Milk is a source of several nutrients which may be beneficial for skeletal muscle. Evidence that links lower milk intake with declines in muscle strength from midlife to old age is lacking. We used data from the Medical Research Council National Survey of Health and Development to test sex-specific associations between milk consumption from age 36 to 60–64 years, low grip strength (GS) or probable sarcopenia, and GS decline from age 53 to 69 years. We included 1340 men and 1383 women with at least one measure of both milk intake and GS. Milk intake was recorded in 5-d food diaries (aged 36, 43, 53 and 60–64 years), and grand mean of total, reduced-fat and full-fat milk each categorised in thirds (T1 (lowest) to T3 (highest), g/d). GS was assessed at ages 53, 60–64, and 69 years, and probable sarcopenia classified at the age of 69 years. We employed logistic regression to examine the odds of probable sarcopenia and multilevel models to investigate decline in GS in relation to milk intake thirds. Compared with T1, only T2 (58·76–145·25 g/d) of reduced-fat milk was associated with lower odds of sex-specific low GS at the age of 69 years (OR (95 % CI): 0·59 (0·37, 0·94), P = 0·03). In multilevel models, only T3 of total milk (≥ 237·52 g/d) was associated with stronger GS in midlife in men (β (95 % CI) = 1·82 (0·18, 3·45) kg, P = 0·03) compared with T1 (≤ 152·0 g/d), but not with GS decline over time. A higher milk intake across adulthood may promote muscle strength in midlife in men. Its role in muscle health in late life needs further examination.

The paper focuses on comparative experiment on manufacturing and inspection of two different prismatic one-off parts, which have different complexity. Our experiment shows that transforming product definition method from the Drawing Centric Definition (DCD) to the Model Centric Definition (MCD) enables 28%-29% time savings in manufacturing and inspection phases of machined one-off part's life cycle. Furthermore, transition from MCD to Model-Based Definition (MBD) enables 5%-9% time savings, respectively. Applying of MBD enables more time savings in complex part compared to a less complex part.

Pompe disease results from lysosomal acid α-glucosidase deficiency, which leads to cardiomyopathy in all infantile-onset and occasional late-onset patients. Cardiac assessment is important for its diagnosis and management. This article presents unpublished cardiac findings, concomitant medications, and cardiac efficacy and safety outcomes from the ADVANCE study; trajectories of patients with abnormal left ventricular mass z score at enrolment; and post hoc analyses of on-treatment left ventricular mass and systolic blood pressure z scores by disease phenotype, GAA genotype, and “fraction of life” (defined as the fraction of life on pre-study 160 L production-scale alglucosidase alfa). ADVANCE evaluated 52 weeks’ treatment with 4000 L production-scale alglucosidase alfa in ≥1-year-old United States of America patients with Pompe disease previously receiving 160 L production-scale alglucosidase alfa. M-mode echocardiography and 12-lead electrocardiography were performed at enrolment and Week 52. Sixty-seven patients had complete left ventricular mass z scores, decreasing at Week 52 (infantile-onset patients, change −0.8 ± 1.83; 95% confidence interval −1.3 to −0.2; all patients, change −0.5 ± 1.71; 95% confidence interval −1.0 to −0.1). Patients with “fraction of life” <0.79 had left ventricular mass z score decreasing (enrolment: +0.1 ± 3.0; Week 52: −1.1 ± 2.0); those with “fraction of life” ≥0.79 remained stable (enrolment: −0.9 ± 1.5; Week 52: −0.9 ± 1.4). Systolic blood pressure z scores were stable from enrolment to Week 52, and no cohort developed systemic hypertension. Eight patients had Wolff–Parkinson–White syndrome. Cardiac hypertrophy and dysrhythmia in ADVANCE patients at or before enrolment were typical of Pompe disease. Four-thousand L alglucosidase alfa therapy maintained fractional shortening, left ventricular posterior and septal end-diastolic thicknesses, and improved left ventricular mass z score.

Trial registry: ClinicalTrials.gov Identifier: NCT01526785 https://clinicaltrials.gov/ct2/show/NCT01526785.

Social Media Statement: Post hoc analyses of the ADVANCE study cohort of 113 children support ongoing cardiac monitoring and concomitant management of children with Pompe disease on long-term alglucosidase alfa to functionally improve cardiomyopathy and/or dysrhythmia.

Cahokia is the largest documented urban settlement in the pre-Columbian United States. Archaeological evidence suggests that the city, located near what is now East St. Louis, Illinois, began to rapidly expand starting around AD 1050. At its height, Cahokia extended across 1000 ha and included large plazas, timber palisade walls, and hundreds of monumental earthen mounds. Following several centuries of occupation, the city experienced a period of gradual abandonment from about AD 1200 to 1400. Here, we present geochemical data from a 1500-year-old sediment core from nearby Horseshoe Lake that records watershed impacts associated with the growth and decline of Cahokia. Sedimentary analysis shows a distinctive 24-cm-thick, gray, fine-grained layer formed between AD 1150 and 1220 and characterized by low carbonate δ13C, elevated sorbed metal concentrations, and higher organic matter δ15N. The deposition of this layer is contemporaneous with archaeological evidence of increased agricultural activity, earthen mound construction, and higher populations surrounding the lake. We hypothesize that these human impacts increased soil erosion, producing new sediment sources from deeper soil horizons, and shifted dissolved transport to the lake, producing lower carbonate δ13C values, higher concentrations of lead, copper, potassium, and aluminum, and increased δ15N, likely due to contributions of enriched nitrogen from sewage.

We show that closed $\mathbb{S}\text{ol}^{3}\times \mathbb{E}^{1}$ -manifolds are Seifert fibred, with general fibre the torus, and base one of the flat 2-orbifolds $T,Kb,\mathbb{A},\mathbb{M}b,S(2,2,2,2),P(2,2)$ or $\mathbb{D}(2,2)$ , and outline how such manifolds may be classified.

The greatly increased cost of fuel has intensified the need for the manufacturer to increase operating efficiency in the aerodynamic, structural and propulsion fields. These aspects have already been highly refined and further improvements will be more and more difficult to realise. However, DOC is also equally affected by equipment and crew costs and this paper therefore attempts to examine the potential for improvements to the flight deck that will determine the most cost-effective combination of crew and equipment required for the safe operation of relatively large transport aircraft.

In the past, design effort has, very logically, been concentrated on those fields that could be shown to give an obvious economic return, and since investment in new instrumentation, flight deck workload analysis and system automation showed less tangible results than increases in speed, range, payload, etc, there was no great incentive to allocate money and effort to “human engineering”.

At last year’s Symposium ‘Designing from the inside out’ the keynote address made a strong case for improved matching of the machine to the man, starting with an understanding at the project stage of the optimum way that systems should be designed to achieve integration between man and machine. This year, we are discussing one aspect of human engineering—the presentation of information to the pilot.

Twenty years ago, the electronic valve gave way to the transistor; now the transistor as a discrete component has been replaced by the integrated circuit, and micro-processors are emerging as cheap, reliable and basic elements of electronic architecture.

Each step has yielded a major reduction in the size of equipment needed to achieve a particular function or to improve performance—but in spite of miniaturisation, an increasing volume of avionics has been incorporated into succeeding generations of aircraft as requirements for greater precision and safety have arisen.

Application has already provided striking improvements in the quality and ease of communication and navigation, which in turn have brought about the demise of the dedicated radio operator and navigator. The trend will continue with more automation of flight control and system management, leading to two-crew operation of most short and medium range aircraft—providing, of course, that the cost of ownership of additional equipment is less than the costs of the displaced crew member, and that flight safety standards continue to improve.

We compute the rings ${H}^{\ast } (N; { \mathbb{F} }_{2} )$ for $N$ a closed $ \mathbb{S} {\mathrm{ol} }^{3} $-manifold, and then determine the Borsuk–Ulam indices $\text{BU} (N, \phi )$ with $\phi \not = 0$ in ${H}^{1} (N; { \mathbb{F} }_{2} )$.

Objective: National security special events occur yearly in the United States. These events require comprehensive advance planning for health and medical contingencies in addition to law enforcement concerns. The planning for and impact of the Republican National Convention (RNC) on the City of St Paul and the Minneapolis–St Paul metropolitan area is described.

Methods: Descriptive analysis of events was provided by the authors based on their planning and operational experiences. Daily data were gathered from area hospitals, emergency medical services agencies, the National Weather Service, federal medical teams, and the Minnesota Department of Health to capture the impact of the RNC on emergency department activity, nonemergency surgery, emergency medical services run volumes, patient visits to onsite and offsite medical clinics, and general hospital occupancy in the metropolitan area.

Results: There were no epidemiological signal events. Weather was not extreme. Confrontations between protestors and law enforcement resulted in frequent use of riot-control agents. Protestors sought medical care from “street medics” and their affiliated free clinics in preference to usual medical facilities. Emergency departments close to the event venue reported decreased patient volumes. Hospitals close to the venue reported significantly decreased nonemergency surgical case volumes. Local hospitals implemented access controls and in 1 case, shut down ventilation systems due to riot-control agent deployment in the streets outside. Emergency medical services volumes were near average, with the exception of St Paul Fire Department on the day of a major protest march.

Conclusions: Planning and operational response for the RNC consumed large amounts of time and resources. The RNC had minimal patient impact on the health care system and in fact caused significant volume decreases at hospitals proximate to the venue. Although contingencies available for a mass casualty event were not needed, they must continue to be available for all such events. Health and medical preparedness and funding is not adequately detailed in the planning framework for national security special events, and this should be a focus for future events. (Disaster Med Public Health Preparedness. 2009;3:224–232)

We show that closed $\widetilde{\mathbb{S}\mathbb{L}}\,\times \,{{\mathbb{E}}^{n}}$ -manifolds are topologically rigid if $n\,\ge \,2$ , and are rigid up to $s$ -cobordism, if $n\,=\,1$ .

Following the disclosure of Mycobacterium bovis infection in badgers in East Sussex in 1976, badgers have been examined from and around farms on which cattle have become infected, but with no other attributable source of infection. These farms are confined to the downland of the south-west of the county and M. bovis has been confirmed in badger populations utilising their land. The available evidence indicates that M. bovis infection in badgers is also confined to this area. A detailed study in one area on the South Downs suggested that M. bovis is endemic in the badger population and therefore presents a continued risk for cattle occupying the area.

A detailed investigation of the possible role of wild mammals, other than badgers, in the maintenance of Mycobacterium bovis in an area on the South Downs of East Sussex was carried out over 3 years. Estimates of population sizes were made where possible and minimum sample sizes were selected to be 95 % certain of including at least one infected animal if the prevalence was at least 5 %. Samples of wild mammals were taken from populations which had the highest potential direct or indirect contact rate with known infected badgers. M. bovis was not isolated from any of the 15 species of wild mammals.

It was concluded that badgers are able to maintain M. bovis in an area independently of other species, and that in the area studied other species were not a source of infection for the cattle herds.

Penetrance and expressivity of the Drosophila mutant Abnormal-abdomen (A53g) may be reduced by adding inhibitors of protein synthesis, of RNA synthesis, and of oxidative phosphorylation to the defined, sterile medium on which larvae are developing. When grown on regular diet, the mutant flies contain a higher concentration of total protein than do wild-type flies. The metabolic inhibitors which reduce the expressivity of the mutation also lower protein concentration in these mutant flies. The reduction of protein synthesis is directly correlated with the reduction of expression of the mutant genotype. The regulation of the morphological abdominal abnormalities by the complex A53g genotype is discussed in relation to the control, by this same genetic system, of the mechanisms of protein synthesis.

Specific sequences derived from the gene for the precursor to the major merozoite surface antigens (PMMSA) of Plasmodium falciparum have been expressed in Escherichia coli and the products have been used to produce antibodies. These antibodies, together with monoclonal antibodies, have been used to investigate the form of the PMMSA protein associated with merozoites. Polypeptide fragments derived by processing from the PMMSA protein have been detected in extracts of merozoites and assigned to locations within the PMMSA coding sequence.

Little is known about how information diffuses to clinicians and influences their purchase and use of new technology. This is especially true about the role of the scientific literature. As a case study, we examined the literature for magnetic resonance imaging (MRI) during the years preceding and the first five years following its clinical introduction. Using a computerized retrieval system, we identified approximately 1,700 citations in which MRI was the major topic. The clinical literature on MRI was heavily concentrated in radiology journals. Less than 28% of articles compared MRI with alternative diagnostic technologies. During the first five years of clinical availability, the diffusion patterns of scientific articles and operational units mirrored the example set by computerized tomography (CT), in that a substantial number of units were purchased in both research and nonresearch settings before studies were available comparing them to alternative diagnostic technologies. These patterns of diffusion, combined with other studies of the MRI literature's content and methodology, suggest that less comprehensive and objective sources of information were important in early purchasing decisions. This study also suggests that the present readership and publication patterns of professional journals may not facilitate effective, rapid information dissemination about innovations to a broad spectrum of clinicians.