Sleeping sickness: with special reference to its occurrence in Uganda and the remedial measures instituted

A haemo -parasitic disease with secondary changes in the lymphatic and central nervous systems, terminating in coma and death and due to the presence in the blood, gland juice and cerebrospinal fluid of the Trypanosoma Gambiense. This disease, known for several years in the Congo as Sleeping Sickness, or Negro lethargy, was attributed to various causes, by some to a miasm arising from the infected locality, by others to contagion from eating from a common bowl, etc. Natives of Uganda also firmly believe that it is conveyo,i by sexual coitus from an infected to a sound person, and this view has also been put forward as a contributory cause by Professor Robert Koch and receives colour from analogy to the "mal du dour:ino" of horses. This, however, is, I feel sure, an error, as on carefully investigating this point in my recent researches in Uganda, I failed entirely to find a single case in support, which could stand close examination. Invariably other possibilities of infection were admitted. As regards Prof. Koch's statements, dici they not come from so eminent an authority one would brush them aside, but the possible fallacies were so many that the statement cannot be seriously taken. To indicate only two, Koch had to rely on native interpreters and entirely on native statements as to their movements. Anyone with the least experience of trying to get information through interpreters will be aware of the difficulties attending, especially when dealing with sexual matters, and native statements at best are notoriously unreliable, as a native almost invariably attempts to give a pleasing answer, and one which he thinks is expected. Secondly, Prof. Koch states that the Baziba women he saw said they had never left their country to accompany their husbands. While this may be true of those particular ones, which I doubt, I know as a fact that numbers of Baziha women were with their men folk who were rubber cutters in the Sesse group of islands,where, as I shall show later, the possibilities and probabilities of infection were enormous, owing to the peculiar distribution of the carrier, Glossina Palpalis. A subsidiary consider_' ation is the fact that sexual impotence in both sexes is a very early symptom, as will be dealt with later

The effects of a graduated aerobic exercise programme on cardiovascular disease risk factors in the NHS workplace: a randomised controlled trial

BACKGROUND: Sufficient levels of physical activity provide cardio-protective benefit. However within developed society sedentary work and inflexible working hours promotes physical inactivity. Consequently to ensure a healthy workforce there is a requirement for exercise strategies adaptable to occupational time constraint. This study examined the effect of a 12 week aerobic exercise training intervention programme implemented during working hours on the cardiovascular profile of a sedentary hospital workforce. METHODS: Twenty healthy, sedentary full-time staff members of the North West London Hospital Trust cytology unit were randomly assigned to an exercise (n = 12; mean +/- SD age 41 +/- 8 years, body mass 69 +/- 12 kg) or control (n = 8; mean +/- SD age 42 +/- 8 years, body mass 69 +/- 12 kg) group. The exercise group was prescribed a progressive aerobic exercise-training programme to be performed 4 times a week for 8 weeks (initial intensity 65% peak oxygen consumption (VO2 peak)) and to be conducted without further advice for another 4 weeks. The control was instructed to maintain their current physical activity level. Oxygen economy at 2 minutes (2minVO2), 4 minutes (4minVO2), VO2 peak, systolic blood pressure (SBP), diastolic blood pressure (DBP), BMI, C-reactive protein (CRP), fasting glucose (GLU) and total cholesterol (TC) were determined in both groups pre-intervention and at 4 week intervals. Both groups completed a weekly Leisure Time Questionnaire to quantify additional exercise load. RESULTS: The exercise group demonstrated an increase from baseline for VO2 peak at week 4 (5.8 +/- 6.3 %) and 8 (5.0 +/- 8.7 %) (P < 0.05). 2minVO2 was reduced from baseline at week 4 (-10.2 +/- 10.3 %), 8 (-16.8 +/- 10.6 %) and 12 (-15.1 +/- 8.7 %), and 4minVO2 at week 8 (-10.7 +/- 7.9 %) and 12 (-6.8 +/- 9.2) (P < 0.05). There was also a reduction from baseline in CRP at week 4 (-0.4 +/- 0.6 mg.L-1) and 8 (-0.9 +/- 0.8 mg.L-1) (P < 0.05). The control group showed no such improvements. CONCLUSION: This is the first objectively monitored RCT to show that moderate exercise can be successfully incorporated into working hours, to significantly improve physical capacity and cardiovascular health

Direct bilirubin levels observed in prolonged neonatal jaundice: a retrospective cohort study

OBJECTIVE: Prolonged neonatal jaundice is common and usually benign; however, assessment of bilirubin fractions is recommended to determine the need for further assessment for congenital liver disease, particularly biliary atresia. The direct (conjugated) bilirubin thresholds currently used are variable and poorly evidenced. Hence, we aimed to delineate direct bilirubin levels in disease-free neonates with prolonged jaundice. METHODS: We performed a retrospective cohort analysis of split bilirubin levels, and subsequent follow-up, for all neonates initially assessed in our prolonged neonatal jaundice clinic over 2 years. We plotted centile charts for total, direct and direct-total bilirubin ratio levels against age at sampling. The association was assessed using linear regression analysis. RESULTS: Data were collected for 420 neonates (501 blood samples) across an age range of 10-70 days. No significant liver disease was found. For each day of older age, total bilirubin fell by 3.72 µmol/L (95% CI 2.46 to 5.00) and direct bilirubin fell by 0.39 µmol/L (0.18 to 0.59). The ratio between the two did not change significantly (-0.0006 to +0.0034). The 95th centile for direct bilirubin was stable at ~25 µmol/L. Direct-total bilirubin ratio was very variable with some 95th centiles >30%. CONCLUSIONS: In a clinically relevant population of disease-free neonates with prolonged jaundice both the total and the direct bilirubin decreased with age. The absolute direct bilirubin is more useful clinically than the direct-total bilirubin ratio. Our results support National Institute for Health and Care Excellence guidance that conjugated bilirubin >25 µmol/L, or even more stringent criteria, constitutes an appropriate threshold for further investigation for neonatal liver disease

An Experimental Microarchitecture for a Superconducting Quantum Processor

Quantum computers promise to solve certain problems that are intractable for classical computers, such as factoring large numbers and simulating quantum systems. To date, research in quantum computer engineering has focused primarily at opposite ends of the required system stack: devising high-level programming languages and compilers to describe and optimize quantum algorithms, and building reliable low-level quantum hardware. Relatively little attention has been given to using the compiler output to fully control the operations on experimental quantum processors. Bridging this gap, we propose and build a prototype of a flexible control microarchitecture supporting quantum-classical mixed code for a superconducting quantum processor. The microarchitecture is based on three core elements: (i) a codeword-based event control scheme, (ii) queue-based precise event timing control, and (iii) a flexible multilevel instruction decoding mechanism for control. We design a set of quantum microinstructions that allows flexible control of quantum operations with precise timing. We demonstrate the microarchitecture and microinstruction set by performing a standard gate-characterization experiment on a transmon qubit.Comment: 13 pages including reference. 9 figure