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After the emergence of the SARS-CoV-2 virus in early 2020, it quickly became clear that symptomatic or asymptomatic infection had the potential to negatively impact on an individual’s fitness to dive through effects on the respiratory, cardiovascular or neurological systems. The significance of these effects in the military diving environment was initially unclear due to an absence of data concerning incidence, chronology or severity. In order to safely return divers to the water and maintain operational capability, the UK Military developed a pathway for SARS-CoV-2 positive divers that stratified risk of sequelae and extent of required clinical investigation, while minimising reliance on viral testing and hospital-based investigations. We present this process, provide rationale and support for its design and detail the number of SARS-CoV-2 positive divers who have been returned to full diving fitness following infection of varying degrees of severity.

Funding Acknowledgements Type of funding sources: Foundation. Main funding source(s): British Heart Foundation Local Departmental Research Funding Background Cardiac resynchronisation therapy (CRT) using fusion pacing requires correct timing of left ventricular pacing to right ventricular activation. The SyncAV™ algorithm, achieves this by dynamic reassessment of intrinsic atrio-ventricular (AV) conduction to adjust the paced/sensed AV delay. However, it is unclear whether AV optimisation maintains resynchronisation during exercise, or whether loss of fusion could lead to decreased exercise capacity. Cardio-pulmonary exercise testing (CPET) is the gold standard method for assessing exercise performance and can provide prognostic information in the heart failure population. Purpose We therefore used CPET measures of exercise capacity to compare the SyncAV™ algorithm to conventional pacing with fixed AV delays, in a double blinded, randomised crossover study (NCT03768804). Methods Patients at least 6 months post-CRT implant performed 2 CPET tests at least 1 week apart, with randomisation to either SyncAV™ with fusion pacing or conventional biventricular pacing with a fixed AVD of 120ms. All other programming was optimised to produce the narrowest QRS duration possible at rest in each case. Results Twenty patients (11 male, age 71 [65-77] years, median [interquartile range]) were recruited, with both ischaemic and non-ischaemic aetiology of heart failure. All had clinical and/or echocardiographic response to CRT. Optimised Fixed AVD and SyncAV™programming resulted in similar narrowing of QRS duration (QRSd) from intrinsic rhythm at rest (131 [103-137] vs 134 [110-137] ms for fixed AVD and SyncAV™ groups respectively, p=0.85). Overall, there was no difference in peak oxygen consumption (V̇O2peak) between programming (14.91 [12.61-18.16] vs 15.61 [12.18-19.70] ml/kg/min, p=0.19), or oxygen consumption at anaerobic threshold (VT1) (7.36 [6.93-8.94] vs 7.87 [6.77-9.24] ml/kg/min, p=0.42), or in the time to reach either V̇O2PEAK (p=0.81) or VT1 (p=0.39). The BORG rating of perceived effort was also similar between groups. CPET performance was also analysed comparing whichever programming gave the narrowest QRSd at rest (119 [96-136] vs 134 [119-142] ms, p Conclusion There is no significant difference in exercise capacity or QRSd between the use of optimised fixed AVD or SyncAV™, lending reassurance to fusion pacing being adequately maintained on exercise. In addition, programming with whichever algorithm gives the narrowest QRSd at rest is associated with a narrower QRSd during exercise, higher peak stroke volume and improved cardiac efficiency. This supports the use of SyncAV™ in the 40% of patients where this gave the narrowest QRSd at rest.

Background Countries with population-based colorectal cancer screening using faecal occult blood test kits performed in the home and posted to the laboratory struggle to achieve higher than 60% uptake. We measured the impact on participation of offering a community laboratory drop-off (CLD) alternative to postal return in New Zealand's Bowel Screening Pilot. Methods From May to September, 2015, a flyer added to the bowel screening test kit offered CLD as an alternative to returning the kit by post. Participation rates for equal-length periods before and after were measured. Interrupted time series and logistic regression models measured CLD-attributable the changes in screening participation. Results Overall, 26% of invitees used the CLD option. The effect of the CLD option on participation varied significantly by age, gender and ethnicity. There was a significant increase in participation among males (+1.75%; P = 0.002); patients under 60 (+1.65%; P = 0.006); Māori and Pacific (+2.88%; P = 0.029); and in the European/other ethnic group (+1.04%; P = 0.045) but not in Asians. Conclusions Both analyses showed that at little or no additional cost, the CLD option produced small but significant increases in participation for non-Asian men and younger invitees. A CLD kit return option may have benefits for other bowel screening programmes.

Objective To test whether a telephone follow-up service for high-needs ethnic groups increases bowel screening participation in non-responders to postal invitations. Methods Māori, Pacific, and Asian ethnicity individuals who failed to return a bowel screening test kit within four weeks of it being posted were randomly allocated (1:1) to a telephone active follow-up service or a control group. The active follow-up service made multiple attempts to contact the invitee and provide support. Participation rates at eight weeks’ post-randomisation were compared, and the effect of the intervention on overall participation rates was imputed. Results A total of 3828 eligible individuals were allocated to active follow-up and 3773 to the control group. The imputed potential overall increase in participation in the active follow-up group was 2.0% (95% CI = 0.6%–3.4%); however, the impact of follow-up varied significantly by ethnicity and deprivation. The imputed increase in participation was significant for Māori (5.2; CI = 1.8%–8.5%) and Pacific (3.6%; CI = 0.7%–6.4%), but not for Asian ethnicities (0.7%; CI=−1.1%–2.4%). In addition, the imputed increase was significant among high deprivation participants (3.9%; CI = 2.0%–5.9%), but not among low deprivation participants (0.3%; CI=−1.6%–2.2%). Conclusions Active follow-up led to higher bowel screening participation in Māori and Pacific but not in Asian ethnicities and was more effective in high deprivation subjects. Active follow-up significantly reduced but did not eliminate ethnic inequalities in bowel screening participation.

This review is concerned with the non-Newtonian behaviour of selected fluid food products and, in particular, with the applicability of the power law. Some alternative models are included which food scientists might find useful in correlating flow properties. The interpretation of rheological characteristics in terms of structure and consistency is mentioned and the need for more detailed studies, particularly with regard to thermodynamic aspects, is pointed out. Application of the power law model to food processing is illustrated with principles of heat transfer and mixing of non-Newtonian foodstuffs.

The Haywood Medical Society met in June 2011 to discuss issues surrounding the preparedness of both civilian and military emergency services to deal with a CBRN threat.

The efficacy of two doses of balsalazide for the maintenance of remission in patients with ulcerative colitis was compared in a double-blind multicentre trial. Sixty-five patients received a 2 g daily dose, and 68 a 4 g dose. The patient groups were similar at entry for sex, age, and disease distribution. Clinical assessment was carried out at 3-monthly intervals, with sigmoidoscopy, rectal biopsy, and blood tests on entry and at 26 and 52 weeks. Clinical relapse over twelve months was significantly less common on the 4 g dose (36%), than on the 2 g dose (55%), P less than 0.01. There were eight withdrawals on 2 g daily and 13 on 4 g daily, six and nine respectively being mainly due to gastrointestinal intolerance. It is concluded that balsalazide is a well-tolerated drug, and is effective for the maintenance of remission in patients with ulcerative colitis, the optimal dose being greater than 2 g daily.

We present the first time-resolved spectroscopic observations, made with the SALT HRS instrument, of a rapidly oscillating Ap star. We used the instrument in the High Stability mode, with the fastest readout settings – a setup never previously used. Over a 2.5-hr track length, we obtained 280 spectra at 8-second integration times and a cadence of 30 seconds. The target, α Circini, is the brightest of the roAp stars, and thus provides an excellent opportunity to test the instrument. Previous time-resolved spectroscopic studies of this star have been conducted by Kurtz, Elkin & Mathys† with the VLT/UVES instrument, and by Mkrtichian & Hatzes‡ with the HARPS instrument on the ESO 3.6-m telescope. Those two studies provide us with benchmarks to compare the performance of SALT/HRS for this type of project. With the upcoming TESS mission, the ability to perform high-precision, time-resolved spectroscopy of pulsating stars will be key for the scientific output of SALT.

Background: Sulfasalazine is accepted therapy for active ulcerative colitis, but side-effects and intolerance are common. Balsalazide is an azo-bonded pro-drug which also releases 5-aminosalicylic acid into the colon, but uses an inert carrier molecule. Aim: To compare the safety and efficacy of sul- fasalazine, 3 g, with balsalazide, 6.75 g, in the initial daily treatment of mild to moderate ulcerative colitis. Methods: A randomized, multicentre, double-blind, parallel group study was performed, with a treatment duration of 8 weeks. Patients on previous maintenance treatment were excluded. The trial medication was the sole treatment for the colitis. Efficacy was assessed by patient diaries, symptom assessment, sigmoidoscopic appearance and histology. Results: Fifty patients were recruited: 26 allocated to the balsalazide group and 24 to the sulfasalazine group. More patients withdrew due to adverse events in the sulfasalazine group (nine patients vs. one patient in the balsalazide group, P=0.004). Improvement occurred in both groups, with a tendency to a faster response with balsalazide. Of the patients taking balsalazide, 61% achieved clinical and sigmoidoscopic remission. Conclusions: Balsalazide, 6.75 g, is effective as the sole treatment for patients with mild to moderately active ulcerative colitis, with significantly fewer withdrawals due to side-effects than in a similar group of patients taking sulfasalazine, 3 g.

To investigate the relationship between stable chromosome aberration frequency in peripheral blood lymphocytes and occupational cumulative radiation exposure.Cytogenetic analysis using G-banding was performed on peripheral blood lymphocyte cultures from 104 workers from the British Nuclear Fuels PLC facility at Sellafield, UK. The study group comprised 61 men with lifetime cumulative doses500 mSv, 39 men with minimal exposure (i.e.50 mSv) who formed a control group and 4 men with intermediate doses.The slope of the dose-response, adjusted for smoking status, for translocations and insertions was 0.55+/-0.31 x 10(-2)/cell/Sv. Consideration of chromosome breakpoints for all aberrations combined in the radiation workers revealed an excess in the C group chromosomes and a deficit in the F group chromosomes with breakpoints being concentrated in the terminal regions whereas the distribution in the control group did not deviate from expectation.The dose-response was not significantly different from the parallel FISH analysis (Tucker et al. 1997) and confirms that chronic radiation exposure appears to be substantially less effective at inducing stable chromosome aberrations in comparison with acute exposure.

The thermal and photooxidative stabilities of high, linear low and metallocene grade polyethylenes are compared using FTIR and hydroperoxide concentration analysis and thermal methods (DSC, TGA). The thermal ageing of solid films follow the order LLDPE > metallocene > HDPE while for light stability the order is LLDPE > HDPE > Metallocene. Derivative UV and FTIR spectroscopic analysis of the three polyethylene types show that the vinyl types and concentrations are different and that they reflect the thermal stability of the polymer materials. Hydroperoxide levels also appear to be important and correlate with the carbonyl index oxidation rates. Differences in catalyst residues play a less prominent role although the effect of the Ti levels may be important. The fluorescence and phosphorescence excitation and emission spectra of the three types of polyethylene are similar confirming earlier identities on the role and presence of unsaturated carbonyl species. There are however, significant differences in a long wavelength component in the fluorescence emission indicating the presence of other active chromophores. These were found to be significant in the case of the metallocene polymer. These chromophores may contribute to the differences in the light stability of the polymers with the metallocene exhibiting the greatest intensity and least stability followed by HDPE and LLDPE.

Background: Despite widespread use of aminosalicylates as maintenance treatment for ulcerative colitis (UC), patients still report troublesome symptoms, often nocturnally. Aim: To compare the efficacy and safety of balsalazide (Colazide) with mesalazine (Asacol) in maintaining UC remission. Methods: A randomized, double-blind comparison of balsalazide 3 g daily (1.04 g 5-ASA) and mesalazine 1.2 g daily for 12 months, in 99 (95 evaluable) patients in UC remission. Results: Balsalazide patients experienced more asymptomatic nights (90% vs. 77%, P = 0.0011) and days (58% vs. 50%, N.S.) during the first 3 months. Balsalazide patients experienced more symptom-free nights per week (6.4 ± 1.7 vs. 4.7 ± 2.8; P = 0.0006) and fewer nights per week with blood on their stools or on the toilet paper, mucus with their stools or with sleep disturbance resulting from symptoms or lavatory visits (each P

Samplels for the analysis of phytoplankton photosynthesis pigments were collected from the equatorial Pacific (5°N to 15°S along 155°E) in October 1990 as part of the Australian contribution to the JGOFS program. Chlorophyll and carotenoid pigments were measured by HPLC using a diode-array detector. A PC-based computer program was used to optimise the pigment ratios and to estimate the contributions of 10 algal classes to the total chlorophyll a concentration at each location and in 7 separate depth bands. For the pigments that occur in more than one algal class, the pigment: chlorophyll a ratios for 19′-butanoyloxyfucoxanthin and 19′-hexanoyloxyfucoxanthin (chrysophytes and haptophytes), neoxanthin (prasinophytes, euglenophytes and chlorophytes) and chlorophyll b (prasinophytes, euglenophytes, prochlorophytes and chlorophytes) increase with depth, while those of violaxanthin (prasinophytes and chlorophytes), diadinoxanthin (dinoflagellates, chrysophytes, haptophytes, euglenophytes and diatoms), lutein (prasinophytes and chlorophytes) and, zeaxanthin (prasinophytes, cyanobacteria, prochlorophytes and chlorophytes) decrease with depth. Peridinin: chlorophyll a increases with depth in dinoflagellates, while alloxanthin: chlorophyll a decreases with depth in cryptomonads. The only pigment ratio that does not change consistently with depth is that of fucoxanthin, which increases with depth in chrysophytes and haptophytes but decreases in diatoms. Based on their contribution to the total chlorophyll a , cyanobacteria ( Synechococcus ) were dominant in the nutrient depleted surface waters, haptophytes were dominant at mid depth (70 m), and prochlorophytes were dominant at depths of 100–125 m. These three algal classes were by far the most important, and each contributed up to 30–40% of the total chloro-phyll a at some depth within the water column. Chlorophytes and chrysophytes contributed up to a maximum of about 12% of the total chlorophyll a , while cryptophytes, diatoms, dinoflagellates, prasinophytes and (possibly) euglenophytes generally contributed up to 4–8% of the chlorophyll a .

Background & Aims: Aminosalicylates are widely used in the treatment of ulcerative colitis (UC). Balsalazide is a novel mesalamine prodrug, activated by colonic bacteria. The aim of this study was to compare the efficacy and safety of balsalazide with that of a pH-dependent formulation of mesalamine in active UC. Methods: A randomized, double-blind study was performed comparing balsalazide, 6.75 g daily, with mesalamine, 2.4 g daily, administered for 4, 8, or 12 weeks to 101 (99 evaluable) patients with symptomatic, sigmoidoscopically verified UC. Results: More patients treated with balsalazide achieved symptomatic remission after 2 (64% [balsalazide] vs. 43% [mesalamine]), 4 (70% vs. 51%), 8 (78% vs. 45%), and 12 weeks (88% vs. 57%) and complete remission (none/mild symptoms, sigmoidoscopy grade 0/1, no rectal steroid use within 4 days) after 4 (38% vs. 12%), 8 (54% vs. 22%), and 12 weeks (62% vs. 37%). Patients taking balsalazide experienced more asymptomatic days (4 weeks, 24% vs. 14%) and achieved the first asymptomatic day more rapidly (median, 10 vs. 25 days). Fewer patients in the balsalazide group reported adverse events (48% vs. 71%); four serious adverse events occurred in the mesalamine group. Conclusions: Balsalazide is more effective and better tolerated than mesalamine as treatment for acute UC. GASTROENTEROLOGY 1998;114:15-22

The influence of long-term ambient storage conditions in the presence of air has been examined on the thermal and photooxidation of unstabilized polypropylene. Samples of polypropylene have been aged under ambient storage for 12 years together with a control sample kept under refrigeration at −20°C. The samples have been examined using second order-derivative absorption, fluorescence and phosphorescence spectroscopic techniques, thermal analysis (d.s.c.), light scattering and hydroperoxide analysis. All the polymer samples stored under ambient conditions exhibit significant increases in luminescent species and hydroperoxide concentrations as a consequence of slow oxidation processes. The d.s.c. and light scattering analysis show that these polymers exhibit an increase in crystallinity compared with that which has been stored by refrigeration. The data are related to the thermal and photooxidative behaviour of the polymers using Fourier transform infra-red spectroscopy (FTi.r.) and compared with that of a modern suspension grade polypropylene.

The ideal imaging method in inflammatory bowel disease would reliably detect inflammation, identify the correct intestinal location, and assess the severity of the disease. The aim of this study was to compare scintigraphic methods of quantifying overall disease activity using both indium-111 (111In) and technetium-99M (99mTc) HMPAO labelled leucocyte scans. The four day faecal excretion of 111In was measured after 111In scintigraphy in 24 patients known to have inflammatory bowel disease. The same patients also underwent 99mTc HMPAO scanning. The scans were performed 10 days or less apart with no changes in treatment between scans. Bowel activity on the 99mTc HMPAO scans was assessed using a computer based method (scan score) and a visual grading method in a further 54 99mTc HMPAO. The results showed a close correlation between inflammatory activity defined by faecal 111In excretion and the scan score generated from the computer analysis of the 99mTc HMPAO image (Spearman rank correlation: rs = 0.78; p < 0.001). Accurate information to localise inflammatory activity could be obtained by simple visual assessment of both types of scan images, although image quality was superior with 99mTc HMPAO. Qualification of disease activity from 99mTc HMPAO images by visual grading was associated with a large variability, only 69% of scans had similar scores when graded by three observers. Computer generated image analysis was more reproducible. In conclusion, in inflammatory bowel disease 99mTc HMPAO scintigraphy and faecal 111In excretion correlated well. Either method can quantify and localise the inflammation. As 99mTc HMPAO scanning provides a quicker result, with a lower radiation dose, and avoids faecal collection, it may be the preferred method.

The frequency of hypoxanthine-guanine phosphori-bosyltransferase (hprt) mutations has been determined in the peripheral T-lymphocytes of 18 workers at the Sellafield nuclear reprocessing installation with cumulative recorded radiation doses of about 500 mSv or more in comparison with a matched control group of 18 workers with doses less than 50 mSv. The mean dose of the exposed group was 663 mSv (range 449.3-880.8), and of the unexposed group 10.9 mSv (range 0-46.5). During the most recent 6 y the mean doses were 40.1 mSv (range 1.9-93.9) and 2.3 mSv (range 0-8.7), respectively. The logarithmic mean mutant frequency of the exposed group (9.3 x 10{sup -6}) was lower than that of the unexposed group (12.4 x 10{sup -6}). The apparent inverse association of mutant frequency and exposure varied in statistical significance tests from borderline top < 0.01 depending on how the analysis was performed and whether recent or total exposure was considered. 22 refs., 1 tab.

Elemental diets are effective in inducing remission in active Crohn's disease, but how they exert this therapeutic effect is unclear. In a previous study a whole protein containing diet proved less effective than one in which food antigens were excluded, suggesting that exclusion of food antigens from the gut was a possible mechanism. This study was designed to test whether an oligopeptide diet of hydrolysed proteins was as effective as an amino acid based diet. These diets were equally antigen free but with different nitrogen sources. Forty four patients with active Crohn's disease were randomised in a controlled trial of amino acid versus oligopeptide diet. The feeds were given by nasogastric tube in equicaloric quantities and were the sole form of nutrition. Treatment was continued for four weeks although failure to improve by day 10 resulted in withdrawal. Quantitative leucocyte scintigraphy was used to investigate the effect of diet treatment on gut inflammation. Clinical and nutritional responses to treatment were also measured. Sixteen patients entered remission (including withdrawal of corticosteroids), six patients could not tolerate the nasogastric tube, and 22 patients failed to respond. The two diets were equally effective. Patients who responded had a rapid drop in clinical index of disease activity and a major reduction in the bowel uptake of leucocytes on scintigraphy. The oligopeptide and amino acid based enteral feeds were equally effective at inducing remission in active Crohn's disease. With both diets clinical improvement was accompanied by a reduction in intestinal inflammation.

Two novel naphthyl ester derivatives have been synthesised and characterised based on a 2-hydroxybenzophenone and a 3,5-di-tert-butylphenol. Thermal and photochemical ageing studies have been carried out to determine their potential as stabilisers in polypropylene (PP). Whilst both compounds exhibit no oven ageing antioxidant properties alone they are somewhat effective melt stabilisers. Differential thermal analysis and mass spectrometry show both compounds fragment at the carbon-oxygen bond (CO) of the ester group. Whereas both compounds exhibit good oven ageing stability for PP with a thermal hindered phenolic antioxidant, Irganox 1010, antagonism is observed when combined with a hindered piperidine light stabilizer, Chimassorb 944. In the latter case the antagonism is significant in the presence of the benzophenone derivative. The benzophenone derivative is not an effective light stabiliser alone in PP despite its high absorptivity in the near-UV region 300–350 nm and its ability to act as an excited state quencher. However, it does exhibit strong synergism with both the hindered phenolic antioxidant and the hindered piperidine stabilisers. The naphthyl benzoate ester on the other hand is an extremely effective light stabiliser alone in PP, has weak absorptivity in the near-UV region and is unable to act as an excited state quencher. Strong synergism is observed with a hindered piperidine light stabiliser, Chimassorb 944 but not with a hindered phenolic antioxidant. Spectroscopic evidence indicates that the naphthylbenzoate ester undergoes a rapid initial photo-Fries rearrangement to produce a more strongly absorbing hydroxynaphthylphenyl methanone product.

A computer-based technique for the quantification of abnormal bowel uptake in Crohn's disease has been developed and compared with pre-existing clinical, laboratory and scintigraphic methods of assessment. The standard technique for labelling leucocytes with 99mTc-HMPAO is applied. Images were obtained at 40, 120 and 240 min after the injection of radiolabelled leucocytes. The count in the bowel area after subtracting background activity corrected to the injected dose and image acquisition times is the 'scan score', an objective measure of disease activity. The scan score is significantly higher in patients with clinically active disease (mean 82.1 +/- SEM 13.6) than in those with quiescent disease (24.7 +/- 7.0) (p < or = 0.005). Optimum separation between active and quiescent disease is achieved with a threshold scan score of 20. The scan score was comparable in small bowel disease (73.3 +/- 16.2), large bowel (94.4 +/- 33) and disease at both locations (94.1 +/- 19.2). The scan score correlated favourably with Crohn's Disease Activity Index (rs = 52, p < or = 0.0001), Harvey & Bradshow Simple Index (rs = 0.4, p < or = 0.001), serum C-reactive protein (rs = 0.72, p < or = 0.001), serum alpha acid glycoprotein (rs 0.67, p < or = 0.001), haemoglobin (rs = 0.66, p < or = 0.001), platelet count (rs = 0.47, p < or = 0.006), albumin (rs = 0.61, p < or = 0.0001) and faecal 111Indium excretion (rs = 0.78, p < or = 0.001), but not with the ESR (rs = 0.22, p < or = 0.4).(ABSTRACT TRUNCATED AT 250 WORDS)

The reliability and clinical applications of computerised image analysis measurement of bowel uptake of Tc-99m HMPAO labelled leucocytes has been examined as a measure of disease activity in Crohn's disease. In 54 studies carried out on 33 patients with established Crohn's disease, the mean 'scan score', a quantitative assessment of image intensity, was 82.1 SEM (13.6), in patients with clinically active disease compared to 24.7 (7.0) in those with quiescent disease, p < or = 0.0005. A significant correlation was found between the scan score and Crohn's Disease Activity Index (rs = 0.52, p < 0.0001), and Harvey and Bradshaw Simple Index (rs = 0.4, p < 0.004). A low scan score correctly identified seven patients whose raised Crohn's Disease Activity Index incorrectly indicated active disease because symptoms used in calculation of the index were not caused by active inflammation. Of the laboratory measurements, the scan score correlated with the haemoglobin (rs = 0.66, p < 0.0001), albumin level (rs = -0.6, p < 0.0001), C-reactive protein (rs = 0.7, p < 0.0001), alpha-acid glycoprotein (rs = 0.57, p < 0.001), and platelet count (rs = 0.47, p < or = 0.006), but not with the erythrocyte sedimentation rate (rs = 0.2, p < or = 0.25). The scan score was raised in all patients who had clinically active disease but normal laboratory tests. The results of this study indicate that the scan score provides an objective indicator of disease activity in Crohn's disease which may be superior to clinical indices, and also to laboratory tests which although objective are often normal in the presence of active disease.

Saccharomyces cerevisiae (baker's yeast) may play an important part in the pathogenesis of Crohn's disease. Because of this the levels of IgG and IgA antibodies against three S cerevisiae strains (NCYC 77, NCYC 79, and NCYC 1108) were assayed in 49 patients with Crohn's disease, 43 with ulcerative colitis, 14 with coeliac disease, and 21 healthy controls. Coded serum samples were tested by ELISA. Similar antibody patterns to all three strains were found. IgG and IgA antibody levels were significantly raised in patients with Crohn's disease compared with healthy controls (p < 0.001 and p < 0.0001 respectively) and with ulcerative colitis patients (p < 0.0001 and p < 0.0006 respectively). Raised IgA, but not IgG, yeast antibody levels were found in two patients with Crohn's disease who were intolerant to yeast, but these values were similar to those in other patients without yeast intolerance. In ulcerative colitis, both IgG and IgA levels were similar to normal controls. Patients with small bowel Crohn's disease had significantly higher IgG antibody levels than those with colonic disease (p < 0.01). High levels of IgG, but not IgA, antibody were present in patients with coeliac disease, the antibody responses being indistinguishable from those found in Crohn's disease. It is concluded that the presence of IgG antibody to S cerevisiae is characteristic but not specific to Crohn's disease. Although raised IgA antibody levels are more frequently found in Crohn's disease, their pathogenic importance remains to be established.

Escherichia coli strains cultured from 74 patients with inflammatory bowel disease at different stages of disease activity (Crohn's disease (40), ulcerative colitis (34)) and 18 healthy controls were studied in relation to haemolysin and verotoxin production and enteroadherence. Disease activity was assessed by standard clinical and laboratory tests. Haemolytic E coli were isolated from 18% of patients with Crohn's disease, 24% with ulcerative colitis, and 11% of healthy controls. None of these differences was significant. No verotoxin producing strains were detected among the 216 E coli isolates examined but the extract from five strains (Crohn's (4), ulcerative colitis (1) produced a distinctive cytopathic effort on Vero cell monolayers which was later shown not to be due to verotoxin. The adhesion indices of E coli isolates cultured were: mean (SEM) 42.2 (6.4) for Crohn's disease, 43.3 (6.2) for ulcerative colitis, and 11.3 (2.0) for normal controls (p less than or equal to 0.0001). Adhesive E coli were isolated from 62% of patients with Crohn's disease and 68% with ulcerative colitis but from only 6% of normal controls (p less than or equal to 0.0002). Neither haemolysin production nor enteroadherence was dependent upon disease activity, disease location, sulphasalazine treatment, or previous intestinal resection. These results indicate that only enteroadherent E coli were frequently associated with inflammatory bowel disease; their relation to the pathogenesis of these conditions, however, remains uncertain.

A new technique for the quantitative analysis of labelled leucocyte images from patients with inflammatory bowel disease is described. The method involves the computer generation of a 'background' image which, after appropriate registration, is subtracted from the patient's image to leave a residue which represents abnormal uptake in the bowel. Quantification of the residual activity yields a scan score which can be related to the level of disease activity in patients with Crohn's disease. In 54 investigations on 33 patients the scan scores correctly agreed with a clinical assessment of disease activity in 16 of 20 cases with inactive disease and 32 out of 34 cases with active disease. Most of the discrepancies reflected inaccuracies in the clinical assessment of activity rather than shortcomings of the imaging technique.

Vascular patients under the care of one surgeon over a 5-year period have been reviewed, from computer-based discharge records, with regard to in-hospital measures of outcome to determine whether or not surgery was being performed to an acceptable standard. Out of 466 procedures, 30 per cent of patients had at least one complication, 14 per cent had further surgery and 9 per cent died. Outcome was examined within the following treatment groups: aorto/iliac aneurysm, aortofemoral bypass, femoroproximal popliteal bypass, femorodistal popliteal bypass, femorocrural bypass, embolectomy and percutaneous transluminal angioplasty. Patients having below-knee bypass surgery were found to have an unacceptably high rate of complications, reoperations and amputations. An overall rate of reoperation for postoperative bleeding of 5 per cent was also considered to be high. With these exceptions, it was concluded that the surgery was being performed to an acceptable standard, but that comparative audit of this type remained difficult while there was a deficiency of national statistics against which the work of individual surgeons could be judged.

An alternative multi-static HF radar architecture, known as the Forward-Based Receiver Augmentation (FBRA) system, has been developed and tested by the Defence Science and Technology Organization [1]. The experimental system has performed beyond expectations in a number of trials involving targets of interest. This is not only due to the impressive hardware capabilities, but also the advanced signal processing for clutter and interference mitigation, particularly STAP which was shown to be indispensable for the successful operation of the system. This paper describes the real-time STAP algorithm in the FBRA system, and demonstrates its experimental detection performance on a cooperative aircraft target with flight path "ground truth" data available from on-board GPS logging equipment.

The main barriers to the level of electronic data interchange required to seamlessly integrate services offered by legacy systems in an Internet environment are the need for applications to share a common data definition and the non-heterogeneity in database platforms. This paper details a collaborative research initiative between the Penrith City Council, Penrith Australia and the Centre for Advanced Systems Engineering (CASE) at the University of Western Sydney. It details the development of a fully functioning XML-based prototype system that provides effective integration of services offered by a collaborating group of legacy systems. The key contribution of this work is to provide an open systems based infrastructure that allows collaborating legacy systems, based on heterogeneous database and server platforms, to offer an integrated query service over the Internet.

Abstract It has been long established that over 80 percent of offshore accidents and injuries is attributed to human error. To significantly reduce offshore incidents a concerted effort by industry, government, certification and academic bodies is needed to properly integrate and apply human factors in the offshore industry. The 2nd International Workshop on Human Factors in Offshore Operations, sponsored by both industry and regulatory agencies, was recently held in Houston, Texas to ddresses this issue. This paper provides an overview of the important issues learned and discussed at the workshop. The workshop was one of the most significant events held by the offshore community to reduce incidents and improve offshore safety, quality and reliability. The Workshop was designed to establish practical solutions to demystify human factors, identify and provide the tools industry needs to midigate human factor related incidents. This paper applies to offshore incident investigation programs, design of both new and existing facilities, operations work force, management systems, human behavior programs and is of interest to Industry leaders responsible for safety in the offshore environment. The 2nd International Workshop on Human Factors in Offshore Operations overview includes discussion on:Inclusion of Human Factors in Incident InvestigationReduction of Human Error in New SystemsReduction of Human Error in Existing SystemsSolving Human Factor Issues as Applied to the Work ForceIntegration of Human Factors in Management SystemsEffective Application of Behavioral Based processes in Offshore Operations Where human factors have been applied offshore, significant improvement has been seen with relatively little cost to implement. This paper gives companies who operate in the offshore industry insight on the human factors tools, resources and guidelines that are available to improve their safety, reliability and economic performance. 1.0 Introduction Safety and health is paramount to offshore operations. Each year new programs such as the Safety Case Program in the North Sea, the Safety and Environmental Management program in the United States and other safety initiatives are introduced and continuously evaluated to reduce risk and improve safety performance. Despite these efforts incidents still occur. As a result of a number of studies and independent analysis of incidents conducted in the 1980's and 1990's, it was found that greater than 80 percent of incidents are a result of human errors occurring during operations. These findings brought the offshore industry, regulators, certification agencies and institutes together in 1996 to find a means to eliminate human factors related incidents. This first cooperative workshop helped to establish the current use of human factors in the Management of Safety and Environmental Hazards for Offshore Operations and Facilities Workshop. The goal of this workshop was to define the state of the art of human factors and behavioral safety to reduce the likelihood of offshore incidents, on the job injuries, environmental hazards, and improve safety, quality, and reliability during the life cycle of an offshore facility. The primary topics of the workshop included facility design, construction, operation, codes and standards, management systems and science.

Sulfasalazine is accepted therapy for active ulcerative colitis, but side-effects and intolerance are common. Balsalazide is an azo-bonded pro-drug which also releases 5-aminosalicylic acid into the colon, but uses an inert carrier molecule.To compare the safety and efficacy of sul- fasalazine, 3 g, with balsalazide, 6.75 g, in the initial daily treatment of mild to moderate ulcerative colitis.A randomized, multicentre, double-blind, parallel group study was performed, with a treatment duration of 8 weeks. Patients on previous maintenance treatment were excluded. The trial medication was the sole treatment for the colitis. Efficacy was assessed by patient diaries, symptom assessment, sigmoidoscopic appearance and histology.Fifty patients were recruited: 26 allocated to the balsalazide group and 24 to the sulfasalazine group. More patients withdrew due to adverse events in the sulfasalazine group (nine patients vs. one patient in the balsalazide group, P=0.004). Improvement occurred in both groups, with a tendency to a faster response with balsalazide. Of the patients taking balsalazide, 61% achieved clinical and sigmoidoscopic remission.Balsalazide, 6.75 g, is effective as the sole treatment for patients with mild to moderately active ulcerative colitis, with significantly fewer withdrawals due to side-effects than in a similar group of patients taking sulfasalazine, 3 g.

Nutritional therapy plays an important role in the management of Crohn disease, particularly during the acute phase. Nutritional supplementation may also prevent relapses during the quiescent phase of Crohn disease, though this aspect has not been widely explored.Thirty-three patients with Crohn disease in remission were studied. All had steroid-dependent disease. Patients were randomized to receive either elemental diet (n = 19, EO28 Extra) or polymeric diet (Forticips, n = 14). The supplement was given orally in addition to normal food in an amount to provide 35%-50% of pre-trial total calorie intake. Prednisolone was withdrawn gradually. Patients were followed up for 12 months. Failure was defined as increase in CDAI by 100 points from baseline to200, inability to withdraw chronic steroid therapy completely, need for surgery or steroid therapy.The nutritional supplement was successful in 14 (43%) patients who remained in remission for 12 months with complete withdrawal of steroids. The response to elemental diet (42%) was similar to that of polymeric diet (43%). Nutrition supplement failed in 13 (39%). Six (18%) patients were intolerant to enteral feeding because of smell and taste problems. Per-protocol analysis of data indicated that the success rate of nutrition supplement in steroid-dependent patients was 52% (14 out of 27 patients). No disease or patient-related factors helped predict the response to nutrition supplement.Nutritional supplementation with either an elemental or polymeric diet may provide a safe and effective alternative to chronic steroid therapy in patients with steroid-dependent Crohn disease.

Despite widespread use of aminosalicylates as maintenance treatment for ulcerative colitis (UC), patients still report troublesome symptoms, often nocturnally.To compare the efficacy and safety of balsalazide (Colazide) with mesalazine (Asacol) in maintaining UC remission.A randomized, double-blind comparison of balsalazide 3 g daily (1.04 g 5-ASA) and mesalazine 1.2 g daily for 12 months, in 99 (95 evaluable) patients in UC remission.Balsalazide patients experienced more asymptomatic nights (90% vs. 77%, P=0.0011) and days (58% vs. 50%, N.S.) during the first 3 months. Balsalazide patients experienced more symptom-free nights per week (6.4+/-1.7 vs. 4.7+/-2.8; P=0.0006) and fewer nights per week with blood on their stools or on the toilet paper, mucus with their stools or with sleep disturbance resulting from symptoms or lavatory visits (each P0.05). Fewer balsalazide patients relapsed within 3 months (10% vs. 28%; P=0.0354). Remission at 12 months was 58%, in both groups. Similar proportions of patients reported adverse events (61% balsalazide vs. 65% mesalazine). There were five serious adverse events (two balsalazide, three mesalazine) and four withdrawals due to unacceptable adverse events (three balsalazide, one mesalazine), of which one in each group was also a serious adverse event.Balsalazide 3 g/day and mesalazine 1.2 g/ day effectively maintain UC remission and are equally well tolerated over 12 months. At this dose balsalazide prevents more relapses during the first 3 months of treatment and controls nocturnal symptoms more effectively.

Aminosalicylates are widely used in the treatment of ulcerative colitis (UC). Balsalazide is a novel mesalamine prodrug, activated by colonic bacteria. The aim of this study was to compare the efficacy and safety of balsalazide with that of a pH-dependent formulation of mesalamine in active UC.A randomized, double-blind study was performed comparing balasalazide, 6.75 g daily, with mesalamine, 2.4 g daily, administered for 4, 8, or 12 weeks to 101 (99 evaluable) patients with symptomatic, sigmoidoscopically verified UC.More patients treated with balsalazide achieved symptomatic remission after 2 (64% [balsalazide] vs. 43% [mesalamine]), 4 (70% vs. 51%), 8 (78% vs. 45%), and 12 weeks (88% vs. 57%) and complete remission (none/mild symptoms, sigmoidoscopy grade 0/1, no rectal steroid use within 4 days) after 4 (38% vs. 12%), 8 (54% vs. 22%), and 12 weeks (62% vs. 37%). Patients taking balsalazide experienced more asymptomatic days (4 weeks, 24% vs. 14%) and achieved the first asymptomatic day more rapidly (median, 10 vs. 25 days). Fewer patients in the balsalazide group reported adverse events (48% vs. 71%); four serious adverse events occurred in the mesalamine group.Balsalazide is more effective and better tolerated than mesalamine as treatment for acute UC.

The British Nuclear Fuels plc facility at Sellafield performs a range of nuclear-related activities. The site has been in operation since 1950 and has, in general, employed a stable work force, many of whom have accumulated relatively high occupational exposures to ionizing radiation. This paper compares the physical dosimetry with two biological end points for evaluating radiation exposure: fluorescence in situ hybridization with whole-chromosome painting probes to quantify stable chromosome aberrations (translocations and insertions), and glycophorin A (GPA) analysis of variant erythrocytes. For the cytogenetic analyses, 81 workers were evaluated in five dose categories, including 23 with minimal radiation exposure (or = 50 mSv) and 58 with exposures ranging from 173 to 1108 mSv, all but 3 being500 mSv. In a univariate analysis, the mean stable chromosome aberration frequencies showed a significant increase with dose category (P = 0.032), and with cumulative dose when dose is treated as a continuous variable (P = 0.015). The slope of the dose response for stable aberrations is 0.79 +/- 0.22 aberrations per 100 cells per sievert (adjusted for smoking status), which is less than that observed among atomic bomb survivors, and suggests a dose and dose-rate effectiveness factor for chronic exposure of about 6. Analyses of the data for GPA N/O and N/N variants from 36 workers revealed no correlation with dose. Neither was there a correlation between the frequencies of N/O GPA variants and stable aberrations, although a weak negative association was observed between N/N variant frequency and stable aberrations (r = -0.38, P = 0.05). These results provide clear evidence for the accumulation of stable aberrations under conditions of chronic occupational exposure to ionizing radiation and show that stable chromosome aberrations are a more sensitive indicator for chronic radiation exposure than GPA variants. In comparison with human studies of brief exposure, chronic low-dose exposures appear substantially less effective for producing somatic effects as reflected by stable chromosome aberrations.

A high recurrence rate following varicose vein surgery has been attributed to inappropriate or inadequate initial surgery1. We have surveyed how varicose veins are assessed and treated by Surgeons in a single Health Region.

A study was carried out to examine the feasibility of setting up a community-based screening programme for abdominal aortic aneurysm (AAA) in men aged 65–79 years served by a district general hospital. A pilot project was run in two general practices from which 800 men were invited to undergo ultrasonography of the abdominal aorta. Of these, 628 (78·5 per cent) attended; 42 (6·7 per cent) were found to have an aneurysm (aortic diameter greater than 29 mm), ten (1·6 per cent) had a large aneurysm (diameter above 49 mm) and seven (1·1 per cent) received aortic grafts. On the basis of these findings it was felt that to screen all men aged 65–79 years (n = 12800) or aged 65–74 years (n = 10300) would lead to more operations than local facilities could handle. A more practical option would be to target annually men aged 65 years, with rescreening at intervals of 5 years until age 75 years, but even this would eventually lead to an unmanageable number of operations.

Purpose: The objective of this study is to optimize a retrospective respiratory‐gated micro‐CT protocol for free‐breathing rats to maintain image quality while reducing scan time and x‐ray dose. Methods: Five male Sprague‐Dawley rats were anaesthetized with ketamine and xylazine. Micro‐CT images were acquired with a GE Locus Ultra scanner at 80 kVp, 50 mA, 10 gantry‐rotations, with a scan time of 50 s and 0.28 Gy entrance dose. The respiratory traces of the free‐breathing rats were recorded throughout the scans and used to retrospectively sort the projection views that were acquired during peak inspiration and end expiration. 3D images were reconstructed with an isotropic voxel spacing of 0.15 mm. To assess the impact of missing projection views, we reconstructed images using all 10 gantry‐rotations and progressively fewer rotations (down to 3). We reconstructed a second set of images where the missing views were filled with the projection that was closest to the desired phase. Image‐based analysis of the imagenoise and missing view artefacts were indicators of the image quality. The physiological data (lung volume, CT density, functional residual capacity and tidal volume) were also computed. Results: By adding nearly in‐phase projections, the missing view artefacts were completely eliminated and the imagenoise was reduced. Measured values of lung volume, lung density and airway volume were stable for 5 or more gantry‐ rotations. Filling the projections using nearly in‐phase views resulted in lower measured values for tidal volume (1.26 mL +/− 0.22 mL in‐phase, 0.89+/− 0.17 mL nearly in‐phase). Conclusions: A 25 s imaging protocol would provide adequate physiological measurements at both respiratory phases for in‐phase reconstructions with reduced image quality. An image containing 50% of in‐phase views (remaining views are nearly in‐phase) is required to measure lung volume, 90% for airway volume and >65% for tidal volume.