Mortality among male anaesthetists in the United Kingdom, 1957-83.

A cohort of 3769 male anaesthetists resident in the United Kingdom between 1957 and 1983 was followed up for a total of 51,431 person years of observation. All subjects were fellows of the Faculty of Anaesthetists and held full registration with the General Medical Council. With all men in social class I being taken as the standard, the standardised mortality ratio among anaesthetists for all causes of death was 68 (95% confidence interval 59 to 77) and the standardised mortality ratio for all cancers was 50 (95% confidence interval 36 to 67). There was no significant excess mortality from lymphomas or leukaemias, but 16 of the 221 deaths in anaesthetists were due to suicide, giving a standardised mortality ratio of 202 (95% confidence interval 115 to 328). When anaesthetists were compared with all doctors the standardised mortality ratio for suicide was only 114, a nonsignificant excess. These findings confirm that the risk of suicide among anaesthetists is twice as high as among other men in social class I but suggest that the risk does not differ significantly from that among doctors as a whole. There was no evidence of a significant excess risk of cancer, and, in particular, the small excess of cancer of the pancreas reported previously could not be confirmed.     

Spatial and temporal variations of Cocconeis placentula var. euglypta (Ehrenb.) 1854 Grunow, 1884 in drift and periphyton

Spatial and temporal variations of Cocconeis placentula var. euglypta in drift and periphyton were studied in mountain streams of the Córdoba Province (Argentina). The sampling program was conducted in study sites located on a confluence between different order streams during an annual cycle. Samples were also taken every two hours during the daylight period in high and low water conditions. The relationship between drift and cellular reproduction was evaluated by valve length biometrics analysis. C. placentula var. euglypta drift was continuous; its density was not always dependent on periphyton density in each locality. C. placentula var. euglypta drift could be related to abiotic factors such as temperature and flow during the annual cycle. There were significant differences between periphyton and drift valve lengths. Moreover, drift can be associated with cellular reproduction because density was higher when valve lengths were shorter at different hours of the day. C. placentula var. euglypta epiphytims on Cladophora glomerata also influenced drift density and size distribution, modifying the relationship between periphyton and drift during the late spring when C. placentula var. euglypta was detached from senescent mats.     

New records of aquatic Oligochaeta from Texas,with observations on their ecological characteristics

Twenty-six species of aquatic oligochaetes are reported from Texas, including 18 Naididae, seven Tubificidae, and one Glossoscolecidae. Illustrations are provided for ten species recorded for the first time from the state: Chaetogaster cristallinus, Nais elinguis, Nais pardalis, Pristina acuminata, Pristina sima, Stylaria lacustris, Aulodrilus limnobius, Ilyodrilus templetoni, Limnodrilus claparedianus, and Sparganophilus tamesis. Species accounts include presently known distributions in Texas and ecological and morphological characteristics.     

Patterns of first-year survival among infants with selected congenital anomalies in Texas, 1995-1997.

BACKGROUND: Few registry-based studies have investigated survival among infants with congenital anomalies. We conducted a registry-based study to examine patterns and probability of survival during the first year of life among infants with selected congenital anomalies. METHODS: Data from the Texas Birth Defects Monitoring Division were merged with linked birth-infant death files for 2,774 infants born January 1, 1995 to December 31, 1997, with at least 1 of 23 common anomalies. Deaths before the first birthday were assessed from infant death files. Kaplan-Meier was used to estimate first-year survival; first-year survival was assessed for specific anomalies and by the number of life-threatening anomalies. RESULTS: Overall, 80.8% of infants with these 23 anomalies survived the first year of life. We observed the highest survival rates for infants with gastroschisis (92.9%, 95% CI = 86.8, 96.3), trisomy 21 (92.3%, 95% CI = 89.5, 94.4) or cleft lip with or without cleft palate (87.6%, 95% CI = 84.0, 90.5). Infants with intermediate survival rates included those with microcephaly (79.7%; 95% CI = 73.6, 84.6), tetralogy of Fallot (75.0%; 95% CI = 65.5, 82.2), or with diaphragmatic hernia (72.8%; 95% CI = 61.8, 81.2). As expected, all infants with anencephaly and almost all infants with trisomy 13 or trisomy 18 died during the first year of life. First-year survival declined as the number of co-occurring life-threatening anomalies increased. CONCLUSIONS: Overall, first-year survival for infants with congenital anomalies was high. Additional population-based studies are needed to quantify improvements in first-year survival.     

Optical depolarization changes on the diffraction pattern in the transition of skinned muscle fibers from relaxed to rigor state

Light diffraction spectra from single or small bundles of skinned striated muscle fibers show large changes in polarization properties when muscles are placed into rigor. The technique of combining optical diffraction and ellipsometry measurements has previously been shown by Yeh and Pinsky to be a sensitive probe of periodic anisotropic regions of the fiber. In the present work, using this method, the observed spectrum shows marked decrease in the measured phase angle, delta, as the fiber approaches the rigor state. The degree of phase angle change is a function of sarcomere length: Maximum overlap of approximately 2.3 microns gives the most change in delta a delta delta R-R approximately 35 degrees decrease for a bundle of three fibers. At a sarcomere length of 2.9 microns this delta delta R-R value is only 10 degrees. At a nonoverlapping length of approximately 3.8 microns, delta does not vary at all upon the removal of ATP. The rigor state was confirmed by stiffness measurements made after small-amplitude (0.75%), quick length changes. Upon re-relaxation, the stiffness of the skinned fiber decreased to the value of the resting state (4 mM ATP) and the phase angle delta returned to its original value. A model based on either anisotropic subunit-2 (S-2) movements or other cross-bridge-related structural anisotropy (form birefringence) changes during the relaxed-rigor transition is suggested.     

Famine in southern Ethiopia 1985-6: population structure,nutritional state,and incidence of death among children.

OBJECTIVE--To assess the effects of drought on mortality in children. DESIGN--Prospective epidemiological study forming part of nutritional monitoring during famine relief work. SETTING--24 Food distribution sites in Arero and Borana provinces in southern Ethiopia. PATIENTS--A monthly average of 14,173 and 5,334 children under 5 were examined in 1985 and 1986, respectively. Altogether 148,966 child months (105,872 for 1985 and 43,094 for 1986) were available for analysis. INTERVENTION--The families of all children were supplied with food each month. Basic medical care was also provided. MAIN OUTCOME MEASURE--Mortality in children under 5. RESULTS--A 40% increase in crude mortality was observed among children living in traditional and stable societies. The severe consequences were observed mainly among children living in relief shelters, where a threefold to fourfold increase in crude mortality was recorded among children. Increased childhood mortality was also associated with high prevalence of malnutrition, living in the most arid areas, and the dry season. A long period of food aid was needed to normalise the nutritional state, especially for children living in relief shelters. CONCLUSIONS--The most severe consequences of the widespread famine that occurred in the Arero and Borana provinces of southern Ethiopia during 1985-6 were seen among children living in relief shelters. Early food intervention may decrease the scale of migration and thus also reduce the severe consequences of a famine.     

Annual pattern of human conception in the State of Texas

A total of 2,828,068 State of Texas singleton conceptions, estimated from the date of the first day of the last menstrual period, were assessed for annual periodicity by multiple-component (1-yr fundamental plus the 6- and 3-month harmonics) Cosinor analysis. An annual pattern (p < 0.001) of conception was detected with a December peak, end of July-beginning of August trough and modest amplitude (total peak-to-trough variation) equal to 13.3% of the yearly mean. Annual patterns (p < 0.005) of generally comparable peak and trough times were also documented for conceptions categorized by maternal marital status, age, ethnicity, years of education, birthplace, and county (Texas-Mexico border vs. non-border) of residence. The amplitude, a measure of the prominence of the annual pattern, varied by race (two-fold greater for non-Hispanic Blacks and Hispanics than non-Hispanic Whites), age (50-60% greater for the 19-year-old and younger group than the 20-29 and 30-44-year-old groups) and maternal education (two-fold greater for those with 0-8 than 13 or more years of schooling). Annual patterns (p < 0.001) in conceptions, generally with December peak and end of July-beginning of August trough, were also detected for neonatal variables categorized by birth weight, birth order, gestational age, and gender. The amplitude of the annual pattern in conceptions varied directly with gestational age and inversely with birth weight class.     

Mortality by cause of death in a rural area of Machakos District, Kenya in 1975-78

This paper examines mortality by cause of death in a rural area of Machakos district in Kenya. The cause-of-death data collected between 1975 and 1978 were likely to be of fairly good quality. The number of deaths was higher among infants and children. Infectious diseases and diseases of the respiratory system were the leading causes of death among children below 5 years of age. Next in prominence were the causes ascribed to congenital anomalies and perinatal conditions. Among adolescents and young adults, injury and poisoning, together with tuberculosis and other infectious and parasitic diseases, were the leading causes of death. Degenerative diseases, especially diseases of the circulatory system and neoplasms and respiratory illness, were responsible for the majority of deaths among the older population.     

Recent decline in the U.S. death rate from myeloproliferative neoplasms, 1999-2006

Background: Myeloproliferative neoplasms (MPNs) are classified as neoplasms of uncertain or unknown behavior in the International Classification of Diseases (ICD) Version 10 and can contribute to risk of death from complications (especially thrombosis). Methods: U.S age-standardized death rates using ICD-Version 10 codes relevant to classical MPN (i.e., polycythemia vera, essential thrombocythemia, and “chronic myeloproliferative disease”) were examined for 1999–2006. The underlying cause of death and also all causes (“multiple causes” or “mentions”) coded on death certificates were considered. Trends were assessed by using percentage change (PC) in rate between 1999 and 2006, and annual percentage change (APC) estimated from linear regression. Results: The decline in death rates was large for MPN, whether based only the underlying cause (PC = ?19.7%, APC = ?3.4%) or on the substantially higher rates based on any cause (PC = ?24.1%, APC = ?3.8%), and was consistent by gender and age group (<65 and 65+ years). For deaths with MPN coded as other than the underlying cause, cardiovascular diseases were the most common underlying cause and the ASR for these deaths declined substantially (PC = ?40.0%). Conclusions: Use of the underlying cause of death in surveillance will considerably underestimate MPN-related mortality rates in the population. Studies are needed on treatment in random samples of MPN patients from population-based cancer registries. Continued surveillance of MPN-related mortality rates in the population is needed in view of recent attempts (including the use of aspirin) to control cardiovascular complications of MPN.     

Mortality of employees of the Atomic Weapons Establishment, 1951-82.

A total of 22,552 workers employed by the Atomic Weapons Establishment between 1951 and 1982 were followed up for an average of 18.6 years. Of the 3115 who died, 865 (28%) died of cancer. Mortality was 23% lower than the national average for all causes of death and 18% lower for cancer. These low rates were consistent with the findings in other workforces in the nuclear industry and reflect, at least in part, the selection of healthy people to work in the industry and the disproportionate recruitment of people from the higher social classes. At some time during their employment 9389 (42%) of the workers were monitored for exposure to radiation, the average cumulative whole body exposure to external radiation being 7.8 mSv. Their mortality was generally similar to that of other employees, even when exposures were lagged by 10 years. The rate ratio after a 10 year lag in workers with a radiation record compared with other workers was 1.01 (95% confidence interval 0.92 to 1.10) for all causes of death and 1.06 (0.89 to 1.27) for all malignant neoplasms. The only significant differences were for prostatic cancer (rate ratio 2.23; 95% confidence interval 1.13 to 4.40) and for cancers of ill defined and secondary sites (rate ratio 2.37; 1.23 to 4.56). Cancers of lymphatic and haemopoietic tissues were notable for their low occurrence in the study population, with only four deaths from leukaemia and two from multiple myeloma in workers with a radiation record, 9.16 and 3.55 deaths respectively being expected on the basis of national rates. Among workers who had a radiation record 3742 (40%) were also monitored for possible internal exposure to plutonium, 3044 (32%) to uranium, 1562 (17%) to tritium, 638 (7%) to polonium, and 281 (3%) to actinium. In these workers mortality from malignant neoplasms as a whole was not increased, but after a 10 year lag death rates from prostatic and renal cancers were generally more than twice the national average, these excesses arising in a small group of workers monitored for exposure to multiple radionuclides. Though mortality from lung cancer in workers monitored for exposure to plutonium was below the national average, it was some two thirds higher than in other radiation workers, the excess being of borderline statistical significance. Mortality from malignant neoplasms as a whole showed a weak and non-significant increasing trend with increasing level of cumulative whole body exposure to external radiation. When the exposures were lagged by 10 years the trend became stronger and significant, the estimated increase in relative risk per 10 mSv being 7.6% (95% confidence interval 0.4% to 15.3%). This trend was confined almost entirely to workers who were also monitored for exposure to radionuclides (p<0.001), the main contributions coming from lung cancer and prostatic cancer. Exposures of the lung and prostate from internal sources of radiation were not quantified, except for the contribution from tritium. It was therefore not possible to assess the extent to which the associations were due to internally deposited radionuclides rather than external exposure. The finding for prostatic cancer taken in conjunction with the results of other studies suggest a specific occupational hazard in a small group of workers in the nuclear industry who had comparatively high exposures to external radiation and who were also monitored for internal exposure to multiple radionuclides. Research is needed to discover whether any of the radionuclides and other substances concerned are concentrated in the prostate. The occurrence of lung cancer in this workforce requires further investigation taking into account smoking habits and tissue doses from inhaled radionuclides.     

Two millennia of changes in human ecology: archaeobotanical and invertebrate records from the lower Ica valley, south coast Peru

This paper presents archaeobotanical and invertebrate evidence from the flotation and analyses of 46 archaeological contexts from six middens from the Samaca and Ullujaya basins, lower Ica Valley, south coast of Peru. This is part of one of the world’s driest deserts and organic remains can enjoy extraordinary preservation in its hyperarid climate. Each of these contexts represents snapshots with which to piece together a picture of changing human ecology in the lower Ica Valley over nearly two millennia, from Ocucaje Phases 3/4 of the Early Horizon (c. 750 b.c.); through to Early Nasca Phases 2/3 (c. a.d. 100–450); Late Nasca Phases 6/7 (c. a.d. 450–600) and Middle Horizon Epoch 2 (c. a.d. 900). They also offer proxy evidence of wider ecological changes in these basins. Read together with geoarchaeological and pollen data, the archaeobotanical data we present show a gradual intensification of agriculture from small-scale Early Ocucaje societies subsisting mainly on gathered marine and terrestrial resources, through to sophisticated irrigation agriculture by Nasca times, but culminating in a collapse of agricultural production and a return to the gathering of wild marine and plant resources much later, during the Middle Horizon. This trajectory of human ecology is consistent with the model presented elsewhere of a gradual removal of Prosopis dominated riparian woodland for the purpose of increasing agricultural production, which in time exposed the landscape of the lower Ica Valley to high-energy, episodic flood events and of one of the world’s strongest and most persistent wind regimes.     

Reexamination of interpregnancy intervals and subsequent birth outcomes: Evidence from U.S. linked birth/infant death records

Abstract

This study examines the net effects of the interpregnancy interval (time period from one birth to the next pregnancy) on the risks of preterm birth, intrauterine growth retardation, and infant mortality, for blacks and whites separately, using data from 1991 U.S. Linked Birth‐Infant Death files. Results show that short (less than 7 months) and long (61+ months) intervals between pregnancies raise the risk of preterm birth and intrauterine growth retardation for both race groups, though the increase in risk is generally less than 30 per cent. Short intervals also raise (slightly) the risk of infant mortality after controlling for birthweight and gestational age.     

Calcium-mediated changes in gap junction structure: evidence from the low angle X-ray pattern

Rat liver gap junctions were isolated in Ca2+-free media and analyzed in controlled environments by x-ray diffraction of partially oriented pellets. Different treatments of the same preparations were compared. The ordered hexagonal lattices gave rise to detail that was sensitive to low Ca2+ concentrations (0.05 mM), but not to Mg2+ (up to 0.16 mM) or pH (between 6.0 and 8.0). The major Ca2+-mediated responses were reductions in the intensity of the (1, 0) peak and in the off- equatorial contributions to the (2, 1) peak, and changes of scale equivalent to a decrease (approximately 2%) in lattice dimension, but an increase (approximately 4%) in the dimension perpendicular to the lattice. A simple structural interpretation of these findings is that Ca2+ induces the subunits of the channel-forming assembly, the connexon, to align more nearly parallel to the channel, thereby causing the connexon to become slightly longer and more radially compact. The rearrangement is of the same nature as one found under less physiological circumstances by electron microscopy (Unwin, P. N. T., and G. Zampighi, 1980, Nature (Lond.)., 283:545-549), and may be part of a coordinated mechanism by which the channel closes.     

Job satisfaction among medical doctors in one of the countries in transition: experience from Croatia

Our aim was to explore and compare the job satisfaction between family physicians and hospital specialists in Split, Croatia. The survey was carried out in 2005 and 2006. A validated questionnaire was composed of two parts: 92 statements and questions about job satisfaction in the form of a Lickert scale (range 1-5) and eight questions concerning demographic issues. The questionnaire was completed and returned by 165 hospital specialists from the University Hospital and by 131 family physicians from the Split County. Response rate for family physicians was 39.81% and 41.46% for hospital specialists. Hospital doctors were divided in two groups: internal and surgical. There were no significant differences between family physicians and hospital specialists in total job satisfaction (F = 1.02; p = 0.41). Family physicians were more satisfied with their workplace conditions than internal medicine specialists (19.37 +/- 4.23 vs. 17.37 +/- 4.59; F = 5.93; p = 0.003), and less satisfied with the possibilities for postgraduate training than surgeons (5.27 +/- 1.90 vs. 6.59 +/- 2.07; F = 9.26; p < 0.001). Global job satisfaction was rather low but does not differ between the three medical groups. Disparities were observed in some segments (opportunity for further training and academic advancement, vacation, and salary). The reason for the family physician's relative satisfaction may be due to stable working conditions, independence in organizing work schedules and personal responsibility.     

Vernalization-induced changes of the DNA methylation pattern in winter wheat.

Vernalization is a cold treatment that induces or accelerates flowering and insures that temperate-zone plants will not flower until after winter. There is evidence that vernalization results in DNA demethylation that induces flowering. Differences in DNA methylation can be determined using methylation-sensitive amplified fragment length polymorphisms (AFLPs). Methylation-sensitive AFLPs utilize restriction enzyme isoschizomers that are differentially sensitive to methylation, producing polymorphisms related to methylation differences as opposed to sequence differences. Near-isogenic lines (NILs) have been developed for spring vs. winter habit in wheat (Triticum aestivum) and allow for the study of a single vernalization locus. In this study, differences in the methylation pattern were determined for spring and winter NILs, as well as for unvernalized and vernalized individuals. Winter wheat was more highly methylated than spring wheat and methylation-related AFLPs were produced between winter and spring wheat. Changes in the methylation pattern were observed at the end of vernalization, one week after the end of vernalization, and four weeks after the end of vernalization of winter wheat. However, the most methylation differences were observed one week after removal of winter wheat from cold treatment. Our data suggest that there is not only a vernalization-induced demethylation related to flower induction, but there is also a more general and non-specific demethylation of sequences unrelated to flowering. Two methylation-related AFLPs induced by vernalization were shared among all of the winter NILs.     

Preferential predatory peeling: Ammonoid vs. nautiloid shells from the Upper Carboniferous of Texas,USA

Narrow groove-like excavations on ammonoid and coiled nautiloid shells are rare in Upper Carboniferous units from Texas, USA. The morphological characteristics of the excavation grooves typically are confined to the ventral and ventrolateral parts of the outer whorl of the shell, are narrower than the length, and have irregular edges where small segments or chips of shells have been removed. Analysis of these features reveals a statistically significant preferential occurrence on ammonoids (1.195% of ca. 3515 specimens) as compared to coiled nautiloids (0.506% of ca. 2965 specimens). The ammonoids typically have longer excavations that penetrate the phragmocone more frequently than those observed in the coiled nautiloids. The groove-like excavations were probably formed by the removal and peeling of shell material by one or more predatory or scavenging arthropods to obtain organic material (tissue and membranes) within the ammonoid and nautiloid body chambers and phragmocones. The excavations probably occurred when the cephalopod was alive (i.e., the cause of death) or shortly after the cephalopod's death. There is no evidence that the excavations are related to sheltering by the excavating organism.