Is childhood type 1 diabetes a wealth-related disease? An ecological analysis of European incidence rates

Aims/Hypothesis: To describe the epidemiology of childhood-onset Type 1 (insulin-dependent) diabetes in Europe, the EURODIAB collaborative group has established prospective, geographically-defined registers of children diagnosed under 15 years. A total of 16,362 cases were registered by 44 centres during the period 1989-1994. The registers cover a population of approximately 28 million children with most European countries represented. Methods In most centres a primary and a secondary source of ascertainment were used so that the completeness of registration could be assessed by the capture-recapture method. Ecological correlation and regression analyses were used to study the relationship between incidence and various environmental, health and economic indicators. Findings: The standardised average annual incidence rate during the period 1989-94 ranged from 3.2 cases per 100,000 per annum in the Former Yugoslavian Republic of Macedonia to 40.2 cases per 100,000 per annum in Finland. Indicators of national prosperity such as infant mortality (r= -0.64) and gross domestic product (r= 0.58) were most strongly and significantly correlated with incidence rate, and previously-reported associations with coffee consumption (r= 0.51), milk consumption (r= 0.58) and latitude (r= 0.40) were also observed. Conclusion/Interpretation: The wide variation in childhood type 1 diabetes incidence rates within Europe could be partially explained by indicators of national prosperity. These indicators could reflect differences in environmental risk factors such as nutrition or lifestyle that are important in determining a country's incidence rate.

Wide Variation in Adenoma Detection Rates at Screening Flexible Sigmoidoscopy

Background & Aims: Wide between-center variation in adenoma detection rates (ADRs) was observed in the U.K. Flexible Sigmoidoscopy Screening Trial (overall, 12.1%; range, 8.6%-15.9%; P <0.0001). The aim of this study was to determine whether the observed differences could be attributed to varying performance by endoscopists, to examine the effect of experience on performance, and to identify an attainable, standard ADR to which endoscopists could aspire. 

Methods: Thirteen medical endoscopists, one per trial center, each performed about 3000 examinations (200 per month) using the same equipment and protocol. Overall and monthly ADRs were compared using multivariable logistic regression. 

Results: Differences in ADRs were not explained by patient characteristics, incidence of colorectal cancer in the local population, or the endoscopists' medical specialty or previous experience. Average ADRs increased significantly with screening experience (up to 400 examinations). Endoscopists were classified as higher, intermediate, or lower adenoma detectors, and performance levels were maintained over time. Higher detectors had ADRs of 15% overall (men, 20%; women, 10%) and also detected more adenomas per case (higher/lower detectors, 21.7/10.4 adenomas per :100 examinations). 

Conclusions: The differences in ADRs were due to variation in performance of the endoscopists. Long-term follow-up will determine whether this variation is clinically important. We suggest that the standards in higher detecting centers should be achievable by all endoscopists screening unscreened populations aged older than 55 years. Endoscopists should aim to stay above the lower 95% confidence interval band for 200 examinations (10% overall; 5% in women, 15% in men).

Photometry of cometary nuclei: Rotation rates, colours and a comparison with Kuiper Belt Objects

We present time-series data on Jupiter Family Comets (JFCs) 17P/Holmes, 47P/Ashbrook-Jackson and 137P/Shoemaker-Levy 2. In addition we also present results from `snap-shot' observations of comets 43P/Wolf-Harrington, 44P/Reinmuth 2, 103P/Hartley 2 and 104P/Kowal 2 taken during the same run. The comets were at heliocentric distances of between 3 and 7 au at this time. We present measurements of size and activity levels for the snap-shot targets. The time-series data allow us to constrain rotation periods and shapes, and thus bulk densities. We also measure colour indices (V - R) and (R - I) and reliable radii for these comets. We compare all of our findings to date with similar results for other comets and Kuiper Belt Objects (KBOs). We find that the rotational properties of nuclei and KBOs are very similar, that there is evidence for a cut-off in bulk densities at ~0.6 g cm-3 in both populations, and the colours of the two populations show similar correlations. For JFCs, there is no observational evidence for the optical colours being dependent on either position in the orbit or orbital parameters.

Radiative rates, collision strengths and effective collision strengths for transitions in Mo XXXIV

Radiative rates for electric dipole (E I), electric quadrupole (E2), magnetic dipole (M1), and magnetic quadrupole (M2) transitions among the lowest 60 fine-structure levels of the (1s(2)) 2S(2)2p(5), 2s2p(6), and 2S(2)2p(4)3l configurations of F-like Mo XXXIV have been calculated using the fully relativistic GRASP code. Additionally, collision strengths for transitions among these levels have been computed over a wide energy range below 3200Ry, using the Dirac Atomic R-matrix Code. Resonances have been resolved in a fine energy mesh in order to calculate the effective collision strengths. Results for radiative rates and excitation rates are presented for all transitions, and for collision strengths for transitions from the lowest three levels to the higher lying levels. The accuracy of the present data is assessed to be similar to 20%.

Radiative rates for E1, E2, M1 and M2 transitions in Fe X

Energies of the 54 levels belonging to the (1s(2)2s(2)2p(6)) 3s(2)3p(5), 3s3p(6), 3s(2)3p(4)3d and 3s3p(5)3d configurations of Fe X have been calculated using the GRASP code of Dyall et al. (1989). Additionally, radiative rates, oscillator strengths, and line strengths are calculated for all electric dipole (E1), magnetic dipole (M1), electric quadrupole (E2), and magnetic quadrupole (M2) transitions among these levels. Comparisons are made with results available in the literature, and the accuracy of the data is assessed. Our energy levels are estimated to be accurate to better than 3%, whereas results for other parameters are probably accurate to better than 20%. Additionally, the agreement between measured and calculated lifetimes is better than 10%.

Excitation rates for transitions in Ca XV

Collision strengths for transitions among the energetically lowest 46 fine-structure levels belonging to the (1s(2)) 2s(2)2p(2), 2s2p(3), 2p(4), and 2s(2)2p3l configurations of Ca XV are computed, over a wide electron energy range below 300 Ryd, using the Dirac Atomic R-matrix Code (DARC) of Norrington & Grant (2003). Resonances in the threshold region have been resolved in a fine energy mesh, and excitation rates are determined over a wide electron temperature range below 10(7) K. The results are compared with those available in the literature, and the accuracy of the data is assessed.

Radiative rates for transitions in Fe XVII

Energies of the lowest 157 levels belonging to the (1s(2)) 2s(2)2p(6), 2s(2)p(5)3l, 2s(2)2p(5)4l, 2s(2)2p(5)4l, 2s2p(5)5l, 2s2p(6)4l and 2s2p(6)5l configurations of Fe XVII have been calculated using the GRASP code of Dyall et al. (1989). Additionally, radiative rates, oscillator strengths, and line strengths are calculated for all electric dipole (E I), magnetic dipole (M I), electric quadrupole (E2), and magnetic quadrupole (M2) transitions among these levels. Comparisons are made with the results already available in the literature, and the accuracy of the data is assessed. Our energy levels are expected to be accurate to better than M whereas results for other parameters are probably accurate to better than 20%.

Radiative rates, collision strengths and effective collision strengths for transitions in Gd XXXVII

Energy levels and radiative rates for transitions among 107 fine-structure levels belonging to the (1s(2)2S(2)p(6)) 3S(2)3p(6)3d(10), 3S(2)3p(6)3d(9)4e. 3S(2)3p(5)3d(10)4e. and 3s3p(6)3d(10)4e configurations of Ni-like Gd XXXVII have been calculated using the fully relativistic GRASP code. Radiative rates and oscillator strengths are tabulated for all allowed transitions among these levels. Additionally. collision strengths for transitions among the lowest 59 levels have been computed using the Dirac Atomic R-matrix Code. Resonances in the threshold region have been delineated, but results for collision strengths are tabulated only at energies above thresholds in the range 120

Energy levels and radiative rates for transitions in Ni XIII-Ni XVI

Energy levels and radiative rates for fine-structure transitions in nickel ions (Ni XIII-XVI) have been calculated using the GRASP code. Configuration interaction and relativistic effects have been included, and comparisons are made with available data. Energy levels and radiative rates are tabulated for transitions among the 48, 43, 32, and 84 levels of Ni XIII, Ni XIV, Ni XV, and Ni XVI, respectively. The energy levels are assessed to be accurate to better than 5% for a majority of levels, while oscillator strengths for all strong transitions are accurate to better than 20%. (C) 2003 Published by Elsevier Inc.