bluuebunny/crossref_metadata_2025 huggingface dataset:
Ability of verbal autopsy data to detect deaths due to uncontrolled hyperglycaemia: testing existing methods and development and validation of a novel weighted score
Authors: Blackstock Sarah , Witham Miles D , Wade Alisha N , Crampin Amelia , Beran David , Ogle Graham D , Davies Justine I
Published: October 2019

Objectives

Verbal autopsy (VA) is a useful tool to ascertain cause of death where no other mechanisms exist. We aimed to assess the utility of VA data to ascertain deaths due to uncontrolled hyperglycaemia and to develop a weighted score (WS) to specifically identify cases. Cases were identified by a study or site physician with training in diabetes. These diagnoses were also compared with diagnoses produced by a standard computer algorithm (InterVA-4).

Setting

This study was done using VA data from the Health and Demographic Survey sites in Agincourt in rural South Africa. Validation of the WS was done using VA data from Karonga in Malawi.

Participants

All deaths from ages 1 to 49 years between 1992 and 2015 and between 2002 and 2016 from Agincourt and Karonga, respectively. There were 8699 relevant deaths in Agincourt and 1663 in Karonga.

Results

Of the Agincourt deaths, there were 77 study physician classified cases and 58 computer algorithm classified cases. Agreement between study physician classified cases and computer algorithm classified cases was poor (Cohen’s kappa 0.14). Our WS produced a receiver operator curve with area under the curve of 0.952 (95% CI 0.920 to 0.985). However, positive predictive value (PPV) was below 50% when the WS was applied to the development set and the score was dominated by the necessity for a premortem diagnosis of diabetes. Independent validation showed the WS performed reasonably against site physician classified cases with sensitivity of 86%, specificity of 99%, PPV of 60% and negative predictive value of 99%.

Conclusion

Our results suggest that widely used VA methodologies may be missing deaths due to uncontrolled hyperglycaemia. Our WS may offer improved ability to detect deaths due to uncontrolled hyperglycaemia in large populations studies where no other means exist.
Perceptions, experiences and barriers to lifestyle modifications in first-generation Middle Eastern immigrants to Sweden: a qualitative study
Authors: Olaya-Contreras Patricia , Balcker-Lundgren Katarina , Siddiqui Faiza , Bennet Louise
Published: October 2019

Objective

The prevalence of type 2 diabetes (T2D) among Iraqi immigrants to Sweden is high and partly related to sedentary physical activity and calorie dense food. The aim of the present study was to explore perceptions, experiences and barriers concerning lifestyle modifications (LSM) in Iraqi immigrants to Sweden at risk for T2D.

Design

A qualitative thematic analysis was conducted on data collected from gender-specific focus group interviews which took place during a culturally adapted randomised controlled intervention study addressing motivation to lifestyle change, self-empowerment, behavioural modifications and sociocultural barriers to LSM. Seven focus groups were held, with an interval of 1–4 weeks between January and May of 2015; each session lasted approximately 1.5 hours.

Setting

The city of Malmö, Sweden.

Participants

Out of 27 women and 23 men assigned to the intervention group, 19 women and 14 men who attended at least one focus group session were included in the study.

Results

Participants expressed awareness of the content of healthy lifestyle practices. They also expressed numerous social and cultural barriers to LSM connected to irregular meals, overeating, food and drinking preferences and family expectations. Overeating was described as a consequence of social and cultural norms and expectations and of poor mental well-being. Facilitators for reaching successful LSM were connected to family involvement and support.

Conclusion

Our study reports that facilitators for LSM are connected to presence of family support. Preventive actions addressing family involvement may benefit Middle Eastern immigrants at high risk for T2D to consider healthier lifestyles practices. Identification of sociocultural barriers and facilitators for LSM are crucial for successful health promotion in minority populations at risk for T2D.

Trial registration

Trial registration number:NCT01420198for the MEDIM-study; Pre-results.
Association of high-sensitivity C-reactive protein in middle-aged and elderly Chinese people with hyperuricaemia and risk of coronary heart disease: a cross-sectional study
Authors: Xie Mingsheng , Xie Dongxing , Yang Ye , Zhang Yi , Li Kun , Zhou Bin , Yang Zidan , Ding Xiang , Li Hui
Published: October 2019

Objectives

Patients with hyperuricaemia are at relatively high risk of developing coronary heart disease (CHD). The purpose of this study was to examine the relationship between high-sensitivity C-reactive protein (hs-CRP) and CHD risk in a middle-aged and elderly population with hyperuricaemia.

Design

A cross-sectional study.

Setting and participants

This study was conducted in a health examination centre of China. Participants were diagnosed with hyperuricaemia based on uric acid concentrations. Specifically, males with a uric acid concentration ≥416 μmol/L were included, as well as females with a concentration ≥360 μmol/L.

Main outcome measures

10-year CHD risk for each individual was evaluated using Framingham risk score based on the Adult Treatment Panel III charts.

Results

A total of 517 patients with hyperuricaemia (438 males and 79 females) aged from 40 to 85 years old were included in the present study. 193 (37.3%) patients were defined with relatively high 10-year CHD risk. Compared with the lowest quintile, the crude ORs of relatively high 10-year CHD risks were 1.43 (95% CI 0.78 to 2.63, p=0.245), 2.05 (95% CI 1.14 to 3.67, p=0.016), 2.77 (95% CI 1.54 to 4.98, p=0.001), 2.12 (95% CI 1.18 to 3.80, p=0.012) in the second, third, fourth and fifth quintiles of serum hs-CRP level, respectively (p for trend=0.057). The multivariable-adjusted ORs of relatively high 10-year CHD risk were 1.40 (95% CI 0.75 to 2.61, p=0.291) in the second, 2.05 (95% CI 1.13 to 3.72, p=0.019) in the third, 2.69 (95% CI 1.47 to 4.89, p=0.001) in the fourth and 2.10 (95% CI 1.15 to 3.84, p=0.016) in the fifth quintile of serum hs-CRP level when compared with the lowest quintile (p for trend=0.068).

Conclusion

This study showed that ORs of relatively high 10-year CHD risk were raised in patients with hyperuricaemia with higher serum hs-CRP level; however, there was a not significant but borderline trend association and that more research is needed.
Evaluation of a shared decision-making intervention for dialysis choice at four Danish hospitals: a qualitative study of patient perspective
Authors: Finderup Jeanette , Dam Jensen Jens , Lomborg Kirsten
Published: October 2019

Objective

To evaluate the ‘Shared Decision-making and Dialysis Choice’ (SDM-DC) intervention with regard to patients’ experience and involvement.

Design

Semistructured individual interviews and systematic text condensation for data analysis.

Setting

The SDM-DC intervention was implemented and evaluated at four different hospitals in Denmark.

Participants

A total of 348 patients had received the SDM-DC intervention, and of these 29 patients were interviewed.

Interventions

SDM-DC was designed for patients facing a choice of dialysis modality. The available modalities were haemodialysis and peritoneal dialysis, either performed by patients on their own or with help from a healthcare professional. The intervention was tailored to individual patients and consisted of three meetings with a dialysis coordinator who introduced a patient decision aid named ‘Dialysis Choice’ to the patient.

Findings

The following were the four main findings: the decision was experienced as being the patient’s own; the meetings contributed to the decision process; ‘Dialysis Choice’ contributed to the decision process; and the decision process was experienced as being iterative.

Conclusions

The patients experienced SDM-DC as involving them in their choice of dialysis modality. Due to the iterative properties of the decision-making process, a shared decision-making intervention for dialysis choice has to be adapted to the needs of individual patients. The active mechanisms of the meetings with the dialysis coordinator were (1) questions to and from the patient, and (2) the dialysis coordinator providing accurate information about the options. The overview of options and the value clarification tool in the decision aid were particularly helpful in establishing a decision-making process based on informed preferences.
Research protocol for mechanical complications after central venous catheterisation: a prospective controlled multicentre observational study to determine incidence and risk factors of mechanical complications within 24 hours after cannulation
Authors: Adrian Maria , Borgquist Ola , Bentzer Peter , Åkeson Jonas , Spångfors Martin , Wrigstad Jonas , Holmström Anders , Linnér Rikard , Kander Thomas
Published: October 2019

Introduction

Central venous catheterisation is a common procedure in intensive care therapy and the use of central venous catheters is essential for treatment of many medical disorders. Although rare, central venous catheterisation is associated with mechanical complications that can be life-threatening if untreated. Real-time ultrasound guidance reduces the incidence of mechanical complications when compared with the anatomic landmark method. The purpose of this study is to determine the incidence of and potential risk factors associated with early mechanical complications of central venous catheterisation in an era where real-time ultrasound guidance has become clinical practice.

Methods and analysis

This is a prospective, controlled, multicentre, observational study. All participating hospitals follow the same clinical guidelines for central venous catheterisation. Each central venous catheter insertion will be recorded in the common electronic chart system according to a recently revised template. An automated script-based search will identify all recorded central venous catheter insertion templates during the study period and relevant variables will be extracted. Outcome measures and independent variables are pre-defined in this study protocol. Multivariable and univariable logistic regression analysis will be used to determine associations and risk factors of mechanical complications.

Ethics and dissemination

The Regional Ethical Review Board in Lund, Sweden has approved this study. The results will be submitted for publication in peer-reviewed medical journals and presented at national and international scientific meetings.

Trial registration number

NCT03782324.
Examining the information needed for acceptance of deintensified screening programmes: qualitative focus groups about cervical screening in Australia
Authors: Dodd Rachael H , Nickel Brooke , Wortley Sally , Bonner Carissa , Hersch Jolyn , McCaffery Kirsten J
Published: October 2019

Objectives

Given the changing understanding of overdiagnosis of screen detected cancers and advances in technology to detect and prevent cancer, updating and scaling back cancer screening programmes is becoming increasingly necessary. The National Cervical Screening Programme (NCSP) in Australia was recently deintensified, with the changes implemented in December 2017. This study examines women’s understanding and acceptance of the renewed screening protocol and how such changes can be communicated more effectively.

Design

Focus groups structured around a presentation of information about the renewed NCSP, with discussions of the information facilitated throughout. Qualitative data analysis was conducted.

Setting

Australia

Participants

Six focus groups were conducted in November 2017 with a community sample of 49 women aged 18–74.

Results

Women demonstrated little or no awareness of the upcoming screening changes in the period just before they occurred. Women expressed most concern and fear that the increased screening interval (from 2 to 5 years) and later age of first screening (from age 18 to 25 years) could lead to missing cancers. Concerns about exit testing were less common. Understanding of the natural history and the prevalence of both human papillomavirus and cervical cancer, and the nature of the new test (catching it ‘earlier’) was key to alleviate concerns about the increased screening interval.

Conclusions

Deintensifying screening programmes should be accompanied by clear and coherent communication of the changes, including the rationale behind them, to limit concerns from the public and facilitate acceptance of renewed programmes. In this case, understanding the biology of cervical cancer was crucial.
Impact of local health insurance schemes on primary care management and control of hypertension: a cross-sectional study in Shenzhen, China
Authors: Li Haitao , Wu Zhu , Hui Xia , Hu Yanhong
Published: October 2019

Background

In China, the local health insurance coverage is usually related to timely reimbursement of hypertensive care in primary care settings, while health insurance that is not local could represent an obstacle for accessibility and affordability of primary care for hypertensive patients.

Objective

To investigate whether local health insurance schemes have a positive impact on hypertension management and control.

Design

We performed an on-site, face-to-face, patients survey in community health centres (CHCs) in Shenzhen, China.

Setting and participants

Hypertensive patients seeking healthcare from CHCs were selected as study participants using a systematic sampling design.

Main measures

We obtained information about insurance status, social capital, drug treatment and control of hypertension. Multivariable stepwise logistic regression models were constructed to test the associations between insurance status and hypertension management, as well as insurance status and social capital.

Results

A total of 867 participants were included in the final study analysis. We found that the participants covered by local insurance schemes were more likely to be managed in primary care facilities (61.1% vs 81.9%; OR=2.58, 95% CI: 1.56 to 4.28), taking antihypertensive drugs (77.2% vs 88.0%; OR=2.23, 95% CI: 1.37 to 3.62) and controlling blood pressure (43.0% vs 52.4%; OR=1.46, 95% CI: 1.03 to 2.07) when compared with those with insurance coverage that is not local. The participants covered by local insurance schemes reported a higher score of perceived generalised trust than those without (4.23 vs 3.97; OR=0.74, 95% CI: 0.53 to 0.86).

Conclusion

Our study demonstrates that local health insurance coverage could help improve management and control of hypertension in a primary care setting. Policymakers suggest initiating social interventions for better management and control of hypertension at the primary care level, although the causal pathways across insurance status, social capital and control of hypertension deserve further investigations.
Discontinuation of non-Vitamin K antagonist oral anticoagulants in patients with non-valvular atrial fibrillation: a population-based cohort study using primary care data from The Health Improvement Network in the UK
Authors: Ruigómez Ana , Vora Pareen , Balabanova Yanina , Brobert Gunnar , Roberts Luke , Fatoba Samuel , Fernandez Oscar , García Rodríguez Luis Alberto
Published: October 2019

Objective

To determine discontinuation rates, patterns of use and predictors of discontinuation of non-vitamin K antagonist oral anticoagulants (NOACs) among patients with non-valvular atrial fibrillation (NVAF) in the first year of therapy.

Design

Population-based cohort study.

Setting

UK primary care.

Population

11 481 patients with NVAF and a first prescription (index date) for apixaban, dabigatran or rivaroxaban (January 2012 to December 2016) with at least 1 year of follow-up and at least one further NOAC prescription in the year following the index date were identified. 1 year rates and patterns of discontinuation were described.

Primary and secondary outcome measures

Outcome measures were the percentage of patients who, in the first year from starting NOAC therapy, discontinued with their oral anticoagulant (OAC) therapy (discontinuation was defined as a gap in OAC therapy of >30 days); switched OAC within 30 days; discontinued and reinitiated OAC therapy. Predictors of discontinuation were also evaluated.

Results

1 year discontinuation rates according to the index NOAC were 26.1% for apixaban, 40.0% for dabigatran and 29.6% for rivaroxaban. Reinitiation rates were 18.1% for apixaban, 21.7% for dabigatran and 17.3% for rivaroxaban, and switching rates were 2.8% for apixaban, 8.8% for dabigatran and 4.9% for rivaroxaban. More than 93% of reinitiations were with the index NOAC. Patients starting on dabigatran were more likely to switch OAC therapy than those starting on apixaban; ORs 4.28 (95% CI 3.24 to 5.65) for dabigatran and 1.89 (95% CI 1.49 to 2.39) for rivaroxaban. Severely reduced renal function was a predictor of any discontinuation, OR 1.77 (95% CI 1.28 to 2.44).

Conclusion

While the majority of patients with NVAF in the UK initiating NOAC treatment received continuous therapy in the first year of treatment, a substantial proportion of patients experienced gaps in treatment leaving them less protected against thromboembolism during these periods.
Rural general practice patients’ coping with hazards and harm: an interview study
Authors: Harbitz Martin Bruusgaard , Brandstorp Helen , Gaski Margrete
Published: October 2019

Objective

The aim of this study is to identify and analyse rural general practice patients’ experiences of hazards and harm that comprise adverse events, and their strategies for coping with them.

Design

Interview study using systematic text condensation and coping strategy theory in an abductive analysis process.

Setting

Nine rural general practice clinics in Norway.

Participants

Twenty participants, aged 21–79 years, all presenting with recent onset of somatic and/or psychiatric complaints.

Results

Participating rural general practice patients described their experiences of a variety of hazards and harms. Their three most discussed cognitive and behavioural coping strategies were: (1) to accept the events; (2) to confront them and (3) to engage in planful problem-solving. While the participants demonstrated a tendency toward accepting hazards and harm that their regular general practitioner created, they were often willing to confront those that locum (ie, substitute) general practitioners created. Participants used planful problem-solving in situations they deemed hazardous, such as breaches of confidentiality or not being taken seriously, as well as during potential/actual emergencies.

Conclusions

Patients at rural general practice clinics actively identify and respond to hazards and harm, applying three coping strategies. Thus, patients themselves may serve as an important safety barrier against hazards and harm; their potential contributions to improving patient safety must be appreciated accordingly and reflected in future research as well as in everyday clinical practice.
Validity of acute cardiovascular outcome diagnoses in European electronic health records: a systematic review protocol
Authors: Davidson Jennifer Anne , Banerjee Amitava , Muzambi Rutendo , Smeeth Liam , Warren-Gash Charlotte
Published: October 2019

Introduction

Cardiovascular diseases (CVDs) are among the leading causes of death globally. Electronic health records (EHRs) provide a rich data source for research on CVD risk factors, treatments and outcomes. Researchers must be confident in the validity of diagnoses in EHRs, particularly when diagnosis definitions and use of EHRs change over time. Our systematic review provides an up-to-date appraisal of the validity of stroke, acute coronary syndrome (ACS) and heart failure (HF) diagnoses in European primary and secondary care EHRs.

Methods and analysis

We will systematically review the published and grey literature to identify studies validating diagnoses of stroke, ACS and HF in European EHRs. MEDLINE, EMBASE, SCOPUS, Web of Science, Cochrane Library, OpenGrey and EThOS will be searched from the dates of inception to April 2019. A prespecified search strategy of subject headings and free-text terms in the title and abstract will be used. Two reviewers will independently screen titles and abstracts to identify eligible studies, followed by full-text review. We require studies to compare clinical codes with a suitable reference standard. Additionally, at least one validation measure (sensitivity, specificity, positive predictive value or negative predictive value) or raw data, for the calculation of a validation measure, is necessary. We will then extract data from the eligible studies using standardised tables and assess risk of bias in individual studies using the Quality Assessment of Diagnostic Accuracy Studies 2 tool. Data will be synthesised into a narrative format and heterogeneity assessed. Meta-analysis will be considered when a sufficient number of homogeneous studies are available. The overall quality of evidence will be assessed using the Grading of Recommendations, Assessment, Development and Evaluation tool.

Ethics and dissemination

This is a systematic review, so it does not require ethical approval. Our results will be submitted for peer-review publication.

PROSPERO registration number

CRD42019123898
Prevalence and correlates of smoking and nicotine dependence: results of a nationwide cross-sectional survey among Singapore residents
Authors: Shahwan Shazana , Abdin Edimansyah , Shafie Saleha , Chang Sherilyn , Sambasivam Rajeswari , Zhang Yunjue , Vaingankar Janhavi Ajit , Teo Yik Ying , Heng Derrick , Chong Siow Ann , Subramaniam Mythily
Published: October 2019

Background

Since the Singapore Mental Health Study in 2010 which reported a 16.0% prevalence rate for current smokers and 4.5% for nicotine dependence, new anti-smoking strategies have been implemented. The aim of this study was to compare smoking trends from the 2010 study with the second Singapore Mental Health Study in 2016 (SMHS 2016).

Methods

A survey of 6126 individuals aged 18 years and above randomly selected among Singapore residents was conducted using the same methodology as the 2010 study. The measures used in this analysis were sociodemographic questions, the Composite International Diagnostic Interview which assessed for psychiatric disorders, the Fagerstrom Test for Nicotine Dependence and a list of chronic physical conditions that were prevalent in Singapore. Logistic regression analyses were used to test for associations between smoking/nicotine-dependence and other measures.

Results

In the SMHS 2016, 16.1% were current smokers and 3.3% were nicotine-dependent. As compared with non-smokers, current smokers were more likely to be younger, male gender, of ethnic minority and had lower/vocational education level. Younger age, male gender, lower/vocational education and psychiatric disorders (major depression, bipolar disorder and alcohol use disorders) predicted nicotine dependence. No associations were found between nicotine dependence and any of the chronic conditions.

Conclusion

The prevalence of current smokers in the population has plateaued while that of nicotine dependence has decreased from 2010. However, the study did not investigate the use of e-cigarettes. Inequalities in smoking and nicotine dependence continue to pervade the population particularly among those of ethnic minority, lower/vocational education and the mentally ill.
Reducing delay in laboratory reports for outpatients from 16% to <3% at a non-profit hospital in New Delhi, India
Authors: Bhartia Saru , Wahi Pradaya , Goyal Rinu
Published: October 2019

In early 2013, several outpatients at Sitaram Bhartia Institute of Science and Research in New Delhi, India complained that their laboratory results were not ready at the promised time. We reviewed the data for 3 months and learnt that 16% of outpatient results were not ready when patients returned to receive them. We formed a multidisciplinary team to fix the problem. After conducting a time-and-motion study, process mapping and discussions the team identified two key problems: (1) the laboratory consultant did not have a set time to validate the results and (2) the reasons of delay in laboratory reports were not documented; this made it hard to identify and solve specific reasons. The team decided to set a fixed time for the consultant to verify results and to document reasons for delay in each case. The team used Plan-Do-Study-Act (PDSA) cycles to finalise the verification system and to set up the documentation system. Documentation led to the identification of new problems which were also solved using PDSA cycles. Delay in reports reduced significantly from 16% in March 2013 to less than 3% in a period of 4 months. We have sustained these gains for the past 5 years.
Nutritional services for children in Beira, Mozambique: a study reporting on participatory use of data to generate quality improvement recommendations
Authors: Lazzerini Marzia , Chhaganlal Kajal , Macome Augusto Cesar , Putoto Giovanni
Published: October 2019

Background

Existing literature suggest frequent gaps in the quality of care (QoC) provided to children with malnutrition in low-income and middle-income countries. Beira is the second largest city in Mozambique. This study included two phases: phase 1 was a systematic assessment of the QoC provided to malnourished children in Beira; phase 2 aimed at using findings of the assessment to develop recommendations, with a participatory approach, to improve QoC.

Methods

In phase 1, all facilities offering nutritional care to children in Beira were included, and exit health outcomes were reviewed against international SPHERE standards. A sample of four (66%) facilities was randomly selected for a comprehensive assessment of all areas contributing to QoC using an adapted WHO tool. In phase 2, key stakeholders were identified, and using a participatory approach, a list of actions for improving the QoC for malnourished children was agreed.

Results

In phase 1, outcomes of 1428 children with either severe acute malnutrition or moderate acute malnutrition (MAM) were reviewed. In-hospital recovery rate (70.1%) was almost in line with the SPHERE standard (75%), while at outpatient level, it was significantly lower (48.2%, risk ratio (RR) 0.68, p<0.0001). Recovery rate was significantly lower in HIV seropositive compared with seronegative (39.2% vs 52.8%, RR 1.34, p=0.005). High heterogeneity in MAM recovery rate was detected among facilities (range 32.5%–61.0%). Overall, out of all domains contributing to QoC in the sample, 28/46 (60.8%) indicated suboptimal care with significant health hazards and 13/46 (28.2%) indicated totally inadequate care with severe health hazards. In phase 2, a list of 38 actions to improve QoC for malnourished children was agreed among 33 local and national stakeholders.

Conclusions

Large heterogeneity in QoC for malnourished children in Beria was detected. The study documents a concrete example of using data proactively, for agreeing actions to improve QoC.
Artificial nutrition and hydration for children and young people towards end of life: consensus guidelines across four specialist paediatric palliative care centres
Authors: Anderson Anna-Karenia , Burke Kimberley , Bendle Lizzie , Koh Michelle , McCulloch Renee , Breen Maggie
Published: October 2019

There is a paucity of evidence on the role, use, benefit and challenges of artificial nutrition and hydration (ANH) in children at end of life. Parents express the difficulty they face with making the decision to withdraw ANH. Decision-making on the role of ANH in an individual child requires careful multidisciplinary team deliberation and clear goals of care with children and families. Four paediatric palliative care specialist centres reviewed the current literature and developed consensus guidelines on ANH at end of life. These guidelines seek to provide a practical approach to clinical decision-making on the role of ANH in a child or young person entering the end-of-life phase.
Differential relationship between state-level minimum wage and infant mortality risk among US infants born to white and black mothers
Authors: Rosenquist Natalie A , Cook Daniel M , Ehntholt Amy , Omaye Anthony , Muennig Peter , Pabayo Roman
Published: October 2019

Background

Compared to other Organisation for Economic Co-operation and Development (OECD) nations, US infant mortality rates (IMRs) are particularly high. These differences are partially driven by racial disparities, with non-Hispanic black having IMRs that are twice those of non-Hispanic white. Income inequality (the gap between rich and poor) is associated with infant mortality. One proposed way to decrease income inequality (and possibly to improve birth outcomes) is to increase the minimum wage. We aimed to elucidate the relationship between state-level minimum wage and infant mortality risk using individual-level and state-level data. We also determined whether observed associations were heterogeneous across racial groups.

Methods

Data were from US Vital Statistics 2010 Cohort Linked Birth and Infant Death records and the 2010 US Bureau of Labor Statistics. We fit multilevel logistic models to test whether state minimum wage was associated with infant mortality. Minimum wage was standardised using the z-transformation and was dichotomised (high vs low) at the 75th percentile. Analyses were stratified by mother's race (non-Hispanic black vs non-Hispanic white).

Results

High minimum wage (adjusted OR (AOR)=0.93, 95% CI 0.83 to 1.03) was associated with decreased odds of infant mortality but was not statistically significant. High minimum wage was significantly associated with reduced infant mortality among non-Hispanic black infants (AOR=0.80, 95% CI 0.68 to 0.94) but not among non-Hispanic white infants (AOR=1.04, 95% CI 0.92 to 1.17).

Conclusions

Increasing the minimum wage might be beneficial to infant health, especially among non-Hispanic black infants, and thus might decrease the racial disparity in infant mortality.
U-shaped relationship between left ventricular mass index and estimated glomerular filtration rate in patients with primary aldosteronism
Authors: Liao Min-Tsun , Liao Che-Wei , Tsai Cheng-Hsuan , Chang Yi-Yao , Chen Zheng-Wei , Pan Chien-Ting , Lin Lung-Chun , Wu Vin-Cent , Kuo Shu-Fen , Wu Xue-Ming , Hung Chi-Sheng , Lin Yen-Hung
Published: October 2019

Estimated glomerular filtration rate (eGFR) is an important topic in patients with primary aldosteronism (PA). However, the relationship between left ventricular structure and eGFR is unclear. We conducted a prospective, observational, and cross-sectional study to analyze 168 patients with PA and 168 propensity score-matched patients with essential hypertension (EH) as the control group, matched by age, gender, and systolic blood pressure. In the patients with PA, the eGFR was not correlated with left ventricular mass index (LVMI; r=−0.065, p=0.404), while in the patients with EH, the eGFR was negatively correlated with LVMI (r=−0.309, p<0.001). To test whether eGFR had a non-linear relationship with LVMI among the patients with PA, we stratified the patients with PA according to the tertile of eGFR (low, medium, and high tertile). The medium tertile of patients had a significantly lower LVMI than those in the other two tertiles (LVMI: 143.5±41.6, 120.5±40.5, and 133.1±34.3 g/m2, from the lowest to highest tertile of eGFR; analysis of covariance p=0.032). The medium tertile of eGFR is associated with lowest LVMI. Patients with PA with high and low eGFR were associated with higher LVMI. The findings implied that the reasons for an increased LVMI in patients with PA may be different to those in patients with EH.
Review of the scientific evolution of gene therapy for the treatment of homozygous familial hypercholesterolaemia: past, present and future perspectives
Authors: Rodriguez-Calvo Ricardo , Masana Luis
Published: October 2019

Familial hypercholesterolaemia (FH) is a devastating genetic disease that leads to extremely high cholesterol levels and severe cardiovascular disease, mainly caused by mutations in any of the main genes involved in low-density lipoprotein cholesterol (LDL-C) uptake. Among these genes, mutations in the LDL receptor (LDLR) are responsible for 80%–90% of the FH cases. The severe homozygous variety (HoFH) is not successfully treated with standard cholesterol-lowering therapies, and more aggressive strategies must be considered to mitigate the effects of this disease, such as weekly/biweekly LDL apheresis. However, development of new therapeutic approaches is needed to cure HoFH. Because HoFH is mainly due to mutations in theLDLR, this disease has been proposed as an ideal candidate for gene therapy. Several preclinical studies have proposed that the transference of functional copies of theLDLRgene reduces circulating LDL-C levels in several models of HoFH, which has led to the first clinical trials in humans. Additionally, the recent development of clustered regularly interspaced short palindromic repeat/CRISPR-associated 9 technology for genome editing has opened the door to therapies aimed at directly correcting the specific mutation in the endogenousLDLRgene. In this article, we review the genetic basis of the FH disease, paying special attention to the severe HoFH as well as the challenges in its diagnosis and clinical management. Additionally, we discuss the current therapies for this disease and the new emerging advances in gene therapy to target a definitive cure for this disease.
Safety and efficacy of switching from adalimumab to sarilumab in patients with rheumatoid arthritis in the ongoing MONARCH open-label extension
Authors: Burmester Gerd R , Strand Vibeke , Rubbert-Roth Andrea , Amital Howard , Raskina Tatiana , Gómez-Centeno Antonio , Pena-Rossi Claudia , Gervitz Leon , Thangavelu Karthinathan , St John Gregory , Boklage Susan , Genovese Mark C
Published: October 2019

Objective

Evaluate open-label sarilumab monotherapy in patients with rheumatoid arthritis switching from adalimumab monotherapy in MONARCH (NCT02332590); assess long-term safety and efficacy in patients continuing sarilumab during open-label extension (OLE).

Methods

During the 48-week OLE, patients received sarilumab 200 mg subcutaneously once every 2 weeks. Safety (March 2017 cut-off) and efficacy, including patient-reported outcomes, were evaluated.

Results

In the double-blind phase, patients receiving sarilumab or adalimumab monotherapy showed meaningful improvements in disease activity; sarilumab was superior to adalimumab for improving signs, symptoms and physical function. Overall, 320/369 patients completing the 24-week double-blind phase entered OLE (155 switched from adalimumab; 165 continued sarilumab). Sarilumab safety profile was consistent with previous reports. Treatment-emergent adverse events were similar between groups; no unexpected safety signals emerged in the first 10 weeks postswitch. Among switch patients, improvement in disease activity was evident at OLE week 12: 47.1%/34.8% had changes ≥1.2 in Disease Activity Score (28 joints) (DAS28)-erythrocyte sedimentation rate/DAS28-C-reactive protein. In switch patients achieving low disease activity (LDA: Clinical Disease Activity Index (CDAI) ≤10; Simplified Disease Activity Index (SDAI) ≤11) by OLE week 24, 70.7%/69.5% sustained CDAI/SDAI LDA at both OLE weeks 36 and 48. Proportions of switch patients achieving CDAI ≤2.8 and SDAI ≤3.3 by OLE week 24 increased through OLE week 48. Improvements postswitch approached continuation-group values, including scores ≥normative values.

Conclusions

During this OLE, there were no unexpected safety issues in patients switching from adalimumab to sarilumab monotherapy, and disease activity improved in many patients. Patients continuing sarilumab reported safety consistent with prolonged use and had sustained benefit.
A randomised controlled trial investigating the effects of administering a non‐steroidal anti‐inflammatory drug to beef calves assisted at birth and risk factors associated with passive immunity, health, and growth
Authors: Pearson Jennifer M , Pajor Edward , Campbell John , Levy Michel , Caulkett Nigel , Windeyer M Claire
Published: October 2019

Background

The objectives of this study were to investigate the impact of pain mitigation at birth to assisted beef calves and determine the risk factors associated with transfer of passive immunity (TPI), health, and growth.

Methods

Two hundred and thirty cow–calf pairs requiring calving assistance were enrolled. Calves were randomised to receive meloxicam (0.5 mg/kg) or an equivalent volume of placebo subcutaneously at birth. Calf blood samples were collected between one and seven days of age to determine serum immunoglobulin (IgG) concentration. Colostrum intake, treatment for disease, mortality, and weaning weights were recorded. Multilevel linear or logistic regression models were used to determine the effects of meloxicam and to identify risk factors.

Results

There was no effect of meloxicam on serum IgG concentrations, average daily gain (ADG), or risk of inadequate TPI (serum IgG concentration <24 g/l), treatment for disease, or mortality (P>0.05). Bottle or tube feeding calves were associated with decreased serum IgG concentrations (P=0.01) compared with nursing. Calves with an incomplete tongue withdrawal reflex had higher odds of being treated for disease compared with those with complete withdrawal (P=0.009). Being born meconium‐stained and having decreased serum IgG concentrations were associated with an increased risk of mortality (P=0.03). Being born of a mature cow, having a higher birth weight, and increased serum IgG concentrations were associated with greater ADG to weaning (P<0.05).

Conclusion

Vigour assessment at birth along with good colostrum management may be important to improve TPI and health in high‐risk calves such as those assisted at birth.
Challenging identity: development of a measure of veterinary career motivations
Authors: Cake Martin , McArthur Michelle L , Mansfield Caroline F , Zaki Sanaa , Carbonneau Kira , Matthew Susan M
Published: October 2019

Background

While little is known about the motivations underpinning veterinary work, previous literature has suggested that the main influences on veterinary career choice are early/formative exposure to animals or veterinary role models. The aim of this study was to develop and provisionally validate a veterinary career motivations questionnaire to assess the strength of various types of career motivations in graduating and experienced veterinarians.

Methods

A cross‐sectional sample of experienced veterinarians (n=305) and a smaller cohort of newly graduated veterinarians (n=53) were surveyed online using a long‐form questionnaire. Exploratory factor analysis (EFA) was used to iteratively derive a final, short‐form questionnaire for survey of a second cross‐sectional sample of experienced veterinarians (n=751).

Results

EFA derived a final questionnaire with 22 items loading onto six factors (social purpose, animal orientation, vocational identity, challenge and learning, career affordances, and people orientation). While motivations based on animal orientation were predictably strong, those based on vocational identity were not universal and were weaker in younger and graduate veterinarians; both of these motivations were rated lower by male veterinarians. Motivations based on challenge and learning emerged as some of the strongest, most universal and most influential; people orientation and social purpose were also important, particularly for older veterinarians.

Conclusion

The major motivations for pursuing a veterinary career may best be represented as an intrinsic passion for animal care and for learning through solving varied challenges. These motivations are largely intrinsically oriented and autonomously regulated, thus likely to be supportive of work satisfaction and wellbeing.
David William Brocklesby
Authors: Brocklesby Helen
Published: October 2019

An internship at the school of tropical medicine led to important work on tick‐borne diseases in Africa and the UK, as well as engendering global collaborations between centres of excellence.
Assessing the performance of statistical classifiers to discriminate fish stocks using Fourier analysis of otolith shape
Authors: Smoliński Szymon , Schade Franziska Maria , Berg Florian
Published: October 2019

The assignment of individual fish to its stock of origin is important for reliable stock assessment and fisheries management. Otolith shape is commonly used as the marker of distinct stocks in discrimination studies. Our literature review showed that the application and comparison of alternative statistical classifiers to discriminate fish stocks based on otolith shape is limited. Therefore, we compared the performance of two traditional and four machine learning classifiers based on Fourier analysis of otolith shape using selected stocks of Atlantic cod (Gadus morhua) in the southern Baltic Sea and Atlantic herring (Clupea harengus) in the western Norwegian Sea, Skagerrak, and the southern Baltic Sea. Our results showed that the stocks can be successfully discriminated based on their otolith shapes. We observed significant differences in the accuracy obtained by the tested classifiers. For both species, support vector machines (SVM) resulted in the highest classification accuracy. These findings suggest that modern machine learning algorithms, like SVM, can help to improve the accuracy of fish stock discrimination systems based on the otolith shape.
Virtual Compton scattering measurements in the nucleon resonance region
Authors: Blomberg A. , Atac H. , Sparveris N. , Paolone M. , Achenbach P. , Benali M. , Beričič J. , Böhm R. , Correa L. , Distler M. O. , Esser A. , Flay D. , Fonvieille H. , Friščić I. , Kohl Y. , Merkel H. , Müller U. , Meziani Z. E. , Mihovilovic M. , Pochodzalla J. , Polychronopoulou A. , Pasquini B. , Schoth M. , Schulz F. , Schlimme S. , Sfienti C. , Sirca S. , Weber A.
Published: October 2019

We report on new measurements of the electric Generalized Polarizability (GP) of the proton $ \alpha_{E}$αE in a kinematic region where a puzzling dependence on momentum transfer has been observed, and we have found that $ \alpha_E = (5.3 \pm 0.6_{stat} \pm 1.3_{sys}) 10^{-4}$αE=(5.3±0.6stat±1.3sys)10-4 fm3 at $ Q^{2}=0.20$Q2=0.20 (GeV/c)2. The new measurements, when considered along with the rest of the world data, suggest that $ \alpha_E$αE can be described by either a local plateau or by an enhancement in the region $ Q^2=0.20$Q2=0.20 (GeV/c)2 to 0.33 (GeV/c)2. The experiment also provides the first measurement of the Coulomb quadrupole amplitude in the $ N \rightarrow \Delta$N→Δ transition through the exploration of the $ p(e,e'p)\gamma$p(e,ep)γ reaction. The new measurement gives $ CMR = (-4.4 \pm 0.8_{stat} \pm 0.6_{sys})\%$CMR=(-4.4±0.8stat±0.6sys)% at $ Q^2=0.20$Q2=0.20 (GeV/c)2 and is consistent with the results from the pion electroproduction world data. It has been obtained using a completely different extraction method, and therefore represents a strong validation test of the world data model uncertainties.
Di-jet/$$\mathbf {e}^{+}\mathbf {e}^{-}+\hbox {MET}$$ to probe $$Z_2$$-odd mediators to the dark sector
Authors: Goertz Florian , Tame-Narvaez Karla , Tenorth Valentin Titus
Published: October 2019

We explore a scenario where dark matter (DM) couples to the Standard Model mainly via a scalar mediator$$\mathcal{S}$$Sthat is odd under a$$Z_2$$Z2symmetry, leading to interesting collider signatures. In fact, iflinear interactionswith the mediator are absent the most important DM production mechanisms at colliders could lead to final states with missing transverse energy (MET) in association with at least two fermions, such as di-jet or di-electron signatures. The framework we consider is model-independent, in a sense that it is only based on symmetry and formulated in the (extended) DM effective field theory (eDMeft) approach. Moreover, it allows to address the smallness of first-generation fermion masses via suppressed$$Z_2$$Z2breaking effects. From a di-jet + MET analysis at the LHC, we find rather loose bounds on the effective$$\mathcal{S}$$S-$$\mathcal{S}$$S-DM-DM interactions, unless the mediator couples very strongly to SM fermions, while a future$$e^+ e^-$$e+e-collider, such as CLIC, could deliver tighter constraints on the corresponding model parameters, given the mediator is leptophilic. We finally highlight the parameter space that allows to produce the observed DM density, including constraints from direct-detection experiments.
Gauge field and brane-localized kinetic terms on the chiral square
Authors: Landim Ricardo G.
Published: October 2019

Extra dimensions have been used as attempts to explain several phenomena in particle physics. In this paper we investigate the role of brane-localized kinetic terms (BLKT) on thin and thick branes with two flat extra dimensions (ED) compactified on the chiral square, and an abelian gauge field in the bulk. The results for a thin brane have resemblance with the 5-D case, leading to a tower of massive KK particles whose masses depend upon the compactification radius and the BLKT parameter. On the other hand, for the thick brane scenario, there is no solution that satisfy the boundary conditions. Because of this, the mechanism of suppressed couplings due to ED (Landim and Rizzo, in JHEP 06:112, 2019) cannot be extended to 6-D.
Physical mechanisms encoded in photoionization yield from IR+XUV setups
Authors: Brabec Thomas , Dinh Phuong Mai , Gao Congzhang , McDonald Chris , Reinhard Paul-Gerhard , Suraud Éric
Published: October 2019

We theoretically examine how and to which extent physical processes can be retrieved from two-color pump-probe experiments of atomic and molecular gases driven by an attosecond XUV pulse train and an infrared (IR) pulse. The He atom, the N2 molecule and Na clusters are investigated with time-dependent density functional theory. Results are interpreted on the basis of a simple model system. We consider observables most commonly used in experiments: ionization yield, photo-electron spectra, and angular distributions. We find that the basic time-dependent signatures are dominated by the interplay of IR laser and continuum electrons. System information, contained in the signal, will in general require careful disentangling from the effects of photon-electron dynamics.

Graphical abstract
Comments on taxonomical status of three gobiid nominal species (genus Gobius) described from Brazilian coast (Teleostei: Gobiiformes: Gobiidae)
Authors: Caires Rodrigo Antunes
Published: October 2019

Three species described and currently included in the genus Gobius from the Brazilian coast are herein discussed. Gobius uranoscopus Sauvage is regarded as junior synonym of Bathygobius soporator based on information on holotype deposited in Muséum National d’Histoire Naturelle, Paris; G. silveiraemartinsi Ihering, known only in Rio Grande do Sul was erected based on a short description, and type material is not available, but I considered that it is junior synonym of Ctenogobius shufeldti; Gobius boekeri Ahl, 1931, described from the coast of Pará, Brazil, is a junior synonym of Gobionellus oceanicus, as both taxa are virtually identical in meristic characters and presumable morphometric differences that Ahl used to substantiate the validity of his new species actually fall into the morphometric range observed in G. oceanicus specimens and may be attributable to individual variation and to the image quality by Ahl’s original description.