bluuebunny/crossref_metadata_2025 huggingface dataset:
Lipoleiomyosarcoma of spermatic cord: an unusual presentation
Authors: Khan Washim Firoz , Rathore Yashwant Singh , Aduri Raja Sumandatta , Mridha Asit Ranjan
Published: August 2019

Spermatic cord malignancies are very rare tumours. Less than 100 cases of cord liposarcoma have been reported in the literature. Divergent differentiation into leiomyosarcoma and liposarcoma is a rare phenomenon but can occur. Lipoleiomyosarcoma usually represents the well-differentiated subtype of this entity. We report such a rare case in spermatic cord with an unusual presentation as a recurrent inguinal hernia in a 62-year-old man.
High-dose anakinra as treatment for macrophage activation syndrome caused by refractory Kawasaki disease in an infant
Authors: Lind-Holst Marie , Hartling Ulla Birgitte , Christensen Anne Estmann
Published: August 2019

We report a 12-week-old boy presenting with incomplete refractory Kawasaki disease (KD) complicated with macrophage activation syndrome (MAS). The infant presented with cerebral irritability, pain, tachypnoea and vomiting for 10 days. He did not fulfil any of the classic diagnostic criteria for KD. Pericardial effusion on echocardiography in addition to severe dilatation of the coronary arteries in combination with leucocytosis and raised acute phase reactants led to the diagnosis of incomplete KD. Treatment with intravenous immunoglobulin and aspirin was initiated but without any response. The condition was subsequently refractory to additional treatment with infliximab and high-dose methylprednisolone. His condition worsened, fulfilling the criteria for MAS. High-dose anakinra was initiated, and remission of the inflammation was achieved.
Hydrocephalus as the first presenting symptom of neurosarcoidosis in two patients: a diagnosis more forthcoming in the context of systemic disease
Authors: McKeever Anna , Cox Amanda , Garnett Matthew , Cunniffe Nicholas G
Published: August 2019

Sarcoidosis is a multisystem disorder, characterised histologically by the presence of non-caseating epithelioid granulomas with exclusion of other granulomatous diseases. While the lungs and lymph nodes are affected in 90%, approximately 5% of patients have neurological involvement. The clinical manifestations of neurosarcoidosis (NS) are diverse, making diagnosis especially difficult in patients without known systemic disease. Hydrocephalus occurs in only 9% of patients with NS and although uncommon, is an important manifestation because it is associated with high morbidity and mortality. We report two cases of NS presenting with hydrocephalus, one as the first presentation of sarcoidosis and one in a patient with known multisystem sarcoidosis. The patient without systemic sarcoidosis posed the greater diagnostic challenge and followed a protracted course with multiple surgical interventions, progression of central nervous system inflammation and significant physical disability.
The role of preoperative vascular imaging and embolisation for the surgical resection of bilateral hip heterotopic ossification
Authors: Zielinski Elizabeth , Chiang Benjamin Je Lin , Satpathy Jibanananda
Published: August 2019

The surgical excision of heterotopic ossification can provide improved function for patients; however, complications can include damage to nearby vessels and nerves, blood loss and recurrence. In the preoperative planning for excision, our case report describes the combination of CT angiography, preoperative embolisation of involved vascular structures and the use of intraoperative vascular surgery for dissection around key structures to aid in the reduction of morbidity in these patients.
Trends and determinants of increasing caesarean sections from 2010 to 2013 in a prospective population-based registry in eastern rural Maharashtra, India
Authors: Patel Archana , Pusdekar Yamini Vinod , Prakash Amber Abhijeet , Simmons Elizabeth , Waikar Manjushree , Rao Sowmya R , Hibberd Patricia L
Published: August 2019

Objective

Our objective was to describe trends in caesarean section (CS) rates, characteristics of women delivering by CS, reasons for CS and impact of CS on perinatal mortality, in a rural Indian population.

Design

Secondary data analysis using a prospective population-based registry.

Setting

Four districts in Eastern Maharashtra, India, 2010 to 2013.

Participants

39 026 pregnant women undergoing labour and delivery.

Main outcomes

CS, single most likely reason, perinatal mortality.

Results

Overall, 20% of the women delivered by CS. Rates increased from 17.4% in 2010 to 22.7% in 2013 (p<0.001) with an absolute risk increase from 1% to 5% during this time-period. Women aged 25+ years old, being nulliparous, having at least a secondary school education, a body mass index 25+ and a multiple gestation pregnancy were more likely to deliver by CS. Perinatal mortality was higher among babies delivered vaginally than those delivered by CS (4.5% vs 2.7%, p<0.001). Prolonged and obstructed labour as the reported reason for CS increased over time for both nulliparous and multiparous women (p<0.001), and 6% to 10% women had no clear reason for CS. Perinatal mortality was higher among babies born vaginally than those delivered by CS (adjusted OR: 0.65, 95% CI 0.56 to 0.76, p<0.001).

Conclusion

Rates of CS increased over time in rural Maharashtra, exceeding WHO recommendations. Characteristics associated with CS and outcomes of CS were similar to previous reports. Further studies are needed to ensure accuracy of reported reasons for CS, why obstructed and prolonged labour leading to CS is increasing in this population and what leads to CS without a clear indication. Such information may be helpful for implementing the Indian Government mandate that no CS be performed without strict medical indications, while ensuring that the overall CS rates are appropriate.

Trial registration number

NCT01073475.
Relative importance of prenatal and postnatal determinants of stunting: data mining approaches to the MINIMat cohort, Bangladesh
Authors: Svefors Pernilla , Sysoev Oleg , Ekstrom Eva-Charlotte , Persson Lars Ake , Arifeen Shams E , Naved Ruchira T , Rahman Anisur , Khan Ashraful Islam , Selling Katarina
Published: August 2019

Introduction

WHO has set a goal to reduce the prevalence of stunted child growth by 40% by the year 2025. To reach this goal, it is imperative to establish the relative importance of risk factors for stunting to deliver appropriate interventions. Currently, most interventions take place in late infancy and early childhood. This study aimed to identify the most critical prenatal and postnatal determinants of linear growth 0–24 months and the risk factors for stunting at 2 years, and to identify subgroups with different growth trajectories and levels of stunting at 2 years.

Methods

Conditional inference tree-based methods were applied to the extensive Maternal and Infant Nutrition Interventions in Matlab trial database with 309 variables of 2723 children, their parents and living conditions, including socioeconomic, nutritional and other biological characteristics of the parents; maternal exposure to violence; household food security; breast and complementary feeding; and measurements of morbidity of the mothers during pregnancy and repeatedly of their children up to 24 months of age. Child anthropometry was measured monthly from birth to 12 months, thereafter quarterly to 24 months.

Results

Birth length and weight were the most critical factors for linear growth 0–24 months and stunting at 2 years, followed by maternal anthropometry and parental education. Conditions after birth, such as feeding practices and morbidity, were less strongly associated with linear growth trajectories and stunting at 2 years.

Conclusion

The results of this study emphasise the benefit of interventions before conception and during pregnancy to reach a substantial reduction in stunting.
Performance evaluation of three rapid antigen tests for the diagnosis of group AStreptococci
Authors: Kim Ha-Nui , Kim Jeeyong , Jang Woong Sik , Nam Jeonghun , Lim Chae Seung
Published: August 2019

Objective

To compare the diagnostic performance of three rapid antigen detection tests (RADTs) for group AStreptococcus(GAS).

Design

A hospital-based, cross-sectional, retrospective study.

Setting

A comparative study of rapid diagnostic tests for GAS using clinical specimens in a single institute.

Participants

225 children in the outpatient clinics ofKorea University Guro Hospitalwith suspicious symptoms were subjected to throat swab sampling. A dual-swab applicator was used. Samples were stored at below −70°C in a 10 mL transport tube containing 1 mL liquid Stuart’s transport medium.

Outcome measures

All tests were performed in the laboratory by trained clinical laboratory scientists. Sensitivity, specificity, accuracy and kappa index of three RADTs were compared with the reference PCR test and culture results.

Results

Of the 225 patients suspected of having GAS, 67 and 90 were positive for GAS in the culture and PCR tests, respectively. Compared with the reference culture, the sensitivity for GAS was 92.5% (CI 83.4 to 97.5), 71.6% (CI 59.3 to 81.9) and 74.63% (CI 62.5 to 84.4) for careUS Strep A Plus, SD Bioline and BD Veritor, respectively, and the specificity was 97.0% (CI 93.1 to 99.0), 94.6% (CI 90.1 to 97.5) and 92.9% (CI 87.8 to 96.2) for careUS Strep A Plus, SD Bioline and BD Veritor, respectively. Compared with the reference GAS real-time PCR, the sensitivity was 73.3% (CI 62.9 to 82.1), 63.3% (CI 52.5 to 73.2) and 67.8% (CI 57.1 to 77.2) for careUS Strep A Plus, SD Bioline and BD Veritor, respectively, and the specificity was 99.3% (CI 95.9 to 99.9), 100.0% (CI 97.3 to 100.0) and 99.3% (CI 95.9 to 99.9) for careUS Strep A Plus, SD Bioline and BD Veritor, respectively.

Conclusions

The careUS Strep A Plus is a useful test that showed highly comparable results with those of the culture test and superior performances among the three RADTs. The use of RADTs should be encouraged to provide acceptable and fast results using simple equipment.
Epidemiology of eating disorders in primary care in children and young people: a Clinical Practice Research Datalink study in England
Authors: Wood Sophie , Marchant Amanda , Allsopp Mark , Wilkinson Kathleen , Bethel Jackie , Jones Hywel , John Ann
Published: August 2019

Objectives

Examination of current temporal trends and clinical management patterns of eating disorders (ED) in primary care is lacking. We aimed to calculate annual incidence rates of EDs in primary care by age, sex and deprivation. We also explored the care received through referrals, psychotropic prescriptions and associated secondary care service use.

Participants and settings

A retrospective electronic cohort study was conducted using the Clinical Practice Research Datalink in those aged 11–24 years between 2004 and 2014 in England (n=1 135 038).

Results

A total of 4775 individuals with a first ever recorded ED diagnosis were identified. The crude incidence rate was 100.1 per 100 000 person years at risk (95% CI 97.2 to 102.9). Incidence rates were highest in females (189.3 per 100 000 person years, 95% CI 183.7 to 195.0, n=4336), 16–20 years of age (141.0 per 100 000 person years, 95% CI 135.4 to 146.9, n=2348) and individuals from the least deprived areas (115.8 per 100 000 person years (95% CI 109.3 to 122.5, n=1203). Incidence rates decreased across the study period (incidence rate ratio (IRR) 0.6, 95% CI 0.5 to 0.8), particularly for individuals with bulimia nervosa (IRR 0.5, 95% CI 0.3 to 0.7) and from the most deprived areas (IRR 0.5, 95% CI 0.4 to 0.7). A total of 17.4% (95% CI 16.3 to 18.5, n=831) of first ever recorded ED cases were referred from primary to secondary care. 27.1% (95% CI 25.9 to 28.4, n=1294) of individuals had an inpatient admission 6 months before or 12 months after an incident ED diagnosis and 53.4% (95% CI 52.0 to 54.9, n=2550) had an outpatient attendance. Antidepressants were the most commonly prescribed psychotropic medication.

Conclusions

New ED presentations in primary care are reducing. Understanding the cause of this decrease (coding behaviours, changes in help-seeking or a genuine reduction in new cases) is important to plan services, allocate resources and deliver effective care.
Attitudes of doctors and nurses to patient safety and errors in medical practice in the Gaza-Strip: a cross-sectional study
Authors: Bottcher Bettina , Abu-El-Noor Nasser , Abuowda Yousef , Alfaqawi Maha , Alaloul Enas , El-Hout Somaya , Al-Najjar Ibrahem , Abu-El-Noor Mysoon
Published: August 2019

Objectives

This study examined the attitudes of nurses and doctors to key patient safety concepts, evaluated differences and similarities between professional groups and assessed positive and negative attitudes to identify target areas for future training.

Setting

Four major governmental hospitals in the Gaza-Strip.

Participants

A convenience sample of 424 nurses and 150 physicians working for at least 6 months in the study hospitals.

Primary and secondary outcome measures

The primary outcome measures were mean scores with SD as measured for individual items and nine main patient safety domains assessed by the Attitudes to Patient Safety Questionnaire. Secondary outcome measures were the proportions of doctors and nurses, that gave a positive response to each item, represented as percentage of each group.

Results

Nurses and doctors held moderately positive attitudes towards patient safety with five out of nine domain scores >3.5 of 5. Doctors showed slightly more positive attitudes than nurses, despite a smaller proportion of doctors having received patient safety training with 37.5% compared with 41.9% of nurses. Both professions displayed their most positive patient safety attitudes in the same domains (‘team functioning’ and ‘working hours as a cause for error’), as well as their two most negative attitudes (‘importance of patient safety in the curriculum’ and ‘professional incompetence as a cause of error’), demonstrating significant deficits in understanding medical errors. A specific challenge will be the negative attitudes of both professions towards patient safety training for wider dissemination of this content in the postgraduate curriculum.

Conclusion

Patient safety attitudes were moderately positive in both professional groups. Target of future patient safety training should be enhancing the understanding of error in medicine. Any training has to be motivating and relevant for clinicians, demonstrating its importance in ongoing professional learning.
Pregnancy outcome among HIV-infected women on different antiretroviral therapies in Ethiopia: a cohort study
Authors: Ejigu Yohannes , Magnus Jeanette H , Sundby Johanne , Magnus Maria C
Published: August 2019

Objective

The objective of the study was to compare pregnancy outcomes according to maternal antiretroviral treatment (ART) regimens.

Design

A retrospective cohort study.

Participants and settings

Clinical data was extracted from ART exposed pregnancies of HIV-infected Ethiopian women attending antenatal care follow-up in public health facilities in Addis Ababa between February 2010 and October 2016.

Outcomes

The primary outcomes evaluated were preterm birth, low birth weight and small-for-gestational-age.

Results

A total 1663 of pregnancies exposed to ART were included in the analyses. Of these pregnancies, 17% resulted in a preterm birth, 19% in low birth weight and 32% in a small-for-gestational-age baby. Compared with highly active antiretroviral therapy (HAART) initiated during pregnancy, zidovudine monotherapy was less likely to result in preterm birth (adjusted OR 0.35, 95% CI 0.19 to 0.64) and low birth weight (adjusted OR 0.48, 95% CI 0.24 to 0.94). We observed no differential risk of preterm birth, low birth weight and small-for-gestational-age, when comparing women who initiated HAART during pregnancy to women who initiated HAART before conception. The risk for preterm birth was higher in pregnancies exposed to nevirapine-based HAART (adjusted OR 1.44, 95% CI 1.06 to 1.96) compared with pregnancies exposed to efavirenz-based HAART. Comparing nevirapine-based HAART with efavirenz-based HAART indicated no strong evidence of increased risk of low birth weight or small-for-gestational-age.

Conclusions

We observed a higher risk of preterm birth among women who initiated HAART during pregnancy compared with zidovudine monotherapy. Pregnancies exposed to nevirapine-based HAART also had a greater risk of preterm births compared with efavirenz-based HAART.
Technical and scale efficiency of provincial health systems in China: a bootstrapping data envelopment analysis
Authors: Chai Peipei , Zhang Yuhui , Zhou Maigeng , Liu Shiwei , Kinfu Yohannes
Published: August 2019

Objective

With escalating health expenditures and increasing health needs, improving health system performance has become imperative in China and internationally. The objective of this study is to examine the efficiency of China’s health system and to understand the underlying causes of the variation in efficiency across provinces.

Setting

A system-wide perspective is adopted, focusing on performance in maternal health, child health and non-communicable diseases (NCDs) in the 31 provinces of mainland China during 2015.

Methods

Analyses were performed using bootstrapping data envelopment technique. Health outcomes were measured by infant survival rates, maternal survival rates and healthy life years calculated only considering NCDs. Health inputs were measured using health expenditure, and density of medical personnel and hospital beds. The model also examined the impact of environmental factors on health system efficiency.

Results

Due to wide-spread scale inefficiency in the country, the average bias-corrected overall technical efficiency (OTE) was 0.8022 (95% CI values ranging from 0.7251 to 0.8492). Socioeconomic status, hospitalisation rate and share of out-of-pocket expenditures were significant determinants of OTE. Nearly 60% of the provinces operated at a decreasing return to scale, meaning that a gain in efficiency could be achieved only through downsizing the scale of operation.

Conclusions

Given the pervasive nature of diminishing returns across provinces, health policy makers must explore the optimum operational scale which is people-centred and focused on prevention, rather than on treatment, of diseases. Moreover, due consideration should be afforded to social determinants of health and health financing arrangements to complement health-sector based reforms and meet the ambitious goals of the Healthy China 2030 Plan.
General practitioner and pharmacist collaboration: does this improve risk factors for cardiovascular disease and diabetes? A systematic review protocol
Authors: Chaudhri Kanika , Hayek Adina , Liu Hueiming , Joshi Rohina
Published: August 2019

Introduction

Cardiovascular disease (CVD) remains a major cause of morbidity and premature mortality globally. Despite the availability of low-cost evidence based medicines, there is a significant treatment gap in those with established or at high risk of CVD in the primary care setting. Pharmacist-based interventions have shown to improve patient outcomes for many chronic diseases including CVD. However, there is little synthesised evidence that has examined the effects of collaborative care between general practitioners (GPs) and pharmacists on patients’ cardiovascular risk outcomes. This protocol aims to outline the methods employed in a systematic review of current literature to assess whether interprofessional collaboration between GPs and pharmacists has an impact on improving cardiovascular risk outcomes among patients in the primary care setting.

Methods and analysis

Randomised controlled trials (RCTs) will be identified through database searches, scanning reference lists of relevant studies, hand searching of key journals and citation searching of key papers. Two independent reviewers will screen studies against eligibility criteria and extract data using standardised forms. Databases including MEDLINE, EMBASE, Cochrane, CINAHL and International Pharmaceutical Abstracts, will be searched from the beginning of each database until October 2018. Primary outcome includes improvement in cardiovascular risk factors, such as hypertension, due to GP and pharmacist cooperation. Secondary outcome is to describe the different types of GP and pharmacist collaborative models of care. A narrative synthesis of findings will be presented. A meta-analysis will be performed if the data are homogenous.

Ethics and dissemination

This study does not require ethics approval. The results of the systematic review described within this protocol will be disseminated through presentations at relevant conferences and publication in a peer-reviewed journal. The methods will be used to inform future reviews.

PROSPERO registration number

CRD42017055259.
How do general practitioners access guidelines and utilise electronic medical records to make clinical decisions on antibiotic use? Results from an Australian qualitative study
Authors: Biezen Ruby , Roberts Cassandra , Buising Kirsty , Thursky Karin , Boyle Douglas , Lau Phyllis , Clark Malcolm , Manski-Nankervis Jo-Anne
Published: August 2019

Objective

This study aimed to explore how general practitioners (GPs) access and use both guidelines and electronic medical records (EMRs) to assist in clinical decision-making when prescribing antibiotics in Australia.

Design

This is an exploratory qualitative study with thematic analysis interpreted using the Theory of Planned Behaviour (TPB) framework.

Setting

This study was conducted in general practice in Victoria, Australia.

Participants

Twenty-six GPs from five general practices were recruited to participate in five focus groups between February and April 2018.

Results

GPs expressed that current EMR systems do not provide clinical decision support to assist with antibiotic prescribing. Access and use of guidelines were variable. GPs who had more clinical experience were less likely to access guidelines than younger and less experienced GPs. Guideline use and guideline-concordant prescribing was facilitated if there was a practice culture encouraging evidence-based practice. However, a lack of access to guidelines and perceived patients’ expectation and demand for antibiotics were barriers to guideline-concordant prescribing. Furthermore, guidelines that were easy to access and navigate, free, embedded within EMRs and fit into the clinical workflow were seen as likely to enhance guideline use.

Conclusions

Current barriers to the use of antibiotic guidelines include GPs’ experience, patient factors, practice culture, and ease of access and cost of guidelines. To reduce inappropriate antibiotic prescribing and to promote more rational use of antibiotic in the community, guidelines should be made available, accessible and easy to use, with minimal cost to practicing GPs. Integration of evidence-based antibiotic guidelines within the EMR in the form of a clinical decision support tool could optimise guideline use and increase guideline-concordant prescribing.
Evolution of the burden of active hepatitis C virus infection in England from September 2015 to September 2016: a repeated cross-sectional analysis
Authors: Lacoin Laure , Hurst Michael , Hill Nathan R , Gordon Jason , Geretti Anna Maria , Aspinall Richard , Corless Lynsey , Gao-Du Yuxiang , Mistry Liam , Mutimer David
Published: August 2019

Objective

To evaluate the impact of treatment with new direct-acting antivirals (DAAs) on the prevalent hepatitis C virus (HCV) population in England.

Design

A repeated cross-sectional analysis.

Setting

Four secondary care hospitals in England.

Participants

Patients who, in 2015 and/or 2016, had chronic HCV infection and were alive were eligible, regardless of the type of HCV intervention received.

Outcome measures

Data including intravenous drug use (IVDU) status, HCV genotype, cirrhosis status, HCV treatment history, vital status and treatment outcomes were collected at two time points in 2015 and 2016 using electronic case report forms.

Results

There were 1605 and 1355 patients with active chronic HCV in 2015 and 2016, respectively. Between 2015 and 2016, the proportion of patients with current IVDU increased (10.3% vs 14.5%, respectively), while that of patients with cirrhosis (28.2% vs 22.4%) and treatment-experienced patients (31.2% vs 27.1%) decreased. Among patients whose treatment outcome was known by 2016, high cure rates were observed, with an overall sustained virological response rate of 93.2%. From 2015 to 2016, there was a progressive increase in the proportion of treated patients who were non-cirrhotic, with current IVDU and non-liver transplant recipients.

Conclusions

The characteristics of patients with HCV remaining in contact with specialised care evolved with a changing landscape of treatment and related health policy. With increasing access to DAAs in UK, high cure rates were achieved in the study cohort.
Comprehensive evaluation of a prospective Australian patient cohort with suspected genetic kidney disease undergoing clinical genomic testing: a study protocol
Authors: Jayasinghe Kushani , Stark Zornitza , Patel Chirag , Mallawaarachchi Amali , McCarthy Hugh , Faull Randall , Chakera Aron , Sundaram Madhivanan , Jose Matthew , Kerr Peter , Wu You , Wardrop Louise , Goranitis Ilias , Best Stephanie , Martyn Melissa , Quinlan Catherine , Mallett Andrew J
Published: August 2019

Introduction

Recent advances in genomic technology have allowed better delineation of renal conditions, the identification of new kidney disease genes and subsequent targets for therapy. To date, however, the utility of genomic testing in a clinically ascertained, prospectively recruited kidney disease cohort remains unknown. The aim of this study is to explore the clinical utility and cost-effectiveness of genomic testing within a national cohort of patients with suspected genetic kidney disease who attend multidisciplinary renal genetics clinics.

Methods and analysis

This is a prospective observational cohort study performed at 16 centres throughout Australia. Patients will be included if they are referred to one of the multidisciplinary renal genetics clinics and are deemed likely to have a genetic basis to their kidney disease by the multidisciplinary renal genetics team. The expected cohort consists of 360 adult and paediatric patients recruited by December 2018 with ongoing validation cohort of 140 patients who will be recruited until June 2020. The primary outcome will be the proportion of patients who receive a molecular diagnosis via genomic testing (diagnostic rate) compared with usual care. Secondary outcomes will include change in clinical diagnosis following genomic testing, change in clinical management following genomic testing and the cost-effectiveness of genomic testing compared with usual care.

Ethics and dissemination

The project has received ethics approval from the Melbourne Health Human Research Ethics Committee as part of the Australian Genomics Health Alliance protocol: HREC/16/MH/251. All participants will provide written informed consent for data collection and to undergo clinically relevant genetic/genomic testing. The results of this study will be published in peer-reviewed journals and will also be presented at national and international conferences.
Prevalence of impaired fasting glucose, type 2 diabetes and associated risk factors in undiagnosed Chinese rural population: the Henan Rural Cohort Study
Authors: Abdulai Tanko , Li Yuqian , Zhang Haiqing , Tu Runqi , Liu Xiaotian , Zhang Liying , Dong Xiaokang , Li Ruiying , Wang Yuming , Wang Chongjian
Published: August 2019

Objective

This study estimated the burden and characterised the risk factors associated with diabetes and impaired fasting glucose (IFG) in an undiagnosed rural population.

Design

Data for 36 960 participants from the Henan Rural Cohort baseline with undiagnosed diabetes were analysed. X2test and multivariate logistic regression analyses were performed to test for association between risk factors and diabetes and IFG.

Results

Women constituted 60.30% of the study participants, mean age of participants was 55.32±12.18 years, risk factors for diabetes and IFG were prevalent (75% dyslipidaemia, 57% overweight/obese, 50% central obesity and 18% metabolic syndrome). The prevalence of diabetes and IFG was 4.19% and 7.22%, respectively. Having a metabolic syndrome (adjusted OR (aOR) 4.7, 95% CI 4.27 to 5.33), dyslipidaemia (aOR 2.76, 95% CI 2.31 to 3.21), centrally obese (aOR 2.38, 95% CI 2.11 to 2.70), being overweight/obese (aOR 1.66, 95% CI 1.45 to 1.79) and a family history of diabetes (aOR 1.50, 95% CI 1.15 to 1.92) were associated with diabetes. These factors were also associated with IFG. Intake of high salt diet (aOR 1.16, 95% CI 1.02 to 1.32) and smoking (aOR 1.22, 95% CI 1.02 to 1.47; significant in men) were also associated with diabetes. Engaging in moderate physical activity (aOR 0.94, 95% CI 0.89 to 0.98) was noted to be negatively associated with diabetes.

Conclusion

Diabetes and IFG remain prevalent in Chinese population with obesity and dyslipidaemia being some of the most significant predictors. Regular physical activity and consumption of fruits and vegetables may be beneficial in keeping blood glucose level low.

Trial registration number

ChiCTR-OOC-15006699
Patient engagement in the development of best practices for transitions from hospital to home: a scoping review
Authors: Zhao Grace , Kennedy Carol , Mabaya Gracia , Okrainec Karen , Kiran Tara
Published: August 2019

Objectives

To explore the extent of patient engagement in the development of best practice reports related to transitions from hospital to home.

Design

Scoping review.

Data sources

Electronic databases (MEDLINE, EMBASE, CINAHL, Scopus, Trip Database, DynaMed Plus and Public Health Plus) and multiple provincial regulatory agency and healthcare organisation websites.

Eligibility criteria

We included best practice reports related to the transition from hospital to a long-term care facility, community dwelling or rehabilitation centre. We included documents disseminated in English between 1947 and 2019.

Data extraction and synthesis

Two independent reviewers screened for eligibility and one extracted and analysed data using a data extraction tool we developed based on established patient engagement frameworks. Only records actively engaging patients were analysed (n=11). The methodological quality of actively engaging patients was assessed using domain 2 (item 5) of stakeholder involvement from the Appraisal of Guidelines for Research and Evaluation II (AGREE II) tool.

Results

The search yielded 1921 citations of which 23 met the inclusion criteria and were included for narrative synthesis. These were disseminated between 1995 and 2019, with 18 (78%) published after 2010. Most were conducted in North America (USA 43%, Canada 22%), Europe (UK 30%) and Australia (4%). Eleven (48%) actively involved patients, of which only two involved patients across all stages of development. Most involved patients through direct or indirect consultation. The mean AGREE II domain 2 item 5 score (of those that actively engaged patients) was 5.9 out of 7.

Conclusions

Only half of existing best practice reports related to the transition from hospital to home actively involved patients in report development. However, the extent of patient engagement has been increasing over time. More organisations should strive to engage patients throughout the best practice development process and provide patients with opportunities for shared leadership.
Goals of older hospitalised patients: a qualitative descriptive study
Authors: van der Kluit Maria Johanna , Dijkstra Geke J , de Rooij Sophia E
Published: August 2019

Objectives

Since the population continues ageing and the number of patients with multiple chronic diseases is rising in Western countries, a shift is recommended from disease oriented towards goal-oriented healthcare. As little is known about individual goals and preferences of older hospitalised patients, the aim of this study is to elucidate the goals of a diverse group of older hospitalised patients.

Design

Qualitative descriptive method with open interviews analysed with inductive content analysis.

Setting

A university teaching hospital and a regional teaching hospital.

Participants

Twenty-eight hospitalised patients aged 70 years and older.

Results

Some older hospitalised patients initially had difficulties describing concrete goals, but after probing all were able to state more concrete goals. A great diversity of goals were categorised into wanting to know what the matter is, controlling disease, staying alive, improving condition, alleviating complaints, improving daily functioning, improving/maintaining social functioning, resuming work/hobbies and regaining/maintaining autonomy.

Conclusions

Older hospitalised patients have a diversity of goals in different domains. Discussing goals with older patients is not a common practice yet. Timely discussions about goals should be encouraged because individual goals are not self-evident and this discussion can guide decision making, especially in patients with multimorbidity and frailty. Aids can be helpful to facilitate the discussion about goals and evaluate the outcomes of hospitalisation.
Protocol for the Data-Linkage Alcohol Cohort Study (DACS): investigating mortality, morbidity and offending among people with an alcohol-related problem using linked administrative data
Authors: Peacock Amy , Chiu Vivian , Leung Janni , Dobbins Timothy , Larney Sarah , Gisev Natasa , Pearson Sallie-Anne , Degenhardt Louisa
Published: August 2019

Introduction

The aims of this program of research are to use linked health and law enforcement data to describe individuals presenting to emergency and inpatient healthcare services with an acute alcohol harm or problematic alcohol use; measure their health service utilisation and law enforcement engagement; and quantify morbidity, mortality, offending and incarceration.

Methods and analysis

We will assemble a retrospective cohort of people presenting to emergency departments and/or admitted to hospitals between 1 January 2005 and 31 December 2014 in New South Wales, Australia with a diagnosis denoting an acute alcohol harm or problematic alcohol use. We will link these data with records from other healthcare services (eg, community-based mental healthcare data, cancer registry), mortality, offending and incarceration data sets. The four overarching areas for analysis comprise: (1) describing the characteristics of the cohort at their first point of contact with emergency and inpatient hospital services in the study period with a diagnosis indicating an acute alcohol harm and/or problematic alcohol use; (2) quantifying health service utilisation and law enforcement engagement; (3) quantifying rates of mortality, morbidity, offending and incarceration; and (4) assessing predictors (eg, age, sex) of mortality, morbidity, offending and incarceration among this cohort.

Ethics and dissemination

Ethics approval has been provided by the New South Wales Population and Health Services Research Ethics Committee. We will report our findings in accordance with the REporting of studies Conducted using Observational Routinely collected health Data (RECORD) statement and Guidelines for Accurate and Transparent Health Estimates Reporting (GATHER) where appropriate. We will publish data in tabular, aggregate forms only. We will not disclose individual results. We will disseminate project findings at scientific conferences and in peer-reviewed journals. We will aim to present findings to relevant stakeholders (eg, addiction medicine and emergency medicine specialists, policy makers) to maximise translational impact of research findings.
Illicit cigarette trade in South Africa: 2002–2017
Authors: Vellios Nicole , van Walbeek Corné , Ross Hana
Published: August 2019

Background

Increasing cigarette excise taxes is widely recognised as the most effective measure to reduce the demand for cigarettes. The presence of illicit trade undermines the effectiveness of tax increases as both a public health and a fiscal measure, because it introduces cheaper alternatives to legal, full-priced cigarettes.

Objective

To assess trends in the size of the illicit cigarette market in South Africa from 2002 to 2017 using gap analysis.

Methods

Tax-paid cigarette sales are compared with consumption estimates from two nationally representative surveys: the All Media and Products Survey and the National Income Dynamics Study. We explore the size of the illicit cigarette market and its changes over the period 2002–2017.

Results

Since 2009, illicit trade has increased sharply. We estimate that illicit trade is between 30% and 35% of the total market in 2017. The acceleration in the growth of the illicit market since 2015 corresponds with a turbulent time at the South African Revenue Service, when many of the enforcement functions were greatly reduced.

Conclusions

The current levels of illicit trade are extremely high and need to be addressed urgently by implementing effective control mechanisms such as a track and trace system to monitor the production, taxation, and sale of cigarettes.
Generation of various classes of entangled states in a two-mode Bose–Einstein condensate under the influence of interatom collisions
Authors: Ghasemian E. , Tavassoly M. K.
Published: August 2019

In this paper, we generate some new classes of entangled states of a bimodal Bose–Einstein condensate (BEC), a pair of tunnel-coupled BEC, in the presence of two- and three-body elastic as well as mode-exchange collisions. The Hamiltonian of the considered system is very complicated, moreover, it can be fortunately transformed into a simple form using a two-mode displacement operator. After introducing the general form of the time evolved state, various classes of entangled states are generated. Indeed, the influence of different orders of tunneling strengths on the generated entangled states has been studied. Depending on the tunneling strength constants, two-, three- and four-partite entangled states are generated, all of which are superposition states of macroscopic number of BEC atoms. Considering three-particle collision dramatically changes the generated entangled states. Moreover, in particular cases, the resulted states are non-entangled. Also, we show that tunneling and collisional interactions can be manipulated to generate a pair of atomic entangled coherent states (quasi-Bell states). In addition, it is observed that the degree of entanglement for two-partite entangled states can be tuned via the number of BEC atoms, i.e. the corresponding concurrences tend to their maximum value by increasing the atoms in both modes of system.
Geodesic structure of the Clifton–Barrow black hole space–time
Authors: Shi Li-Li , Hu Jian-Ping , Zhang Yu , Ma Chen , Duan Peng-Fei
Published: August 2019

In this paper, we investigate the geodesic structure of Clifton–Barrow black hole space–time. Through the numerical analysis of the effective potential and the motion equation, the orbital types of test particles and photons and the corresponding orbital motion diagrams of each orbital types under certain conditions are obtained. We find that angular momentum [Formula: see text] and [Formula: see text] determine the existence of bound orbits and circular orbits. And we also find that the radius of unstable circular orbit decreases with increases in [Formula: see text] while the radius of stable circular orbit increases. Furthermore, as [Formula: see text] increases, the radius of unstable circular orbit increases, while the radius of stable circular orbit decreases. For null geodesic, parameters [Formula: see text] and [Formula: see text] do not affect the types of null orbits. The radius of the unstable circular orbits increases with the increase of [Formula: see text]. However, the radius of the unstable circular orbits remains unchanged as [Formula: see text] increases. Also, we show that the precession direction of the bound orbits of the test particles is counterclockwise for [Formula: see text], but clockwise with [Formula: see text]. Moreover, different energy values have an effect on the curvature of escape and absorb orbits curve.
PRICING-HEDGING DUALITY FOR CREDIT DEFAULT SWAPS AND THE NEGATIVE BASIS ARBITRAGE
Authors: MAI JAN-FREDERIK
Published: August 2019

Assuming the absence of arbitrage in a single-name credit risk model, it is shown how to replicate the risk-free bank account until a credit event by a static portfolio of a bond and infinitely many credit default swap (CDS) contracts. This static portfolio can be viewed as the solution of a credit risk hedging problem whose dual problem is to price the bond consistently with observed CDSs. This duality is maintained when the risk-free rate is shifted parallel. In practice, there is a unique parallel shift [Formula: see text] that is consistent with observed market prices for bond and CDSs. The resulting, risk-free trading strategy in case of positive [Formula: see text] earns more than the risk-free rate, is referred to as negative basis arbitrage in the market, and [Formula: see text] defined in this way is a scientifically well-justified definition for what the market calls negative basis. In economic terms, [Formula: see text] is a premium for taking the residual risks of a bond investment after interest rate risk and credit risk are hedged away. Chiefly, these are liquidity and legal risks.
Engaging the Asian Giants: India, China and Bangladesh’s Crucial Balancing Act
Authors: PATTANAIK SMRUTI S.
Published: August 2019

Bangladesh has engaged both India and China as they fulfill its aspirations for development without raising the apprehensions of either. High-level visits between Bangladesh and India and the resolution of some of the long pending issues have removed some earlier distrust, greatly institutionalizing the relationship between the two. India opposes the Belt and Road Initiative (BRI), while Bangladesh is a participant. China shares a robust relationship with the military of Bangladesh, while security cooperation between India and Bangladesh is nascent, involving capacity building and cooperation to meet non-traditional security challenges. Bangladesh has kept the sensitivities of the two countries in mind as it engages with both. Therefore, it has built its energy and infrastructure with the largest credit line ever offered by India while also engaging with China to invest massively in infrastructure projects. Bangladesh is the only country in South Asia to have profited from relations with both India and China in such a way. In this study, four sectors have been selected in which Bangladesh has engaged both countries and benefitted immeasurably.
Large values of Hecke–Maass L-functions with prescribed argument
Authors: Peyrot Alexandre
Published: August 2019

We investigate the existence of large values of [Formula: see text]-functions attached to Maass forms on the critical line with prescribed argument. The results obtained rely on the resonance method developed by Soundararajan and furthered by Hough.
On Eisenstein polynomials and zeta polynomials II
Authors: Miezaki Tsuyoshi , Oura Manabu
Published: August 2019

Eisenstein polynomials, which were defined by the second author, are analogues to the concept of an Eisenstein series. The second author conjectured that there exist some analogous properties between Eisenstein series and Eisenstein polynomials. In the previous paper, the first author provided new analogous properties of Eisenstein polynomials and zeta polynomials for the Type II case. In this paper, the analogous properties of Eisenstein polynomials and zeta polynomials are shown to also hold for the Type I, Type III, and Type IV cases. These properties are finite analogies of certain properties of Eisenstein series.
Variant of the truncated Perron formula and primes in polynomial sets
Authors: Ramana D. S. , Ramaré O.
Published: August 2019

We show under the Generalized Riemann Hypothesis that for every non-constant integer-valued polynomial [Formula: see text], for every [Formula: see text], and almost every prime [Formula: see text] in [Formula: see text], the number of primes from the interval [Formula: see text] that are values of [Formula: see text] modulo [Formula: see text] is the expected one, provided [Formula: see text] is not more than [Formula: see text]. We obtain this via a variant of the classical truncated Perron’s formula for the partial sums of the coefficients of a Dirichlet series.
Weierstrass coefficients of the canonical lifting
Authors: Finotti Luís R. A.
Published: August 2019

Given an ordinary elliptic curve [Formula: see text] over a field of characteristic [Formula: see text], there are functions [Formula: see text] and [Formula: see text] such that the curve [Formula: see text] where [Formula: see text] and [Formula: see text] is the canonical lifting of [Formula: see text]. Although these functions are not uniquely determined, we prove that they can be taken to be in [Formula: see text], defined for all ordinary elliptic curves of the given characteristic, and modular, with [Formula: see text] and [Formula: see text].
Generating functions and congruences for some partition functions related to mock theta functions
Authors: Baruah Nayandeep Deka , Begum Nilufar Mana
Published: August 2019

Recently, Andrews, Dixit and Yee introduced partition functions associated with Ramanujan/Watson third-order mock theta functions [Formula: see text] and [Formula: see text]. In this paper, we find several new exact generating functions for those partition functions as well as the associated smallest part functions and deduce several new congruences modulo powers of 5.
Small prime solutions to diagonal Diophantine equations
Authors: Gao Gaiyun , Liu Zhixin
Published: August 2019

Let [Formula: see text] be an integer, [Formula: see text], [Formula: see text], [Formula: see text], where [Formula: see text] are nonzero integers, and let [Formula: see text] be an integer. Suppose that [Formula: see text] satisfy some necessary congruent conditions. In this paper, it is proved that

(i) if [Formula: see text] are not all of the same sign, then the equation [Formula: see text] has prime solutions satisfying [Formula: see text], (ii) if all [Formula: see text] are positive and [Formula: see text], then [Formula: see text] is solvable in primes [Formula: see text],

where [Formula: see text].

Our result uses [Formula: see text] as an improvement of the recent result [Formula: see text] due to Zhao (2016), and largely improves the results [Formula: see text] for [Formula: see text] proved by Yang and Hu (2016).
Investigation on electrical conductivity and dielectric property of La0.8Pb0.2(Fe,Ti)0.5O3ceramic nanoparticles
Authors: Triyono D. , Supriyadi Y. , Laysandra H.
Published: August 2019

The modification of the structure lanthanum orthoferrites (LaFeO[Formula: see text] to obtain ceramic materials with enhanced structural, optical, and electrical properties constitutes an active area of research. The preparation of La[Formula: see text]Pb[Formula: see text](Fe, Ti)[Formula: see text]O3(LPFTO) ceramic nanoparticles by following a cation substitution approach from LaFeO3using sol–gel and sintering methods is described. The electrical and dielectric properties of the obtained material are investigated. The contribution of grain and grain boundary in the conduction mechanism is demonstrated by complex impedance analysis. The LPFTO ceramic nanoparticles exhibit a giant dielectric constant of the order of 108. The conductivity analysis suggests the occurrence of thermally activated semiconductor behavior. Moreover, the ferromagnetic–paramagnetic semiconductor transition temperature is observed at 385[Formula: see text]K. The ac conductivity behavior satisfies the nonoverlapping small-polaron tunneling (NSPT) model.