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In 2004, there were 11,092 presentations to Irish hospitals with deliberate self-harm, including 7,933 cases of drug overdose, of which 31% involved paracetamol. Limiting the availability of paracetamol reduces morbidity and mortality associated with paracetamol overdose. The present study aimed to determine the level of compliance with statutory regulations governing the sale of paracetamol in Ireland.
Researchers visited pharmacy and non-pharmacy outlets (newsagents, mini-markets and supermarkets) in Dublin city and attempted to purchase amounts of paracetamol that exceeded the statutory limits for a single transaction. All paracetamol tablets purchased in non-pharmacy outlets were in blister-packs and all non-pharmacy outlets sold packs with 12 tablets or fewer per pack.
Amounts of paracetamol in excess of statutory limits for a single transaction were purchased in
50.0% of pharmacies
81.8% of newsagents/mini-markets
20.0% of supermarkets.
We recommend that
(a) the sale of paracetamol in newsagents/mini-markets should be discontinued
(b) the sale of paracetamol in supermarkets should continue, but automated check-out tills should be programmed to prevent the sales that exceed statutory limits
(c) there should be greater efforts to ensure compliance with statutory regulations in pharmacies.
Background: Biallelic variants in POLR1C are associated with POLR3-related leukodystrophy (POLR3-HLD), or 4H leukodystrophy (Hypomyelination, Hypodontia, Hypogonadotropic Hypogonadism), and Treacher Collins syndrome (TCS). The clinical spectrum of POLR3-HLD caused by variants in this gene has not been described. Methods: A cross-sectional observational study involving 25 centers worldwide was conducted between 2016 and 2018. The clinical, radiologic and molecular features of 23 unreported and previously reported cases of POLR3-HLD caused by POLR1C variants were reviewed. Results: Most participants presented between birth and age 6 years with motor difficulties. Neurological deterioration was seen during childhood, suggesting a more severe phenotype than previously described. The dental, ocular and endocrine features often seen in POLR3-HLD were not invariably present. Five patients (22%) had a combination of hypomyelinating leukodystrophy and abnormal craniofacial development, including one individual with clear TCS features. Several cases did not exhibit all the typical radiologic characteristics of POLR3-HLD. A total of 29 different pathogenic variants in POLR1C were identified, including 13 new disease-causing variants. Conclusions: Based on the largest cohort of patients to date, these results suggest novel characteristics of POLR1C-related disorder, with a spectrum of clinical involvement characterized by hypomyelinating leukodystrophy with or without abnormal craniofacial development reminiscent of TCS.
Migrant youths endure many challenges. Such challenges can be stressful and lead to psychological difficulties. We investigated the relationship between migration, psychopathology and stressful events in children and adolescents. We hypothesised that migrant youths would show higher levels of psychopathology and more stressful life events than non-migrant youths.
Using the Child cohort (Cohort ‘98) of the ‘Growing up in Ireland’ study we investigated psychopathology, as measured by the Strengths and Difficulties questionnaire (SDQ) at age 9 and 13 and stressful life events in migrant and non-migrant youths.
There was no significant difference between the proportion of migrant and non-migrant youths reporting psychopathology in childhood (p>0.05) or adolescence (p>0.05). Analysis of the SDQ subscales revealed that a significantly greater proportion of migrant youths had hyperactivity problems in childhood (p = 0.04) but a greater proportion of non-migrant youths had emotional problems in early adolescence (p = 0.04). We found that migrant youths experienced significantly more stressful life events than their non-migrant counterparts (p<0.01), however, once ‘Moving house/country‘ was removed as a stressor, there was no difference between the groups (p>0.27).
Contrary to our hypothesis, we observed that there were few differences between migrant and non-migrant youths in the levels of psychopathology. Migrant youths experienced a greater number of stressful life events, however, this was attributable to stressors relating to moving. An increased understanding of the factors promoting resilience, as demonstrated by the migrant youths, could aid health professionals and policy makers to effectively tailor interventions for mental health promotion.
This study aimed to evaluate the effects of an intervention including nutritional telemonitoring, nutrition education, and follow-up by a nurse on nutritional status, diet quality, appetite, physical functioning and quality of life of Dutch community-dwelling elderly. We used a parallel arm pre-test post-test design with 214 older adults (average age 80 years) who were allocated to the intervention group (n 97) or control group (n 107), based on the municipality. The intervention group received a 6-month intervention including telemonitoring measurements, nutrition education and follow-up by a nurse. Effect measurements took place at baseline, after 4·5 months, and at the end of the study. The intervention improved nutritional status of participants at risk of undernutrition (β (T1)=2·55; 95 % CI 1·41, 3·68; β (T2)=1·77; 95 % CI 0·60, 2·94) and scores for compliance with Dutch guidelines for the intake of vegetables (β=1·27; 95 % CI 0·49, 2·05), fruit (β=1·24; 95 % CI 0·60, 1·88), dietary fibre (β=1·13; 95 % CI 0·70, 1·57), protein (β=1·20; 95 % CI 0·15, 2·24) and physical activity (β=2·13; 95 % CI 0·98, 3·29). The intervention did not have an effect on body weight, appetite, physical functioning and quality of life. In conclusion, this intervention leads to improved nutritional status in older adults at risk of undernutrition, and to improved diet quality and physical activity levels of community-dwelling elderly. Future studies with a longer duration should focus on older adults at higher risk of undernutrition than this study population to investigate whether the impact of the intervention on nutritional and functional outcomes can be improved.
The stability of VFB catholytes was investigated using both light-scattering measurements and visual observation. V2O5 precipitates after an induction time τ which shows an Arrhenius variation with temperature. The value of τ increases with increasing [S] and with decreasing [VV] but the activation energy remains constant with a value of (1.791±0.020) eV. Plots of ln τ against [S] and [VV] show good linearity and the slopes give values of βS = 2.073 M-1 and βV5 = –3.434 M-1 for the fractional rates of variation of τ with [S] and [VV], respectively. Combining the Arrhenius Equation with the observed log-linear variation of τ with [S] and [VV] provides a model for simulating the stability of catholytes. The addition of H3PO4 has a strong stabilizing effect on catholytes at higher temperatures. For example, at 50°C the induction time for precipitation for a typical catholyte is enhanced ∼ 12.5-fold by 0.1 M added H3PO4. At concentrations of H3PO4 less than ∼0.04 M, the precipitation time increases with increasing concentration at all temperatures investigated (30–70°C). At higher concentrations, induction time begins to decrease with increasing concentration of H3PO4: the changeover concentration depends on the temperature. Experiments at 70°C using other phosphate additives (sodium triphosphate, Na5P3O10, and sodium hexametaphosphate, (NaPO3)6) showed similar results to H3PO4.
The stability of vanadium flow battery (VFB) catholytes was investigated using both lightscattering measurements and visual observation. V2O5 precipitates after an induction time τ which shows an Arrhenius variation with temperature. The value of τ increases with increasing concentration of sulfate and with decreasing concentration of VV but the activation energy remains constant with a value of (1.791±0.020) eV. Plots of ln τ against [S] and [VV] show good linearity and the slopes give values of βS = 2.073 M-1 and βV5 = –3.434 M-1 for the fractional rates of variation of τ with [S] and [VV], respectively. Combining the Arrhenius Equation with the observed log-linear variation of τ with [S] and [VV] provides a model for simulating the stability of catholytes.
Osvald Demuth (1936–1988) studied constructive analysis from the viewpoint of the Russian school of constructive mathematics. In the course of his work he introduced various notions of effective null set which, when phrased in classical language, yield a number of major algorithmic randomness notions. In addition, he proved several results connecting constructive analysis and randomness that were rediscovered only much later.
In this paper, we trace the path that took Demuth from his constructivist roots to his deep and innovative work on the interactions between constructive analysis, algorithmic randomness, and computability theory. We will focus specifically on (i) Demuth’s work on the differentiability of Markov computable functions and his study of constructive versions of the Denjoy alternative, (ii) Demuth’s independent discovery of the main notions of algorithmic randomness, as well as the development of Demuth randomness, and (iii) the interactions of truth-table reducibility, algorithmic randomness, and semigenericity in Demuth’s work.
For all IPS drinks, the mean package size was larger than the mean serving size (mean (sd)=412 (157) ml and 359 (159) ml, respectively). The mean (sd) package size of IPS drinks was significantly different for all countries (range: Australia=370 (149) ml to New Zealand=484 (191) ml; P<0·01). The mean (sd) package size of Dutch BPS drinks (1313 (323) ml) was significantly smaller compared with the other countries (New Zealand=1481 (595) ml, Australia=1542 (595) ml, Canada=1550 (434) ml; P<0·01). The mean (sd) serving size of BPS drinks was significantly different across all countries (range: Netherlands=216 (30) ml to Canada=248 (31) ml; P<0·00). New Zealand had the largest package and serving sizes of the countries assessed. In all countries, a large number of different serving sizes were used to provide information on the amount appropriate to consume in one sitting.
At this point there is substantial inconsistency in package sizes and manufacturer-recommended serving sizes of sweet beverages within and between four high-income countries, especially for IPS drinks. As consumers do factor serving size into their judgements of healthiness of a product, serving size regulations, preferably set by governments and global health organisations, would provide consistency and assist individuals in making healthier food choices.
We describe two cases of infant botulism due to Clostridium butyricum producing botulinum type E neurotoxin (BoNT/E) and a previously unreported environmental source. The infants presented at age 11 days with poor feeding and lethargy, hypotonia, dilated pupils and absent reflexes. Faecal samples were positive for C. butyricum BoNT/E. The infants recovered after treatment including botulism immune globulin intravenous (BIG-IV). C. butyricum BoNT/E was isolated from water from tanks housing pet ‘yellow-bellied’ terrapins (Trachemys scripta scripta): in case A the terrapins were in the infant's home; in case B a relative fed the terrapin prior to holding and feeding the infant when both visited another relative. C. butyricum isolates from the infants and the respective terrapin tank waters were indistinguishable by molecular typing. Review of a case of C. butyricum BoNT/E botulism in the UK found that there was a pet terrapin where the infant was living. It is concluded that the C. butyricum-producing BoNT type E in these cases of infant botulism most likely originated from pet terrapins. These findings reinforce public health advice that reptiles, including terrapins, are not suitable pets for children aged <5 years, and highlight the importance of hand washing after handling these pets.
The high molecular weight glutenin subunits (HMW-GS) and glutenin macropolymer (GMP) in wheat grain are important characteristics that affect the quality of wheat products. Light intensity, as one of the environmental factors affecting grain yield and quality, has been studied extensively; however, little is known about its impact on HMW-GS and distribution of GMP granules in wheat grain. In the present study, two strong-gluten winter wheat cultivars with different subunit compositions were used to evaluate the effect of shading at different grain-filling stages on changes in HMW-GS and distribution of GMP granules in wheat grains. No effects of shading on initial formation time of each individual subunit were found; they responded similarly to shading with an increase in relative content, though the accumulation amount per grain of each individual subunit was decreased due to a decrease in grain weight induced by shading. Shading at different grain-filling stages, especially at the middle grain-filling stage, led to a significant increase in GMP content during grain filling; however, the proportions (by volume, number and surface area) of the larger GMP granules were increased by shading at middle and late grain-filling stages and decreased by shading at early grain-filling stage. It was also found that the content of total HMW-GS was positively correlated with volume proportions of larger GMP granules and negatively correlated with volume proportions of small GMP granules, which indicated that the pattern of response of distribution of GMP granules to shading was closely related to the regulatory effect of shading on the HMW-GS.
We describe a funnel cone for concentrating an ion beam on a target. The cone utilizes the reflection characteristic of ion beams on solid walls to focus the incident beam and increase beam intensity on target. The cone has been modeled with the TRIM code. A prototype has been tested and installed for use in the 350-keV K+ NDCX target chamber.
In this paper, we use the metric coefficients and the equation of motion in the 2nd post-Newtonian approximation in scalar-tensor theory including intermediate range gravity to derive the deflection of light and compare it with previous works. These results will be useful for precision astrometry missions like Gaia, SIM, and LATOR (Laser Astrometric Test Of Relativity) which aim at astrometry with micro-arcsecond and nano-arcsecond accuracies and a need for the 2nd post-Newtonian framework and ephemeris to determine the stellar and spacecraft positions.
Thermoelectric modules are of great interest for power generation applications where temperature gradients of approximately 500K exist, and hot side temperatures near 800K. The fabrication of such modules requires optimization of the material compositions, low contact resistivities, and low thermal loss.
AgPbmSbTe2+m (LAST) and Ag(Pb1-xSnx)m SbTe2+m (LASTT) compounds are among the best known materials appropriate for this temperature range. Various measurement systems have been developed and used to characterize bulk samples in the LAST and LASTT systems within this operating temperature range. From the characterized data, modeling of modules based on these materials and segmented legs using LAST(T) with Bi2Te3 have been used to identify the optimal geometry for the individual legs, and the length of the Bi2Te3 segments. We have segmented LAST(T) with Bi2Te3 and achieved contact resistivities of less than 10 μΩ•cm2.
Here we give a detailed presentation on the procedures used in the fabrication of thermoelectric generators based on LAST, LASTT, and segmented with Bi2Te3 materials. We also present the output data on these generators.
PbTe-based thermoelectric (TE) materials exhibit promising thermoelectric properties and have potential applications in waste heat recovery from sources such as truck engines and shipboard engines. TE components designed for these applications will be subject to mechanical/thermal loading and vibration as a result from in-service conditions, including mechanical vibration, mechanical and/or thermal cycling, and thermal shock.
In the current study, we present and discuss the mechanical properties of several PbTe-based compositions with different dopants and processing methods, including n-type and p-type specimens fabricated both by casting and by powder processing. Room temperature hardness and Young's modulus are studied by Vickers indentation and nanoindentation while fracture strength is obtained by biaxial flexure testing. Temperature dependent Young's modulus, shear modulus, and Poisson's ratio are studied via resonant ultrasound spectroscopy (RUS).
GaN-based heterostructure devices are of interest for pressure and stress sensing applications due to their potential for use at high temperatures and in caustic environments. We have grown n-GaN/u-AlGaN/n-GaN heterostructure devices on sapphire substrates by organometallic vapor phase epitaxy (OMVPE) using the epitaxial layer overgrowth (ELO) method. The devices were fabricated with varying AlGaN layer thickness and composition. Current-voltage (I-V) characteristics were obtained to characterize the performance of these devices under hydrostatic pressures up to 500 MPa. For a fixed bias, the current was observed to decrease in magnitude with increasing hydrostatic pressure for all devices tested. The current modulation is attributed to piezoelectric effects. Specifically, the polarization charge densities at both GaN/AlGaN interfaces are sensitive to changes in the hydrostatic pressure, and these charges affect the shape of the potential barrier and the current. Changes in the AlGaN layer thickness and composition modify the interfacial polarization, with thicker AlGaN layers and higher Al content increasing the effect of pressure on the observed I-V characteristics. The decreases in current magnitude with increasing pressure are linear over the pressure range tested. In order to quantify the performance of these devices, we calculate a pressure gauge factor based on a normalized change in current divided by the change in pressure. Values obtained range from 0.1–1.0 GPa−1, consistent with our previously published results for a single device. In addition, the turn-on voltages under both forward and reverse bias conditions are observed to increase with increasing AlGaN layer thickness and composition, a result that agrees with our device model. These turn-on voltages are governed by different mechanisms in the forward and reverse bias directions. Under forward bias, the mechanism is a transition from a thermionic to a tunneling process. However, under reverse bias, the turn-on occurs when the total electric field changes sign in the AlGaN layer.