Trends in mortality of childhood-onset insulin-dependent diabetes mellitus in Leicestershire: 1940-1991

The relative risk of death by calendar date of diagnosis was investigated in a population-based incident cohort of 845 (463 males:382 females) IDDM diagnosed in Leicestershire before the age of 17 years between 1940 and 1989. The mortality status of 844 (99.9%) patients was determined as of the 31 December 1991, representing 14,346 person-years of risk. Trends in relative risk of death were investigated using Cox proportional hazards modelling for within cohort comparisons and age/sex and calendar time adjusted standardized mortality ratios (SMR) using generalized linear modelling for external comparisons. Median age at diagnosis was 10 years (range 3 months to 16 years); median duration of diabetes 15 years (range 1-51 years). Forty-four patients had died (5.2%; median age at death 31 years, range 11-51 years). A further four patients died at presentation (within 24 h) from ketoacidosis and are excluded from all analyses. Calendar date of diagnosis was found to be an important predictor of mortality. Adjusting for attained age there was evidence of a decline in relative risk of death with calendar date of diagnosis of 3.4% (95% CI, 0.005-6.9%) per annum, equivalent to a 32% fall per decade (95% CI, 5-51%), or 84% (95% CI, 21-97) from 1940 to 1989. The data are consistent with a large fall in mortality between the 1940s and 1950s representing over 50% of the total reduction in mortality between 1940 and 1991. Neither sex nor age at diagnosis were significant predictors of mortality. Over the study period 1940-89 the SMR (male and female combined) fell from 981 (541-1556) to 238 (60-953) relative to the general population. This population-based study shows that the prognosis for Type 1 (insulin-dependent) diabetes mellitus has improved markedly over the period 1940-1991.     

Central alveolar hypoventilation in neurosarcoidosis

Although the lung is almost always involved in sarcoidosis and respiratory failure is not uncommonly caused by intrinsic lung disease, chronic alveolar hypoventilation on the basis of neurosarcoidosis has not been previously described. This report describes the case of a 42-year-old woman with sarcoidosis and documented involvement of the lungs, muscle, peripheral nerves, and skin. She presented with ventilatory failure and a vital capacity of 700mL and required hospitalization for intubation and mechanical ventilation. After failing ventilator weaning attempts and requiring continuous ventilatory assistance, she was extubated to continuous use of noninvasive intermittent positive pressure ventilation (IPPV). She eventually weaned to nocturnal-only use of noninvasive IPPV. However, her PaCO2 remained elevated during daytime hours despite the fact that her vital capacity had returned to 3,600mL. She was not obese, and her oxyhemoglobin saturation (SaO2) was normal on room air. Subsequent attempts to discontinue nocturnal nasal IPPV resulted in marked nocturnal decreases in SaO2 and return of symptoms. This case illustrates successful noninvasive management of an apparently unique occurrence of central alveolar hypoventilation caused by neurosarcoidosis.     

Equivalent oxygen percentage as a function of hydration in hydrogel lenses: an in vivo study

Although many investigations have examined the parameters of hydrogel lens hydration loss, the in vivo effect (in humans) on lens oxygen behavior has not been characterized previously. Human subjects wore 2 different lenses (a thin, 38% water polymacon lens and a thin, 55% water bufilcon lens) for 5-min periods under either fully hydrated (i.e., with saline regularly applied to the lens) or partially hydrated (i.e., with "normal" wear of 1 blink every 5 s) conditions. An equivalent oxygen percentage (EOP) technique and a gravimetric method were used to determine lens oxygen behavior and hydration, respectively. The hydration results demonstrate that significant lens dehydration occurs during the partially hydrated (normal blink rate) condition compared to the in situ, fully hydrated situation. A corresponding, statistically significant diminution in oxygen equivalency was also observed.     

From ethnographic record to system design

This paper explores the issues involved in moving from ethnographic explorations of work in context to a practical contribution to system design. It does so using the example of an interdisciplinary research project involving sociologists and computer scientists in the domain of air traffic control systems. It forms a pair with another paper (Sommerville et al., 1992) exploring these questions from the perspective of our computer science partners. We characterise ethnography as a research method, and consider the differences between undertaking it for strictly sociological or anthropological purposes by contrast with interdisciplinary and design purposes. We summarise some of our results in ethnographic explications of the work of air traffic controllers, and the sociality which it manifests. We describe the dialogues involved in rendering these observations informative for systems design, and the mutual translations implied in attempting to reconcile sociological with software engineering questions about supporting the work. We conclude by specifying some features of cooperative work which an engineering approach is in danger of overlooking; the ways, and limits, in which ethnographers can form a bridge between users and designers; and some of the conflicts of interest entrained in generating technical change.The research is funded by the UK MRC/SERC/ESRC Cognitive Science/HCI Initiative with the title Social Analysis of Control Systems for HCI Design, grant number SPG 8931598. The computer science partners are Professor Ian Sommerville, Dr Tom Rodden, Dr Pete Sawyer and Mr Richard Bentley. Thanks are due to Val King, Kjeldt Schmidt, Ian Sommerville and Tom Rodden for very helpful comments on earlier drafts of this paper.     

Compiling OR-parallelism into AND-parallelism

This paper suggests a general method for compiling OR-parallelism into AND-parallelism. An interpreter for an AND/OR-parallel language written in the AND-parallel subset of the language induces a source-to-source transformation from the full language into the AND-parallel subset. This transformation can be identified and implemented as a special purpose compiler or applied using a general purpose partial evaluator. The method is demonstrated to compile a variant of Concurrent Prolog into an AND-parallel subset of the language called Flat Concurrent Prolog (FCP). It is also shown applicable to the compilation of OR-parallel Prolog to FCP. The transformation identified is simple and efficient. The performance of the method is discussed in the context of programming examples. These compare well with conventionally compiled Prolog programs.     

A STUDY ON THE PERFORMANCE OF THE CATALYTIC POROUS-WALL THREE-PHASE REACTOR

A theoretical investigation of a catalytic porous-wall reactor in which gaseous and liquid reactants approach each other from opposite sides of the catalyst is undertaken. Equations for the annular liquid-channel are coupled with those for the catalytic wall and solved numerically and analytically using a simplified model. For the model reaction under study, the main design and operation parameters which affect reactor performance are the Thiele modulus, Peclet number, width of the liquid channel and the inlet concentration of the reactant in the liquid phase.

The effect of reactor configuration is peculiar to the cylindrical geometry because the thickness and relative location of the catalytic wall as well as the selection of the liquid and gas channels can influence the reactor performance. Thin-walled catalyst tubes have larger effectiveness factors and as the tube radius approaches that of the reactor, conversion in the reactor increases especially when the liquid is saturated with the gaseous reactant. Concentration of the liquid reactant in the feed has a significant effect if the reactant is depleted at some point inside the catalyst wall. Since the reaction zone width can be adjusted by changing the feed composition, this might have important implications with respect to selectivity.     

Thermal Decomposition of Europium Hydroxide

The thermal decomposition of europium hydroxide in an air atmosphere was investigated by means of weight-loss measurements, infrared spectroscopy, X-ray diffraction analysis, and electron microscopy. These studies showed that EU(OH)° decomposed at temperatures between 225° and 300°C into EuOOH, which was stable up to about 425°C. Between 435° and 465°C this compound decomposed into cubic Eu₂O₃, which was stable until its inversion to the high-temperature monoclinic form. X-ray diffraction data were collected for Eu(OH)₃ and EuOOH and showed that the trihydroxide has a hexagonal crystal structure and the oxyhydroxide is possibly orthorhombic. The Eu(OH)₂, EuOOH, and cubic EunOa powders contained particles up to several microns in size consisting of agglomerates of crystallites in the size range 200 to 400 A. The single monoclinic Eu₂O₃ sample studied contained crystallites whose average size was greater than 2000 A.