bluuebunny/crossref_metadata_2025 huggingface dataset:
Prevalence and causes of blindness and visual impairment; and cataract surgical services in Katsina state of Nigeria
Authors: Taryam Manal Omran , Rabiu Muhammad M , Muhammad Nasiru , Oladigbolu Kehinde , Abdurrahman Halima
Published: September 2019

Aim

To generate data on blindness and visual impairment for planning and monitoring a comprehensive eye care programme in Katsina state of Nigeria.

Method

A rapid assessment of avoidable blindness (RAAB) survey methodology was used to select 3120 persons aged 50 years and over. The sample was selected using a multistage cluster randomised sampling. Each participant had visual acuity and lens assessment. Persons with vision less than 6/12 in any eye were assessed for the cause of visual impairment. Persons with cataract were asked why they had not had surgery. Data were captured electronically with the mRAAB Android-based software and analysed with STATA V.14 software.

Results

A response rate of 90.1% was achieved. The age-sex adjusted blindness prevalence was 5.3% (95% CI 5.2% to 5.3%). Women were 30% more likely to be blind (OR 1.3, 95% CI 1.2 to 1.3). The principal causes of blindness were cataract (70%), other posterior segment (12%) and glaucoma (7%); 86.7% of blindness was avoidable. The prevalence of cataract blindness is 2.6% (95% CI 2.5% to 2.6%) with higher odds in women (OR 1.2, 95% CI 1.2 to 1.3, p<0.005). The cataract surgical coverage <6/60 for persons was 28.2% and women were 45% less likely to have had cataract surgery (OR 0.55, 95% CI 0.34 to 0.78, p<0.005). The major barriers to cataract surgery are lack of felt need and the cost of services.

Conclusion

Katsina state of Nigeria has high burden of avoidable blindness affecting more women. The state eye care programme should have cataract services that are more accessible, affordable and gender sensitive.
Risk of diabetes associated with fatty acids in the de novo lipogenesis pathway is independent of insulin sensitivity and response: the Insulin Resistance Atherosclerosis Study (IRAS)
Authors: Qureshi Waqas , Santaren Ingrid D , Hanley Anthony J , Watkins Steven M , Lorenzo Carlos , Wagenknecht Lynne E
Published: September 2019

Objective

To examine the associations of fatty acids in the de novo lipogenesis (DNL) pathway, specifically myristic acid (14:0), palmitic acid (16:0),cis-palmitoleic acid (c16:1 n-7),cis-myristoleic acid (c14:1n5), stearic acid (18:0) andcis-oleic acid (c18:1 n-9), with 5-year risk of type 2 diabetes. We hypothesized that DNL fatty acids are associated with risk of type 2 diabetes independent of insulin sensitivity.

Research design and methods

We evaluated 719 (mean age 55.1±8.5 years, 44.2% men, 42.3% Caucasians) participants from the Insulin Resistance Atherosclerosis Study. Multivariable logistic regression models with and without adjustment of insulin sensitivity were used to assess prospective associations of DNL fatty acids with incident type 2 diabetes.

Results

Type 2 diabetes incidence was 20.3% over 5 years. In multivariable regression models, palmitic, palmitoleic, myristic, myristoleic and oleic acids were associated with increased risk of type 2 diabetes (p<0.05). Palmitic acid had the strongest association (OR per standard unit of palmitic acid 1.46; 95% CI 1.23 to 1.76; p<0.001), which remained similar with addition of insulin sensitivity and acute insulin response (AIR) to the model (OR 1.36; 95% CI 1.09 to 1.70, p=0.01). Oleic and palmitoleic acids were also independently associated with incident type 2 diabetes. In multivariable models, ratios of fatty acids corresponding to stearoyl CoA desaturase-1 and Elovl6 enzymatic activity were significantly associated with risk of type 2 diabetes independent of insulin sensitivity and AIR.

Conclusions

We observed associations of DNL fatty acids with type 2 diabetes incidence independent of insulin sensitivity.
Quality appraisal of clinical practice guidelines for diabetes mellitus published in China between 2007 and 2017 using the AGREE II instrument
Authors: Gao Yuting , Wang Jinjing , Luo Xufei , Song Xiaoyang , Liu Lian , Ke Lixin , Liao Zhihong , Wang Dongke , Mu Yiming , Chen Yaolong , Estill Janne Anton Markus
Published: September 2019

Objective

The aim of this study was to systematically evaluate the quality of the clinical practice guidelines (CPGs) for diabetes mellitus published in China over the period of January 2007 to April 2017.

Methods

We searched the China National Knowledge Infrastructure, Chinese Biomedical Literature database, VIP database and WanFang databases and guideline websites for CPGs for diabetes mellitus published between January 2007 and April 2017 in China. Two reviewers independently screened the literature according to the inclusion and exclusion criteria and extracted data. We used the the Appraisal of Guidelines for Research and Evaluation II (AGREE II) tool (Canadian Institutes of Health Research, Ottawa, Canada) to evaluate the quality of the included guidelines, calculated the scores of each domain and evaluated the consistency among the assessors via use of the intragroup correlation coefficient. And then we compared the results with Chinese CPGs and international CPGs. We conducted a subgroup analysis based on different classification criteria and compared scores of each domain subgroup analyses.

Results

A total of 98 guidelines were identified. The correlation coefficient within the group was 0.93, suggesting that the consistency between the evaluators was good. The scores of the six domains of AGREE II were described in median (IQR) as follows: scope and purpose 53.7 (50.0–59.7), stakeholder involvement 31.5 (27.3–37.0), rigour of development 19.1 (15.3–22.2), clarity of presentation 59.3 (50.0–64.8), applicability 18.1 (13.9–25.7) and editorial independence 0.0 (0.0–0.0). The mean score in each domain of quality of Chinese diabetes CPGs was lower than that of CPGs published worldwide but higher than the mean score of Chinese guidelines of all topics. A funding source, the updated version, organisation and publishers of the guidelines and target fields are all the factors influencing the quality of CPGs to a certain degree.

Conclusions

A large number of Chinese diabetes CPGs have been produced. Their quality remain unsatisfactorily low compared with CPGs worldwide, there is still room for improvement. Chinese guideline developers should pay more attention to the transparency of methodology, and use the AGREE II instrument to develop and report guidelines.
Rationale and design of a statewide telestroke registry: Lone Star Stroke Consortium Telestroke Registry (LeSteR)
Authors: Astudillo Cesar , Ankrom Christy , Trevino Alyssa , Malazarte Rene M , Bambhroliya Arvind B , Savitz Sean , Topel Christopher H , Milling Truman J , Wu Tzu-Ching
Published: September 2019

Introduction

The Lone Star Stroke Consortium Telestroke Registry (LeSteR) currently consisting of 3 academic hub centres and 27 partner spokes is a statewide initiative organised by leading academic health centres in the State of Texas to understand practice patterns of acute stroke management via telestroke (TS) in Texas, a state with one of the largest rural populations in the USA.

Methods and analysis

All patients who had presumed stroke for whom a TS consultation has been obtained in the network are entered into a web-based, Health Insurance Portability and Accountability Act-compliant database from September 2013 to present. Spokes were enrolled into LeSteR in a staggered approach in two data collection phases: a retrospective phase and a prospective phase. Basic clinical, demographic data and relevant time metrics are collected in the retrospective phase. Starting 1 September 2015, additional outcome data including 90-day modified Rankin score, readmission and 90-day disposition are obtained by a standard phone interview. From the registry initiation to 31 December 2017, there are 8089 patients who had suspected stroke in the registry. Over 60% of patients enrolled after 1 September 2015 have reported outcome data. Enrolment is still active for this registry.

Ethics and dissemination

LeSteR is a statewide TS registry organised by academic health centres that will provide significant insight regarding the impact of TS in the State of Texas. Findings from LeSteR will provide data that can be analysed to improve the allocation of healthcare resources using TS to treat stroke in a state with one of the largest rural populations.
Hospital Survey on Patient Safety Culture (HSPSC): a systematic review of the psychometric properties of 62 international studies
Authors: Waterson Patrick , Carman Eva-Maria , Manser Tanja , Hammer Antje
Published: September 2019

Objective

To carry out a systematic review of the psychometric properties of international studies that have used the Hospital Survey on Patient Safety Culture (HSPSC).

Design

Literature review and an analysis framework to review studies.

Setting

Hospitals and other healthcare settings in North and South America, Europe, the Near East, the Middle East and the Far East.

Data sources

A total of 62 studies and 67 datasets made up of journal papers, book chapters and PhD theses were included in the review.

Primary and secondary outcome measures

Psychometric properties (eg, internal consistency) and sample characteristics (eg, country of use, participant job roles and changes made to the original version of the HSPSC).

Results

Just over half (52%) of the studies in our sample reported internal reliabilities lower than 0.7 for at least six HSPSC dimensions. The dimensions ‘staffing’, ‘communication openness’, ‘non-punitive response to error’, ‘organisational learning’ and ‘overall perceptions of safety’ resulted in low internal consistencies in a majority of studies. The outcomes from assessing construct validity were reported in 60% of the studies. Most studies took place in a hospital setting (84%); the majority of survey participants (62%) were drawn from nursing and technical staff. Forty-two per cent of the studies did not state what modifications, if any, were made to the original US version of the instrument.

Conclusions

While there is evidence of a growing worldwide trend in the use of the HSPSC, particularly within Europe and the Near/Middle East, our review underlines the need for caution in using the instrument. Future use of the HSPSC needs to be sensitive to the demands of care settings, the target population and other aspects of the national and local healthcare contexts. There is a need to develop guidelines covering procedures for using, adapting and translating the HSPSC, as well as reporting findings based on its use.
Intelligence in young adulthood and alcohol use disorders in a prospective cohort study of Danish men: the role of psychiatric disorders and parental psychiatric history
Authors: Just-Østergaard Emilie , Flensborg-Madsen Trine , Knop Joachim , Sørensen Holger Jelling , Becker Ulrik , Mortensen Erik Lykke
Published: September 2019

Objectives

The aims were to estimate the association between intelligence measured in young adulthood and risk of alcohol use disorders (AUD) in men and to investigate the potential modification of this association by psychiatric disorders, parental AUD and parental psychiatric disorders.

Design

Prospective cohort study based on a linkage of intelligence test scores from draft board examinations and register data on AUD diagnoses during 36 years of follow-up.

Setting

Denmark.

Participants

3287 Danish men from the Copenhagen Perinatal Cohort (born 1959–1961) who appeared before the draft board at a mean age of 18.7 years.

Primary outcome measure

First registration with AUD during follow-up was the primary outcome. Information on AUD was based on diagnoses retrieved from national hospital and outpatient treatment registers, defined according to the International Classification of Diseases.

Results

361 (11.0%) men were registered with AUD during follow-up. Low intelligence scores were associated with increased odds of AUD adjusting for parental AUD, parental psychiatric disorders, maternal smoking during pregnancy, birth weight, maternal age at birth, parity and childhood socioeconomic position (OR per SD decrease in intelligence=1.69, 95% CI 1.49 to 1.92). Separate analyses indicated significant interaction (p<0.001) between intelligence and psychiatric disorders. The adjusted OR per SD decrease in intelligence score was 2.04 (95% CI 1.67 to 2.49) in men without other psychiatric disorders whereas the OR was 1.21 (95% CI 1.01 to 1.46) in men with other psychiatric disorders. No interaction was found between intelligence and parental AUD or between intelligence and parental psychiatric disorders.

Conclusions

The association between intelligence in young adulthood and AUD is modified by other psychiatric disorders as low intelligence is primarily a risk factor for men without other psychiatric disorders. Future studies should take other psychiatric disorders into account when investigating associations between intelligence and AUD.
Impact of Ebola outbreak on reproductive health services in a rural district of Sierra Leone: a prospective observational study
Authors: Quaglio Gianluca , Tognon Francesca , Finos Livio , Bome David , Sesay Santigie , Kebbie Atiba , Di Gennaro Francesco , Camara Bienvenu Salim , Marotta Claudia , Pisani Vincenzo , Bangura Zainab , Pizzol Damiano , Saracino Annalisa , Mazzucco Walter , Jones Susan , Putoto Giovanni
Published: September 2019

Objectives

To assess the trends concerning utilisation of maternal and child health (MCH) services before, during and after the Ebola outbreak, quantifying the contribution of a reorganised referral system (RS).

Design

A prospective observational study of MCH services.

Setting

Pujehun district in Sierra Leone, 77 community health facilities and 1 hospital from 2012 to 2017.

Main outcome measures

MCH utililization was evaluated by assessing: (1) institutional deliveries, Cesarean-sections, paediatric and maternity admissions and deaths, and major direct obstetric complications (MDOCs), at hospital level; (2) antenatal care (ANC) 1 and 4, institutional delivery and family planning, at community level. Contribution of a strengthened RS was also measured.

Results

At hospital level, there is a significant difference between trends Ebola versus pre-Ebola for maternal admissions (7, 95% CI 4 to 11, p<0.001), MDOCs (4, 95% CI 1 to 7, p=0.006) and institutional deliveries (4, 95% CI 2 to 6, p=0.001). There is also a negative trend in the transition from Ebola to post-Ebola for maternal admissions (−7, 95% CI −10 to −4, p<0.001), MDOCs (−4, 95% CI −7 to −1, p=0.009) and institutional deliveries (−3, 95% CI −5 to −1, p=0.001). The differences between trends pre-Ebola versus post-Ebola are only significant for paediatric admissions (3, 95% CI 0 to 5, p=0.035). At community level, the difference between trends Ebola versus pre-Ebola and Ebola versus post-Ebola are not significant for any indicators. The differences between trends pre-Ebola versus post-Ebola show a negative difference for institutional deliveries (−7, 95% CI −10 to −4, p<0.001), ANC 1 (−6, 95% CI −10 to −3, p<0.001), ANC 4 (−8, 95% CI −11 to −5, p<0.001) and family planning (−85, 95% CI −119 to −51, p<0.001).

Conclusions

A stronger health system compared with other districts in Sierra Leone and a strengthened RS enabled health facilities in Pujehun to maintain service provision and uptake during and after the Ebola epidemic.
Functional status and life satisfaction of patients with stable angina pectoris in Austria
Authors: Spinka Fabian , Aichinger Josef , Wallner Eva , Brecht Stephan , Rabold Thomas , Metzler Bernhard , Zweiker Robert , Lang Irene , Delle Karth Georg
Published: September 2019

Objectives

Although substantial progress in the treatment of stable angina pectoris (sAP) has been made, little is known about the functional status and quality of life (QoL) of patients in different healthcare systems.

Design and methods

We undertook a survey using the Seattle Angina Questionnaire (SAQ) (five domains scored form 0—worst assessment to 100—best assessment) to assess symptoms, QoL (including limitation of activities), demographics, geographic distribution and individual disease data in patients with stable coronary artery disease in Austrian cardiology practices.

Results

A total of 660 patients with sAP with a mean age of 69.2 years were included. SAQ scores were 67.5±24.4 for physical limitation, 65.5±26.6 for angina stability, 79.3±23.2 for angina frequency, 86.3±16.2 for treatment satisfaction and 63.7±24.2 for overall QoL. Multiple regression identified male gender, but also female gender, Eastern Austrian residence and high body mass index as predictive factors for SAQ scoring. A total of 35.6% of the patients reported at least one desirable activity that was limited through AP symptoms.

Conclusions

Activity and QoL assessments are in accordance with published literature: The number and the diversity of desired activities indicate the need to focus on patient’s individual activity level to improve symptom management.
Childhood adversities and 5-HTTLPR polymorphism as risk factors of substance use disorders: retrospective case-control study in Murcia (Spain)
Authors: Navarro-Mateu Fernando , Quesada Mari Paz , Escámez Teresa , Alcaráz Mª José , Seiquer de la Peña Catherine , Salmerón Diego , Huerta José María , Vilagut Gemma , Chirlaque Maria Dolores , Navarro Carmen , Husky Mathilde , Kessler Ronald C , Alonso Jordi , Martínez Salvador
Published: September 2019

Objective

To explore the separate and joint associations of childhood adversities and 5-HTTLPR polymorphism as risk factors for substance use disorders among adults.

Design

Retrospective case-control study.

Setting

Cases from the substance unit and controls from a representative sample of the adult general population in the metropolitan area of Murcia (Spain).

Participants

Cases were defined as outpatients 18 years old or older currently in the treatment for alcohol, opioids or cocaine use disorders in the clinical unit. Controls were randomly selected among individuals without substance use disorders who participated in the Psychiatric Enquiry to General Population in Southeast Spain-Murcia (PEGASUS-Murcia) project, a cross-sectional study of a representative sample of the adult general population. In all, 142 cases and 531 controls were interviewed and a subsample of 114 cases (80.3%) and 329 controls (62%) provided a biological sample.

Exposure

A history of 12 childhood adversities, lifetime mental disorders and sociodemographic variables was assessed with the Composite International Diagnostic Interview (CIDI)version 3.0). Buccal swabs were obtained to genotype the 5-HTTLPR polymorphism with the biallelic and the triallelic classification.

Main outcome and measure

Multivariable logistic regression models were performed to estimate adjusted ORs and 95% CI.

Results

Childhood adversities were associated with an elevated risk of substance use disorders (OR=5.77, 95% CI 3.46 to 9.61). Homozygotes for the short allele of the 5-HTTLPR polymorphism also showed the elevated risk of substance use disorders for the biallelic and triallelic classification: (1.97 (1.10 to 3.55) and 2.01 (1.11 to 3.64), respectively). No evidence for gene × environment interactions was found.

Conclusions

Childhood adversities and the 5-HTTLPR polymorphism are involved in the aetiology of substance use disorders though findings exploring the existence of a gene–environment interaction were inconclusive.
Rates of retention of persons with a mental health disorder in outpatient smoking cessation and reduction trials, and associated factors: protocol for a systematic review and meta-analysis
Authors: Metse Alexandra Patricia , Stockings Emily , Bailey Jacqueline , Regan Timothy , Bartlem Kate , Wolfenden Luke , Taylor Gemma , Wiggers John , Bowman Jenny
Published: September 2019

Introduction

Smoking among persons with a mental health disorder is associated with inequitable health, social and economic burden. Randomised controlled trials (RCTs) are considered the gold standard design for the assessment of healthcare intervention efficacy/effectiveness. However, many RCTs of smoking interventions for persons with a mental health disorder lack rigour due to low participant retention. No systematic review has pooled retention rates in randomised trials of smoking interventions for persons with a mental health disorder or explored associated factors. The aims of the systematic review will therefore be to: (1) summarise overall rates of participant retention in smoking cessation and reduction trials involving persons with a mental health disorder (including for experimental and control groups separately) and (2) determine if retention rates vary according to participant, environmental, researcher and study factors.

Methods and analysis

PsycINFO, EMBASE, MEDLINE, CENTRAL and The Cochrane Tobacco Addiction Review Group Specialised Register will be searched for reports of RCTs of outpatient smoking cessation or reduction interventions for adults with a mental health disorder. The search terms will include MeSH terms and free text words, and there will be no language or date restrictions. All databases will be searched from inception to present. Data will be analysed using the Mantel-Haenszel fixed-effect model, and where substantial heterogeneity (I2>50%) is detected, DerSimonian & Laird inverse-variance random effects model. Pooled estimates and 95% CIs will be calculated for overall participant retention rates and for intervention and control trial arms separately. Associations between participant retention and participant, environmental, researcher and study factors will be assessed via subgroup analyses and, where sufficient data are obtained, meta-regression.

Ethics and dissemination

This study does not require ethical approval. The findings of this review will be disseminated via publication in a peer-reviewed open access medical journal and presentations at international scientific meetings.
Zoledronate in the prevention of Paget’s (ZiPP): protocol for a randomised trial of genetic testing and targeted zoledronic acid therapy to preventSQSTM1-mediated Paget’s disease of bone
Authors: Cronin Owen , Forsyth Laura , Goodman Kirsteen , Lewis Steff C , Keerie Catriona , Walker Allan , Porteous Mary , Cetnarskyj Roseanne , Ranganath Lakshminarayan R , Selby Peter L , Hampson Geeta , Chandra Rama , Ho Shu , Tobias Jon H , Young-Min Steven , McKenna Malachi J , Crowley Rachel K , Fraser William D , Gennari Luigi , Nuti Ranuccio , Brandi Maria Luisa , Del Pino-Montes Javier , Devogelaer Jean-Pierre , Durnez Anne , Isaia Giancarlo , Di Stefano Marco , Guañabens Núria , Blanch Josep , Seibel Markus J , Walsh John P , Kotowicz Mark A , Nicholson Geoffrey C , Duncan Emma L , Major Gabor , Horne Anne , Gilchrist Nigel L , Boers Maarten , Murray Gordon D , Charnock Keith , Wilkinson Diana , Russell R Graham G , Ralston Stuart H
Published: September 2019

Introduction

Paget’s disease of bone (PDB) is characterised by increased and disorganised bone remodelling affecting one or more skeletal sites. Complications include bone pain, deformity, deafness and pathological fractures. Mutations in sequestosome-1 (SQSTM1) are strongly associated with the development of PDB. Bisphosphonate therapy can improve bone pain in PDB, but there is no evidence that treatment alters the natural history of PDB or prevents complications. The Zoledronate in the Prevention of Paget’s disease trial (ZiPP) will determine if prophylactic therapy with the bisphosphonate zoledronic acid (ZA) can delay or prevent the development of PDB in people who carrySQSTM1mutations.

Methods and analysis

People with a family history of PDB aged >30 years who test positive forSQSTM1mutations are eligible to take part. At the baseline visit, participants will be screened for the presence of bone lesions by radionuclide bone scan. Biochemical markers of bone turnover will be measured and questionnaires completed to assess pain, health-related quality of life (HRQoL), anxiety and depression. Participants will be randomised to receive a single intravenous infusion of 5 mg ZA or placebo and followed up annually for between 4 and 8 years at which point baseline assessments will be repeated. The primary endpoint will be new bone lesions assessed by radionuclide bone scan. Secondary endpoints will include changes in biochemical markers of bone turnover, pain, HRQoL, anxiety, depression and PDB-related skeletal events.

Ethics and dissemination

The study was approved by the Fife and Forth Valley Research Ethics Committee on 22 December 2008 (08/S0501/84). Following completion of the trial, a manuscript will be submitted to a peer-reviewed journal. The results of this trial will inform clinical practice by determining if early intervention with ZA in presymptomatic individuals withSQSTM1mutations can prevent or slow the development of bone lesions with an adverse event profile that is acceptable.

Trial registration number

ISRCTN11616770
Operative treatment of displaced midshaft clavicle fractures: has randomised control trial evidence changed practice patterns?
Authors: Schneider Prism , Bransford Richard , Harvey Edward , Agel Julie
Published: September 2019

Objectives

To determine if level 1 evidence from a landmark trial changed practice patterns for treatment of patients with displaced midshaft clavicle fractures.

Design

Retrospective cohort study.

Setting

Two level 1 trauma centres.

Participants

Displaced midshaft clavicle fractures.

Results

686 patients met inclusion criteria. The pretrial cohort (n=108) was 68.5% male, with a mean age of 37.7 (±13.9) years. The post-trial cohort (n=578) was 76.1% male, with a mean age of 41.9 (±12.7) years. There was nearly a 10-fold increase in the patients treated with openreduction and internal fixation (ORIF) in the post-trial cohort (34.1%) compared with the pretrial cohort (3.7%) (p<0.001). Patients in the post-trial cohort were more likely to undergo ORIF if they were <40 years (OR=2.2; 95% CI 1.53 to 3.10), if their Injury Severity Score was >9 (OR=1.6; 95% CI 0.89 to 2.99) or if they were treated at a centre that participated in theCanadian Orthopaedic Trauma Society (COTS)trial (OR=5.2; 95% CI 3.31 to 8.21).

Conclusions

This study demonstrated a significant shift towards more frequentORIFfor displaced midshaft clavicle fractures following the COTS trial. Quantifying changes in practice pattern following publication of level 1 evidence is important to further our understanding of the impact largerandomisedclinical trailsare having on clinical practice.
Neonatal azithromycin administration to prevent infant mortality: study protocol for a randomised controlled trial
Authors: Sie Ali , Bountogo Mamadou , Nebie Eric , Ouattara Mamadou , Coulibaly Boubacar , Bagagnan Cheik , Zabre Pascal , Lebas Elodie , Brogdon Jessica , Godwin William W , Lin Ying , Porco Travis , Doan Thuy , Lietman Thomas M , Oldenburg Catherine E
Published: September 2019

Introduction

Biannual mass azithromycin distribution to children aged 1–59 months has been shown to reduce all-cause mortality. Children under 28 days of age were not treated in studies evaluating mass azithromycin distribution for child mortality due to concerns related to infantile hypertrophic pyloric stenosis (IHPS). Here, we report the design of a randomised controlled trial to evaluate the efficacy and safety of administration of a single dose of oral azithromycin during the neonatal period.

Methods and analysis

TheNouveaux-nés et Azithromycine: une Innovation dans le Traitement des Enfants(NAITRE) study is a double-masked randomised placebo-controlled trial designed to evaluate the efficacy of a single dose of azithromycin (20 mg/kg) for the prevention of child mortality. Newborns (n=21 712) aged 8–27 days weighing at least 2500 g are 1:1 randomised to a single, directly observed, oral dose of azithromycin or matching placebo. Participants are followed weekly for 3 weeks after treatment to screen for adverse events, including IHPS. The primary outcome is all-cause mortality at the 6-month study visit.

Ethics and dissemination

This study was approved by the Institutional Review Boards at the University of California, San Francisco in San Francisco, USA (Protocol #18-25027) and the Comité National d’Ethique pour la Recherche in Ouagadougou, Burkina Faso (Protocol #2018-10-123). The findings of this trial will be presented at local, regional and international meetings and published in open access peer-reviewed journals.

Trial registration number

NCT03682653; Pre-results.
Intoxication in dogs and cats: a basic approach to decontamination
Authors: Humm Karen , Greensmith Tom
Published: September 2019

Background: There are two types of intoxicated patient that present to veterinary practices: the asymptomatic patient with a known exposure and the patient with clinical signs that may (or may not) be due to a toxin or poison. Deciding when (or if) to treat these patients is often an inexact science and the decision must be made based on numerous risk factors, the owner's level of comfort with risk and any financial constraints.

Aim of the article: This article is the first in a series of four and aims to provide a basic overview of the approach to decontamination of an asymptomatic patient presented with a known intoxication. It also outlines therapies that may be considered in both symptomatic and asymptomatic patients, and these will be discussed in more detail in future articles.
Fetuses, newborns, & parental responsibility
Authors: Singh Prabhpal
Published: September 2019

I defend a relational account of difference in the moral status between fetuses and newborns. The difference in moral status between a fetus and a newborn is that the newborn baby is the proper object of ‘parental responsibility’ whereas the fetus is not. ‘Parental responsibilities’ are a moral dimension of a ‘parent-child relation’, a relation which newborn babies stand in, but fetuses do not. I defend this relational account by analysing the concepts of ‘parent’ and ‘child’, and conclude that the difference in the moral status between fetuses and newborns means one may claim abortion is morally permissible while also claiming infanticide is not morally permissible, without inconsistency between the two claims.
Withdrawing life-sustaining treatment: a stock-take of the legal and ethical position
Authors: Ruck Keene Alexander Charles Edward , Lee Annabel
Published: September 2019

This article, prompted by an extended essay published in theJournal of Medical Ethicsby Charles Foster, and the current controversy surrounding the case of Vincent Lambert, analyses the legal and ethical arguments in relation to the withdrawal of life-sustaining treatment from patients with prolonged disorders of consciousness. The article analyses the legal framework through the prism of domestic law, case-law of the European Court of Human Rights and the Convention on the Rights of Persons with Disabilities, and examines the challenge to the ethical consensus made by Foster. It concludes that the right approach remains a version of the approach that has prevailed for the last 25 years since the decision inAiredale NHS Trust v Bland[1993] AC 789, refined to reflect that that there is now, and rightly, a much more limited place for judgments made about the ‘burden’ of treatment or the quality of life enjoyed by the person made on the basis of assumptions about that person as a category as opposed to investigation of that person as an individual human being.
Multicohort study of change in job strain, poor mental health and incident cardiometabolic disease
Authors: Magnusson Hanson Linda L , Rod Naja Hulvej , Vahtera Jussi , Peristera Paraskevi , Pentti Jaana , Rugulies Reiner , Madsen Ida Elisabeth Huitfeldt , LaMontagne Anthony D , Milner Allison , Lange Theis , Suominen Sakari , Stenholm Sari , Xu Tianwei , Kivimäki Mika , Westerlund Hugo
Published: September 2019

Objectives

Several recent large-scale studies have indicated a prospective association between job strain and coronary heart disease, stroke and diabetes. Job strain is also associated with poorer mental health, a risk factor for cardiometabolic disease. This study investigates the prospective relationships between change in job strain, poor mental health and cardiometabolic disease, and whether poor mental health is a potential mediator of the relationship between job strain and cardiometabolic disease.

Methods

We used data from five cohort studies from Australia, Finland, Sweden and UK, including 47 757 men and women. Data on job strain across two measurements 1–5 years apart (time 1 (T1)–time 2 (T2)) were used to define increase or decrease in job strain. Poor mental health (symptoms in the top 25% of the distribution of the scales) at T2 was considered a potential mediator in relation to incident cardiometabolic disease, including cardiovascular disease and diabetes, following T2 for a mean of 5–18 years.

Results

An increase in job strain was associated with poor mental health (HR 1.56, 95% CI 1.38 to 1.76), and a decrease in job strain was associated with lower risk in women (HR 0.70, 95% CI 0.60–0.84). However, no clear association was observed between poor mental health and incident cardiometabolic disease (HR 1.08, 95% CI 0.96–1.23), nor between increase (HR 1.01, 95% CI 0.90–1.14) and decrease (HR 1.08, 95% CI 0.96–1.22) in job strain and cardiometabolic disease.

Conclusions

The results did not support that change in job strain is a risk factor for cardiometabolic disease and yielded no support for poor mental health as a mediator.
Yellow-cedar blue intensity tree-ring chronologies as records of climate in Juneau, Alaska, USA
Authors: Wiles Gregory C. , Charlton Joshua , Wilson Rob J.S. , D’Arrigo Rosanne D. , Buma Brian , Krapek John , Gaglioti Benjamin V. , Wiesenberg Nicholas , Oelkers Rose
Published: September 2019

This is the first study to generate and analyze the climate signal in blue intensity (BI) tree-ring chronologies from Alaska yellow-cedar (Callitropsis nootkatensis (D. Don) Oerst. ex D.P. Little). The latewood BI chronology shows a much stronger temperature sensitivity than ring width and can thus provide information on past climate. The well-replicated BI chronology exhibits a positive January–August mean maximum temperature signal for 1900–1975, after which it loses temperature sensitivity following the 1976–1977 shift in northeastern Pacific climate. The positive temperature response appears to recover and remains strong for the most recent decades, but the coming years will continue to test this observation. This temporary loss of temperature sensitivity from about 1976 to 1999 is not evident in ring width or in a change in forest health but is consistent with prior work linking cedar decline to warming. A confounding factor is the uncertain influence of a shift in color variation from the heartwood–sapwood boundary. Future expansion of the yellow-cedar BI network and further investigation of the influence of the heartwood–sapwood transitions in the BI signal will lead to a better understanding of the utility of this species as a climate proxy.
Importance of α-induced reactions and the inverse (γ,α) process on p-nuclei
Authors: Lahiri Chirashree
Published: September 2019

We have calculated astrophysical reaction cross-sections for [Formula: see text] reactions of some nuclei important for the calculation of p-process reaction-decay network. Reaction rates for [Formula: see text]-induced reactions are calculated with the semi-microscopic optical potential constructed using double folding method, where nuclear density distributions for finite nuclei along with the effective nucleon–nucleon interaction are the important components of the folded potential. For this purpose, density distributions of target nuclei are obtained from relativistic mean field approach. Astrophysical reaction cross-section for elastic scattering of [Formula: see text]-particle from [Formula: see text] target is compared with the existing experimental results to constrain the newly formed potential. Further, to check the credibility of the present theoretical framework, the astrophysical S-factor for [Formula: see text] reactions are compared with the experimental observation, wherever available. Finally, an estimate of dominant photodisintegration channels at various astrophysical temperature is discussed for p-nuclei [Formula: see text] and [Formula: see text].
Antiferromagnetic coupling in copper(II)porphyrin dimers linked by copper(II) or palladium(II) ion
Authors: Carvalho Mary-Ambre , Dekkiche Hervé , Richeter Sébastien , Bailly Corinne , Karmazin Lydia , McKearney Declan , Leznoff Daniel B. , Rogez Guillaume , Vileno Bertrand , Choua Sylvie , Ruppert Romain
Published: September 2019

The synthesis of porphyrin dimers linked by metal ions is described and the X-ray structure of two new dimers is presented. As previously shown for diamagnetic metal ions, strong electronic interactions between the individual subunits were observed. Antiferromagnetic coupling between copper(II)porphyrins linked by palladium(II) or copper(II) ions was studied by EPR and SQUID measurements. For the palladium(II)-linked dimer, the very small antiferromagnetic coupling was estimated by EPR measurements ([Formula: see text] <-1 cm[Formula: see text]. For the trinuclear-copper(II)-linked dimer, a large antiferromagnetic coupling between the copper(II) ions was measured. In this trinuclear compound, the linking copper(II) ion is used as a relay to increase the interaction between the two copper(II)porphyrins.
Synthesis and characterization of novel 5-monocarbohydrate-10,20-bis-aryl-porphyrins
Authors: Figueira Flávio , Lourenço Leandro M. O. , Neves Maria G. P. M. S. , Cavaleiro José A. S. , Tomé João P. C.
Published: September 2019

The synthesis of derivatives bearing glucose or galactose units linked by an acrylate spacer to one free meso position of a bis-aryl-porphyrin macrocycle was developed and characterized by standard spectroscopic techniques. The new mono-substituted gluco- and galacto-porphyrin derivatives 5–8 present an alternative to the widespread tetra-aryl porphyrin functionalization. Singlet oxygen studies showed a comparable singlet oxygen production with TPP. Furthermore, the less bulky architectures here synthesized present an opportunity to enhance the PDT and PDI capabilities of glycoporphyrins with a simple synthetic modification at one of the meso positions.
Machine Learning-Based Crop Drought Mapping System by UAV Remote Sensing RGB Imagery
Authors: Su Jinya , Coombes Matthew , Liu Cunjia , Zhu Yongchao , Song Xingyang , Fang Shibo , Guo Lei , Chen Wen-Hua
Published: September 2019

Water stress has adverse effects on crop growth and yield, where its monitoring plays a vital role in precision crop management. This paper aims at initially exploiting the potentials of UAV aerial RGB image in crop water stress assessment by developing a simple but effective supervised learning system. Various techniques are seamlessly integrated into the system including vegetation segmentation, feature engineering, Bayesian optimization and Support Vector Machine (SVM) classifier. In particular, wheat pixels are first segmented from soil background by using the classical vegetation index thresholding. Rather than performing pixel-wise classification, pixel squares of appropriate dimension are defined as samples, from which various features for pure vegetation pixels are extracted including spectral and color index (CI) features. SVM with Bayesian optimization is adopted as the classifier. To validate the developed system, a Unmanned Aerial Vehicle (UAV) survey is performed to collect high-resolution atop canopy RGB imageries by using DJI S1000 for the experimental wheat fields of Gucheng town, Heibei Province, China. Two levels of soil moisture were designed after seedling establishment for wheat plots by using intelligent irrigation and rain shelter, where field measurements were to obtain ground soil water ratio for each wheat plot. Comparative experiments by three-fold cross-validation demonstrate that pixel-wise classification, with a high computation load, can only achieve an accuracy of 82.8% with poor F1 score of 71.7%; however, the developed system can achieve an accuracy of 89.9% with F1 score of 87.7% by using only spectral intensities, and the accuracy can be further improved to 92.8% with F1 score of 91.5% by fusing both spectral intensities and CI features. Future work is focused on incorporating more spectral information and advanced feature extraction algorithms to further improve the performance.
Prevalence of Self-reported Polycystic Ovary Syndrome and Profiles of Health Among Women of Different Generations: A Cross Sectional Study
Authors: Avery Jodie C. , Moran Lisa J. , Moore Vivienne , Fernandez Renae C. , Whitrow Melissa , Stocks Nigel , Gill Tiffany K. , Musker Michael , Davies Michael , Rumbold Alice
Published: September 2019

Objective: Although polycystic ovary syndrome (PCOS) is considered a lifelong disorder, very little is understood about the diagnosis and impact of this condition in women outside of the peak reproductive years. We examined the frequency of diagnosed PCOS and concurrent health conditions in women across the lifespan.

Methods: Data were analysed from 1509 women aged 15–95 years participating in a cross-sectional, face-to-face population survey in South Australia, 2015. We assessed the prevalence of PCOS in 10-year age groups and the frequency of comorbidities in women with and without PCOS subgrouped by age (< 45, [Formula: see text] 45 years). The main outcome measures were Diagnosed PCOS and other chronic conditions; lifestyle factors. Logistic regression analyses determined the risk of comorbidities in women with PCOS adjusting for age and BMI.

Results: Overall prevalence of PCOS was 5.6% (95% confidence interval (CI) 4.6–6.9%), peaking in the 35–44 year age group (9.1%), and lowest in those aged 15–24 (4.1%) or [Formula: see text] 65 (3.7%) years. Women with PCOS and aged <45 years were more likely to report diabetes (16.7% vs. 3.8%), cardiovascular disease (15.5% vs. 7.2%) and arthritis (15.5% vs. 7.2%) than their peers; these differences were diminished in the [Formula: see text] 45 year age group. The odds of diabetes and cardiovascular disease were more than doubled among women with PCOS (adjOR 2.23, 95% CI 1.49–4.31; adjOR 3.18, 95% CI 1.31–7.68).

Conclusion: PCOS is underdiagnosed in young and post-menopausal women. Diabetes and cardiovascular disease are key comorbidities requiring greater attention in younger women with PCOS.
Distributed Deep Forest and its Application to Automatic Detection of Cash-Out Fraud
Authors: Zhang Ya-Lin , Zhou Jun , Zheng Wenhao , Feng Ji , Li Longfei , Liu Ziqi , Li Ming , Zhang Zhiqiang , Chen Chaochao , Li Xiaolong , Qi Yuan (Alan) , Zhou Zhi-Hua
Published: September 2019

Internet companies are facing the need for handling large-scale machine learning applications on a daily basis and distributed implementation of machine learning algorithms which can handle extra-large-scale tasks with great performance is widely needed. Deep forest is a recently proposed deep learning framework which uses tree ensembles as its building blocks and it has achieved highly competitive results on various domains of tasks. However, it has not been tested on extremely large-scale tasks. In this work, based on our parameter server system, we developed the distributed version of deep forest. To meet the need for real-world tasks, many improvements are introduced to the original deep forest model, including MART (Multiple Additive Regression Tree) as base learners for efficiency and effectiveness consideration, the cost-based method for handling prevalent class-imbalanced data, MART based feature selection for high dimension data, and different evaluation metrics for automatically determining the cascade level. We tested the deep forest model on an extra-large-scale task, i.e., automatic detection of cash-out fraud, with more than 100 million training samples. Experimental results showed that the deep forest model has the best performance according to the evaluation metrics from different perspectives even with very little effort for parameter tuning. This model can block fraud transactions in a large amount of money each day. Even compared with the best-deployed model, the deep forest model can additionally bring a significant decrease in economic loss each day.
Correlated Multi-label Classification with Incomplete Label Space and Class Imbalance
Authors: Braytee Ali , Liu Wei , Anaissi Ali , Kennedy Paul J.
Published: September 2019

Multi-label classification is defined as the problem of identifying the multiple labels or categories of new observations based on labeled training data. Multi-labeled data has several challenges, including class imbalance, label correlation, incomplete multi-label matrices, and noisy and irrelevant features. In this article, we propose an integrated multi-label classification approach with incomplete label space and class imbalance (ML-CIB) for simultaneously training the multi-label classification model and addressing the aforementioned challenges. The model learns a new label matrix and captures new label correlations, because it is difficult to find a complete label vector for each instance in real-world data. We also propose a label regularization to handle the imbalanced multi-labeled issue in the new label, and
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regularization norm is incorporated in the objective function to select the relevant sparse features. A multi-label feature selection (ML-CIB-FS) method is presented as a variant of the proposed ML-CIB to show the efficacy of the proposed method in selecting the relevant features. ML-CIB is formulated as a constrained objective function. We use the accelerated proximal gradient method to solve the proposed optimisation problem. Last, extensive experiments are conducted on 19 regular-scale and large-scale imbalanced multi-labeled datasets. The promising results show that our method significantly outperforms the state-of-the-art.