bluuebunny/crossref_metadata_2025 huggingface dataset:
Pedogenic siderites fossilizing Ediacaran soil microorganisms on the Baltica paleocontinent
Authors: Bojanowski Maciej J. , Goryl Magdalena , Kremer Barbara , Marciniak-Maliszewska Beata , Marynowski Leszek , Środoń Jan
Published: November 2019

Ediacaran siderite-bearing sedimentary rocks from the western part of the East European craton exhibit features typical of redoximorphic paleosols, including pedogenic siderite (e.g., sphaerosiderite) with uniform and negative δ18O and highly variable δ13C values. The siderite precipitated in water-logged soils in a hot and humid climate, and represents a rare example of pedogenic siderite formed before the rise of vascular plants. Morphology of soil microorganisms was preserved in three dimensions due to the early siderite precipitation. These are mainly filamentous and tube-like threads, which might belong to cyanobacteria or fungi, and spherical structures resembling green algae. This microbial life fostered development of strongly reducing soils in tropical wetlands on the Baltica paleocontinent. The Ediacaran sediments of the western East European craton, traditionally regarded as marine, are reinterpreted as containing sections affected by freshwater conditions, documenting the presence of microbial life on the Ediacaran land.
Phosphorus burial in ferruginous SiO2-rich Mesoproterozoic sediments
Authors: Johnson Brooke R. , Tostevin Rosalie , Gopon Philip , Wells Jon , Robinson Stuart A. , Tosca Nicholas J.
Published: November 2019

Persistently low atmospheric oxygen requires that net organic carbon burial was muted through much of Earth’s middle age. In order to achieve global mass balance with respect to O2, recent models have suggested that redox-dependent mechanisms, such as Fe(II)-phosphate precipitation, limited phosphate availability in dominantly anoxic and ferruginous oceans, in turn limiting net primary production, and therefore organic carbon burial. Nevertheless, observational constraints on phosphorus cycling in ferruginous Proterozoic systems are rare, leaving these models largely untested. Here, we present high-resolution petrographic and mineralogical data showing that the 1.3 Ga Sherwin Ironstone (Roper Group, Australia) was dominated by syndepositional precipitation of the Fe(II)-silicate minerals greenalite and berthierine, interlaminated with abundant authigenic calcium fluorapatite (CFA). Set in a quantitative geochemical framework, these data reveal that elevated marine SiO2(aq) concentrations facilitated extensive Fe(II)-silicate production, leaving CFA, rather than Fe(II)-phosphate, as the principal inorganic phosphorous sink in shallow-water Roper Group sediments. More broadly, the physical and chemical factors that triggered Fe(II)-silicate and CFA burial in the Roper Seaway highlight semi-restricted basins as important loci of phosphorus removal from the mid-Proterozoic ocean.
Thyroid scintigraphy differentiates subtypes of congenital hypothyroidism
Authors: Worth Chris , Hird Beverly , Tetlow Lesley , Wright Neville , Patel Leena , Banerjee Indraneel
Published: November 2019

Introduction

UK screening for congenital hypothyroidism (CH) is based on dried blood spot Thyroid Stimulating Hormone (TSH). Scintigraphy may identify CH subtypes classified as dysplasia, gland in situ (GIS) and ectopia, but is not performed in all centres. We retrospectively investigated the role of scintigraphy to identify CH subtypes in a single tertiary centre cohort.

Methods

Babies who screened positive for CH between 2007 and 2017 were studied (n=418 of 534 783). Scintigraphy outcomes were correlated with TSH and levothyroxine dose. GIS patients were analysed for 3-year outcomes.

Results

303 patients started levothyroxine. Scintigraphy demonstrated three subtypes: GIS (n=139, 46%) ectopia (n=84, 28%) and dysplasia (n=80, 26%). Three-year follow up demonstrated permanence in 54% of 37 GIS cases.

Discussion

Thyroid scintigraphy differentiates subtypes of CH and suggests a higher than expected proportion of patients with GIS and ectopia. CH is permanent in half of those with GIS.
Factor XIII deficiency leading to preseptal haematoma post-strabismus surgery
Authors: Jain Mayank , Kekunnaya Ramesh , Badakere Akshay
Published: November 2019

A young girl with constant exotropia was planned for surgery. Thorough preoperative workup was done and the patient underwent strabismus surgery. The girl developed preseptal haematoma on the third postoperative day with marked chemosis and oozing of blood from the conjunctival cul-de-sac. A history of factor XIII (FXIII) deficiency was later revealed by the caretakers. The patient was admitted and fresh frozen plasma was transfused for 5 days along with intravenous tranexamic acid. Orbital ultrasound and CT scan were done to confirm the location of the haematoma. The child improved significantly after 5 days and the proptosis subsided. FXIII deficiency is a rare form of bleeding disorder that is not revealed on routine coagulation profile tests. Fresh frozen plasma and recombinant FXIII are now available for treatment.
Online multifactorial prevention programme has no effect on the number of running-related injuries: a randomised controlled trial
Authors: Fokkema Tryntsje , de Vos Robert-Jan , van Ochten John M , Verhaar Jan A N , Davis Irene S , Bindels Patrick J E , Bierma-Zeinstra Sita M A , van Middelkoop Marienke
Published: November 2019

Objective

To examine the effect of a multifactorial, online injury prevention programme on the number of running-related injuries (RRIs) in recreational runners.

Methods

Adult recreational runners who registered for a running event (distances 5 km up to 42.195 km) were randomised into the intervention group or control group. Participants in the intervention group were given access to the online injury prevention programme, which consisted of information on evidence-based risk factors and advices to reduce the injury risk. Participants in the control group followed their regular preparation for the running event. The primary outcome measure was the number of self-reported RRIs in the time frame between registration for a running event and 1 month after the running event.

Results

This trial included 2378 recreational runners (1252 men; mean [SD] age 41.2 [11.9] years), of which 1196 were allocated to the intervention group and 1182 to the control group. Of the participants in the intervention group 37.5% (95% CI 34.8 to 40.4) sustained a new RRI during follow-up, compared with 36.7% (95% CI 34.0 to 39.6) in the control group. Univariate logistic regression analysis showed no significant difference between the intervention and control group (OR 1.08; 95% CI 0.90 to 1.30). Furthermore, the prevention programme seemed to have a negative impact on the occurrence of new RRIs in the subgroup of runners with no injuries in the 12 months preceding the trial (OR 1.30; 95% CI 0.99 to 1.70).

Conclusion

A multifactorial, online injury prevention programme did not decrease the total number of RRIs in recreational runners.

Trial registration number

NTR5998.
Variation in post-colonoscopy colorectal cancer across colonoscopy providers in English National Health Service: population based cohort study
Authors: Burr Nicholas E , Derbyshire Edmund , Taylor John , Whalley Simon , Subramanian Venkataraman , Finan Paul J , Rutter Matthew D , Valori Roland , Morris Eva J A
Published: November 2019

Objectives

To quantify post-colonoscopy colorectal cancer (PCCRC) rates in England by using recent World Endoscopy Organisation guidelines, compare incidence among colonoscopy providers, and explore associated factors that could benefit from quality improvement initiatives.

Design

Population based cohort study.

Setting

National Health Service in England between 2005 and 2013.

Population

All people undergoing colonoscopy and subsequently diagnosed as having colorectal cancer up to three years after their investigation (PCCRC-3yr).

Main outcome measures

National trends in incidence of PCCRC (within 6-36 months of colonoscopy), univariable and multivariable analyses to explore factors associated with occurrence, and funnel plots to measure variation among providers.

Results

The overall unadjusted PCCRC-3yr rate was 7.4% (9317/126 152), which decreased from 9.0% in 2005 to 6.5% in 2013 (P<0.01). Rates were lower for colonoscopies performed under the NHS bowel cancer screening programme (593/16 640, 3.6%), while they were higher for those conducted by non-NHS providers (187/2009, 9.3%). Rates were higher in women, in older age groups, and in people with inflammatory bowel disease or diverticular disease, in those with higher comorbidity scores, and in people with previous cancers. Substantial variation in rates among colonoscopy providers remained after adjustment for case mix.

Conclusions

Wide variation exists in PCCRC-3yr rates across NHS colonoscopy providers in England. The lowest incidence was seen in colonoscopies performed under the NHS bowel cancer screening programme. Quality improvement initiatives are needed to address this variation in rates and prevent colorectal cancer by enabling earlier diagnosis, removing premalignant polyps, and therefore improving outcomes.
Outcomes at follow-up of negative colonoscopy in average risk population: systematic review and meta-analysis
Authors: Heisser Thomas , Peng Le , Weigl Korbinian , Hoffmeister Michael , Brenner Hermann
Published: November 2019

Objective

To review and summarise the evidence on the prevalence of colorectal adenomas and cancers at a follow-up screening colonoscopy after negative index colonoscopy, stratified by interval between examinations and by sex.

Design

Systematic review and meta-analysis of all available studies.

Data sources

PubMed, Web of Science, and Embase. Two investigators independently extracted characteristics and results of identified studies and performed standardised quality ratings.

Eligibility criteria

Studies assessing the outcome of a follow-up colonoscopy among participants at average risk for colorectal cancer with a negative previous colonoscopy (no adenomas).

Results

28 studies were identified, including 22 cohort studies, five cross sectional studies, and one case-control study. Findings for an interval between colonoscopies of one to five, five to 10, and more than 10 years were reported by 17, 16, and three studies, respectively. Summary estimates of prevalences of any neoplasm were 20.7% (95% confidence interval 15.8% to 25.5%), 23.0% (18.0% to 28.0%), and 21.9% (14.9% to 29.0%) for one to five, five to 10, and more than 10 years between colonoscopies. Corresponding summary estimates of prevalences of any advanced neoplasm were 2.8% (2.0% to 3.7%), 3.2% (2.2% to 4.1%), and 7.0% (5.3% to 8.7%). Seven studies also reported findings stratified by sex. Summary estimates stratified by interval and sex were consistently higher for men than for women.

Conclusions

Although detection of any neoplasms was observed in more than 20% of participants within five years of a negative screening colonoscopy, detection of advanced neoplasms within 10 years was rare. Our findings suggest that 10 year intervals for colonoscopy screening after a negative colonoscopy, as currently recommended, may be adequate, but more studies are needed to strengthen the empirical basis for pertinent recommendations and to investigate even longer intervals.

Study registration

Prospero CRD42019127842.
Relationships of surrogate indexes of insulin resistance with insulin sensitivity assessed by euglycemic hyperinsulinemic clamp and subclinical vascular damage
Authors: Fiorentino Teresa Vanessa , Marini Maria Adelaide , Succurro Elena , Andreozzi Francesco , Sesti Giorgio
Published: November 2019

Introduction

Insulin resistance plays a crucial role in the pathogenesis of type 2 diabetes and cardiovascular disease. The triglyceride to high-density lipoprotein cholesterol (TG/HDL-C) ratio, visceral adiposity index (VAI), lipid accumulation product (LAP) and triglycerides × fasting glucose (TyG) index are surrogate measures of insulin sensitivity based on anthropometric and/or biochemical parameters routinely collected in clinical practice. Herein, we compared the relationships of these four surrogate indexes with insulin sensitivity assessed by the gold standard euglycemic hyperinsulinemic clamp technique, and subclinical vascular damage.

Research design and methods

631 subjects with different degrees of glucose tolerance underwent euglycemic hyperinsulinemic clamp. The surrogate TG/HDL-C ratio, VAI, LAP and TyG indexes were computed. Pulse pressure and carotid intima-media thickness (IMT) were measured as indicators of subclinical vascular damage.

Results

All the four surrogate indexes showed a significant correlation with insulin-stimulated glucose disposal in the whole study population. However, only LAP index had a significant association with insulin sensitivity across the different glucose tolerance groups. LAP index showed the highest area under the receiver operating characteristic curve (0.728) to detect individuals with insulin resistance defined as the bottom quartile of insulin-stimulated glucose disposal, followed by TG/HDL-C ratio (0.693), TyG index (0.688) and VAI (0.688). A significant association was found between the four indexes of insulin sensitivity and pulse pressure and IMT. All the four indexes have a similar ability to detect individuals with vascular atherosclerosis defined by IMT>0.9 mm. Conversely, LAP index had the greatest ability to recognize individuals with increased vascular stiffness defined by pulse pressure ≥60 mm Hg.

Conclusion

Among the surrogate TG/HDL-C ratio, VAI, LAP and TyG indexes of insulin sensitivity, LAP index showed a significant association with insulin-stimulated glucose disposal across the different glucose tolerance categories and the highest ability to detect insulin resistance and subclinical vascular damage.
Protecting the poor? Impact of the national health equity fund on utilization of government health services in Cambodia, 2006-2013
Authors: Annear Peter Leslie , Tayu Lee John , Khim Keovathanak , Ir Por , Moscoe Ellen , Jordanwood Tapley , Bossert Thomas , Nachtnebel Matthias , Lo Veasnakiry
Published: November 2019

Introduction

Cambodia’s health equity fund (HEF) is the country’s most significant social security scheme, covering the poorest one-fifth of the national population. During the last two decades, the HEF system was scaled up from an initial two health districts to national coverage of public health facilities. This is the first national study to examine the impact of the HEF on the utilisation of public health facilities.

Methods

We first investigated the level of national HEF population coverage and health service use made by HEF eligible members using an administrative HEF operational dataset. Second, through multilevel interrupted time series analysis of routine monthly utilisation statistics during 2006–2013, we evaluated the impact of the HEF on hospital and health centre utilisation.

Results

The proportion of HEF beneficiaries using hospital services in a given year (4.6%) appeared to exceed rates in the general population (3.3%). The introduction of the HEF was associated with: a significant level change in the monthly number of consultations at HCs followed by a gradual slope increase in time trend and a significant level change in the monthly number of deliveries. Overall, this was equivalent to a 15.6% net increase in number of consultations and 5.3% in deliveries in the first year. At RHs: a significant level change in the number of RH inpatient cases, followed by a sustained slope increase; a significant slope increase in the number of outpatient consultations and in the overall number of newborn deliveries. Overall, this was equivalent to a 47.9% net increase in inpatient cases, 24.1% in outpatient cases and 31.4% in deliveries in the first year.

Conclusion

The implementation of the HEF scheme was associated with increased utilisation of primary and secondary care services by the poor.
Development of a core information set for colorectal cancer surgery: a consensus study
Authors: McNair Angus G K , Whistance Robert N , Main Barry , Forsythe Rachael , Macefield Rhiannon , Rees Jonathan , Pullyblank Anne , Avery Kerry , Brookes Sara , Thomas Michael G , Sylvester Paul A , Russell Ann , Oliver Alfred , Morton Dion , Kennedy Robin , Jayne David , Huxtable Richard , Hackett Roland , Dutton Susan , Coleman Mark G , Card Mia , Brown Julia , Blazeby Jane
Published: November 2019

Objective

‘Core information sets’ (CISs) represent baseline information, agreed by patients and professionals, to stimulate individualised patient-centred discussions. This study developed a CIS for use before colorectal cancer (CRC) surgery.

Design

Three phase consensus study: (1) Systematic literature reviews and patient interviews to identify potential information of importance to patients, (2) UK national Delphi survey of patients and professionals to rate the importance of the information, (3) international consensus meeting to agree on the final CIS.

Setting

UK CRC centres.

Participants

Purposive sampling was conducted to ensure CRC centre representation based upon geographical region and caseload volume. Responses were received from 63/81 (78%) centres (90 professionals). Adult patients who had undergone CRC surgery were eligible, and purposive sampling was conducted to ensure representation based on age, sex and cancer location (rectum, left and right colon). Responses were received from 97/267 (35%) patients with a wide age range (29–87), equal sex ratio and cancer location. Attendees of the international Tripartite Colorectal Conference were eligible for the consensus meeting.

Outcomes

Phase 1: Information of potential importance to patients was extracted verbatim and operationalised into a Delphi questionnaire. Phase 2: Patients and professionals rated the importance information on a 9-point Likert scale, and resurveyed following group feedback. Information rated of low importance were discarded using predefined criteria. Phase 3: A modified nominal group technique was used to gain final consensus in separate consensus meetings with patients and professionals.

Results

Data sources identified 1216 pieces of information that informed a 98-item questionnaire. Analysis led to 50 and 23 information domains being retained after the first and second surveys, respectively. The final CIS included 11 concepts including specific surgical complications, short and long-term survival, disease recurrence, stoma and quality of life issues.

Conclusions

This study has established a CIS for professionals to discuss with patients before CRC surgery.
Effectiveness-implementation hybrid type 2 trial evaluating two psychoeducational programmes for severe hypoglycaemia in type 1 diabetes: implementation study protocol
Authors: Soukup Tayana , Hull Louise , Smith Emma Lauretta , Healey Andy , Bakolis Ioannis , Amiel Stephanie A , Sevdalis Nick , Group PWD
Published: November 2019

Introduction

Two of the most acute and feared complications in type 1 diabetes (T1D) are hypoglycaemia and severe hypoglycaemia (SH). While impaired awareness of hypoglycaemia (IAH) can lead to SH with cognitive and motivational barriers implicated, the available education does not integrate behavioural change techniques to address these. A novel Hypoglycaemia Awareness Restoration Programme despite optimised care (HARPdoc) is currently being tested against an established blood glucose awareness training (BGAT) within a parallel, two-arm, group randomised, blinded trial (with its own protocol;NCT02940873) with adults with T1D whose problems with hypoglycaemia and SH have persisted despite otherwise optimised insulin management. While both programmes are aimed at reducing hypoglycaemia, SH and IAH, it is the former that integrates behavioural change techniques.

The aim of the current (implementation) study is to evaluate delivery of both HARPdoc and BGAT and explore associations between implementation outcomes and trial endpoints; as well as to develop an evidence-based implementation blueprint to guide implementation, sustainment and scale-up of the effective programmes.

Methods and analysis

Guided by the implementation science tools, frameworks, methods and principles, the current study was designed through a series of focus groups (n=11) with the key intervention stakeholders (n=28)—including (1) individuals with lived experience of T1D, IAH and a pilot version of the HARPdoc (n=6) and (2) diabetes healthcare professionals (n=22). A mixed-methods approach will be used throughout. Stakeholder engagement has underpinned study design and materials to maximise relevance, feasibility and impact.

Ethics and dissemination

The protocol has been reviewed and received ethical approval by the Harrow Research Ethics Committee (18/LO/1020; 240752) on 1 October 2018. The findings will be submitted to a peer-reviewed journal and presented at scientific meetings.

Trial registration number

NCT02940873; Pre-results.
The association between depression and later educational attainment in children and adolescents: a systematic review protocol
Authors: Wickersham Alice , Epstein Sophie , Sugg Holly Victoria Rose , Stewart Robert , Ford Tamsin , Downs Johnny
Published: November 2019

Introduction

Depression represents a major public health concern for children and adolescents, and is thought to negatively impact subsequent educational attainment. However, the extent to which depression and educational attainment are directly associated, and whether other factors play a role, is uncertain. Therefore, we aim to systematically review the literature to provide an up-to-date estimate on the strength of this association, and to summarise potential mediators and moderators on the pathway between the two.

Methods and analysis

To identify relevant studies, we will systematically search Embase, PsycINFO, PubMed, Education Resources Information Centre and British Education Index, manually search reference lists and contact experts in the field. Studies will be included if they investigate and report on the association between major depression diagnosis or depressive symptoms in children and adolescents aged 4–18 years (exposure) and later educational attainment (outcome). Two independent reviewers will screen titles, abstracts and full texts according to eligibility criteria, perform data extraction and assess study quality according to a modified version of the Newcastle-Ottawa Scale. If sufficiently homogeneous studies are identified, summary effect estimates will be pooled in meta-analysis, with further tests for study heterogeneity, publication bias and the effects of moderators using meta-regression.

Ethics and dissemination

Because this review will make use of already published data, ethical approval will not be sought. The review will be submitted for publication in a peer-reviewed journal, presented at practitioner-facing conferences, and a lay summary will be written for non-scientific audiences such as parents, young people and teachers. The work will inform upcoming investigations on the association between child and adolescent mental health and educational attainment.

PROSPERO registration number

CRD42019123068
Patient-centred infertility care: a scoping review protocol
Authors: Webair Hana Hasan , Ismail Tengku Alina Tengku , Ismail Shaiful Bahari , Mohd Noor Norhayati
Published: November 2019

Introduction

Patient-centred infertility care (PCIC) is one of the quality indicators of effective fertility care. The application of this indicator requires a clear definition from the patient’s perspective. This proposed scoping review aims to explore the extent and nature of published scientific literature on PCIC in the past decade, identify gaps in the literature and define PCIC from infertile patients’ perspectives.

Methods and analysis

We will conduct the proposed scoping review following the method of Arksey and O’Malley. The literature search will include studies published from 2009 to 2019, and will be conducted on the MEDLINE, PsycINFO, Scopus, Cochrane Library, and Cumulative Index to Nursing and Allied Health Literature (CINAHL) databases; reference lists will be mined for literature not contained on these databases. A grey literature search will also be conducted. To be included in the review, studies should have been conducted on people with a history of infertility, with a focus on patient-centred fertility care. Studies that have not been published in full text and studies published in languages other than English will be excluded. After study selection, data will be charted in a prepared form. We will analyse the data using descriptive numerical and qualitative thematic analyses to answer the research questions. NVivo V.12 will be used for data extraction.

Ethics and dissemination

This work does not warrant any ethical or safety concerns. This scoping review will synthesise existing literature on PCIC, and the results will be published to be readily available for clinical audiences and policymakers. These findings may support clinicians and decision-makers in applying PCIC, thereby promoting high-quality healthcare in the concerned population.
Global epidemiology of septic shock: a protocol for a systematic review and meta-analysis
Authors: Tianyi Frank Leonel , Tochie Joel Noutakdie , Danwang Celestin , Mbonda Aime , Temgoua Mazou N , Mapoh Sylvester Yari , Nkemngu Njinkeng J , Tallah Esther , Bigna Jean Joel
Published: November 2019

Background

Septic shock is a life-threatening infection frequently responsible for hospital admissions or may be acquired as nosocomial infection in hospitalized patients with resultant significant morbidity and mortality . There is a dearth of data on a résumé and meta-analysis on the global epidemiology of this potentially deadly condition. Therefore, we propose the first systematic review to synthesize existing data on the global incidence, prevalence and case fatality rate of septic shock worldwide.

Methods

We will include cross-sectional, case-control and cohort studies reporting on the incidence, and case fatality rate of septic shock. Electronic databases including PubMed, Embase, WHO Global Health Library and Web of Science will be searched for relevant records published between 1 January 2000 and 31 August 2019. Independents reviewers will perform study selection and data extraction, as well as assessment of methodological quality of included studies. Appropriate meta-analysis will then be used to pool studies judged to be clinically homogenous. Egger’s test and funnel plots will be used to detect publication bias. Findings will be reported and compared by human development level of countries.

Ethics and dissemination

Being a review, ethical approval is not required as it was obtained in the primary study which will make up the review. This review is expected to provide relevant data to help in evaluating the burden of septic shock in the general population. The overall findings of this research will be published in a peer-reviewed journal.

PROSPERO registration number

CRD42019129783.
Can Waterlow score predict 30-day mortality and length of stay in acutely admitted medical patients (aged ≥65 years)? Evidence from a single centre prospective cohort study
Authors: Wang James Wei , Smith Phillip , Sarker Shah-Jalal , Elands Sophie , Oliveira Amelia , Barratt Claire , Thorn Chris , Holme Tom , Lynch Mary
Published: November 2019

Objective

This study aimed to explore the potential for the Waterlow score (WS) to be used as a predictor of 30-day mortality and length of hospital stay (LHS) in acutely admitted medical patients aged 65 years and older.

Design

Prospective observational cohort study.

Setting

UK District General Hospital.

Subjects

834 consecutive patients aged 65 years and older admitted acutely to medical specialties between 30 May and 22 July 2014.

Methods

Admission WS (range 4–64) assessment paired with the patient’s status at 30 days in terms of mortality and their LHS.

Primary outcomes

30-day mortality and length of inpatient stay.

Results

834 consecutive acute medical admissions had their WS recorded. 30-day mortality was 13.1% (109 deaths). A significant difference in the distribution of WS (p<0.001) was seen between those who survived (median 12) and those who died (median 16) within 30 days, particularly within respiratory (p<0.001), stroke (p<0.001), cardiology (p<0.016), non-respiratory infections (p<0.018) and trauma (p<0.044) subgroups. Odds of dying within 30 days increased threefold for every 10-unit increase in the WS (p<0.001, 95% CI 2.1 to 4.3). LHS was also positively linearly associated with the WS in those who survived 30 days (median=5, IQR=10; r=0.32, p<0.01). A five-unit increase in WS was associated with approximately 5 days increase in LHS. On the other hand, quadratic regression showed this relationship was curvilinear and negative (concave) for those who died within 30 days where a five-unit increase in WS was associated with an approximately 10 days decrease in LHS.

Conclusion

This study demonstrates an association between a high WS and both 30-day mortality and LHS. This is particularly significant for mortality in patients in the respiratory, stroke and cardiac subcategories. The WS, a nursing-led screening tool that is carried out on virtually all admissions to UK hospitals, could have additional use at the time of patient admission as a risk assessment tool for 30-day mortality as well as a predictor of LHS.
Household preparedness for emergency events: a cross-sectional survey on residents in four regions of China
Authors: Chen Chao Yi , Xu Wei , Dai Yajun , Xu Weilan , Liu Chaojie , Wu Qunhong , Gao Lijun , Kang Zheng , Hao Yanhua , Ning Ning
Published: November 2019

Objective

This study aimed to assess household preparedness for emergency events and its determinants in China.

Design

A cross-sectional questionnaire survey was conducted on 3541 households in China in 2015.

Participants

Households were selected using a stratified cluster sampling strategy, representing central, eastern, western and southern regions of China. The designed questionnaires were administered through face-to-face interviews.

Outcome measures

Household emergency preparedness was measured with 14 indicators, tapping into the supply of nine emergency necessities (food and water, extra batteries, battery-powered radio, battery-operated torch, first-aid kit, gas mask, fire extinguisher, escape ropes, whistle), coverage of accident insurance, knowledge of local emergency response systems (emergency numbers, exit routes and shelters) and availability of a household evacuation plan. If an individual acted on 9 of the 14 indicators, they were deemed well prepared. Logistic regression models were established to identify predictors of well preparedness based on 3541 returned questionnaires containing no missing values.

Results

Only 9.9% of households were well prepared for emergencies: 53.6% did not know what to do and 31.6% did not want to think about it. A higher level of preparedness was found in the respondents who have attained higher education (adjusted OR=0.826 compared with the higher level), participated in emergency training activities (adjusted OR=2.299), had better emergency knowledge (adjusted OR=2.043), reported less fate-submissiveness (adjusted OR=1.385) and more self-reliance (adjusted OR=1.349), prior exposure to emergency events (adjusted OR=1.280) and held more positive attitudes towards preparedness (adjusted OR=1.286).

Conclusion

Household preparedness for emergency events is poor in China. Lack of motivation, negative attitude to preparedness and knowledge shortfall are major but remediable barriers for household preparedness.
The ORVAC trial protocol: a phase IV, double-blind, randomised, placebo-controlled clinical trial of a third scheduled dose of Rotarix rotavirus vaccine in Australian Indigenous infants to improve protection against gastroenteritis
Authors: Middleton Bianca Fleur , Jones Mark A , Waddington Claire S , Danchin Margaret , McCallum Carly , Gallagher Sarah , Leach Amanda Jane , Andrews Ross , Kirkwood Carl , Cunliffe Nigel , Carapetis Jonathan , Marsh Julie A , Snelling Tom
Published: November 2019

Introduction

Rotavirus vaccines were introduced into the Australian National Immunisation Program in 2007. Despite this, Northern Territory Indigenous children continue to be hospitalised with rotavirus at a rate more than 20 times higher than non-Indigenous children in other Australian jurisdictions, with evidence of waning protection in the second year of life. We hypothesised that scheduling an additional (third) dose of oral human rotavirus vaccine (Rotarix, GlaxoSmithKline) for children aged 6 to <12 months would improve protection against clinically significant all-cause gastroenteritis.

Methods and analysis

This Bayesian adaptive clinical trial will investigate whether routinely scheduling an additional dose of Rotarix for Australian Indigenous children aged 6 to <12 months old confers significantly better protection against clinically important all-cause gastroenteritis than the current two-dose schedule at 2 and 4 months old. There are two coprimary endpoints: (1) seroconversion from baseline serum anti-rotavirus immunoglobulin A (IgA) titre <20 U/mL prior to an additional dose of Rotarix/placebo to serum anti-rotavirus IgA titre >20 U/mL following the administration of the additional dose of Rotarix/placebo and (2) time from randomisation to medical attendance (up to age 36 months old) for which the primary reason is acute gastroenteritis/diarrhoea. Secondary endpoints include the change in anti-rotavirus IgA log titre, time to hospitalisation for all-cause diarrhoea and for rotavirus-confirmed gastroenteritis/diarrhoea, and rotavirus notification. Analysis will be based on Bayesian inference with adaptive sample size.

Ethics, registration and dissemination

Ethics approval has been granted by Central Australian Human Research Ethics Committee (HREC-16-426) and Human Research Ethics Committee of the Northern Territory Department of Health and Menzies School of Health Research (HREC-2016-2658). Study investigators will ensure the trial is conducted in accordance with the principles of the Declaration of Helsinki and with the ICH Guidelines for Good Clinical Practice. Individual participant consent will be obtained. Results will be disseminated via peer-reviewed publication. The trial is registered with Clinicaltrials.gov (NCT02941107) and important modifications to this protocol will be updated.

Trial registration number

NCT02941107; Pre-results.
Marital status, telomere length and cardiovascular disease risk in a Swedish prospective cohort
Authors: Chen Ruoqing , Zhan Yiqiang , Pedersen Nancy , Fall Katja , Valdimarsdóttir Unnur A , Hägg Sara , Fang Fang
Published: November 2019

Objective

To investigate if marital status is associated with risk of cardiovascular disease (CVD) and to explore the potential influence of leucocyte telomere length (LTL), a marker of biological ageing, on such association.

Design

Population-based prospective cohort study

Settings

Swedish Twin Registry.

Participants

Based on the Screening Across the Lifespan Twin Study from the Swedish Twin Registry, we included 10 058 twins born between 1900 and 1958 who underwent an interview between 1998 and 2002 during which information about marital status was collected. Blood samples from these participants were subsequently collected between 2004 and 2008 and used for LTL assessment using quantitative PCR technique.

Main outcome measures

Incident cases of CVD were identified through the Swedish Patient Register and Causes of Death Register through December 31, 2016. Multivariable linear regression and Cox proportional hazards regression models were used to estimate the regression coefficients (βs) and HRs with 95% CIs respectively. Potential confounders included age, sex, educational attainment and body mass index.

Results

A total of 2010 participants were diagnosed with CVD during a median follow-up of 9.8 years. LTL was shorter among individuals living singly, including those who were divorced or separated (β:−0.014, 95% CI: −0.035, 0.007), widowed (β:−0.035, 95% CI: −0.061, –0.010), or living alone (β:−0.033, 95% CI: −0.052, –0.014), than individuals who were married or cohabitating. One SD increase of LTL was associated with a lower risk of CVD (HR: 0.79, 95% CI: 0.66, 0.93). Individuals who were divorced or separated, widowed, or living alone had a higher risk of CVD than individuals who were married or cohabitating. The summary HR of CVD was 1.21 (95% CI: 1.08, 1.35) when comparing individuals who were living singly, regardless of reason, with the individuals who were married or cohabitating. LTL appeared to mediate little of the association between marital status and CVD (HR additionally adjusted for LTL: 1.20; 95% CI: 1.08, 1.34).

Conclusions

Living singly, regardless of reason, was associated with a shorter LTL and a higher risk of CVD. The association between marital status and CVD was however not greatly attributable to telomere shortening.
Study protocol: a randomised non-inferiority trial using interactive virtual presence to remotely assist parents with child restraint installations
Authors: Schwebel David C , MacKay Jennifer Morag , Redden David
Published: November 2019

Background

Motor vehicle crashes are the third-leading cause of death to American children aged 1–5 years. When installed correctly, child restraints (car seats) reduce risk of serious injury and death. However, most restraints are installed incorrectly. The current gold standard for correct installation is systematic car seat checks, where certified technicians help parents, but car seat checks are highly underused due to barriers in access, scheduling and resources.

Methods

The present study protocol describes plans to evaluate use of interactive virtual presence technology (interactive merged reality)—joint, simultaneous remote verbal and visual interaction and exposure to the same 3D stimuli—to assist remotely located parents installing child restraints. If effective, this technology could supplement or replace in-person checks and revolutionise how government, industry and non-profits help parents install child restraints properly. Building from preliminary studies, we propose a randomised non-inferiority trial to evaluate whether parents who install child restraints while communicating with remote expert technicians via interactive virtual presence on their smartphones achieve installations and learning not inferior in safety to parents who install restraints with on-site technicians. We will randomly assign 1476 caregivers at 7 US sites to install child restraints either via interactive virtual presence or live technicians. Correctness of installation will be assessed using objective checklists, both following installation and again 4 months later.

Conclusion

We aim to demonstrate that child restraint installation is accurate (>90% correct) when conducted remotely, that such installations are not inferior to installation accuracy with live experts and that parents learn and retain information about child restraint installation.
Factors influencing bone loss in anorexia nervosa: assessment and therapeutic options
Authors: Legroux Isabelle , Cortet Bernard
Published: November 2019

Decreased mineral density is one of the major complications of anorexia nervosa. The phenomenon is even more pronounced when the disease occurs during adolescence and when the duration of amenorrhoea is long. The mechanisms underlying bone loss in anorexia are complex. Oestrogen deficiency has long been considered as the main factor, but cannot explain the phenomenon on its own. The essential role of nutrition-related factors—especially leptin and adiponectin—has been reported in recent studies. Therapeutic strategies to mitigate bone involvement in anorexia are still a matter for debate. Although resumption of menses and weight recovery appear to be essential, they are not always accompanied by a total reversal of bone loss. There are no studies in the literature demonstrating that oestrogen treatment is effective, and the best results seem to have been obtained with agents that induce bone formation—such as IGF-1—especially when associated with oestrogen. As such, bone management in anorexia remains difficult, hence, the importance of early detection and multidisciplinary follow-up.
Ultrasonographic measurement of adrenal gland‐to‐aorta ratio as a method of estimating adrenal size in dogs
Authors: Agut Amalia , Martinez Miryam , Anson Agustina , Soler Marta
Published: November 2019

Background

Adrenal size has been used as the principal criterion for differentiating a normal gland from adrenal hyperplasia. The objectives of this study were to establish an ultrasonographic measurement of adrenal gland‐to‐aorta (adrenal/Ao) ratio to estimate the adrenal size and to assess the effects of bodyweight, age and sex on the adrenal/Ao ratio in non‐adrenal gland disease dogs.

Methods

Two hundred and thirty‐four dogs (120 entire females and 114 entire males) considered non‐adrenal gland disease were included in this study. Dogs were allocated into three bodyweight categories (<10 kg, 10–20 kg and >20 kg), and four age groups (<1 year, 1–5 years, 5–10 years and >10 years old). Measurements of the maximal thickness of caudal pole of both adrenal glands and the aortic luminal diameter in sagittal plane were performed on the ultrasonographic images. Three different ratios were calculated for each dog.

Results

Sex and age did not influence on the adrenal/Ao ratio. There were differences (P<0.05) between the three dog sizes for adrenal/Ao ratio, being the highest value for small size and the lowest value for large size.

Conclusions

In this study, only bodyweight influences the ultrasound measurement of the adrenal/Ao ratio in non‐adrenal gland disease dogs.
Evidence for temperature-dependent shifts in spawning times of anadromous alewife (Alosa pseudoharengus) and blueback herring (Alosa aestivalis)
Authors: Lombardo Steven M. , Buckel Jeffrey A. , Hain Ernie F. , Griffith Emily H. , White Holly
Published: November 2019

We analyzed four decades of presence–absence data from a fishery-independent survey to characterize the long-term phenology of river herring (alewife, Alosa pseudoharengus; and blueback herring, Alosa aestivalis) spawning migrations in their southern distribution. We used logistic generalized additive models to characterize the average ingress, peak, and egress timing of spawning. In the 2010s, alewife arrived to spawning habitat 16 days earlier and egressed 27 days earlier (peak 12 days earlier) relative to the 1970s. Blueback herring arrived 5 days earlier and egressed 23 days earlier (peak 13 days earlier) in the 2010s relative to the 1980s. The changes in ingress and egress timing have shortened the occurrence in spawning systems by 11 days for alewife over four decades and 18 days for blueback herring over three decades. We found that the rate of vernal warming was faster during 2001–2016 relative to 1973–1988 and is the most parsimonious explanation for changes in spawning phenology. The influence of a shortened spawning season on river herring population dynamics warrants further investigation.
Cosmological singularities in conformal Weyl gravity
Authors: Heydarzade Yaghoub
Published: November 2019

In this work, we study the issue of the past and future cosmological singularities in the context of the fourth-order conformal Weyl gravity. In particular, we investigate the emergent universe scenario proposed by Ellis et al., and find the stability conditions of the corresponding Einstein static state using the fixed point approach. We show that depending on the values of the parameters of the conformal Weyl gravity theory, there are possibilities for having initially stable emergent states for an FRW universe with both the positive and negative spatial curvatures. This represents that the conformal Weyl gravity can be free of the initial singularity problem. Then, following Barrow et al., we address the possible types of the finite-time future cosmological singularities. We discuss how these singularities also can be avoided in the context of this theory.
Non-Canonical Microstate Becomes Salient in High Density EEG During Propofol-Induced Altered States of Consciousness
Authors: Shi Wen , Li Yamin , Liu Zhian , Li Jing , Wang Qiang , Yan Xiangguo , Wang Gang
Published: November 2019

Dynamically assessing the level of consciousness is still challenging during anesthesia. With the help of Electroencephalography (EEG), the human brain electric activity can be noninvasively measured at high temporal resolution. Several typical quasi-stable states are introduced to represent the oscillation of the global scalp electric field. These so-called microstates reflect spatiotemporal dynamics of coherent neural activities and capture the switch of brain states within the millisecond range. In this study, the microstates of high-density EEG were extracted and investigated during propofol-induced transition of consciousness. To analyze microstates on the frequency domain, a novel microstate-wise spectral analysis was proposed by the means of multivariate empirical mode decomposition and Hilbert–Huang transform. During the transition of consciousness, a map with a posterior central maximum denoted as microstate F appeared and became salient. The current results indicated that the coverage, occurrence, and power of microstate F significantly increased in moderate sedation. The results also demonstrated that the transition of brain state from rest to sedation was accompanied by significant increase in mean energy of all frequency bands in microstate F. Combined with studies on the possible cortical sources of microstates, the findings reveal that non-canonical microstate F is highly associated with propofol-induced altered states of consciousness. The results may also support the inference that this distinct topography can be derived from canonical microstate C (anterior-posterior orientation). Finally, this study further develops pertinent methodology and extends possible applications of the EEG microstate during propofol-induced anesthesia.
Stability of planar rarefaction wave to the 3D bipolar Vlasov–Poisson–Boltzmann system
Authors: Wang Shu , Wang Teng
Published: November 2019

We investigate the time-asymptotic stability of planar rarefaction wave for the 3D bipolar Vlasov–Poisson Boltzmann (VPB) system, based on the micro–macro decompositions introduced in [T. P. Liu and S. H. Yu, Boltzmann equation: Micro–macro decompositions and positivity of shock profiles, Comm. Math. Phys. 246 (2004) 133–179; Energy method for the Boltzmann equation, Physica D 188 (2004) 178–192] and our new observations on the underlying wave structures of the equation to overcome the difficulties due to the wave propagation along the transverse directions and its interactions with the planar rarefaction wave. Note that this is the first stability result of basic wave patterns for bipolar VPB system in three dimensions.
Groups with the same number of centralizers
Authors: Khoramshahi K. , Zarrin M.
Published: November 2019

For any group [Formula: see text], let [Formula: see text] denote the set of all non-abelian centralizers of [Formula: see text]. Jafarian Amiri and Rostami, Groups with a few nonabelian centralizers, Publ. Math. Debrecen 87(3–4) (2015) 429–437 put forward the following question: Let [Formula: see text] and [Formula: see text] be finite simple groups. Is it true that if [Formula: see text], then [Formula: see text] is isomorphic to [Formula: see text]? In this paper, among other things, we give a negative answer to this question.
A characterization of extending generalized triangular matrix rings
Authors: Mohammadi Rasul , Moussavi Ahmad , Zahiri Masoome
Published: November 2019

A right module [Formula: see text] is extending if every submodule is essential in a direct summand of [Formula: see text]. In this note, we obtain a characterization of the right extending generalized triangular matrix rings. This answers a question which was raised in “E. Akalan, G. F. Birkenmeier and A. Tercan, Characterizations of extending modules and [Formula: see text]-extending generalized triangular matrix rings, Comm. Algebra 40 (2012) 1069–1085”.