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Introduction: Diabetes mellitus (DM) is a common disease with a highly significant burden among the Saudi population. This study aimed to investigate the effects of adding either magnetic or laser therapy to medications in patients with diabetic peripheral neuropathy (DPN). Methods: Seventy-one medically controlled diabetic patients were randomly assigned to 1) Magnetic group: 26 patients were exposed to magnetic therapy for 20 minutes/session, 2 sessions/week, for 3 months 2) Laser group: 25 patients were exposed to laser therapy with intensity 5.7 J/cm2 for 30 minutes/session, 2 times/week, for 3 months. 3) Drug group: 20 patients received only the regular medications for diabetic control and pain analgesia. Pain and neuropathy were assessed by the visual analog scale (VAS) and the Toronto Clinical Neuropath Scoring System (TRCNSS). Conduction velocities and amplitudes of peroneal and sural nerves were measured by electromyography. Results: The results showed significant increases in conduction velocities and amplitudes in both magnetic and laser groups in parallel with significant reductions in TRCNSS. Non-significant changes were obtained only after using only medications (P>0.05). The mean values of VAS reduced significantly in the three groups. The least significant differences showed significant changes among the three groups, whereas non-significant differences were obtained between both magnetic and laser groups. Conclusion: There were non-significant differences between both magnetic and laser therapy groups. Addition of either magnetic or laser therapy to medications could bring extra positive benefits to patients with DPN. Both magnetic and laser therapy can be applied with medications for the treatment of patients with DPN.

This study aims at developing models to predict the operating speeds of passenger cars on horizontal curves of rural multi-lane highways. A total of 16 compound curves and 35 simple curves located on two major rural multi-lane divided highways in Jordan were selected for the study. Continuous speed data were collected using an affordable (low cost) speedometer application loaded on smartphones equipped with Global Positioning System (GPS) technology. A stepwise multiple linear regression analysis at a 95% confidence interval has been performed to develop the speed prediction models. The obtained model at the beginning of the compound curve indicated that the 85th percentile speed at the midpoint of approach independent tangent and the deflection angle of the first curve is found to be statistically significant to predict operating speed. At both points of the compound curve and end of the curve, the significant variables were the radius of the first curve and the total length of the compound curve. For simple curves, the obtained models indicated that the curve radius and the 85th percentile speed at the midpoint of approach independent tangents were positively correlated with the operating speed at beginning of curve, while the degree of curvature was negatively correlated with the operating speed at both middle and end of the curve.

AimsDemineralised bone matrix (DBM) is rarely used for the local delivery of prophylactic antibiotics. Our aim, in this study, was to show that a graft with a bioactive glass and DBM combination, which is currently available for clinical use, can be loaded with tobramycin and release levels of antibiotic greater than the minimum inhibitory concentration for Staphylococcus aureus without interfering with the bone healing properties of the graft, thus protecting the graft and surrounding tissues from infection.Materials and MethodsAntibiotic was loaded into a graft and subsequently evaluated for drug elution kinetics and the inhibition of bacterial growth. A rat femoral condylar plug model was used to determine the effect of the graft, loaded with antibiotic, on bone healing.ResultsWe found that tobramycin loaded into a graft composed of bioglass and DBM eluted antibiotic above the minimum inhibitory concentration for three days in vitro. It was also found that the antibiotic loaded into the graft produced no adverse effects on the bone healing properties of the DBM at a lower level of antibiotic.ConclusionThis antibiotic-loaded bone void filler may represent a promising option for the delivery of local antibiotics in orthopaedic surgery. Cite this article: Bone Joint J 2016;98-B:1126–31.

As health care practitioners, dental hygienists need information-gathering skills and the confidence to both perform literature searches in Internet databases and assess the results in order to utilize the wealth of scientific literature that supports evidence-based practice. The aim of this study was to assess the information-seeking strategies of dental hygienists. A self-administered electronic survey of thirty-eight questions was sent to 5,007 licensed dental hygienists in District III of the American Dental Hygienists’ Association. The overall response rate was 7.9 percent (396/5,007). Most (90.9 percent) of the respondents were currently practicing dental hygiene, with 62.9 percent having practiced more than ten years. Approximately 56 percent had graduated from a two-year dental hygiene program and had graduated before 1998. Nearly all of the respondents who graduated in 1999 or after were confident using a computer (96.2 percent) and the Internet (95.4 percent); lower percentages of the pre-1999 graduates expressed such confidence (68.6 percent using a computer and 80.7 percent using the Internet). Most respondents (90.9 percent) who graduated in 1999 or after reported receiving evidence-based decision making (EBDM) training in their dental hygiene program— an increase over the 51.8 percent of pre-1999 graduates who reported having received it—though lower percentages (78.2 and 48.0 percent, respectively) reported thinking their EBDM training was adequate. Though the response rate was low, these results may suggest that information-gathering skills are being more effectively addressed in recent dental hygiene education than previously. Continuing education courses that teach hands-on navigation of databases and methods to search the scientific literature and analytically appraise it could increase both the skills and comfort level of dental hygienists, especially those who graduated more than a decade ago.

Ensuring the privacy of digital data saved on computer systems and the information transmitted through the web or other computer systems is considered the primary aim of encryption. Recent encryption algorithms play a vital role in assuring the security of Information Technology Systems and Communications, given that they can provide confidentiality, authentication, integrity, and non-repudiation. In the present paper, we propose NASE as a Novel Algorithm in Symmetric Encryption based on the Feistel Cipher structure with newly added features that will enhance the security of the encrypted data. NASE involves generating a random number of block size, iterations, and different keys for each block, which are generated automatically. The proposed algorithm works for more than one language (e.g., English, Arabic, etc.) and it is possible to use double or triple encryption with different keys for additional security. In addition to the complexity of the algorithm, NASE is very fast and is easily applied to different applications.

Deep brain stimulation (DBS) has shown promise for relieving nociceptive and neuropathic symptoms of refractory chronic pain. We assessed the efficacy of a new target for the affective component of pain, the anterior cingulate cortex (ACC). A 49-year-old man with neuropathic pain underwent bilateral ACC DBS. Patient-reported outcome measures were collected before and 2 years after surgery using a Visual Analogue Scale, Short-Form 36 quality of life survey, McGill pain questionnaire, EuroQol-5D questionnaires (EQ-5D; Health State) and neuropsychological assessments. The patient improved with DBS. Two years after surgery, the Visual Analogue Scale decreased from 6.7 to 3.0, McGill pain questionnaire improved by 42% and EQ-5D Health State increased by 150%. Stimulating the ACC at 130 Hz, 330 µs and 3 V facilitated neuropathic pain relief. The DBS remained efficacious during the 2-year follow-up period. Affective ACC DBS can relieve chronic neuropathic pain refractory to pharmacotherapy and restore quality of life.

Synoptic variations of atmospheric CO2 produced by interactions between weather and surface fluxes are investigated mechanistically and quantitatively in midlatitude and tropical regions using continuous in-situ CO2 observations in North America, South America and Europe and forward chemical transport model simulations with the Parameterized Chemistry Transport Model. Frontal CO2 climatologies show consistently strong, characteristic frontal CO2 signals throughout the midlatitudes of North America and Europe. Transitions between synoptically identifiable CO2 air masses or transient spikes along the frontal boundary typically characterize these signals. One case study of a summer cold front shows CO2 gradients organizing with deformational flow along weather fronts, producing strong and spatially coherent variations. In order to differentiate physical and biological controls on synoptic variations in midlatitudes and a site in Amazonia, a boundary layer budget equation is constructed to break down boundary layer CO2 tendencies into components driven by advection, moist convection, and surface fluxes. This analysis suggests that, in midlatitudes, advection is dominant throughout the year and responsible for 60–70% of day-to-day variations on average, with moist convection contributing less than 5%. At a site in Amazonia, vertical mixing, in particular coupling between convective transport and surface CO2 flux, is most important, with advection responsible for 26% of variations, moist convection 32% and surface flux 42%. Transport model sensitivity experiments agree with budget analysis. These results imply the existence of a recharge-discharge mechanism in Amazonia important for controlling synoptic variations of boundary layer CO2, and that forward and inverse simulations should take care to represent moist convective transport. Due to the scarcity of tropical observations at the time of this study, results in Amazonia are not generalized for the tropics, and future work should extend analysis to additional tropical locations.

Objective: To investigate microbiology laboratory reporting policies, whether practitioners working in primary care adhered to the relevant guidelines when submitting swabs from venous leg ulcers (VLUs), and the impact of laboratory reports on antibiotic usage for VLUs. Method: Questionnaires were sent to all microbiology laboratories in England and Wales, and to clinicians who had submitted VLU swabs to one laboratory. Results: Ninety-five (47%) laboratories responded. Laboratories processed a mean of 7.3 leg ulcer swabs/100,000 population/week but were often unable to identify the leg ulcer aetiology from the clinical details provided. All laboratories stated that they routinely reported group A haemolytic streptococci and meticillin-sensitive and resistant Staphylococcus aureus; 75% always reported antibiotic susceptibility for these isolates. The majority reported other beta-haemolytic streptococci. A total of 126 clinicians (64%) returned their questionnaires; 100 had confirmed in their swab submission that the ulcer was of venous aetiology and so were included in the analysis. Eighty per cent of the swabs were submitted in accordance with guidelines, with increased pain (61%) being the most common reason. Discharge/exudate (52%) and malodour (41%) were common reasons for swab submissions, even though the guidelines do not cite them as clinical signs of infection. Reporting of antibiotic susceptibilities was associated with increased antibiotic usage. Conclusion: Clinicians in primary care generally adhere to guidelines when submitting VLU specimens for microbiological investigation. Clinicians need to include clinical information with the swab so that laboratories can interpret the microbiology results. To reduce the use of antibiotics in the management of VLUs, laboratories need to be selective in their organism and antibiotic-susceptibility reporting. Declaration of interest: None.

Registration on a primary care disease register is a necessary first step for the provision of systematic care for ischaemic heart disease (IHD). We examined whether there is any potential bias in IHD registration based upon the ethnic origin of the patient.'Observed' rates of ischaemic heart disease registration from 12 general practices in Bristol were contrasted with national 'expected' rates derived from the Health Survey for England, 1999, with the aim of comparing rates of registration between patients whose countries of origin were South Asian and non-South Asian. Ethnicity was classified by the patients' surname. Data were stratified by age, sex and ethnicity.Overall, no major differences in 'observed' and 'expected' rates of registration between South Asian and non-South Asians were observed. In general, however, 'observed' rates were lower than the 'expected' rates for both groups.We found no overall bias in IHD registration based upon the patient's ethnic origin but we did observe generally low rates of IHD registration overall.

The theory of Fatou and Julia has been extended in [3] for the class of functions that are meromorphic outside a sufficiently small, non-empty totally disconnected compact set of essential singularities. For a certain subclass of these functions we study (a) accessibility of boundary points of the Fatou components and (b) the number of completely invariant domains.

HgCdTe 2D arrays are needed in both medium (MW) and long (LW) wavebands for imaging, search, and track and guidance applications. Often the detector is the performance-limiting component in the system, and it is necessary to use detectors with very low excess noise and few defective pixels. Normally the detector is cooled sufficiently to freeze-out thermally generated leakage currents, so the main interest is to understand the mechanisms that determine the general detector performance and the cause of defective pixels. This paper describes the detector technology and the ion beam junction-forming process. The fundamental performance limits of homojunction HgCdTe technology and the doping levels needed to produce a detector with impact-ionization limited performance are discussed. Extensive studies have been made on defective pixels in long wavelength arrays and some technologies for reducing them are described here. Defective pixels have been found to be associated with material dislocations crossing the p-n junction and a model has been proposed for the noise-generating mechanism.

Dedicated to George Szekeres on his 90th birthdayFor a transcendental entire function f let M(r) denote the maximum modulus of f(z) for |z| = r. Then A(r) = log M(r)/logr tends to infinity with r. Many properties of transcendental entire functions with sufficiently small A(r) resemble those of polynomials. However the dynamical properties of iterates of such functions may be very different. For instance in the stable set F(f) where the iterates of f form a normal family the components are preperiodic under f in the case of a polynomial; but there are transcendental functions with arbitrarily small A(r) such that F(f) has nonpreperiodic components, so called wandering components, which are bounded rings in which the iterates tend to infinity. One might ask if all small functions are like this.A striking recent result of Bergweiler and Eremenko shows that there are arbitrarily small transcendental entire functions with empty stable set—a thing impossible for polynomials. By extending the technique of Bergweiler and Eremenko, an arbitrarily small transcendental entire function is constructed such that F is nonempty, every component G of F is bounded, simply-connected and the iterates tend to zero in G. Zero belongs to an invariant component of F, so there are no wandering components. The Julia set which is the complement of F is connected and contains a dense subset of “buried’ points which belong to the boundary of no component of F. This bevaviour is impossible for a polynomial.

Reduction of stroke burden requires preventive interventions targeted at important risk factors. This report presents the analysis of risk factors for ischaemic stroke from a representative cohort of middle aged men from South Wales and south-west England. Data on risk factors were collected through validated questionnaires and physical and clinical measurements. Details of possible cerebrovascular events were retrieved, classified into ischaemic, haemorrhagic and uncertain subtypes, and validated. The ratio of definite ischaemic to definite haemorrhagic strokes was calculated. This showed that the vast majority of strokes of unknown subtype were likely to ischaemic. After exclusion of known haemorrhagic strokes and subarrachnoid haemorrhages the remaining strokes were labelled ischaemic. Hazard ratios for possible risk factors were calculated for all ischaemic, and for fatal and non-fatal strokes. There were 293 ischaemic strokes. Statistically significant age-adjusted hazard ratios were: 1.50 (95% confidence interval 1.16–1.95) for being in a manual social class, 1.82 (1.24–2.67) if smoking >15 cigarettes/d at enrolment, 1.19 (1.13–1.24) and 1.23 (1.14–1.34) per 10 mmHg increase in systolic and diastolic blood pressure, respectively, 0.67 (0.46–0.96) for the top quintile high density lipoprotein-cholesterol:cholesterol ratio compared to the bottom quintile, 2.04 (1.40–2.99) for presence of angina, 3.90 (2.01–7.58) for presence of atrial fibrillation, and 3.35 (1.90–5.80) for presence of diabetes. Risk factors were more strongly associated with fatal than non-fatal strokes. Multivariate analyses revealed that, while there was some attenuation of the effect of social class, angina and elevated BP, the risks from atrial fibrillation and diabetes were increased

In general the Julia set of an entire or meromorphic function is either connected or has an uncountable set of components. Conditions are found which ensure the second alternative. If a transcendental entire function has a completely invariant Fatou component then its Julia set is locally connected at no point in the plane. If the Julia set of a transcendental entire function is locally connected at some point, then the Julia set is connected. An entire function is constructed for which every periodic point is repelling, is a singleton component of the Julia set and lies on the boundary of no Fatou component.

Let f be a non-Mobius self-map of C *. Write J *(f) for the Julia Set of f in Ĉ and J(f) for the closure of J *(f) in C. Then we have one of the three cases (i)J(f), J *(f) are connected, (ii)J(f) is connected, J *(f) has infinitely many components, (iii)J(f) has two components, J *(f) has infinitely many components. All three cases can occur. It is known that F(f) has at most one multiply-connected domain A whose connectivity must in fact be two. If in addition A is relatively compact in nC *, then either (i) A is a Herman ring, (ii) A is pre-periodic but nor periodic, or (iii) A is a wandering component Example of all three cases are constructed.

The Caerphilly and Speedwell studies have previously reported the predictive power of heat-precipitation, nephelometric, fibrinogen for 10-year incidence of ischaemic heart disease. A Clauss, clotting time, fibrinogen was also measured at baseline, but has not previously been reported. The predictive power of the two assays is compared. Both methods were employed on fasting blood samples from a total of 4391 men aged 45–63 years. Over the following 10 years 533 (12%) developed major ischaemic heart disease. Nephelometric fibrinogen was higher by 0.33 g/l among the men who developed disease; clottable fibrinogen was higher by 0.20 g/l. This difference is statistically significant (P = 0.01). Relative odds of developing heart disease increased steadily to 3.53 (P < 0.0001) in the 20% of men with the highest nephelometric fibrinogen; for clottable fibrinogen the corresponding relative odds increased to 2.24 (P < 0.0001). When both measures of fibrinogen were included in logistic regression models together with age and smoking habit, the trend for incidence to increase with increasing nephelometric fibrinogen remained highly significant (P < 0.0001), whereas for the Clauss fibrinogen the trend almost entirely disappeared (P = 0.37). We conclude that functional assays of clottable fibrinogen may not reflect all of the mechanisms which mediate the association between fibrinogen and cardiovascular disease and that assays of both ‘heat precipitable’ and ‘clottable’ fibrinogen should be included in all future prospective studies.

There are currently more than 40 million people over the age of 65 in the United States. Many of these Older Adults find it difficult to leave home for a variety of health and psychological reasons including multiple and complex chronic conditions such as heart disease, lung disease, diabetes, pain, depression, cognitive and mobility impairments or lack of caregiver support. Where do these patients receive theirhealth careand inwhat settingmakes themost sense for these frail individuals? What happens when a patient is unable to get into a traditional office practice for routine medical care and follow-up? Multiple studies suggest they end up in the ER or hospitalized for conditions that could have been prevented with earlier diagnosis and treatment. Many receive futile care that is not in-line with their values or consistent with the trajectory of their decline because of the absence of a health caredirective. One current National health care focus is on developing ways to prevent avoidable hospital readmissions as well as associated costs not only in dollars and cents but in the human burden of suffering that accompanies frequent hospitalizations and ER visits. Atul Gawande, in his January 24, 2011 New Yorker article “The Hot spotters” discusses the savings to be had while providing excellence in Primary Care by concentrating on the sickest, highest cost users of health care. those who are most often homebound and currently receiving their “primary care” in the ER and hospital settings. For all of these reasons, House Calls are a rapidly growing arena for Nurse Practitioner involvement. Whether it’s running an independent House Calls Primary Care Practice full time, or whether it’s scheduling a few visits to homebound patients from a regular clinic or office practice, these visits to Older Adults in their home settings are a valuable benefit to our communities that will extend the spectrum of health care services and improve access to care for frail Older Adults. This venue for NP practice providing longitudinal care in the home setting is also rewarding and multi-dimensional. Given our

Earth system processes exhibit complex patterns across time, as do the models that seek to replicate these processes. Model output may or may not be significantly related to observations at different times and on different frequencies. Conventional model diagnostics provide an aggregate view of model-data agreement, but usually do not identify the time and frequency patterns of model misfit, leaving unclear the steps required to improve model response to environmental drivers that vary on characteristic frequencies. Wavelet coherence can quantify the times and frequencies at which models and measurements are significantly different. We applied wavelet coherence to interpret the predictions of twenty ecosystem models from the North American Carbon Program (NACP) Site-Level Interim Synthesis when confronted with eddy covariance-measured net ecosystem exchange (NEE) from ten ecosystems with multiple years of available data. Models were grouped into classes with similar approaches for incorporating phenology, the calculation of NEE, and the inclusion of foliar nitrogen (N). Models with prescribed, rather than prognostic, phenology often fit NEE observations better on annual to interannual time scales in grassland, wetland and agricultural ecosystems. Models that calculate NEE as net primary productivity (NPP) minus heterotrophic respiration (HR) rather than gross ecosystem productivity (GPP) minus ecosystem respiration (ER) fit better on annual time scales in grassland and wetland ecosystems, but models that calculate NEE as GPP – ER were superior on monthly to seasonal time scales in two coniferous forests. Models that incorporated foliar nitrogen (N) data were successful at capturing NEE variability on interannual (multiple year) time scales at Howland Forest, Maine. Combined with previous findings, our results suggest that the mechanisms driving daily and annual NEE variability tend to be correctly simulated, but the magnitude of these fluxes is often erroneous, suggesting that model parameterization must be improved. Few NACP models correctly predicted fluxes on seasonal and interannual time scales where spectral energy in NEE observations tends to be low, but where phenological events, multi-year oscillations in climatological drivers, and ecosystem succession are known to be important for determining ecosystem function. Mechanistic improvements to models must be made to replicate observed NEE variability on seasonal and interannual time scales.

GEC-Marconi Infra-Red Limited (GMIRL) is Europe's largest supplier of infrared detectors. Its leading position in this field is illustrated in this article by describing the key detector technologies that will supply major projects into the year 2000, and beyond.

We consider polynomials of the form , where q ≤ 2 and show that, for . the Hausdorff dimension of the Julia set of such a polynomial satisfics where . This enables is to obtain an explict value for a bound given by Eremenko for the growth of the mean spherical derivative of a polynomial.

The purpose of this study was the evaluation of community based optometric monitoring of stable glaucoma patients and glaucoma suspects compared to the routine Hospital Eye Services (HES) monitoring. Four hundred and five subjects were recruited from routine outpatient clinics at the Bristol Eye Hospital. All eligible participants were seen in the routine hospital clinic and then within two months were given a 'Gold Standard Assessment' (GSA) by an independent research team. Participants then visited one of 12 glaucoma-trained optometrists, for a standard battery of tests. Randomisation resulted in 204 subjects being allocated to community care, with reviews on a six monthly basis, with 201 who remained a control group within the hospital. Referral criteria were established to enable optometric detection of apparent glaucomatous progression. A questionnaire was used to assess patient satisfaction with both care types. Additionally a cost analysis exercise was performed.

Background An evaluation of progress with participatory approaches for improvement of health knowledge and health experiences of disadvantaged people in eight Districts of Eastern Nepal has been undertaken. Methods A random selection of Village Development Committees and households, within the eight Districts where participation and a Rights-based Approach had been promoted specifically by local NGOs were compared with similar villages and households in eight Districts where this approach had not been promoted. Information was sought by structured interview and observation by experienced enumerators from both groups of householders. Health knowledge and experiences were compared between the two sets of households. Adjustments were made for demographic confounders. Results Complete data sets were available for 628 of the 640 households. Health knowledge and experiences were low for both sets of households. However, health knowledge and experiences were greater in the participatory households compared with the non-participatory households. These differences remained after adjustment for confounders. Conclusions The study was designed to evaluate progress with participatory processes delivered by non-governmental organisations over a five year period. Improvements in health knowledge and experiences of disadvantaged people were demonstrated in a consistent and robust manner where interventions had taken place.

The minimum speed for just-suspension,Njs, of porous palm shell-activated carbon (PSAC) particles has been determined in a 15 cm diameter cylindrical tank using a 6-curved blade (6CB) impeller, compared to a 6-blade downpumping mixed-flow (6MFD) impeller and a Rushton turbine (6DT). The particles size ranged from 0.75–1.00 mm, 1.00–1.40 mm, and 1.40–2.36 mm with concentrations between 0 and 5% by weight. The 6CB being a radial impeller performed similarly to 6DT in terms of speed and power requirement at just-suspension, and particles distribution on the base. The 6MFD, with power requirement 100% to 200% less than the radial impellers, was the most efficient for suspending the particles, as usually reported for the range of solid concentrations used here. Specific power per unit mass for all three impellers showed reduction towards minima as the concentration of particles increased. The geometric factor,S, values agreed reasonably with published data, when the particle density was adjusted taking into account water filling the pores of the submerged activated carbon. This result means that Zwietering’s equation can be used to predict suspension for porous particles with adjustment to the particle density.Svalues for curved-blade impellers are presented for the first time.

The Tapuaenuku Igneous Complex (TIC) is a mid‐Cretaceous layered intrusion and dike swarm cropping out at the axis of the Inland Kaikoura Ranges, South Island, New Zealand. The TIC is part of an extensive, but poorly preserved, igneous province that formed during or after cessation of subduction along the margin of Gondwana c. 100 Ma ago. The TIC is a complex, multiphase intrusion that is subdivided into eight units (in order of relative emplacement): (1) radial dike swarm—basanite, trachybasalt, and shoshonite/latite dikes; (2) Layered Series (LS)—basin‐shaped mafic cumulate rocks; (3) Staircase Intrusives— noncumulate gabbro and monzogabbro enclosed by a discontinuous sheet of cumulate gabbro; (4) Lower Hodder Gabbro and minor gabbroic intrusives—small stocks of noncumulate gabbro, monzogabbro, and monzonite; (5) Red Hills Breccia Pipe—heterolithic breccia emplaced in a pipe or diatreme; (6) Hodder Intrusives—a monzonite and sodalite syenite laccolith intruding the LS; (7) monzonite, orthoclase...

Human conversion of natural ecosystems to croplands modifies not only the exchange of water and energy between the surface and the atmosphere, but also carbon fluxes. To investigate the impacts of crops on carbon fluxes and resulting atmospheric CO2 concentrations in the mid-continent region of the United States, we coupled a crop-specific phenology and physiology scheme for corn, soybean and wheat to the coupled ecosystem–atmosphere model SiB3–RAMS. Using SiBcrop–RAMS improved carbon fluxes at the local scale and had regional impacts, decreasing the spring uptake and increasing the summer uptake over the mid-continent. The altered fluxes changed the mid-continent atmospheric CO2 concentration field at 120 m compared to simulations without crops: concentrations increased in May and decreased >20 ppm during July and August, summer diurnal cycle amplitudes increased, synoptic variability correlations improved and the gradient across the mid-continent region increased. These effects combined to reduce the squared differences between the model and high-precision tower CO2 concentrations by 20%. Synoptic transport of the large-scale N–S gradient caused significant day-to-day variability in concentration differences measured between the towers. This simulation study shows that carbon exchange between crops and the atmosphere significantly impacts regional CO2 fluxes and concentrations.DOI: 10.1111/j.1600-0889.2010.00485.x

Conventionally, measurements of carbon isotopes in atmospheric CO2 (δ13CO2) have been used to partition fluxes between terrestrial and ocean carbon pools. However, novel analytical approaches combined with an increase in the spatial extent and frequency of δ13CO2 measurements allow us to conduct a global analysis of δ13CO2 variability to infer the isotopic composition of source CO2 to the atmosphere (δs). This global analysis yields coherent seasonal patterns of isotopic enrichment. Our results indicate that seasonal values of δs are more highly correlated with vapor pressure deficit (r=0.404) than relative humidity (r=0.149). We then evaluate two widely used stomatal conductance models and determine that Leuning Model, which is primarily driven by vapor pressure deficit is more effective globally at predicting δs (RMSE = 1.7 ‰) than the Ball-Berry model, which is driven by relative humidity (RMSE = 2.8) ‰. Thus stomatal conductance on a global scale may be more sensitive to changes in vapor pressure deficit than relative humidity. This approach highlights a new application of using δ13CO2 measurements to test global models.

As part of the Speedwell study, traffic noise exposure and risk factors for ischemic heart disease were studied in a sample of 2,348 men whose ages ranged from 45 to 63 y. The road traffic noise emission level, Leq, ranged between 51 and 70 dB(A) (6-22 h, 10-m distance). Significant associations were found between noise and potential ischemic heart disease risk factors, including total triglycerides, platelet count, plasma viscosity, glucose (increases), and systolic and diastolic blood pressure (decreases). Not all results support the hypothesis that traffic noise increases ischemic heart disease risk. The results were controlled for a number of potential confounding factors.

Summary Background Few population-based longitudinal studies on diet and stroke have been conducted, and associations between dietary fat and fish intake and risk of stroke are unclear. Objectives To prospectively examine relationships between intakes of total fat, saturated fat, unsaturated fat, white fish and oily fish and risk of stroke in a well-defined population of 2710 middle-aged men. Study design Prospective cohort study. Methods Detailed information on health and lifestyle factors was collected via interview, and diet was assessed on three occasions using a food frequency questionnaire. Stroke ascertainment was by self-report and inspection of clinical records. Extracted data were assessed by two independent experts. Results During a median follow-up of 18 years, 225 strokes (209 ischaemic and 19 haemorrhagic) were eligible for inclusion in the analyses. For most recent diet (i.e. food frequency questionnaire data collected immediately prior to the stroke event), there was a slightly lower risk of stroke with higher intakes of unsaturated fat and oily fish. Multiple adjusted hazard ratios (HRs) for the lowest vs highest quintiles of unsaturated fat and oily fish intakes were 0.66 [95% confidence interval (CI) 0.41–1.05, P trend = 0.13] and 0.66 (95% CI 0.41–1.05, P trend = 0.09), respectively. Baseline and cumulative diets showed a slightly higher risk of stroke with higher intake of white fish; HRs for the lowest vs highest quintiles were 1.16 (95% CI 0.76–1.77, P trend = 0.22) and 1.28 (95% CI 0.77–2.13, P trend = 0.48), respectively. Conclusions Overall, strong associations were not found between intakes of different types of fat and fish and risk of stroke in middle-aged men. The inverse associations between unsaturated fat and oily fish intakes and risk of stroke were weak, but the direction of association was broadly consistent with other studies; however, these relatively weak associations were not conventionally statistically significant.

The predictive power of height for future ischaemic heart disease (IHD) was examined in 4860 men from two communities in South Wales and the West of England. At follow-up, men in the shortest fifth of the height distribution had experienced twice as many incident IHD events (fatal and non-fatal myocardial infarction) as was the case for men from the tallest fifth. Adjustment for age, social class and smoking habit failed to alter these relationships significantly. In the data from South Wales, determinants of height were examined; birth rank and number of siblings showed a trend with height. This trend was found only in men whose fathers were manual workers and may be related to inadequate nutrition in the higher birth ranks and larger families. These results support the suggestion that early childhood factors may be relevant to IHD in middle age and possible mechanisms are discussed.

The paper discusses the connectivity of periodic and preperiodic domains in the stable set in the iteration of a meromorphic function. The connectivity of an invariant component has one of the values 1, 2, ∞. Examples are constructed to show that the connectivity of a preperiodic component may take any value.

For functions meromorphic in the plane, apart from an exceptional case, the Julia set J is the closure of the set of all preimages of poles. The repelling periodic cycles are dense in J. In contrast with the case of transcendental entire functions, J may be a subset of a straight line and general classes of functions for which this is the case can be determined. J may also lie on a quasicircle through infinity which is not a straight line.

This paper describes long wavelength (LW) infra-red detectors made from HgCdTe grown by Metal Organic Vapour Phase Epitaxy (MOVPE) and the performance in a low photon flux background compatible with a multispectral requirement. The detectors are staring, focal plane arrays consisting of HgCdTe mesa-diode arrays bump bonded to silicon read-out circuits. The HgCdTe structure is grown on GaAs and consists of an absorber layer sandwiched between wider band-gap cladding layers. Device processing is wafer-scale. Wet etching is used to define the mesas and the mesa sidewalls are passivated with inter-diffused CdTe. The GaAs substrate is removed after bump bonding to minimise the thermal stress on cooling. The technology is sufficiently advanced to enable production not only of LWIR detectors but also dual band MWIR/LWIR detectors, as reported last year. Cameras for both types have been developed. There is now increasing interest in using the technology for LWIR multispectral imaging. Due to the requirement for narrow bandwidths, resulting in low radiant flux, the diode quality, in terms of dark current and resistance, must be exceptionally good. This requirement has been difficult to achieve in many technologies, however MOVPE grown MCT has consistently provided LWIR arrays with the necessary low dark current and high resistance. Performance from arrays of size 640x512 with 24 μm pixels and having a cut-off of 10 μm will be described. These achieve diode impedances of several GΩ's with less than 1 nA dark current at 90K.

As part of two large heart surveys, associations between traffic noise exposure and cardiovascular risk factors were studied. The Caerphilly sample (small town, total sample) consisted of 2512 men aged 45 to 59 years and the Speedwell sample (suburb of a major city, random sample) of 2030 men of same age group. Both studies have a prospective design; cross-sectional results are presented here. Acoustic measurements were carried out in both areas. Among the possible risk factors for ischaemic heart disease studied were blood pressure, blood coagulation, blood lipids and other biochemical factors. Statistically significant noise effects were detected for systolic blood pressure, total cholesterol, HDL cholesterol, total triglycerides, blood viscosity, platelet count and glucose level, although not all of these were consistent with noise being a risk factor for heart disease. In a subsample, the additional influence of work noise as determined by noise dosimetry was studied in 255 men, taking the use of ear protection into account. The associations between traffic noise and risk factors were more pronounced in men who also were exposed to high work noise levels.

To examine whether there are ethnic differences in the healthcare-seeking behaviour and management of patients with chest pain.Prospective cohort of patients attending accident and emergency departments with chest pain.Hospitals in England and Wales from 1 January 2002 to 31 December 2003.Patients with chest pain.Whether patients arrived by ambulance, whether they received thrombolysis and the time it took from symptom onset to arrive at hospital and receive thrombolysis.South Asian patients were less likely to arrive by ambulance (age and sex adjusted odds ratio 0.64, 95% CI 0.60 to 0.69, p0.001) regardless of admission diagnosis. Overall, they were more likely to receive thrombolysis (adjusted multivariable odds ratio 1.19, 95% CI 1.10 to 1.30, p0.001) and the difference was more marked if they had non-specific ECG changes for heart disease rather than definite evidence of a myocardial infarction. There was no evidence of an important clinical delay in South Asians receiving thrombolysis after arrival at hospital.There are ethnic differences in healthcare-seeking behaviour and the way doctors manage South Asians with chest pain. The relative underuse of ambulances by South Asians may either reflect cultural differences or geographical proximity to hospitals. Doctors may have a lower threshold for giving thrombolytic therapy to South Asian men with chest pain possibly because they are aware of the increased risk of coronary heart disease in this population.