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BackgroundData from emergency departments (EDs) in England describe the epidemiology of violent assaults. However, the potential of such data to inform hospital-based public health interventions remains unknown.ObjectiveTo identify determinants of assaults using ED data to inform development of programmes delivered in acute Trusts for reducing assault-related injuries in the community.MethodsData were collected from a large North London acute Trust on assault-related injuries reporting to A&E over 18 months (July 2010–February 2012). Information was recorded on patient demographics and assaults (place of assault, type of assault, relation to assailant) through questionnaires administered by ED reception staff.Results1210 assaults were recorded between July 2010 and February 2012. 18% of assaults were severe (strangling, stabbings, sexual assaults). 75% of assault victims were men, 37% were young adults (20–30 years) and 15% were teenagers. A higher proportion of victims lived in more deprived areas. Apart from public streets (48%), the main location of assaults was at home (20%). Female compared with male victims were significantly more likely to be both assaulted at home (OR 6.13; 95% CI 4.41 to 8.54) and to be assaulted by a known assailant (family member, friend, partner/ex-partner; OR 8.20, 95% CI 5.85 to 11.48).ConclusionsThe results highlight the notable contribution of domestic violence to assaults presenting to hospital ED. Such findings can be used to plan interventions such as screening hospital patients for domestic violence. ED data have the potential to inform hospital-based initiatives to address issues such as assaults in the local population.

We describe a large-scale far-infrared line and continuum survey of protoplanetary disk through to young debris disk systems carried out using the ACS instrument on the Herschel Space Observatory. This Open Time Key program, known as GASPS (Gas Survey of Protoplanetary Systems), targeted ?250 young stars in narrow wavelength regions covering the [OI] fine structure line at 63 ?m the brightest far-infrared line in such objects. A subset of the brightest targets were also surveyed in [OI]145 ?m, [CII] at 157 ?m, as well as several transitions of H2O and high-excitation CO lines at selected wavelengths between 78 and 180 ?m. Additionally, GASPS included continuum photometry at 70, 100 and 160 ?m, around the peak of the dust emission. The targets were SED Class II-III T Tauri stars and debris disks from seven nearby young associations, along with a comparable sample of isolated Herbig AeBe stars. The aim was to study the global gas and dust content in a wide sample of circumstellar disks, combining the results with models in a systematic way. In this overview paper we review the scientific aims, target selection and observing strategy of the program. We summarise some of the initial results, showing line identifications, listing the detections, and giving a first statistical study of line detectability. The [OI] line at 63 ?m was the brightest line seen in almost all objects, by a factor of ?10. Overall [OI]63 ?m detection rates were 49%, with 100% of HAeBe stars and 43% of T Tauri stars detected. A comparison with published disk dust masses (derived mainly from sub-mm continuum, assuming standard values of the mm mass opacity) shows a dustmass threshold for [OI]63 ?m detection of ?10-5M?. Normalising to a distance of 140 pc, 84% of objects with dust masses ?10-5M?can be detected in this line in the present survey; 32% of those of mass 10-6-10-5M?, and only a very small number of unusual objects with lower masses can be detected. This is consistent with models with a moderate UV excess and disk flaring. For a given disk mass, [OI] detectability is lower for Mstars compared with earlier spectral types. Both the continuum and line emission was, in most systems, spatially and spectrally unresolved and centred on the star, suggesting that emission in most cases was from the disk. Approximately 10 objects showed resolved emission, most likely from outflows. In the GASPS sample, [OI] detection rates in T Tauri associations in the 0.3-4 Myr age range were ?50%. For each association in the 5-20 Myr age range, ?2 stars remain detectable in [OI]63 ?m, and no systems were detected in associations with age >20 Myr. Comparing with the total number of young stars in each association, and assuming a ISM-like gas/dust ratio, this indicates that ?18% of stars retain a gas-rich disk of total mass ?1 MJupiterfor 1-4 Myr, 1-7% keep such disks for 5-10 Myr, but none are detected beyond 10-20 Myr. The brightest [OI] objects from GASPS were also observed in [OI]145 ?m, [CII]157 ?m and CO J= 18 - 17, with detection rates of 20-40%. Detection of the [CII] line was not correlated with disk mass, suggesting it arises more commonly from a compact remnant envelope.

The likely mortality benefit from pre-optimisation of high risk surgical patients depends on the baseline risk of death. The baseline risk estimated from the control groups of studies of pre-optimisation may not reflect the risk in other institutions. We determined the 28-day mortality of ‘high risk’ adult surgical patients in our institution by performing a retrospective cohort study of 554 patients undergoing major or ultra-major general or vascular surgery lasting more than two hours. Patients were identified as being high risk based on the presence of risk factors used in previous studies of pre-optimisation. The 28-day mortality (95% CI) was 0% for patients with no risk factors and 2.3 (0.8 to 3.7)% for patients with at least one risk factor. These data indicate that the risk of death amongst high risk surgical patients may vary considerably between institutions.

We report a case of inadvertent intravenous administration of enteral feed, a very rare but potentially life-threatening complication of enteral feeding. Bacterial contamination of feed results in a severe septic response that requires broad-spectrum antibiotic cover and aggressive organ support. The failure of measures aimed at prevention of this complication must be investigated, and practice changed to ensure that further incidents are avoided.

Melioidosis is an infectious disease that can present with multiple foci of disease involvement. Assessment of disease extent can be difficult, especially in musculoskeletal, visceral and soft tissue infection. This study examined the usefulness of white cell scans in this condition. 99mTc stannous colloid white cell scanning was performed in 21 patients with culture-proven melioidosis. Scan results were compared with clinical assessment and correlated with other forms of imaging. White cell scans demonstrated all but one of the clinically apparent sites of musculoskeletal, visceral and other soft tissue infection. Unsuspected disseminated soft tissue lesions were seen in two patients, including femoral node uptake in both, and these patients subsequently presented with relapsing musculoskeletal disease. Unsuspected musculoskeletal disease was found in one patient. Clinically suspected musculoskeletal disease was accurately excluded by white cell scan in another patient. The results of white cell scanning were also examined in disease of other viscera. Renal and prostatic disease were visualized. Unsuspected parotid involvement was found in two patients. Only one of two spinal lesions was visualized. Pulmonary disease was not necessarily associated with abnormal uptake. White cell scanning is a quick and effective way of assessing the extent of musculoskeletal, visceral and soft tissue disease in melioidosis.

To describe the effects of collagen vascular diseases on the eyelids and periorbital tissues.

1. The primary objective of this study was to examine in man, how induced changes in global cerebral blood flow (gCBF) affected a regional cerebral blood flow (rCBF) increase resulting from a neural activation task (opening of eyes). A secondary objective was to quantify how such induced changes in gCBF were distributed between representative regions of either predominantly grey matter or white matter. 2. Positron emission tomography with intravenous infusion of H2(15)O, was used to measure gCBF in six normal males. Concomitant measures of rCBF were obtained in three different regions of interest (ROI): a representative area of predominantly grey matter, a representative area of predominantly white matter and an area of visual cortex. 3. Cerebral blood flow was altered by establishing steady‐state changes in PCO2 at a near constant ventilation of approximately 30 l min‐1. The mean PET,CO2 (+/‐ S.D.) levels (mmHg) that resulted were: low, 21.8 +/‐ 1.8; normal, 39.8 +/‐ 1.0, and high, 54.8 +/‐ 1.2. The normal and high levels were obtained by adding appropriate amounts of CO2 to the inspirate. The corresponding mean gCBF levels across all six subjects with eyes closed were: low, 24.2 +/‐ 4.6; normal, 37.2 +/‐ 3.9 and high, 66.8 +/‐ 7.6 ml min‐1 dl‐1. 4. Blood flow in grey matter (insular cortex) and white matter (centrum semiovale) at normal levels of PCO2 averaged 56.8 +/‐ 10.1 and 20.3 +/‐ 3.4 ml min dl‐1 respectively. As PCO2 rose, the increase in rCBF to grey matter was approximately three times greater than that to white matter. 5. An activation state of eyes open in a brightly lit room was compared to a baseline state of eyes closed in a darkened room at the three levels of PCO2 (and hence at three levels of gCBF). Over the whole gCBF range a significant (P = 0.028) effect of increasing rCBF in the visual cortex ROI was found in response to opening the eyes; the effect of this activation on rCBF was not significantly dependent (P = 0.34) on the PCO2 (and hence gCBF) level. The effect of the activation on the rCBF was apparently ‘additive’ to the rise of rCBF associated with PCO2‐related gCBF increase. 6. The results confirm the need to normalize for changes in gCBF during studies of rCBF in response to an activation protocol. They also provide support for the use of an ‘additive’ model to achieve such normalization provided that other cortical areas behave in a similar manner to that of the visual cortex.

1. The role of supra‐brainstem structures in the ventilatory response to inhaled CO2 is unknown. The present study uses positron emission tomography (PET), with infusion of H2(15)O, to measure changes in relative regional cerebral blood flow (rCBF) in order to identify sites of increased neuronal activation during CO2‐stimulated breathing (CO2‐SB) in awake man. 2. Five male volunteers were scanned during CO2‐SB (mean +/‐ S.E.M.; end‐tidal PCO2, 50.3 +/‐ 1.7 mmHg; respiratory frequency, 16.4 +/‐ 2.7 min‐1; tidal volume, 1.8 +/‐ 0.2 l). As control, scans were performed during ‘passive’ isocapnic (elevated fraction of inspired CO2) positive pressure ventilation (end‐tidal PCO2, 38.4 +/‐ 1.0 mmHg; respiratory frequency, 15.5 +/‐ 2.2 min‐1; tidal volume, 1.6 +/‐ 0.2 l). With CO2‐SB, all subjects reported dyspnoea. 3. The anatomical locations of the increases in relative rCBF (CO2‐SB versus control) were obtained using magnetic resonance imaging. 4. Group analysis identified neuronal activation within the upper brainstem, midbrain and hypothalamus, thalamus, hippocampus and parahippocampus, fusiform gyrus, cingulate area, insula, frontal cortex, temporo‐occipital cortex and parietal cortex. No neuronal activation was seen within the primary motor cortex (at sites previously shown to be associated with volitional breathing). 5. These results suggest neuronal activation within the limbic system; this activation may be important in the sensory and/or motor respiratory responses to hypercapnia in awake man.

Within the substantia nigra, anatomical, neurochemical and pharmacological findings strongly suggest that transmitter and protein are secreted from the dendrites of nigrostriatal neurones. This phenomenon may underlie a non classical modulatory cellular mechanism. Two conductances are generated in nigrostriatal neurones independent of somatic action potentials, that might mediate this modulation. However, these conductances have never been directly nor precisely located specifically within the dendrites. The aim of this study was to record the membrane properties of substantia nigra zona compacta neurones in response to selective sectioning of the population of long ‘apical’ dendrites i.e. the removal of the zona reticulata. Intracellular recordings from substantia nigra zona compacta neurones were made from mesencephalic slices of the guinea-pig brain maintained in vitro. In cells without the apical dendrites, the membrane potential, input resistance and mean firing frequency was not significantly different from the control neurones. However, removal of the substantia nigra zona reticulata virtually abolished one conductance in particular. This conductance, seen in control neurones, is a long lasting slow depolarization which is resistant to tetrodotoxin blockade of sodium channels: rather, it is mediated by the entry of calcium ions and is optimally deinactivated at a hyperpolarised membrane potential. Hence, this study strongly suggests that this conductance is generated exclusively in the ‘apical’ dendrites. It has been postulated that this long lasting calcium conductance is central to the modulation of nigrostriatal neuronal excitability. Thus, the ‘apical’ dendrites could play a specific and active role in the functioning of nigrostriatal neurones.

Most studies on the interaction between food supply and reproduction in animals have assumed that energy is likely to be the factor limiting egg number and/or size. In this paper, we investigate whether dietary protein proximately constrains egg production in birds. We provisioned breeding blue tits with two food supplements that differed only in the concentration of five essential amino acids. Birds receiving a supplementary diet containing an amino acid balance close to that required for egg protein formation laid significantly larger clutches (18 greater) than control birds, whereas birds receiving an otherwise identical supplementary diet but without a favourable amino acid balance did not increase egg production. To our knowledge, this is the first demonstration that dietary amino acid composition may limit egg production in free–living birds.

1. Positron emission tomographic (PET) imaging of regional cerebral blood flow (rCBF), using a new 3‐dimensional technique of data collection, was used to identify areas of neuronal activation associated with volitional inspiration and separately with volitional expiration in five normal male subjects. A comparison of the activated areas was also undertaken to isolate regions specific for one or other active task. 2. Scans were performed during intravenous infusion of H2(15)O under conditions of (a) volitional inspiration with passive expiration, (b) passive inspiration with volitional expiration and (c) passive inspiration with passive expiration. Four measurements in these three conditions were performed in each subject. Breathing pattern was well matched between conditions. 3. Regional increases in brain blood flow, due to increased neural activity associated with either active inspiration or active expiration, were derived using a pixel by pixel comparison of images obtained during the volitional and passive ventilation phases. Data were pooled from all runs in all subjects and were then processed to detect statistically significant (P < 0.05) increases in rCBF comparing active inspiration with passive inspiration and active expiration with passive expiration. 4. During active inspiration significant increases in rCBF were found bilaterally in the primary motor cortex dorsally just lateral to the vertex, in the supplementary motor area, in the right lateral pre‐motor cortex and in the left ventrolateral thalamus. 5. In active expiration significant increases in rCBF were found in the right and left primary motor cortices dorsally just lateral to the vertex, the right and left primary motor cortices more ventrolaterally, the supplementary motor area, the right lateral pre‐motor cortex, the ventrolateral thalamus bilaterally, and the cerebellum. 6. Using this modified and more sensitive PET technique, these findings essentially replicate those for volitional inspiration obtained in a previous study. For volitional expiration the areas activated are more extensive, but overlap with those involved in volitional inspiration. 7. The technique used has been successful in demonstrating the regions of the brain involved in the generation of volitional breathing, and probably in the volitional modulation of automatic breathing patterns such as would be required for the production of speech.

Nuclear run-on experiments have shown that the high level of expression of the mouse cytosolic glutathione peroxidase mRNA in erythroid cells is due to up-regulation of the gene at the transcriptional level. Studies of the chromatin structure around the cytosolic glutathione peroxidase gene have revealed a series of DNase I hypersensitive sites (DHSS) in the 3' flanking region of the gene in erythroid and other high-expression tissues that are lacking in low-expression cells, in addition to a DHSS over the promoter region in both high- and low-expression tissues. Functional transfection experiments have demonstrated that one of the 3' DHSS regions functions as an enhancer in erythroid cells but not in a low-expression epithelial cell line; and site-directed mutagenesis and footprinting experiments reveal that the activity of the erythroid cell-specific enhancer requires a cluster of binding sites for the CACC/GT box factors and the GATA and Ets families of transcription factors.

Context. Circumstellar discs are ubiquitous around young stars, but rapidly dissipate their gas and dust on timescales of a few Myr. The HerschelSpace Observatory allows for the study of the warm disc atmosphere, using far-infrared spectroscopy to measure gas content and excitation conditions, and far-IR photometry to constrain the dust distribution.Aims. We aim to detect and characterize the gas content of circumstellar discs in four targets as part of the Herschelscience demonstration phase.Methods. We carried out sensitive medium resolution spectroscopy and high sensitivity photometry at λ~ 60–190 μm using the Photodetector Array Camera and Spectrometer instrument on the HerschelSpace Observatory.Results. We detect [OI] 63 μm emission from the young stars HD 169142, TW Hydrae, and RECX 15, but not HD 181327. No other lines, including [CII] 158 and [OI] 145, are significantly detected. All four stars are detected in photometry at 70 and 160 μm. Extensive models are presented in associated papers.

The HerschelGASPS key program is a survey of the gas phase of protoplanetary discs, targeting 240 objects which cover a large range of ages, spectral types, and disc properties. To interpret this large quantity of data and initiate self-consistent analyses of the gas and dust properties of protoplanetary discs, we have combined the capabilities of the radiative transfer code MCFOST with the gas thermal balance and chemistry code ProDiMo to compute a grid of ≈300 000 disc models (DENT). We present a comparison of the first Herschel/GASPS line and continuum data with the predictions from the DENT grid of models. Our objective is to test some of the main trends already identified in the DENT grid, as well as to define better empirical diagnostics to estimate the total gas mass of protoplanetary discs. Photospheric UV radiation appears to be the dominant gas-heating mechanism for Herbig stars, whereas UV excess and/or X-rays emission dominates for T Tauri stars. The DENT grid reveals the complexity in the analysis of far-IR lines and the difficulty to invert these observations into physical quantities. The combination of Herschelline observations with continuum data and/or with rotational lines in the (sub-)millimetre regime, in particular CO lines, is required for a detailed characterisation of the physical and chemical properties of circumstellar discs.

Planets are formed in disks around young stars. With an age of ~10 Myr, TW Hya is one of the nearest T Tauri stars that is still surrounded by a relatively massive disk. In addition a large number of molecules has been found in the TW Hya disk, making TW Hya the perfect test case in a large survey of disks with Herschel–PACS to directly study their gaseous component. We aim to constrain the gas and dust mass of the circumstellar disk around TW Hya. We observed the fine-structure lines of [O i] and [C ii] as part of the open-time large program GASPS. We complement this with continuum data and ground-based 12CO 3–2 and 13CO 3–2 observations. We simultaneously model the continuum and the line fluxes with the 3D Monte-Carlo code MCFOSTand the thermo-chemical code ProDiMoto derive the gas and dust masses. We detect the [O i] line at 63 μm. The other lines that were observed, [O i] at 145 μm and [C ii] at 157 μm, are not detected. No extended emission has been found. Preliminary modeling of the photometric and line data assuming [ 12CO] /[ 13CO]  = 69 suggests a dust mass for grains with radius <1 mm of ~1.9 × 10-4$M_{\odot}$(total solid mass of 3 × 10-3$M_{\odot}$) and a gas mass of (0.5–5) × 10-3$M_{\odot}$. The gas-to-dust mass may be lower than the standard interstellar value of 100.

In an effort to simultaneously study the gas and dust components of the disc surrounding the young Herbig Ae star HD 169142, we present far-IR observations obtained with the PACS instrument onboard the HerschelSpace Observatory. This work is part of the open time key program GASPS, which is aimed at studying the evolution of protoplanetary discs. To constrain the gas properties in the outer disc, we observed the star at several key gas-lines, including [OI] 63.2 and 145.5 μm, [CII] 157.7 μm, CO 72.8 and 90.2 μm, and o-H2O 78.7 and 179.5 μm. We only detect the [OI] 63.2 μm line in our spectra, and derive upper limits for the other lines. We complement our data set with PACS photometry and 12/13CO data obtained with the Submillimeter Array. Furthermore, we derive accurate stellar parameters from optical spectra and UV to mm photometry. We model the dust continuum with the 3D radiative transfer code MCFOST and use this model as an input to analyse the gas lines with the thermo-chemical code ProDiMo. Our dataset is consistent with a simple model in which the gas and dust are well-mixed in a disc with a continuous structure between 20 and 200 AU, but this is not a unique solution. Our modelling effort allows us to constrain the gas-to-dust mass ratio as well as the relative abundance of the PAHs in the disc by simultaneously fitting the lines of several species that originate in different regions. Our results are inconsistent with a gas-poor disc with a large UV excess; a gas mass of 5.0 ±2.0 × 10-3$M_{\odot}$is still present in this disc, in agreement with earlier CO observations.

In an effort to simultaneously study the gas and dust components of the disc surrounding the young Herbig Ae star HD 169142, we present far-IR observations obtained with the PACS instrument onboard the HerschelSpace Observatory. This work is part of the open time key program GASPS, which is aimed at studying the evolution of protoplanetary discs. To constrain the gas properties in the outer disc, we observed the star at several key gas-lines, including [OI] 63.2 and 145.5 μm, [CII] 157.7 μm, CO 72.8 and 90.2 μm, and o-H2O 78.7 and 179.5 μm. We only detect the [OI] 63.2 μm line in our spectra, and derive upper limits for the other lines. We complement our data set with PACS photometry and 12/13CO data obtained with the Submillimeter Array. Furthermore, we derive accurate stellar parameters from optical spectra and UV to mm photometry. We model the dust continuum with the 3D radiative transfer code MCFOST and use this model as an input to analyse the gas lines with the thermo-chemical code ProDiMo. Our dataset is consistent with a simple model in which the gas and dust are well-mixed in a disc with a continuous structure between 20 and 200 AU, but this is not a unique solution. Our modelling effort allows us to constrain the gas-to-dust mass ratio as well as the relative abundance of the PAHs in the disc by simultaneously fitting the lines of several species that originate in different regions. Our results are inconsistent with a gas-poor disc with a large UV excess; a gas mass of 5.0 ±2.0 × 10-3$M_{\odot}$is still present in this disc, in agreement with earlier CO observations.

The HerschelGASPS key program is a survey of the gas phase of protoplanetary discs, targeting 240 objects which cover a large range of ages, spectral types, and disc properties. To interpret this large quantity of data and initiate self-consistent analyses of the gas and dust properties of protoplanetary discs, we have combined the capabilities of the radiative transfer code MCFOST with the gas thermal balance and chemistry code ProDiMo to compute a grid of ≈300 000 disc models (DENT). We present a comparison of the first Herschel/GASPS line and continuum data with the predictions from the DENT grid of models. Our objective is to test some of the main trends already identified in the DENT grid, as well as to define better empirical diagnostics to estimate the total gas mass of protoplanetary discs. Photospheric UV radiation appears to be the dominant gas-heating mechanism for Herbig stars, whereas UV excess and/or X-rays emission dominates for T Tauri stars. The DENT grid reveals the complexity in the analysis of far-IR lines and the difficulty to invert these observations into physical quantities. The combination of Herschelline observations with continuum data and/or with rotational lines in the (sub-)millimetre regime, in particular CO lines, is required for a detailed characterisation of the physical and chemical properties of circumstellar discs.

Context. Circumstellar discs are ubiquitous around young stars, but rapidly dissipate their gas and dust on timescales of a few Myr. The HerschelSpace Observatory allows for the study of the warm disc atmosphere, using far-infrared spectroscopy to measure gas content and excitation conditions, and far-IR photometry to constrain the dust distribution.

Planets are formed in disks around young stars. With an age of ~10 Myr, TW Hya is one of the nearest T Tauri stars that is still surrounded by a relatively massive disk. In addition a large number of molecules has been found in the TW Hya disk, making TW Hya the perfect test case in a large survey of disks with Herschel–PACS to directly study their gaseous component. We aim to constrain the gas and dust mass of the circumstellar disk around TW Hya. We observed the fine-structure lines of [O i] and [C ii] as part of the open-time large program GASPS. We complement this with continuum data and ground-based 12CO 3–2 and 13CO 3–2 observations. We simultaneously model the continuum and the line fluxes with the 3D Monte-Carlo code MCFOSTand the thermo-chemical code ProDiMoto derive the gas and dust masses. We detect the [O i] line at 63 μm. The other lines that were observed, [O i] at 145 μm and [C ii] at 157 μm, are not detected. No extended emission has been found. Preliminary modeling of the photometric and line data assuming [ 12CO] /[ 13CO]  = 69 suggests a dust mass for grains with radius <1 mm of ~1.9 × 10-4$M_{\odot}$(total solid mass of 3 × 10-3$M_{\odot}$) and a gas mass of (0.5–5) × 10-3$M_{\odot}$. The gas-to-dust mass may be lower than the standard interstellar value of 100.