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Mortality levels of national populations have often been studied in relation to levels of gross domestic product (GDP) at time of death. Following the life course perspective, we assessed whether old-age mortality levels for subsequent cohorts are differentially associated with GDP levels prevailing at different ages of the cohorts. We used all-cause and cause-specific mortality data by sex, age at death (65-99), year at death (1950-1999), and year of birth (1865-1924) for Denmark, England and Wales, Finland, France, the Netherlands, Norway, and Sweden. Trends in national GDP per capita between 1865 and 1999 were reconstructed from historical national accounts data. Through Poisson regression analyses, we determined for each country both univariate and multivariate associations across five-year birth cohorts between mortality and GDP levels prevailing at time of death, and at earlier ages of the cohorts (i.e. 0-5, 6-19, 20-49, and 50-64). For the subsequent cohorts, levels of GDP at time of death were strongly inversely associated with all-cause mortality, especially among women, and among men in England and Wales, Finland, and France. In most countries, stronger associations were observed with GDP levels prevailing at earlier ages of the cohorts. After control for GDP at time of death, these associations remained. An independent association of GDP at earlier ages of the cohort was also observed for cause-specific mortality. The associations were negative for ischaemic heart diseases, cerebrovascular diseases, and stomach cancer. They were positive for prostate cancer, breast cancer, COPD (women), and lung cancer (women). GDP prevailing at ages 20-49 (men) and ages 50-64 (women) had the largest associations with old-age mortality. These findings suggest an independent, mostly negative effect of GDP prevailing at earlier ages of subsequent cohorts on old-age mortality. Socio-economic circumstances during adulthood and middle age seem more important in determining old-age mortality trends than those during infancy or childhood. [ABSTRACT FROM AUTHOR]

Objective: Different from the general observed decline in old-age mortality, for The Netherlands and Norway there have been reports of stagnation in the decline since the 1980s. We detect periods of stagnation in recent old-age mortality trends, and explore for which causes of death the recent stagnation is most apparent.Study Design and Setting: We applied Poisson regression analysis to total and cause-specific mortality data by age (80+), period (1950-1999), and sex for seven European low-mortality countries.Results: We found large heterogeneity in the pace of decline in the countries under investigation, with periods of stagnation being widespread. In the 1980s and 1990s, stagnation was observed in Denmark, The Netherlands, and Norway (males). Continued mortality decline was observed especially in France. Although smoking has had a marked influence on the trends in old-age mortality, the role of smoking in the recent stagnation seems only modest and restricted to Norway. Mortality from cardiovascular diseases showed important crossnational variations in the pace of decline. Mortality from diseases specifically related to old age increased recently in all countries, except France.Conclusion: Old-age mortality seems highly plastic and susceptible to many factors, with both favorable and unfavorable effects on trends over time. [ABSTRACT FROM AUTHOR]

Abstract: Aim: To assess whether secular trends in stomach cancer mortality were correlated with trends in infant mortality rate (IMR) or gross domestic product (GDP). Methods: Data from seven European countries were analyzed. We used Poisson regression to describe mortality trends among birth cohorts of 1865–1939 and correlation coefficients to determine associations with IMR/GDP. Results: Large differences were observed between birth cohorts in mortality from stomach cancer. In each country, these cohort differences were closely related to IMR/GDP levels at birth time. However, stronger associations were observed with measures of living conditions during later life. In comparisons between countries, stomach cancer mortality rates were not consistently related to national levels of IMR/GDP. Conclusion: General living conditions in childhood do not seem to have had a predominant effect on secular trends in stomach cancer mortality. The mortality decline is likely to be related to more 1specific factors, such as declining Helicobacter pylori prevalence. [Copyright &y& Elsevier]

Objectives: To assess, in a population-based study, whether secular trends in cardiovascular disease mortality in seven European countries were correlated with past trends in infant mortality rate (IMR) in these countries. Study Design and Setting: Data on ischemic heart disease (IHD) and stroke mortality in 1950-1999 in the Netherlands, England & Wales, France, and four Nordic countries were analyzed. We used Poisson regression to describe trends in mortality according to birth cohort, for the cohorts born between 1860 and 1939. Pearson correlation coefficients were calculated to determine associations between IMR and IHD, or stroke mortality. Results: IHD mortality increased for successive cohorts up to 1900, and then started to decline. Stroke mortality levels were virtually stable among birth cohorts up to 1880, but declined rapidly among later cohorts. A strong positive association was found between cohort-specific IMR levels and stroke mortality rates. There were no strong cohort-wise associations between IMR and IHD mortality. Conclusion: These results support other studies in suggesting that living conditions in early childhood may influence population levels of stroke mortality. Future studies should determine the contribution of specific early life factors to the mortality decline in IHD and especially stroke. [ABSTRACT FROM AUTHOR]

In energy transformation processes such as combustion, gasification and reforming of fossil and renewable fuels, the conservation of energy (first law of thermodynamics) as well as the quality of energy (second law of thermodynamics) is important. This study focuses on the conversion of biomass with air and/or steam into gaseous components and char represented by solid carbon (graphite). Energy and exergy (available energy) losses are analysed by calculating the composition of a dry, ash-free typical biomass feed represented by CH1.4O0.59N0.0017 in equilibrium with varying amounts of air and/or steam. The analysis is carried out for adiabatic systems at atmospheric pressure, with input of biomass and air at ambient conditions and steam at atmospheric pressure and temperature of 500 K.For air gasification, energy and exergy in the product gas have a sharp maximum at the point where all carbon is consumed, the carbon boundary point. This is the optimum point for operating an air-blown biomass gasifier. For gasification with steam, operation at the carbon boundary point is also optimal, but thermodynamic process losses hardly increase when adding more steam than required. The efficiency of steam and air-blown gasification was compared using the definition of rational efficiency. Although gasification by steam is more efficient (87.6% vs. 80.5%), this difference is expected to level off if exergy losses for the production of steam are taken into account. The choice between steam and air as a gasifying medium therefore seems to depend more on the required gas compositions. For steam gasification, the product gas contains mainly methane and carbon dioxide, while hydrogen, carbon monoxide, and (at least 38%) nitrogen are the main product gases for air gasification. [Copyright &y& Elsevier]

Résumé Objectifs Décrire les réalités liées au diagnostic et au traitement de l’infection urinaire (IU) chez les enfants fébriles vietnamiens, ainsi que les caractéristiques cliniques et la fréquence des germes uropathogènes et leur taux de résistance. Méthodes Étude prospective de 28 mois réalisée chez les enfants fébriles traités pour IU documentée dans le département de néphrologie de l’hôpital pédiatrique Nhi-Dong 2 à Hô-Chi-Minh-Ville (Vietnam). Après l’obtention de prélèvements sanguins et urinaires, les enfants ont été traités par la ceftriaxone intraveineuse (75 mg/kg/j). Après 48 heures d’apyrexie, le relais a été pris par céfixime (8 mg/kg/j) par voie orale pour une durée de traitement totale de 14 jours. L’adaptation du traitement n’était envisagée que chez les enfants ne répondant pas cliniquement, sans tenir compte de l’antibiogramme. Résultats Cent-quarante-trois enfants ont été traités (51 % de filles) dont 80 % avaient eu leur premier épisode d’IU avant l’âge de 2 ans. Escherichia coli était responsable de 80 % des IU, avec un taux de résistance de 91 % à l’ampicilline et de 74 % au cotrimoxazole. Des entérobactéries productrices de β-lactamases à spectre étendu ( BLSE ) ont été isolées dans 52 % des cultures. Selon l’antibiogramme, le traitement initial par ceftriaxone était inapproprié dans 63 % des cas. Conclusions E. coli est responsable de la majorité des IU chez l’enfant vietnamien avec un taux élevé de résistance aux antibiotiques de première ligne. La production de BLSE est extrêmement élevée. Nous proposons une prise en charge plus rationnelle des enfants fébriles avec IU ainsi qu’un traitement antibiotique empirique tenant compte de l’émergence des germes multirésistants. Summary Background To describe the practical problems related to urinary tract infection (UTI) management in febrile Vietnamese children. Methods During a prospective 28-month inclusion period, 143 febrile children with significant bacteriuria were treated for UTI in the nephrology department of Nhi Dong 2 children's hospital in Ho Chi Minh City, Vietnam. Patients were treated after blood and urine samples had been taken for culture, according to a local antibiotic protocol, parenterally with ceftriaxone 75 mg/kg/day. Oral treatment with cefixime 8 mg/kg/day was started after 48 h of apyrexia for 2 weeks. According to local protocol, antibiotic therapy was only changed if children did not respond clinically to treatment regardless of antibiogram results. Results Among these 143 children, 51% were girls and 80% of them had their first UTI before the age of 2 years. The commonest causative agent was Escherichia coli (80% of cases) with a high resistance rate to ampicillin (91%) and cotrimoxazole (74%). Extended-spectrum β-lactamase ( ESBL ) production was observed in 52% of Enterobacteriaceae isolates. According to antibiotic susceptibility, the initial treatment with ceftriaxone was found to be inappropriate in 63% of cases. Conclusions E. coli was responsible for 80% of UTIs in Vietnamese children with a high rate of resistance to first-line antibiotics. ESBL production was found to be extremely high in this study. Based on these data, we propose a new empiric treatment schedule for Vietnamese children suspected of UTI. [ABSTRACT FROM AUTHOR]

We sought to ascertain the long-term outcome and genotype-phenotype correlations available for primary hyperoxaluria type 1 in a large retrospective cohort study. We examined the clinical history of 155 patients (129 families primarily from Western Europe, North Africa, or the Middle East) as well as the enzymatic or genetic diagnosis. The median age at first symptom was 4 years, and at diagnosis 7.7 years, at which time 43% had reached end-stage renal disease. Presentations included: (1) early nephrocalcinosis and infantile renal failure, (2) recurrent urolithiasis and progressive renal failure diagnosed during childhood, (3) late onset with occasional stone passage diagnosed in adulthood, (4) diagnosis occurring on post-transplantation recurrence, and (5) family screening. The cumulative patient survival was 95, 86, and 74% at ages 10, 30, and 50 years, respectively, with the cumulative renal survival of 81, 59, 41, and 10% at ages 10, 20, 30, and 50 years, respectively; 72 patients had undergone a total of 97 transplantations. Among the 136 patients with DNA analysis, the most common mutation was p.Gly170Arg (allelic frequency 21.5%), with a median age at end-stage renal disease of 47 years for homozygotes, 35 years for heterozygotes, and 21 years for other mutations. Our results underscore the severe prognosis of primary hyperoxaluria type 1 and the necessity for early diagnosis and treatment, as well as confirm a better prognosis of the p.Gly170Arg mutation. [ABSTRACT FROM AUTHOR]

Abstract: Objective: To determine if there are steroid-dependent changes in transcallosal transfer during the menstrual cycle in normal women. Methods: We tested 13 normally cycling women during the menstrual, follicular and midluteal phases. Blood levels of estradiol (E) and progesterone (P) were determined by radioimmunoassay. Ipsilateral tonic voluntary muscle activity suppression, called ipsilateral silent period (iSP), was evoked by applying transcranial magnetic stimulation (TMS) over the left motor cortex and by measuring the EMG of the ipsilateral first dorsal interosseus (FDI) muscle. Both iSP-duration and transcallosal conduction times were measured and related to cycle phase and steroid levels. Results: Duration of iSPs varied over the cycle with largest differences between follicular and midluteal phases. During the midluteal phase high levels of P were significantly related to short iSPs. This relation also applied to E levels and iSPs during the follicular phase. Conclusions: Our study shows for the first time that the transcallosal transfer is modulated by E and P and changes over the menstrual cycle. Significance: It is suggested that gonadal steroid hormones affect the interhemispheric interaction and change the functional cerebral organization sex dependently via its neuromodulatory properties on GABAergic and glutamatergic neurons. [Copyright &y& Elsevier]

Sediment and water can potentially be altered, chemically, physically and biologically as they are sampled at the seafloor, brought to the surface, processed and analysed. As a result, in situ observations of relatively undisturbed systems have become the goal of a growing body of scientists. Our understanding of sediment biogeochemistry and exchange fluxes was revolutionized by the introduction of benthic chambers and in situ micro-electrode profilers that allow for the direct measurement of chemical fluxes between sediment and water at the sea floor and for porewater composition. Since then, rapid progress in the technology of in situ sensors and benthic chambers (such as the introduction of gel probes, voltammetric electrodes or one- and two-dimensional optodes) have yielded major breakthroughs in the scientific understanding of benthic biogeochemistry. This paper is a synthesis of discussions held during the workshop on sediment biogeochemistry at the “Benthic Dynamics: in situ surveillance of the sediment–water interface” international conference (Aberdeen, UK—March 25–29, 2002). We present a review of existing in situ technologies for the study of benthic biogeochemistry dynamics and related scientific applications. Limitations and possible improvement (e.g., technology coupling) of these technologies and future development of new sensors are discussed. There are countless important scientific and technical issues that lend themselves to investigation using in situ benthic biogeochemical assessment. While the increasing availability of these tools will lead research in yet unanticipated directions, a few emerging issues include greater insight into the controls on organic matter (OM) mineralization, better models for the understanding of benthic fluxes to reconcile microelectrode and larger-scale chamber measurements, insight into the impacts of redox changes on trace metal behavior, new insights into geochemical reaction pathways in surface sediments, and a better understanding of contaminant fate in nearshore sediments. [Copyright &y& Elsevier]