Seasonal variation in month of diagnosis in children with type 1 diabetes registered in 23 EURODIAB centres during 1989-2008

Objectives: To investigate seasonal variation in month of diagnosis in children with type 1 diabetes registered in EURODIAB centres during 1989-2008.
Methods: 23 population-based registers recorded date of diagnosis in new cases of clinically diagnosed type 1 diabetes in children aged under 15 years. Completeness of ascertainment was assessed through capture-recapture methodology and was high in most centres. A general test for seasonal variation (11df) and Edward's test for sinusoidal (sine wave) variation (2df) were employed. Time series methods were also used to investigate if meteorological data were predictive of monthly counts after taking account of seasonality and long term trends.
Results: Significant seasonal variation was apparent in all but two small centres, with an excess of cases apparent in the winter quarter. Significant sinusoidal pattern was also evident in all but two small centres with peaks in December (14 centres), January (5 centres) or February (2 centres). Relative amplitude varied from ±11% to ±39% (median ±18%). There was no relationship across the centres between relative amplitude and incidence level. However there was evidence of significant deviation from the sinusoidal pattern in the majority of centres. Pooling results over centres, there was significant seasonal variation in each age-group at diagnosis, but with significantly less variation in those aged under 5 years. Boys showed marginally greater seasonal variation than girls. There were no differences in seasonal pattern between four sub-periods of the 20 year period. In most centres monthly counts of cases were not associated with deviations from normal monthly average temperature or sunshine hours; short term meteorological variations do not explain numbers of cases diagnosed.
Conclusions: Seasonality with a winter excess is apparent in all age-groups and both sexes, but girls and the under 5s show less marked variation. The seasonal pattern changed little in the 20 year period.

Environmental indifference? A critique of environmentally deterministic theories of peatland archaeological site construction in Ireland

Climate change, whether gradual or sudden, has frequently been invoked as a causal factor to explain many aspects of cultural change during the prehistoric and early historic periods. Critiquing such theories has often proven difficult, not least because of the imprecise dating of many aspects of the palaeoclimate or archaeological records and the difficulties of merging the two strands of research. Here we consider one example of the archaeological record – peatland site construction in Ireland – which has previously been interpreted in terms of social response to climate change and examine whether close scrutiny of the archaeological and palaeoenvironmental records uphold the climatically deterministic hypotheses. We evaluate evidence for phasing in the temporal distribution of trackways and related sites in Irish peatlands, of which more than 3,500 examples have been recorded, through the examination of ~350 dendrochronological and 14C dates from these structures. The role of climate change in influencing when such sites were constructed is assessed by comparing visually and statistically the frequency of sites over the last 4,500 years with well-dated, multi-proxy climate reconstructions from Irish peatlands. We demonstrate that national patterns of “peatland activity” exist that indicate that the construction of sites in bogs was neither a constant nor random phenomenon. Phases of activity (i.e. periods in which the number of structures increased), as well as the ‘lulls’ that separate them, show no consistent correlation with periods of wetter or drier conditions on the bogs, suggesting that the impetus for the start or cessation of such activity was not climatically-determined. We propose that trigger(s) for peatland site construction in Ireland must instead also be sought within the wider, contemporary social background. Perhaps not surprisingly, a comparison with archaeological and palynological evidence shows that peatland activity tends to occur at times of more expansive settlement and land-use, suggesting that the bogs were used when the landscape was being more widely occupied. Interestingly, the lulls in peatland site construction coincide with transitional points between nominal archaeological phases, typically defined on the basis of their material culture, implying that there may indeed have been a cultural discontinuity at these times. © 2012 Elsevier Ltd. All rights reserved.

The Adult Cystic Fibrosis Airway Microbiota Is Stable over Time and Infection Type, and Highly Resilient to Antibiotic Treatment of Exacerbations

Cystic fibrosis (CF) is characterized by defective mucociliary clearance and chronic airway infection by a complex microbiota. Infection, persistent inflammation and periodic episodes of acute pulmonary exacerbation contribute to an irreversible decline in CF lung function. While the factors leading to acute exacerbations are poorly understood, antibiotic treatment can temporarily resolve pulmonary symptoms and partially restore lung function. Previous studies indicated that exacerbations may be associated with changes in microbial densities and the acquisition of new microbial species. Given the complexity of the CF microbiota, we applied massively parallel pyrosequencing to identify changes in airway microbial community structure in 23 adult CF patients during acute pulmonary exacerbation, after antibiotic treatment and during periods of stable disease. Over 350,000 sequences were generated, representing nearly 170 distinct microbial taxa. Approximately 60% of sequences obtained were from the recognized CF pathogens Pseudomonas and Burkholderia, which were detected in largely non-overlapping patient subsets. In contrast, other taxa including Prevotella, Streptococcus, Rothia and Veillonella were abundant in nearly all patient samples. Although antibiotic treatment was associated with a small decrease in species richness, there was minimal change in overall microbial community structure. Furthermore, microbial community composition was highly similar in patients during an exacerbation and when clinically stable, suggesting that exacerbations may represent intrapulmonary spread of infection rather than a change in microbial community composition. Mouthwash samples, obtained from a subset of patients, showed a nearly identical distribution of taxa as expectorated sputum, indicating that aspiration may contribute to colonization of the lower airways. Finally, we observed a strong correlation between low species richness and poor lung function. Taken together, these results indicate that the adult CF lung microbiome is largely stable through periods of exacerbation and antibiotic treatment and that short-term compositional changes in the airway microbiota do not account for CF pulmonary exacerbations.

Comparing poverty and deprivation dynamics:Issues of reliability and validity

In this paper we seek to establish if earlier findings relating to the relationship between income poverty persistence and deprivation persistence could be due to a failure to take measurement error into account. To address this question, we apply a model of dynamics incorporating structural and error components. Our analysis shows a general similarity between latent poverty and deprivation dynamics. In both cases we substantially over-estimate the probability of exiting from poverty or deprivation. We observe a striking similarity across dimensions for both observed and latent outcomes. In both cases levels of poverty and deprivation persistence are higher for the latent case. However, there is no evidence that earlier results relating to the differences in the determinants of poverty and deprivation persistence are a consequence of differential patterns of reliability. Taking measurement error into account seems more likely to accentuate rather than diminish the contrasts highlighted by earlier research. Since longitudinal differences relating to poverty and deprivation cannot be accounted for by measurement error, it seems that we must accept that we are confronted with issues relating to validity rather than reliability. Even where we measure these dimensions over reasonable periods of time and allow for measurement error, they continue to tap relatively distinct phenomenon. Thus, if measures of persistent poverty are to constitute an important component of EU social indicators, a strong case can be made for including parallel measures of deprivation persistence and continuing to explore the relationship between them. © Springer Science+Business Media, Inc. 2006.

Influence of skin model on in vitro performance of drug-loaded soluble microneedle arrays

A plethora of studies have described the in vitro assessment of dissolving microneedle (MN) arrays for enhanced transdermal drug delivery, utilising a wide variety of model membranes as a representation of the skin barrier. However, to date, no discussion has taken place with regard to the choice of model skin membrane and the impact this may have on the evaluation of MN performance. In this study, we have, for the first time, critically assessed the most common types of in vitro skin permeation models - a synthetic hydrophobic membrane (Silescol(®) of 75 µm) and neonatal porcine skin of definable thickness (300-350 µm and 700-750 µm) - for evaluating the performance of drug loaded dissolving poly (methyl vinyl ether co maleic acid) (PMVE/MA) MN arrays. It was found that the choice of in vitro skin model had a significant effect on the permeation of a wide range of small hydrophilic molecules released from dissolving MNs. For example, when Silescol(®) was used as the model membrane, the cumulative percentage permeation of methylene blue 24h after the application of dissolvable MNs was found to be only approximately 3.7% of the total methylene blue loaded into the MN device. In comparison, when dermatomed and full thickness neonatal porcine skin were used as a skin model, approximately 67.4% and 47.5% of methylene blue loaded into the MN device was delivered across the skin 24h after the application of MN arrays, respectively. The application of methylene blue loaded MN arrays in a rat model in vivo revealed that the extent of MN-mediated percutaneous delivery achieved was most similar to that predicted from the in vitro investigations employing dermatomed neonatal porcine skin (300-350 µm) as the model skin membrane. On the basis of these results, a wider discussion within the MN community will be necessary to standardise the experimental protocols used for the evaluation and comparison of MN devices.

Realizing a high magnetic moment in Gd/Cr/FeCo: The role of the rare earth

The search for materials or systems exhibiting a high magnetic saturation has been of longstanding importance. It has been suggested that increased saturation could be achieved by coupling a transition metal via a spacer to a rare earth. We report Gd/Cr/Fe₇₀Co₃₀ multilayer stacks and find reduced yet modulating magnetic moment as a function of Cr thickness. Through a micro structural analysis the lowered moment is indicated by the nucleation of the ultrathin Gd films into an fcc phase. We discuss the possible solution in terms of quasi-perfect lattice match seed material to promote growth of hcp Gd.

The effects of winter ice cover on the trophic ecology of whitefish (Coregonus lavaretus L.) in subarctic lakes

Lakes in Arctic and subarctic regions display extreme levels of seasonal variation in light, temperature and ice cover. Comparatively little is known regarding the effects of such seasonal variation on the diet and resource use of fish species inhabiting these systems. Variation in the diet of European whitefish Coregonus lavaretus (L.) during periods of ice cover in this region is often regarded as 'common knowledge'; however, this aspect of the species' ecology has not been examined empirically. Here, we outline the differences in invertebrate community structure, fish activity, and resource use of monomorphic whitefish populations between summer (August-September) and winter (February-March) in three subarctic lakes in Finnish Lapland. Benthic macroinvertebrate densities did not exhibit measurable differences between summer and winter. Zooplankton diversity and abundance, and activity levels of all fish species (measured as catch per unit effort) were lower in winter. The summer diet of C. lavaretus was typical of a generalist utilising a variety of prey sources. In winter, its dietary niche was significantly reduced, and the diet was dominated by chironomid larvae in all study sites. Pelagic productivity decreases during winter, and fish species inhabiting these systems are therefore restricted to feeding on benthic prey. Sampling time has strong effect on our understanding of resource utilisation by whitefish in subarctic lakes and should be taken into account in future studies of these systems. © 2012 John Wiley & Sons A/S.

Palaeoglacial and palaeoclimatic conditions in the NW Pacific, as revealed by a morphometric analysis of cirques upon the Kamchatka Peninsula

The distribution of glacial cirques upon the Kamchatka peninsula, Far Eastern Russia, is systematically mapped from satellite images and digital elevation model data. A total of 3,758 cirques are identified, 238 of which are occupied by active glaciers. The morphometry of the remaining 3,520 cirques is analysed. These cirques are found to show a very strong N bias in their azimuth (orientation), likely resulting from aspect-related variations in insolation. The strength of this N bias is considered to indicate that former glaciation upon the peninsula was often ‘marginal’, and mainly of cirque-type, with peaks extending little above regional equilibrium-line altitudes. This is supported by the fact that S and SE-facing cirques are the highest in the dataset, suggesting that glacier-cover was rarely sufficient to allow S and SE-facing glaciers to develop at low altitudes. The strength of these azimuth-related variations in cirque altitude is thought to reflect comparatively cloud-free conditions during former periods of glaciation. It is suggested that these characteristics, of marginal glaciation and comparatively cloud-free conditions, reflect the region’s former aridity, which was likely intensified at the global Last Glacial Maximum, and during earlier periods of ice advance, as a result of the development of negative pressure anomalies over the North Pacific (driven by the growth of the Laurentide Ice Sheet), combined with other factors, including an increase in the extent and duration of sea ice, a reduction in global sea levels, cooler sea surface temperatures, and the localised growth of mountain glaciers. There is published evidence to suggest extensive glaciation of the Kamchatka Peninsula at times during the Late Quaternary, yet the data presented here appears to suggest that such phases were comparatively short-lived, and that smaller cirque-type glaciers were generally more characteristic of the period.

Magnetic properties of copper hexadecaphthalocyanine (F16CuPc) thin films and powders

The structural and magnetic properties of F16CuPc thin films and powder, including x-ray diffraction (XRD), superconducting quantum interference device (SQUID) magnetometry, and theoretical modelling of exchange interactions are reported. Analysis of XRD from films, with thickness ranging between 100 and 160 nm, deposited onto Kapton and a perylene-3,4,9,10-tetracarboxylic-3,4,9,10-dianhydride (PTCDA) interlayer shows that the stacking angle (defined in the text) of the film is independent of the thickness, but that the texture is modified by both film thickness and substrate chemistry. The SQUID measurements suggest that all samples are paramagnetic, a result that is confirmed by our theoretical modelling including density functional theory calculations of one-dimensional molecular chains and Green's function perturbation theory calculations for a molecular dimer. By investigating theoretically a range of different geometries, we predict that the maximum possible exchange interaction between F16CuPc molecules is twice as large as that in unfluorinated copper-phthalocyanine (CuPc). This difference arises from the smaller intermolecular spacing in F16CuPc. Our density functional theory calculation for isolated F16CuPc molecule also shows that the energy levels of Kohn-Sham orbitals are rigidly shifted similar to 1 eV lower in F16CuPc compared to CuPc without a significant modification of the intramolecular spin physics, and that therefore the two molecules provide a suitable platform for independently varying magnetism and charge transport. 

Resource utilisation and costs of palliative cancer care in an interdisciplinary health care model

This paper presents a detailed description of health care resource utilisation and costs of a pilot interdisciplinary health care model of palliative home care in Ontario, Canada. The descriptive evaluation entailed examining the use of services and costs of the pilot program: patient demographics, length of stay broken down by disposition (discharged, alive, death), access to services/resources, use of family physician and specialist services, and drug use. There were 434 patients included in the pilot program. Total costs were approximately CAN$2.4 million, and the cost per person amounted to approximately CAN$5586.33 with average length of stay equal to over 2 months (64.22 days). One may assume that length of stay would be influenced by the amount of service and support available. Future research might investigate whether in-home palliative home care is the most cost effective and suitable care setting for those patients requiring home care services for expected periods of time. © 2009 SAGE Publications.

Vegetation changes and human settlement of Easter Island during the last millennia: a multiproxy study of the Lake Raraku sediments

Earlier palynological studies of lake sediments from Easter Island suggest that the island underwent a recent and abrupt replacement of palm-dominated forests by grasslands, interpreted as a deforestation by indigenous people. However, the available evidence is inconclusive due to the existence of extended hiatuses and ambiguous chronological frameworks in most of the sedimentary sequences studied. This has given rise to an ongoing debate about the timing and causes of the assumed ecological degradation and cultural breakdown. Our multiproxy study of a core recovered from Lake Raraku highlights the vegetation dynamics and environmental shifts in the catchment and its surroundings during the late Holocene. The sequence contains shorter hiatuses than in previously recovered cores and provides a more continuous history of environmental changes. The results show a long, gradual and stepped landscape shift from palm-dominated forests to grasslands. This change started c. 450 BC and lasted about two thousand years. The presence of Verbena litoralis, a common weed, which is associated with human activities in the pollen record, the significant correlation between shifts in charcoal influx, and the dominant pollen types suggest human disturbance of the vegetation. Therefore, human settlement on the island occurred c. 450 BC, some 1500 years earlier than is assumed. Climate variability also exerted a major influence on environmental changes. Two sedimentary gaps in the record are interpreted as periods of droughts that could have prevented peat growth and favoured its erosion during the Medieval Climate Anomaly and the Little Ice Age, respectively. At c. AD 1200, the water table rose and the former Raraku mire turned into a shallow lake, suggesting higher precipitation/evaporation rates coeval with a cooler and wetter Pan-Pacific AD 1300 event. Pollen and diatom records show large vegetation changes due to human activities c. AD 1200. Other recent vegetation changes also due to human activities entail the introduction of taxa (e.g. Psidium guajava, Eucalyptus sp.) and the disappearance of indigenous plants such as Sophora toromiro during the two last centuries. Although the evidence is not conclusive, the American origin of V. litoralis re-opens the debate about the possible role of Amerindians in the human colonisation of Easter Island.

The use and meanings of 'time of wetness' in understanding stone decay

Moisture is a well documented, and crucial, control on the nature of stone decay. The term time of wetness has frequently been adopted to describe how long a stone block is wet, with a view to understanding the impact of this on decay processes. Although this term has proved conceptually useful, it has been used in different ways, by different groups to mean mean quite different things. For example, the time of wetness for a stone block surface (the traditional understanding) may be quite different from that of a block interior, controlled by the different dynamics of wetting and drying in those zones. Thus, surface wetting will occur regularly (sometimes swiftly followed by drying, depending on the time of year), with block interior wetting requiring the accumulation of surface moisture to penetrate to depth (more likely in autumn and winter months), and drying out much more slowly. This relatively new but important perspective, framed in the context of climate change, is crucial to understanding the length of time stone may remain damp at depth following a period of prolonged precipitation. The nature and speed of drying is also relevant in quantifying time of wetness of both surfaces and the interior of building stones.
These ideas related to time of wetness have implications for decay processes, specifically how a prolonged time of deep wetness may re-focus the emphasis of salt weathering in natural building stones toward chemical action. Literature on chemical change is discussed, suggesting that chemical change occurring during periods of prolonged wetness is likely to be significant in itself, with implications for weakening the stone (in terms of, for example, cement dissolution or grain boundary weakening) and exacerbating physical damage from salt crystallisation when blocks finally dry out.

Statistics sunspots and settlement: Influences on sum of probability curves

Large data sets of radiocarbon dates are becoming a more common feature of archaeological research. The sheer numbers of radiocarbon dates produced, however, raise issues of representation and interpretation. This paper presents a methodology which both reduces the visible impact of dating fluctuations, but also takes into consideration the influence of the underlying radiocarbon calibration curve. By doing so, it may be possible to distinguish between periods of human activity in early medieval Ireland and the statistical tails produced by radiocarbon calibration.

Habitat Isolation Reduces the Temporal Stability of Island Ecosystems in the Face of Flood Disturbance

Natural ecosystems are increasingly exposed to multiple anthropogenic stressors, including land-use change, deforestation, agricultural intensification, and urbanisation, all of which have led to widespread habitat fragmentation, which is also likely to be amplified further by predicted climate change. The potential interactive effects of these different stressors cannot be determined by studying each in isolation, although such synergies have been largely ignored in ecological field studies to date. Here, we use a model system of naturally fragmented islands in a braided river network, which is exposed to periodic inundation, to investigate the interactive effects of habitat isolation and flood disturbance. Food web structure was similar across the islands during periods of hydrological stability, but several key properties were altered in the aftermath of flood disturbance, based on distance of the islands from the regional source pool of species: taxon richness and mean food chain length declined with habitat isolation after flooding, while the proportion of basal species increased. Greater species turnover through time reflected the slower process of re-colonisation on the more distant islands following disturbance. Increased variability of several food web properties over a 1-year period highlighted the reduced temporal stability of isolated habitat fragments. Many of these effects reflected the differential successes of predator and prey species at re-colonising the islands: even though larger, more mobile consumers may reach the more distant islands first, they cannot establish populations until the lower trophic levels have successfully reassembled. These results highlight the susceptibility of fragmented ecosystems to environmental perturbations. © 2013 Elsevier Ltd.

Vitrectomy with Internal Limiting Membrane Peeling versus No Peeling for Idiopathic Full-Thickness Macular Hole

To determine whether internal limiting membrane (ILM) peeling improves anatomic and functional outcomes of full-thickness macular hole (FTMH) surgery when compared with the no-peeling technique.