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Aims. To identify production and processing practices that might reduce Campylobacter numbers contaminating chicken broiler carcasses.Methods and Results. Numbers of campylobacters were determined on carcass neck skins after processing or in broiler house litter samples. Supplementary information that described farm layouts, farming conditions for individual flocks, the slaughterhouse layouts and operating conditions inside plants was collected, matched with each Campylobacter test result. Statistical models predicting the numbers of campylobacters on neck skins and in litter were constructed. Carcass microbial contamination was more strongly influenced by on farm production practices compared with slaughterhouse activities. We observed correlations between the chilling, washing and de-feathering stages of processing and numbers of campylobacters on carcasses. There were factors on farm that also correlated with numbers of campylobacters in litter. These included bird gender, the exclusion of dogs from houses, beetle presence in the house litter and the materials used to construct the house frame.Conclusions. Changes to farming practices have greater potential for reducing chicken carcass microbial contamination compared with processing interventions.Significance and impact of the study. Routine commercial practices were identified that were correlated with lowered numbers of campylobacters. Consequently, these practices are likely to be both cost-effective and suitable for adoption into established farms and commercial processing.

Background and aimsVarenicline and nicotine replacement therapy (NRT) are the most commonly used medications to quit smoking. Given their widespread use, monitoring adverse risks remains important. This study aimed to estimate the neuropsychiatric and cardiovascular risks associated with varenicline and NRT as used in routine UK care.DesignCase–cross‐over study.SettingUK‐based electronic primary care records in the Clinical Practice Research Datalink from 2006 to 2015 linked to hospital and mortality data sets.ParticipantsAdult smokers observed during periods when exposed and not exposed to either varenicline or NRT.MeasurementsMain outcomes included suicide, self‐harm, myocardial infarction (MI), all‐cause death and cause‐specific death [MI, chronic obstructive pulmonary disease (COPD)]. In primary analyses, conditional logistic regression was used to compare the chance of varenicline or NRT exposure during the risk period (90 days prior to the event) with the chance of exposure during an earlier single reference period (91–180 days prior to the event) or multiple 90‐day reference periods to increase statistical power.FindingsIn the primary analyses, findings were inconclusive for the associations between varenicline and the main outcomes using a single reference period, while NRT was associated with MI [odds ratio (OR) = 1.40, 95% confidence interval (CI) = 1.18–1.67]. Using multiple reference periods, varenicline was associated with an increased risk of self‐harm (OR = 1.32, 95% CI = 1.12–1.56) and suicide (OR = 3.56, 95% CI = 1.32–9.60) but a reduction in all‐cause death (OR = 0.75, 95% CI = 0.61–0.93). NRT was associated with MI (OR = 1.54, 95% CI = 1.36–1.74), self‐harm (OR = 1.30, 95% CI = 1.18–1.44) and deaths from MI (OR = 1.53, 95% CI = 1.11–2.10), COPD (OR = 1.33, 95% CI = 1.14–1.56) and all causes (OR = 1.28, 95% CI = 1.18–1.40) when using multiple reference periods.ConclusionsThere appear to be positive associations between (1) nicotine replacement therapy (NRT) and myocardial infarction, death and risk of self‐harm and (2) varenicline and increased risk of self‐harm and suicide, as well as a negative association between varenicline and all‐cause death. The associations may not be causal. They may reflect health changes at the time of smoking cessation (nicotine replacement therapy is prescribed for people with cardiac problems) or be associated with quit attempts (exposure to both medicines was associated with self‐harm).

This study aimed to determine the effectiveness and safety of varenicline versus NRT for smoking cessation in people with neurodevelopmental disorders, compared to those without, at up to four years after exposure. We analysed electronic medical records from the Clinical Practice Research Datalink using three different statistical approaches: multivariable logistic regression, propensity score matching (PSM), and instrumental variable analysis. Exposure was prescription of varenicline versus NRT and the primary outcome was smoking cessation at 2-years. We included 235,314 people aged 18 and above with eligible smoking cessation prescriptions in the effectiveness analysis. Smokers with neurodevelopmental disorders were 48% less likely (95% confidence interval: 42%, 54%) to be prescribed varenicline than NRT, compared to smokers without neurodevelopmental disorders. At 2-year follow-up, smokers with neurodevelopmental disorders prescribed varenicline were 38% more likely to quit smoking (95% confidence interval: 6%, 78%). Similar results were obtained using PSM and instrumental variable analyses. There was little evidence showing that varenicline increased the likelihood of mental health related adverse events in people with neurodevelopmental disorders. Varenicline is less likely to be prescribed to people with neurodevelopmental disorders despite results suggesting it is more effective than NRT and little evidence of increased likelihood of mental health related adverse events.

IntroductionSmoking among persons with a mental health disorder is associated with inequitable health, social and economic burden. Randomised controlled trials (RCTs) are considered the gold standard design for the assessment of healthcare intervention efficacy/effectiveness. However, many RCTs of smoking interventions for persons with a mental health disorder lack rigour due to low participant retention. No systematic review has pooled retention rates in randomised trials of smoking interventions for persons with a mental health disorder or explored associated factors. The aims of the systematic review will therefore be to: (1) summarise overall rates of participant retention in smoking cessation and reduction trials involving persons with a mental health disorder (including for experimental and control groups separately) and (2) determine if retention rates vary according to participant, environmental, researcher and study factors.Methods and analysisPsycINFO, EMBASE, MEDLINE, CENTRAL and The Cochrane Tobacco Addiction Review Group Specialised Register will be searched for reports of RCTs of outpatient smoking cessation or reduction interventions for adults with a mental health disorder. The search terms will include MeSH terms and free text words, and there will be no language or date restrictions. All databases will be searched from inception to present. Data will be analysed using the Mantel-Haenszel fixed-effect model, and where substantial heterogeneity (I2>50%) is detected, DerSimonian & Laird inverse-variance random effects model. Pooled estimates and 95% CIs will be calculated for overall participant retention rates and for intervention and control trial arms separately. Associations between participant retention and participant, environmental, researcher and study factors will be assessed via subgroup analyses and, where sufficient data are obtained, meta-regression.Ethics and disseminationThis study does not require ethical approval. The findings of this review will be disseminated via publication in a peer-reviewed open access medical journal and presentations at international scientific meetings.

ObjectivesOur primary objective was to estimate smoking prevalence and prescribing rates of varenicline and nicotine replacement therapy (NRT) in people with and without general practitioner (GP)-recorded dementia. Our secondary objective was to assess and compare quit rates of smokers with versus without GP-recorded dementia who were prescribed varenicline or NRT for smoking cessation.DesignA retrospective cohort study based on the analysis of electronic medical records within the Clinical Practice Research Datalink (2007–2015).Setting683 general practices in England.ParticipantsPeople with and without GP-recorded dementia, aged 18 years and have a code indicating that they are a current smoker.InterventionIndex prescription of varenicline or NRT (from 1 September 2006).Outcome measuresThe primary outcomes were smoking prevalence and prescribing rates of varenicline and NRT (2007–2015). The secondary outcome was smoking cessation at 2 years.ResultsAge and sex-standardised prevalence of smoking was slightly higher in people with GP-recorded dementia than in those without. There were 235 314 people aged 18 years and above prescribed NRT or varenicline. Among smokers with GP-recorded dementia (N=447), 409 were prescribed NRT and 38 varenicline. Smokers with GP-recorded dementia were 74% less likely (95% CI 64% to 82%) to be prescribed varenicline than NRT, compared with smokers without GP-recorded dementia. Compared with people without GP-recorded dementia, people with GP-recorded dementia had consistently lower prescribing rates of varenicline from 2007 to 2015. Two years after prescription, there was no clear evidence for a difference in the likelihood of smoking cessation after prescription of these medications between individuals with and without dementia (OR 1.0, 95% CI 0.8 to 1.2).ConclusionsBetween 2007 and 2015, people with GP-recorded dementia were less likely to be prescribed varenicline than those without dementia. Quit rates following prescription of either NRT or varenicline were similar in those with and without dementia.

Objective We conducted a prospective cohort study of the Clinical Practice Research Database to estimate rates of varenicline and nicotine replacement therapy (NRT) prescribing and the relative effects on smoking cessation, and mental health. Methods We used multivariable logistic regression, propensity score matched regression, and instrumental variable analysis. Exposure was varenicline or NRT prescription. Mental disorders were bipolar, depression, neurotic disorder, schizophrenia, or prescriptions of antidepressants, antipsychotics, hypnotics/anxiolytics, mood stabilizers. Outcomes were smoking cessation, and incidence of neurotic disorder, depression, prescription of antidepressants, or hypnotics/anxiolytics. Follow-ups were 3, 6, and 9 months, and at 1, 2, and 4 years. Results In all patients, NRT and varenicline prescribing declined during the study period. Seventy-eight thousand four hundred fifty-seven smokers with mental disorders aged ≥18 years were prescribed NRT (N = 59 340) or varenicline (N = 19 117) from September 1, 2006 to December 31, 2015. Compared with smokers without mental disorders, smokers with mental disorders had 31% (95% CI: 29% to 33%) lower odds of being prescribed varenicline relative to NRT, but had 19% (95% CI: 15% to 24%) greater odds of quitting at 2 years when prescribed varenicline relative to NRT. Overall, varenicline was associated with decreased or similar odds of worse mental health outcomes than NRT in patients both with and without mental disorders, although there was some variation when analyses were stratified by mental disorder subgroup. Conclusions Smoking cessation medication prescribing may be declining in primary care. Varenicline was more effective than NRT for smoking cessation in patients with mental disorders and there is not clear consistent evidence that varenicline is adversely associated with poorer mental health outcomes. Implications Patients with mental disorders were less likely to be prescribed varenicline than NRT. We triangulated results from three analytical techniques. We found that varenicline was more effective than NRT for smoking cessation in patients with mental disorders. Varenicline was generally associated with similar or decreased odds of poorer mental health outcomes (ie, improvements in mental health) when compared with NRT. We report these findings cautiously as our data are observational and are at risk of confounding.

ObjectiveTo examine the direction and magnitude of the relation between family meal frequency and dietary and family functioning outcomes in children (aged 2–18 years).DesignSystematic literature review with meta-analysis.MethodsIndependent electronic searches, 1 for each outcome of interest, were conducted across 5 databases: PubMed, Cumulative Index to Nursing and Allied Health Literature, Web of Science, Scopus, and PsycINFO. Studies were included if they were peer-reviewed and published in English in the US through December 2018.Main Outcome MeasuresDiet and family functioning.ResultsDietary outcomes showed some evidence of a positive association between family meal frequency and fruits, vegetables, fruits and vegetables, sugar-sweetened beverages, and the Healthy Eating Index. There was less clear evidence of this relation in snacks, fast food, and desserts. A positive association was found between family meal frequency or dinner family meal frequency and family functioning outcomes. All studies included had cross-sectional and longitudinal study designs.Conclusions and ImplicationsThere is some evidence to show a positive relation between family meal frequency and dietary outcomes. There is stronger evidence for the relation with family functioning outcomes. Most articles included in the systematic reviews were excluded from meta-analysis owing to inadequate data and high methodological diversity across exposure and outcome variables.

A major barrier to clinicians referring service users with psychosis for psychological therapies is the belief that they will not engage. We investigated therapy receipt after discharge, in a sample of service users who had already demonstrated willingness to engage in psychological therapy during an inpatient admission. Only one-third of service users (33%; 16/48) received at least 1 session of evidence-based therapy at 6-month follow-up after discharge. Therapy receipt was more common for service users with (i) lower delusional distress at discharge, (ii) Black and Minority Ethnic (BME) background, and (iii) discharged to an Early Intervention (EI) service.

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Flood Risk Management (FRM) is often essential to reduce the risk of flooding to properties and infrastructure in urban landscapes, but typically degrades the habitats required by many aquatic animals for foraging, refuge and reproduction. This conflict between flood risk management and biodiversity is driven by conflicting directives, such as the EU Floods and Water Framework Directives, and has led to a requirement for synergistic solutions for FRM that integrate river restoration actions. Unfortunately, ecological monitoring and appraisal of combined FRM and river restoration works is inadequate. This paper uses a case study from the River Don in Northern England to evaluate the effects of the FRM and subsequent river restoration works on instream habitat and the associated fish assemblage over an 8-year period. Flood risk management created a homogeneous channel but did not negatively affect fish species composition or densities, specifically brown trout. Densities of adult brown trout were comparable pre and post-FRM, while densities of juvenile bullhead and brown trout increased dramatically post FRM. River restoration works created a heterogeneous channel but did not significantly improve species composition or brown trout density. Species composition post-river restoration works returned to that similar to pre-FRM over a short-term period, but with improved numbers of juvenile bullhead. Although habitat complexity increased after river restoration works, long-term changes in species composition and densities were marginal, probably because the river reset habitat complexity within the time framework of the study.

Background Evidence shows that the relationship between depression and smoking may be bi-directional, with smoking increasing the risk for subsequent depression, and vice versa—translating into significantly higher smoking rates among those with depression compared to the general population. Computational models can be used to assess trends in smoking but have not been utilized to examine populations with behavioral health comorbidities. We develop the first joint model of smoking and depression, projecting future smoking patterns under a 'status quo' scenario. Methods We use a compartmental model to simulate individuals transitioning across smoking and depressive states from birth to age 99 or death. The model is calibrated to reproduce smoking and depression data from the 2005-2014 U.S. National Survey on Drug Use and Health. Current smokers report smoking within the past year and smoked at least 100 cigarettes in their lifetime while those with depression report a major depressive episode in the past year. Parameters for the effects of smoking and depression on each other were drawn from existing literature. [Smoking and depression model diagram] Results From 2015 to 2050, smoking prevalence among women with depression is projected to decline by 43.5% (27.6% to 15.6%), compared to 46.9% (17.9% to 9.5%) for women who report never having had a depressive episode. Among men with depression, smoking prevalence is expected to decline by 32.0% (34.4% to 23.4%), compared to 39.0% (24.1% to 14.7%) for men who report never being depressed. The likelihood of smoking among those with depression is projected to increase. Conclusions This model can be used to examine trends and identify optimal interventions to address smoking disparities by depressive status. Smoking prevalence among people with depression is expected to decline, though not as rapidly as for those without depression. In the absence of population-level strategies, smoking and tobacco-related diseases will continue to further disproportionately burden people with depression.

Background: There is limited evidence about the effectiveness of varenicline and nicotine replacement therapy (NRT) for long-term smoking cessation in primary care, or whether the treatment effectiveness differs by socioeconomic position (SEP). Therefore, we estimated the long-term effectiveness of varenicline versus NRT ( > 2 years) on smoking cessation, and investigated whether effectiveness differs by SEP. Methods: This is a prospective cohort study of electronic medical records from 654 general practices in England, within the Clinical Practice Research Datalink, using three different analytical methods: multivariable logistic regression, propensity score matching and instrumental variable analyses. Exposure was prescription of varenicline versus NRT, and the primary outcome was smoking cessation at 2 years' follow-up; outcome was also assessed at 3, 6, and 9 months, and at 1 and 4 years after exposure. SEP was defined using the Index of Multiple Deprivation. Results: At 2 years, 28.8% (N=20 362/70 610) of participants prescribed varenicline and 24.3% (N=36 268/149 526) of those prescribed NRT quit; adjusted odds ratio was 1.26 [95% confidence interval (CI): 1.23 to 1.29], P < 0.0001. The association persisted for up to 4 years and was consistent across all analyses. We found little evidence that the effectiveness of varenicline differed greatly by SEP. However, patients from areas of higher deprivation were less likely to be prescribed varenicline; adjusted odds ratio was 0.91 (95% CI: 0.90 to 0.92), P < 0.0001. Conclusions: Patients prescribed varenicline were more likely to be abstinent up to 4 years after first prescription than those prescribed NRT. In combination with other evidence, the results from this study may be used to update clinical guidelines on the use of varenicline for smoking cessation.

IntroductionTobacco is the world’s leading preventable cause of disease and death. People with depression are twice as likely to smoke and are less responsive to standard tobacco treatments as compared with the general population. A Cochrane systematic review of randomised controlled trials of smoking cessation treatment for smokers with current or historical depression found that adding mood management to usual smoking treatment improved quit rates. However, the review did not examine if variation in intervention delivery or intervention functions impacted on treatment effectiveness.With the aim of providing information to develop tailored approaches to treating smoking for people with current depression, we will add-on to the Cochrane review in three ways: (1) use the Template for Intervention Description and Replication checklist to determine if variations in mood management delivery have impact on intervention effectiveness, (2) use the Taxonomy of Behaviour Change techniques for smoking cessation to examine which behaviour change functions are most effective for smoking cessation in people with current depression and (3) examine the difference in change in depression scores between intervention and control arms.Methods and analysisWe will include randomised controlled trials of smokers with current depression as identified by a previous Cochrane review and the in-progress update of this Cochrane review. We will use meta-regression to examine (1) if variations in delivery of mood management impact on smoking cessation intervention effectiveness, (2) determine which behaviour change functions are most effective for smoking cessation and (3) use meta-analysis of the difference in change in depression scores between treatment arms from baseline to follow-up to determine if offering smoking cessation treatment causes psychological harm.Ethics anddisseminationEthical approval is not required for this study. We will disseminate the findings of this work at national and international conferences, and to relevant patient panels.PROSPERO registration numberCRD42017070741.

Design and Shielding of Radiotherapy Treatment Facilities provides readers with a single point of reference for protection advice to the construction and modification of radiotherapy facilities. The book assembles a faculty of national and international experts on all modalities including megavoltage and kilovoltage photons, brachytherapy and high-energy particles, and on conventional and Monte Carlo shielding calculations. This book is a comprehensive reference for qualified experts and radiation-shielding designers in radiation physics and also useful to anyone involved in the design of radiotherapy facilities.

Aims To investigate whether smokers prescribed varenicline had lower risks of serious ill‐health during the 4 years following treatment compared with those prescribed nicotine replacement therapy (NRT). Design Observational cohort study of electronic medical records. Setting A total of 370 UK general practices sampled from the Clinical Practice Research Datalink. Participants A total of 126 718 patients aged 18 and over who were issued smoking cessation prescriptions between 1 September 2006 and 31 March 2014. Measurements Our primary outcome was all‐cause mortality within 2 years of first prescription as indicated by linked Office of National Statistics data. Our secondary outcomes were cause‐specific mortality, all‐cause, cause‐specific hospitalization, primary care diagnosis of myocardial infarction or chronic obstructive pulmonary disease (COPD), body mass index and attendance rate to primary care within 2 years of first prescription. Risk differences and 95% confidence intervals were estimated by multivariable adjusted regression and propensity score matched regression. We used instrumental variable analysis to overcome residual confounding. Findings People prescribed varenicline were healthier at baseline than those prescribed NRT in almost all characteristics, highlighting the potential for residual confounding. Our instrumental variable analysis results found that people prescribed varenicline had a similar risk of mortality at 2 years [risk difference per 100 patients treated = 0.67, 95% confidence interval (CI) = ‐0.11 to 1.46)] to those prescribed NRT, and there were similar rates of all‐cause hospitalization, incident primary‐care diagnoses of myocardial infarction and COPD. People prescribed varenicline subsequently attended primary care less frequently. Conclusions Smokers prescribed varenicline in primary care in the United Kingdom do not appear to be less likely to die, be hospitalized or experience a myocardial infarction or chronic obstructive pulmonary disease during the following 2 years compared with smokers prescribed nicotine replacement therapy, but they gain more weight and attend primary care less frequently.

Despite the documented risk of secondary poisoning to non-target species by anticoagulant rodenticides there is no statutory post-approval monitoring of their use in the UK. This paper presents results from two Scottish monitoring schemes for the period 2000-2010; recording rodenticide use on arable farms and the presence of residues in raptor carcasses. More than three quarters of arable farms used anticoagulant rodenticides; predominately the second generation compounds difenacoum and bromadiolone. There was widespread exposure to anticoagulant rodenticides in liver tissues of the raptor species tested and the residues encountered generally reflected agricultural use patterns. As found in other studies, Red Kites (Milvus milvus) appeared to be particularly vulnerable to rodenticide exposure, 70 % of those sampled (n = 114) contained residues and 10 % died as a result of rodenticide ingestion. More unexpectedly, sparrowhawks (Accipiter nisus), which prey almost exclusively on birds, had similar exposure rates to species which prey on rodents. Although, with the exception of kites, confirmed mortality from rodenticides was low, the widespread exposure recorded is concerning. Particularly when coupled with a lack of data about the sub-lethal effects of these compounds. This raises questions regarding whether statutory monitoring of use is needed; both to address whether there are deficiencies in compliance with approval conditions or whether the recommended risk management procedures are themselves adequate to protect non-target wildlife.

There is increasing interest in the use of instrumental variable analysis to overcome unmeasured confounding in observational pharmacoepidemiological studies. This is partly because instrumental variable analyses are potentially less biased than conventional regression analyses. However, instrumental variable analyses are less precise, and regulators and clinicians find it difficult to interpret conflicting evidence from instrumental variable compared with conventional regression analyses. In this paper, we describe three techniques to assess which approach (instrumental variable versus conventional regression analyses) is least biased. These techniques are negative control outcomes, negative control populations and tests of covariate balance. We illustrate these methods using an analysis of the effects of smoking cessation therapies (varenicline) prescribed in primary care.

Recent increases in chronic cardiovascular diseases, such as hypertension, have put pressure on the food industry to reduce sodium levels. Dairy products, though full of vital nutrients, are perceived as being high in sodium. However, the reduction of salt in dairy products could potentially alter the microbial stability, as well as cause unfavorable changes in flavor. In order to reduce the sodium level, while maintaining acceptable flavor and microbial stability, salt replacers and alternative antimicrobial agents may need to be introduced into the food matrix. To identify potential antimicrobials for use in reduced sodium dairy products, this study evaluated the efficacy of eight commercially available antimicrobials in TSA, milk agar, and cheese agar. Antimicrobials included MicroGard 100, MicroGard 430, Nisaplin, NovaGard CB1, Protect-M, PuraQ Verdad RV75, SEA-i F75 and VMY1P. Antimicrobials were also tested in combination with six commercial sodium reduction agents (potassium chloride, Puracal PP/USP, Purasal Hi Pure P Plus, PuraQ Verdad NV10, SaltWise 0029 and SaltWise 1029) to if there were any interference with antimicrobial activity. Antimicrobials with and without sodium reduction agents were added to the agar systems, then a five-strain cocktail of Listeria monocytogenes, Salmonella or Escherichia coli O157:H7 was spread plated at three concentrations: 101, 102 and 104 CFU/plate. Samples were then incubated at 35°C and observed for growth after 24 and 48h. SEA-i F75 was the most effective antimicrobial in each of the agars tested. Additionally, no interactions were observed between SEA-i F75 and any of the sodium replacement agents. SEA-i F75 was selected for use in a final challenge study using six formulations of LMPS mozzarella cheese: regular sodium control cheese (1.7% NaCl, no antimicrobial added); low sodium control cheese (0.7% NaCl, no antimicrobial added); low sodium treated cheese (0.7% NaCl, treatment with SEA-i F75); low sodium cheese with KCl as salt replacer (0.7% NaCl, 1.0% KCl, treatment with SEA-i F75); low sodium cheese with Alta 2345 as salt replacer (0.7% NaCl, 0.25% Alta 2345, treatment with SEA-i F75); and low sodium cheese with Salona as salt replacer (0.7% NaCl, 0.95% Salona, treatment with SEA-i F75). Fifteen gram cheese pieces from each formulation were dipped in an antimicrobial solution containing 0.25% SEA-i F75 then inoculated with L. monocytogenes, Salmonella, or E. coli O157:H7 at a target inoculum concentration of 102-103 CFU/g and incubated at either 4° or 12°C. In all trials, over all formulations and temperatures tested, initial decreases in counts, followed by organism recovery were observed. Therefore, SEA-i F75 was not effective at reducing the counts of pathogenic bacteria in LMPS mozzarella cheese. Results from this study highlight the effect of the food matrix, and its components on antimicrobial efficacy. Future research…

SUMMARY The purpose of this study was to determine whether SEPs would improve the predictive power of VEPs for the prognosis of asphyxiated infants. 57 term infants had SEPs and VEPs recorded during the first three days of life, during the first week and at follow-up visits. All survivors have been followed for 18 to 24 months. 34 had a normal outcome, 12 had severe neurological sequelae and 11 died. The SEPs had both high sensitivity (96 per cent) and negative predictive power (97 per cent); normal SEPs virtually guaranteed normal outcome. The VEPs had both a specificity and positive predictive power of 100 per cent; abnormal VEPs guaranteed abnormal outcome. Both together had a higher predictive power than either alone. The combination of VEPs and SEPs yields a powerful means of prognostication for term asphyxiated infants; the results suggest that both be included in the assessment of this population. RESUME Validite pronostique des PES (potentiels evoques somesthesiques) et PEV (potentiels evoques vistiels) apres anoxie cerebrale neonatale a terme Le but de cette etude etait de determiner si les PES pouvaient ameliorer la valeur predictive des PEV dans le pronostic des enfants anoxiques. 57 nourrissons beneficierent de PES et PEV durant les trois premiers jours de vie, la premiere semaine et lors des suivis ulterieurs. Le devenir fut normal dans 34 cas, il y eu 12 cas de sequelles neurologiques lourdes et 11 deces. Les PES presenternt a la fois une sensibiliteelevee (96 pour cent) et une valeur predictive negative (97 pour cent); un PES normal etait pratiquement la garantie d'un devenir normal. Les PEV avaient a la fois une specificite et une valeur predictive de 100 pour cent; des PEV anormaux etaient totalement relies a un devenir anormal. Les deux examens reunis avaient une valeur predictive meilleure que l'un ou l'autre des examens isoles. La combinaison de PES et PEV est un element puissant de pronostic pour les enfants anoxiques au terme; ces resultats suggerent que les deux examens soient pratiquees dans I'evaluation de la population a risque. ZUSAMMENFASSUNG Prognostische'Zuverlassigkeit von SEPs und VEPs fur reif geborene Kinder mit Asphyxie Es war das Ziel dieser Arbeit festzustellen, ob SEPs die Aussage-Kraft von VEPs fur die Prognose von Kindern mit Asphyxie verbesern konnen. Bei 57 reif geborenen Kindern wurden in den ersten drei Lebenstagen, in der ersten Wochen und bei Kontrolluntersuchungen SEPs und VEPs abgeleitet. Alle Uberlebenden wurden uber 18 bis 24 Monate nachuntersucht. 34 waren gesund, 12 hatten schwere ne'urologische Folgeerscheinungen und 11 starben. Die SEPs hatten eine hohe Sensitivitat (96 Prozent) und eine negative prognostische Aussagekraft (97 Prozent); normale SEPs garantierten sozusagen eine normale Entwicklung. Die VEPs hatten eine Spezifitat und eine positive prognostische Aussagekraft von 100 Prozent; abnorme VEPs garantierten eine abnorme Entwicklung. Beide zusammen hatten eine hohere prognostische Aussagekraft als jedes fur sich allein. Die Kombination von VEPs und SEPs ergibt einen starken prognostichen Parameter fur reif geborene Kinder mit Asphyxie; die Ergebnisse sprechen dafur, das beide zur Beurteilung dieser Kinder herangezogen werden. RESUMEN Fiabilidad pronostica del SEP y del VEP en lactantes a termino con asfixia El proposito de este estudio fue el determinar si el SEP podria mejorar la capacidad predictiva del VEP en el pronostico de lactantes con asfixia. A 57 ninos a termino se les registro el SEP y el VEP durante los tres primeros dias de vida, durante la primera semana y en las visitas siguientes. Todos los supervivientes habian sido seguidos durante 18 a 24 meses. 34 habian seguido un curso normal, 12 tenian secuelas neurologicas graves y 11 murieron. El SEP tenia al mismo tiempo una alta sensibilidad (96 por ciento) y una capacidad predictiva negativa (97 por ciento); un SEP normal virtualmente garantizaba un curso normal. El VEP tenia una especificidad y una capacidad predictiva positiva del 100 por ciento; un VEP anormal garantizaba un curso anormal. Ambos conjuntamente tenian una capacidad predictiva superior a cada uno por separado. La combinacion de VEP y SEP constituye un poderoso medio de pronostico en los lactantes con asfixia; los resultados sugieren que ambos deben ser incluidos en la evalucion de este tipo de poblacion.

The treatment of bentonite clay sols with the salts of amines and aminoalcohols containing not more than 6 carbon atoms gives gels of hydrophilic organic ammonium bentonites. The gels, e.g. 3 wt.-% methylammonium bentonite, ethylammonium bentonite and triethanolammonium bentonite in water, have plastic rheology and high yield values which depend on the nature of the organic substituents. Use of these organic derivatives of bentonite offers a means of gelling aqueous systems alternative to the use of the purified montmorillonite clays.

Background It is possible that some people who quit smoking experience improved mental health after cessation and therefore remain abstinent, whereas other people who quit may experience worse mental health after cessation and therefore be more likely to relapse to smoking. Thus, in this study we aimed to examine the association between an enduring change in mental health following the cessation period and future risk of relapse. Methods A secondary analysis of prospective data pooled from five placebo-controlled randomised trials for smoking reduction conducted in Europe, USA and Australia. Change in mental health (SF-36, scored 0–100) was measured from baseline to four months for those who were biologically-validated as point-prevalence abstainers at four month follow-up. Thereafter we assessed whether relapse to smoking by 12 months was more likely in those whose mental health had worsened between baseline and four months compared with those who saw no change or an improvement. Results After adjustment for baseline mental health and other major covariates, there was no greater tendency to relapse at 12 months for those whose mental health worsened after cessation compared with those who had no change or an improvement. The odds ratio and 95 % confidence interval was 1.01 (0.97 to 1.05). Conclusions People whose mental health worsens after smoking cessation are at no greater risk of subsequent relapse to smoking than those whose mental health stays the same or improves. Electronic supplementary material The online version of this article (doi:10.1186/s12889-015-2473-z) contains supplementary material, which is available to authorized users.

ObjectivesThe association between smoking reduction and mental health is of particular interest given that many smokers report that smoking offers mental health benefits. We aimed to assess the association between smoking reduction and change in mental health using two different analytical approaches to determine if there was any evidence of an association. There were no prior hypotheses.DesignA secondary analysis of prospective individual level patient data from 5 merged placebo-controlled randomised trials of nicotine replacement therapy for smoking reduction.ParticipantsAll participants were adult smokers, selected because they wanted to reduce but not stop smoking, and had smoked for at least 3 years. Participants were excluded if they were pregnant, breastfeeding, under psychiatric care, deemed to be unfit by a general practitioner, or part of a cessation programme. 2066 participants were enrolled in the trials, 177 participants were biologically validated as prolonged reducers, and 509 as continuing smokers at both 6-week and 18-week follow-ups.Primary outcomeChange in mental health from baseline to an 18-week follow-up was measured using the emotional well-being subscale on the Short Form Health Survey-36.ResultsAfter adjustment for confounding variables, the differences for reducers compared with continuing smokers were: regression modelling −0.6 (95% CI −4.4 to 3.2) and propensity score matching 1.1 (95% CI −2.0 to 4.1).ConclusionsSmoking reduction, sustained for at least 12 weeks, was not associated with change in mental health, suggesting that reducing smoking was no better or worse for mental health than continuing smoking. Clinicians offering smoking reduction as a route to quit can be confident that, on average, smoking reduction is not associated with negative change in mental health.

Clumpiness of the interstellar medium may play an important role in the transfer of infrared continuum radiation in star forming regions (Boisse, 1990). For example, in homogeneous models, C II emission should be confined to the cloud edge (Viala, 1986). However, in star formation regions (such as M17SW, M17 and W51), it is observed to extend deep into the molecular cloud (Stutzki et al., 1988; Keene et al., 1985). One plausible interpretation of these observations is that, due to their clumpiness, the clouds are penetrated by UV radiation far deeper than expected from simple homogeneous models.

The relationship between the n-value and critical current (IC) is investigated for six different ITER-candidate Nb3Sn wires characterized as a function of magnetic field (B≤28 T), temperature (4.2 K ≤T≤12 K) and intrinsic axial strain (−1%≤eI≤+0.4%). For the five wires exhibiting intrinsic behaviour, n(IC) can be parameterized by a modified power law of the form n = 1+rICs, where s is a constant with a value of 0.41 ± 0.03. The parameter r decreases as the magnitude of the intrinsic strain increases and is a relatively weak function of temperature. For one of the wires, the n-value saturates at high critical currents (low magnetic fields), characteristic of extrinsic filament nonuniformities.

Comprehensive measurements are reported of the critical current density (JC) of internal-tin and bronze-route Nb3Sn superconducting wires as a function of magnetic field (B?23?T), temperature (4.2?K ?T?12?K) and axial strain (?1.6%??I?0.40%). Electric field?temperature characteristics are shown to be equivalent to the standard electric field?current density characteristics to within an experimental uncertainty of ~20?mK, implying that JC can be described using thermodynamic variables. We report a new universal relation between normalized effective upper critical field (BC2*(0)) and strain that is valid over a large strain range for Nb3Sn wires characterized by high upper critical fields. A power-law relation between BC2*(0,?I) and TC*(?I) (the effective critical temperature) is observed with an exponent of ~2.2 for high-upper-critical-field Nb3Sn compared to the value ?3 for binary Nb3Sn. These data are consistent with microscopic theoretical predictions and suggest that uniaxial strain predominantly affects the phononic rather than the electronic properties of the material. The standard Summers scaling law predicts a weaker strain dependence than is observed. We propose a scaling law for JC(B,T,?I) based on microscopic theory and phenomenological scaling that is sufficiently general to describe materials with different impurity scattering rates and electron?phonon coupling strengths. It parametrizes complete datasets with a typical accuracy of ~4%, and provides reasonable predictions for the JC(B,T,?I) surface from partial datasets.

In recent years, we have carried out experiments at the University of Rochester’s Omega laser in which supersonic, dense-plasma jets are formed by the interaction of strong shocks in a complex target assembly (Foster et al., Phys. Plasmas 9 (2002) 2251). We describe recent, significant extensions to this work, in which we consider scaling of the experiment, the transition to turbulence, and astrophysical analogues. In new work at the Omega laser, we are developing an experiment in which a jet is formed by laser ablation of a titanium foil mounted over a titanium washer with a central, cylindrical hole. Some of the resulting shocked titanium expands, cools, and accelerates through the vacuum region (the hole in the washer) and then enters a cylinder of low-density foam as a jet. We discuss the design of this new experiment and present preliminary experimental data and results of simulations using AWE hydrocodes. In each case, the high Reynolds number of the jet suggests that turbulence should develop, although this behaviour cannot be reliably modelled by present, resolution-limited simulations (because of their low-numerical Reynolds number).

Ground-penetrating radar is becoming increasingly popular for use as a non-destructive assessment method for investigating reinforced concrete structures. The amount of data collected however can be very large and take a significant level of subjective experience to interpret. This study focuses upon the use of a neural network approach to automate and facilitate the post-processing of ground penetrating radar results. The radar data is reduced to a simplified data set by using an edge detection routine. Signal reflections from reinforcing bars displaying a hyperbolic image format are detected using a multi-layer perceptron (MLP) network with a single hidden layer containing 8 nodes to recognise a simplified hyperbolic shape. Training and testing of the network was carried out making use of an emulsion analogue tank, simulating the properties of concrete, and using real concrete specimens. The results showed that the use of a MLP neural network approach could be quite effective in automating the identification and location of embedded steel reinforcing bars from a radar investigation. Accurate estimation of depth, or cover, requires a reliable knowledge of the dielectric properties of the concrete, and recent work using a specially-developed wideband horn antenna for direct determination of in situ properties is also outlined.

The use of helical (Walters) springs is an effective technique for measuring the critical current density (JC) of superconducting wires in high fields as a function of both compressive and tensile axial strains. We report JC versus strain measurements for Nb3Sn wires on a number of helical springs of different materials and geometries, together with results from finite element analysis (FEA) of these systems. The critical current density, n-value and effective upper critical field data are universal functions of intrinsic strain (to within ± 5%) for measurements on four different spring materials. The strains on the wire due to the differential thermal contraction of the spring are equivalent to the applied mechanical strains and hence only produce a change in the parameter eM (the applied strain at the peak in JC). Variable-strain JC data for springs having turns with rectangular and tee-shaped cross-sections (and hence different transverse strain gradients across the wire) show good agreement when the strain-gauge calibration data are corrected to give the strain at the midpoint of the wire. The correction factors can be obtained from FEA or analytical calculations. Experimental and FEA results show that the applied strain varies periodically along the wire with an amplitude that depends on the spring material and geometry. We suggest that Ti–6Al–4V springs with an integer number of turns and optimized tee-shaped cross-sections enable highly accurate measurements of the intrinsic properties of superconducting wires.

There is an increased interest in the use of ground-penetrating radar as a non-destructive assessment method for investigating reinforced concrete structures. The method involves the collection of a large volume of data, which takes a skilled operative significant time to interpret. A neural network approach has been used in this work to automate and facilitate this post-processing procedure. In addition, a novel technique for the estimation of the diameter of reinforcing bars is presented. This method involves the comparison of signals received with the transducer in a fixed location above the bar but with different orientations of the transducer axis. The radar data is first pre-processed by use of an edge detection routine and then the resulting images compared for different orientations. An emulsion analogue tank, simulating the properties of concrete, was used to generate training data and the resulting neural network was then tested on readings from bars in concrete slabs. The results show that data taken with the transducer axis parallel and then orthogonal to the bar can be analysed by means of a MLP neural network to effectively estimate the diameter of embedded steel reinforcing bars.

– Minnow trapping was used to determine the distribution and abundance of two small, benthic species of fish, common bullies (Gobiomorphus cotidianus) and koaro (Galaxias brevipinnis), in five oligotrophic lakes varying in both turbidity and the extent of water-level variation. Koaro were 5–20 times more abundant in the large turbid lakes than in the clear ones, indicating that turbidity may reduce the extent of salmonid predation on koaro. However, the scarcity of koaro in the clear lakes was related mainly to the prevalence of brown trout (Salmo trutta) compared with rainbow trout (Oncorhynchus mykiss) as the former were more piscivorous and had a stronger inverse relationship with koaro. Common bullies were more abundant at sites 20 m or more away from the shoreline, and at depths of 9–12 m irrespective of season, year and turbidity level. However, the overall abundance of bullies was reduced by 70–90% in the turbid lakes. As bullies are relatively insensitive to the direct effects of increased turbidity, indirect effects such as reductions in macrophytes from reduced water clarity or smothering of benthic habitats by settled solids are thought to influence their abundance in the lakes affected by glacial turbidity. There was no relationship between the extent of water-level fluctuation and the abundance of koaro or common bullies in the lakes, but the depth distribution of bullies was shallowest in the lake with the least water-level fluctuation and was deepest in the lake with the greatest water-level fluctuation.

Gamma rays from excited states feeding a proton-emitting isomeric-state in 151Lu have been observed for the first time. Comparison with state-of-the-art nonadiabatic quasiparticle calculations indicates an oblately deformed, 3/2+ proton-emitting state with a quadrupole deformation of β2 = −0.11. The calculations suggest an increase in quadrupole deformation, to β2 = −0.18, with increasing spin which is understood in terms of the mixing of Nilsson states at the Fermi surface. It is also shown that the proton decay half-life is consistent with that from a 3/2+ state with a quadrupole deformation of β2 = −0.12. peerReviewed

Systematic measurements have been made of the E – J characteristics of a Nb 3 Sn wire over four decades of electric field (0.1–1000 μV m −1 ) and five decades of current density (10 3 –5×10 8 A m −2 ) as a function of magnetic field, temperature and strain. They were parameterised using the power law E = αJ n . At low magnetic fields n tends to a constant saturation value, which decreases at high compressive and tensile strains and increases with increasing electric field. In the high magnetic-field range, n is independent of E -field and can be approximated by a strain and temperature scaling law of the form n ( B , T , e )= G ( T )( B c2 * ( T , e )− B ), where B c2 * ( T , e ) is an effective upper critical field.

Systematic measurements have been made of the engineering critical current density ( J e ) and N -value (where E = αJ N ) of a jellyroll Nb 3 Sn wire as a function of magnetic field and strain at 4.2 K. Strain cycling to very high tensile strains at 4.2 K was used to investigate the reversibility of the wire's properties. The J e data were fully reversible up to 0.67% strain, and can be approximately parameterised by the scaling law F p (4.2 K ,B,e)=J e B=A[B c2 ∗ (4.2 K ,e)] 0.5 b 0.5 (1−b) 2 , where A=1.28×10 10 Am −2 T 0.5 . However it is noted that the maximum pinning force density is not a single-valued function of B c2 ∗ , so that highly accurate parameterisation requires that A depends on strain. The N -values are a strong function of strain, peaking at ∼0.33% with values nearly double the equivalent zero-strain values.

Smoking is the world’s leading cause of preventable illness and death (1). Accounting for 6 million deaths annually, 600,000 of smoking-related deaths occur in non-smokers exposed to second hand smoke (2). A major risk factor for six of the eight leading causes of death worldwide, smoking affects nearly every organ of the body (3). Smokers usually underestimate their risk of smoking-related diseases (4). Awareness of health concerns are a major motivator to quit (5,6). One in every two smokers will die from their addiction, however quitting substantially reduces this risk (7,8). Making an attempt to quit smoking and then sustaining abstinence are both equally important in ultimately succeeding quitting. Smokers frequently attempt quitting several times unsuccessfully before achieving long-term abstinence (9,10). Smokers who seek support in quitting are much more likely to quit than those who try to quit alone, and the most effective aid for achieving smoking cessation is medication (e.g., nicotine replacement therapy, or varenicline) coupled with tailored behavioral support from specialist stop smoking services, like the National Health Service Stop Smoking Services (NHS SSS) in the UK (11-13).

Juvenile (12-152 g) shortfinned eels Anguilla australis and longfinned eels A. dieffenbachii caught in New Zealand streams were fed squid mantle Nototodarus spp. 4 days per week in laboratory experiments. A linear multiple regression equation showed the amount of food eaten (0-2.7% w day -1 ) explained 77.7% of the variation in specific growth rates ( - 0.60 to +1.07% w day -1 ) among individual eels, while previous growth rates, water temperature (10.0-20.6°C), and eel weight (12-152 g) explained a further 5.6, 1.4 and 0.8%, respectively. Growth in length ranged from -0.3 to +0.9 mm day - 1 . Eels which were starved and then given high rations grew substantially faster than expected. Once growth rates were adjusted for differences in ration and other factors, there were no significant differences in growth rates between species or individual fish. Growth of shortfinned eels fed maximum rations of commercial eel food depended on fish size and water temperatures and ceased below 9.0° C. Growth rates in the wild were substantially less than the maximum possible, after seasonal changes in water temperatures were taken into account, indicating that food supplies and not low water temperatures were controlling growth rates in the wild.

A glucose-sensitive gel formulation containing concanavalin A and glycogen has been reported previously. Precipitation resulting from the addition of concanavalin A to glycogen has been documented, but the formation of glucose-sensitive gels based on lectin-glycogen interactions is novel and used here in our studies. An improved in-vitro self-regulating drug-delivery system, using covalently modified glucose-sensitive gels based on concanavalin A and a polysaccharide displacement mechanism, is described. The successful use of the covalently modified gels addresses a problem identified previously where significant leaching of the mitogenic lectin from the gel membranes of non-coupled gels was encountered. Concanavalin A was covalently coupled to glycogen by use of derivatives of Schiff's bases. The resulting gels, like the non-coupled gels, were shown to undergo a gel-sol transformation in response to glucose. Insulin delivery was demonstrated using this covalently modified system in conditions of repeated glucose triggering at 20°C and 37°C. The magnitude of the response was less variable than for the dextran-based gels studied previously. The performance of this system has been improved in terms of concanavalin A leaching. This could, therefore, be used as the basis of the design of a self-regulating drug-delivery device for therapeutic agents used to treat diabetes mellitus.

The family of wake profiles formed from the Falkner–Skan boundary-layer solutions with negative pressure gradient, m , was shown in (Woodley and Peake, 1997) to be inviscidly absolutely unstable. However, due to numerical difficulties, the limit m→0 was not considered there, although the results that were found appeared to indicate that the double Blasius profile ( m=0 ) is absolutely unstable. In this note we repeat those calculations using an alternative formulation, and show that in fact the absolute instability present for m becomes neutral as m→0 , so that the flat-plate wake is only convectively, and not absolutely, unstable. In addition, the effects of viscosity are included here using the Orr–Sommerfeld equation, and two sets of saddle points are now found, one set corresponding to the inviscid family, which can be either pinching or non-pinching depending on the values of m and the Reynolds number, and another set which is always pinching, but which is stable for m close to zero.

The signal importance of policy and regulation in the transport field is beyond dispute. Equally, it is said of transport issues that they are all too often at the mercy of policy innovations from cognate sectors (Hallsworth et al., 1998). In this paper we suggest that this is precisely the case in the courier services sector. In the past two decades the fast courier sector has been the fastest-growing sector of physical transportation—and it is perhaps most simply defined by reference to such key players as UPS, DHL and FedEx. The rise in the numbers of delivery-dedicated fleets of aircraft, vans and trucks has been inexorable—impacting on all facets of the “transport problem”. However, rather than concentrate on the wider effects of this important transport sector we choose in this paper to focus on the roots of the industry and the signal importance of policy in the form of market regulation and competition.

We present an overview of the performance of the High Speed Photometer (HSP), one of the five original instruments on the Hubble Space Telescope (HST). As its name implies, the HSP was designed for precise high time resolution photometry from visual to ultraviolet wavelengths; sample times as short as 10.7 μs were possible. Three image dissectors along with 23 different broad‐ and narrowband filters spanning the spectral range from 1200 to 7500 A were used for photometry of stars and galaxies. A fourth image dissector with associated polarization analyzers allowed the measurement of broadband linear polarization at near‐ultraviolet wavelengths. Simultaneous observations in the blue and red could be made using one of the dissectors and a photomultiplier. Except for an instability in the sensitivity of one of the image dissectors and a reduced throughput in a specialized observational mode, the instrument met or exceeded operational specifications until it was removed from HST in 1993 December. The...

Following the investigation of the long-time limit of the impulse response of an incompressible swept boundary layer (Taylor & Peake 1998), we now consider the corresponding behaviour of two representative sets of compressible swept-wing profiles, one set in subsonic flow and the other in supersonic flow. The key feature of the incompressible analysis was the occurrence of modal pinch points in the cross-flow wavenumber plane, and in this paper the existence of such pinches over a wide portion of space in high-speed flow is confirmed. We also show that close to the attachment line, no unstable pinches in the chordwise wavenumber plane can be found for these realistic wing profiles, contrary to predictions made previously for incompressible flow with simple Falker–Skan–Cooke profiles (Lingwood 1997). A method for searching for absolute instabilities is described and applied to the compressible boundary layers, and we are able to confirm that these profiles are not absolutely unstable. The pinch point property of the compressible boundary layers is used here to predict the maximum local growth rate achieved by waves in a wavepacket in any given direction. By determining the direction of maximum amplification, we are able to derive upper bounds on the amplification rate of the wavepacket over the wing, and initial comparison with experimental data shows that the resulting N-factors are more consistent than might be expected from existing conventional methods.

Event‐related potentials were recorded in 25 dyslexic children with auditory processing deficits and 25 normal children, 7 to 12 years old. Three tasks were run: orthographic, phonological, and semantic classification tasks. N2 and P3 latencies and P3 amplitude (P3amp) and reaction times (RT) to targets were measured. No significant RT differences were found between the groups although a group, age, and task interaction was seen. P3 latencies decreased with age across tasks, and N2 latencies decreased with the semantic and phonological tasks. P3 latencies were significantly longer in dyslexic than control children in the phonological and semantic tasks; for the latter task, dyslexics also had longer N2 latencies. In the phonological task, latencies decreased with age only for the control children; the dyslexic children showed no maturational changes. Across tasks, there were significant distributional group differences in the P3, due to a more posteriorly located P3, and marked frontal negativity in the d...

Artificial neural network models are now being widely used in various areas of statistical research. Nevertheless, there is a certain degree of reluctance amongst members of the business profession in applying neural networks to business analysis. One of the major causes of scepticism is the inability of the models to provide explanation on how they reach their decisions. The current experiment is concerned with solving this problem by developing a framework for establishing the impacts of the input variables on the network output. The framework was tested on a feedforward neural network model for turnover forecasting which was developed in co-operation with a British retailer using real world marketing data. The results obtained are compared with those from a sensitivity analysis.

Artificial neural networks are now being extensively used in the area of marketing analysis, as they are well suited to this type of non-linear problem. A retail company planned to improve its performance by using neural networks to predict turnover, and data used in the experiment was provided by the company. The study compares the performance of a combination of neural networks to that of a single neural network. The results show that backpropagation neural networks are effective tools which can give good results in solving a non-linear prediction problem, even when data is poorly represented.