specific imprinted genes have been disrupted demonstrate that fetal and placental growth may be regulated by imprinted genes, in which paternally expressed genes enhance, and maternally expressed genes restrain, growth. We review the current information on, and suggest possible functional roles for, imprinted genes in placental development.
Intralesional injection of collagenase clostridium histolyticum (CCH) improves Peyronie's disease (PD) symptoms; however, patient perspectives regarding PD and CCH treatment have not been fully ...elucidated. This cross-sectional qualitative study included heterosexual men with PD who received ≥1 injection of study medication and had ≥1 posttreatment Peyronie's Disease Questionnaire (PDQ) assessment during a prior phase 2b clinical trial. These patients were "responders" if they reported (as part of the Global Assessment of the PDQ) that overall symptoms and effects of PD had at least "improved in a small but important way" after CCH therapy. Among 45 patients interviewed, penile bending or curvature was the most common and bothersome PD symptom reported (by 97.8% and 48.9% of patients, respectively). Patients indicated that multiple alterations were necessary in their sex lives because of penile symptoms and specified that these changes impacted their emotional health and partner relationship. Treatment with CCH improved PD symptoms (44.4%), frequency of or ability to have vaginal intercourse (22.2%) and partner relationship (22.2%), particularly among responders. Given that physical, psychologic and sexual function are impacted by PD, clinical trials that evaluate treatments for PD should include patient-reported outcome measures (e.g., the PDQ) to assess overall well-being after treatment.
Radioactive isotopes produced through cosmic muon spallation are a background for rare-event detection in nu detectors, double-beta-decay experiments, and dark-matter searches. Understanding the ...nature of cosmogenic backgrounds is particularly important for future experiments aiming to determine the pep and CNO solar neutrino fluxes, for which the background is dominated by the spallation production of {sup 11}C. Data from the Kamioka liquid-scintillator antineutrino detector (KamLAND) provides valuable information for better understanding these backgrounds, especially in liquid scintillators, and for checking estimates from current simulations based upon MUSIC, FLUKA, and GEANT4. Using the time correlation between detected muons and neutron captures, the neutron production yield in the KamLAND liquid scintillator is measured to be Y{sub n}=(2.8+-0.3)x10{sup -4} mu{sup -1} g{sup -1} cm{sup 2}. For other isotopes, the production yield is determined from the observed time correlation related to known isotope lifetimes. We find some yields are inconsistent with extrapolations based on an accelerator muon beam experiment.
This paper presents an overview of recent resonance ionization schemes used at the Collinear Resonance Ionization Spectroscopy (CRIS) setup located at ISOLDE, CERN. The developments needed to reach ...high spectral resolution and efficiency will be discussed. Besides laser ionization efficiency and high resolving power, experiments on rare isotopes also require low-background conditions. Ongoing developments that aim to deal with beam-related sources of background are presented.
Auxotrophic mutants of Mycobacterium tuberculosis have been proposed as new vaccine candidates. We have analyzed the virulence and vaccine potential of M. tuberculosis strains containing defined ...mutations in genes involved in methionine (metB), proline (proC), or tryptophan (trpD) amino acid biosynthesis. The metB mutant was a prototrophic strain, whereas the proC and trpD mutants were auxotrophic for proline and tryptophan, respectively. Following infection of murine bone marrow-derived macrophages, H37Rv and the metB mutant strain survived intracellularly for over 10 days, whereas over 90% of proC and trpD mutants were killed during this time. In SCID mice, both H37Rv and the metB mutant were highly virulent, with mouse median survival times (MST) of 28.5 and 42 days, respectively. The proC mutant was significantly attenuated (MST, 130 days), whereas the trpD mutant was essentially avirulent in an immunocompromised host. Following infection of immunocompetent DBA mice with H37Rv, mice survived for a median of 83.5 days and the metB mutant now showed a clear reduction in virulence, with two of five infected mice surviving for 360 days. Both proC and trpD mutants were avirulent (MST of >360 days). In vaccination studies, prior infection with either the proC or trpD mutant gave protection equivalent (proC mutant) to or better (trpD mutant) than BCG against challenge with M. tuberculosis H37Rv. In summary, proC and trpD genes are essential for the virulence of M. tuberculosis, and mutants with disruptions in either of these genes show strong potential as vaccine candidates.
We present preliminary results about the detection of high redshift (U)LIRGs in the Bullet cluster field by the PACS and SPIRE instruments within the Herschel Lensing Survey (HLS) Program. We ...describe in detail a photometric procedure designed to recover robust fluxes and deblend faint Herschel sources near the confusion noise. The method is based on the use of the positions of Spitzer/MIPS 24 μm sources as priors. Our catalogs are able to reliably (5σ) recover galaxies with fluxes above 6 and 10 mJy in the PACS 100 and 160 μm channels, respectively, and 12 to 18 mJy in the SPIRE bands. We also obtain spectral energy distributions covering the optical through the far-infrared/millimeter spectral ranges of all the Herschel detected sources, and analyze them to obtain independent estimations of the photometric redshift based on either stellar population or dust emission models. We exemplify the potential of the combined use of Spitzer position priors plus independent optical and IR photometric redshifts to robustly assign optical/NIR counterparts to the sources detected by Herschel and other (sub-)mm instruments. Herschel is an ESA space observatory with science instruments provided by European-led Principal Investigator consortia and with important participation from NASA.
We report results of a search for an isotropic gravitational-wave background (GWB) using data from Advanced LIGO's and Advanced Virgo's third observing run (O3) combined with upper limits from the ...earlier O1 and O2 runs. Unlike in previous observing runs in the advanced detector era, we include Virgo in the search for the GWB. The results of the search are consistent with uncorrelated noise, and therefore we place upper limits on the strength of the GWB. We find that the dimensionless energy density Ω(sub GW) ≤ 5.8 × 10(exp -9) at the 95% credible level for a at (frequency-independent) GWB, using a prior which is uniform in the log of the strength of the GWB, with 99% of the sensitivity coming from the band 20-76.6 Hz; Ω(sub GW)(f) ≤ 3.4 × 10(exp -9) at 25 Hz for a power-law GWB with a spectral index of 2/3 (consistent with expectations for compact binary coalescences), in the band 20-90.6 Hz; and Ω(sub GW)(f) ≤ 3.9 × 10(exp -10) at 25 Hz for a spectral index of 3, in the band 20-291.6 Hz. These upper limits improve over our previous results by a factor of 6.0 for a at GWB, 8.8 for a spectral index of 2/3, and 13.1 for a spectral index of 3. We also search for a GWB arising from scalar and vector modes, which are predicted by alternative theories of gravity; we do not find evidence of these, and place upper limits on the strength of GWBs with these polarizations. We demonstrate that there is no evidence of correlated noise of magnetic origin by performing a Bayesian analysis that allows for the presence of both a GWB and an effective magnetic background arising from geophysical Schumann resonances. We compare our upper limits to a fiducial model for the GWB from the merger of compact binaries, updating the model to use the most recent data-driven population inference from the systems detected during O3a. Finally, we combine our results with observations of individual mergers and show that, at design sensitivity, this joint approach may yield stronger constraints on the merger rate of binary black holes at z ≳ 2 than can be achieved with individually resolved mergers alone.
To investigate the occurrence of status epilepticus and seizure clusters, and the duration until first seizure at epilepsy monitoring units in the United States.
The authors examined the inpatient ...video-EEG monitoring reports of 514 consecutive patients admitted to five comprehensive epilepsy centers during the year 2000. Time to first seizure, seizure clustering, and seizure duration were ascertained from reports and entered into a database.
In 169 admissions with complex partial seizures (CPSs) or secondarily generalized tonic-clonic (2GTC) seizures, there were 5 (3.0%) patients with status epilepticus, 30 (17.8%) with 4-hour seizure clusters, and 82 (48.5%) with 24-hour seizure clusters. There were no statistically significant differences between centers, except that seizure clusters were observed to be less common at the one center with a formal drug withdrawal protocol. The average time to CPS or 2GTC seizure was 2.1 days; the average number of days to nonepileptic event was 1.2 days (p = 0.001).
Although status epilepticus is uncommon at epilepsy monitoring units, clusters of seizures are common. Intensive monitoring with drug withdrawal must be performed in a highly supervised, hospitalized setting. Inpatient video-EEG monitoring is efficient, with recording of the first epileptic or nonepileptic events in 2 days or less.
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