bluuebunny/crossref_metadata_2025 huggingface dataset:
Characteristics and prognostic values of traditional pathological parameters and advanced molecular subtypes in women in Beijing with operable breast cancer: a retrospective analysis
Authors: Li Qin , Li Li , Jiang Xiaoyue , Du Qi , Li Yingrui , Li Teng , Gong Hong , Cao Bangwei
Published: November 2018

Objectives

This study investigated the characteristics and prognostic values of traditional pathological parameters and advanced molecular subtypes in women with operable breast cancer in Beijing.

Design

A retrospective study through case information enquiry or telephonic follow-up.

Setting

Beijing Friendship Hospital.

Participants

1042 patients with primary operable breast cancer between 2008 and 2012 were enrolled in the study.

Measures

The characteristics and 5-year relapse rates according to the Nottingham Prognosis Index (NPI) and molecular subtypes were analysed.

Results

In 1042 patients, the percentages of high histological grade, N1+N2, T2+T4 were 7.3%, 24.2%, 46.9%, respectively. In patients with invasive breast cancer, the percentages of auxiliary staging, positive margins, vascular invasion and nerve infiltration were 65.0%, 2.8%, 10.5% and 1.1%, respectively. The missing percentages of auxiliary staging, margins, vascular tumour invasion and nerve infiltration were 14.2%, 31.4%, 46.5% and 97.4%, respectively. The percentages of ER-positive, PR-positive, HER2-positive and Ki-67 high expression were 64.3%, 43.8%, 18.8% and 62.7%, respectively. The percentages of luminal A, luminal B, HER2-overexpression and basal-like breast cancers were 10.5%, 54.2%, 8.2% and 11.2%, respectively. Luminal A, luminal B and basal-like breast cancer subtypes were more common in the >60 years group, the 41–60 years group and the 20–40 years group, respectively. The 5-year relapse rates according to NPI were as follows: 6.2% in the low recurrence risk group, 10.4% in the moderate recurrence risk group and 12.9% in the high recurrence risk group. The 5-year relapse rates according to molecular subtypes were as follows: luminal A 4.0%, luminal B 7.0%, HER2-overexpression14.2%, basal-like 15.6%.

Conclusions

Reasonable analysis of traditional pathological parameters and advanced molecular subtypes in women with operable breast cancer in Beijing may be useful to guide precise treatment and predict prognosis.
Stillbirth among women in nine states in India: rate and risk factors in study of 886,505 women from the annual health survey
Authors: Altijani Noon , Carson Claire , Choudhury Saswati Sanyal , Rani Anjali , Sarma Umesh C , Knight Marian , Nair Manisha
Published: November 2018

Objectives

To assess the rate of stillbirth and associated risk factors across nine states in India.

Design

Secondary analysis of cross-sectional data from the Indian Annual Health Survey (2010–2013).

Setting

Nine states in India: Madhya Pradesh, Chhattisgarh, Rajasthan, Uttarakhand, Jharkhand, Odisha, Bihar, Assam and Uttar Pradesh.

Participants

886 505 women, aged 15–49 years.

Main outcome measures

Stillbirth rate with 95% CI. Adjusted OR to examine the associations between stillbirth and (1) socioeconomic, behavioural and biodemographic risk factors and (2) complications in pregnancy (anaemia, eclampsia, other hypertensive disorders, antepartum and intrapartum haemorrhage, obstructed labour, breech presentation, abnormal fetal position).

Results

The overall rate of stillbirth was 10 per 1000 total births (95% CI 9.8 to 10.3). Indicators of socioeconomic deprivation were strongly associated with an increase in stillbirth: rural residence (adjusted OR (aOR) 1.27, 95% CI 1.16 to 1.39), female illiteracy (aOR 1.43, 95% CI 1.17 to 1.74), low socioeconomic status (aOR 2.42, 95% CI 1.82 to 3.21), schedule caste background (aOR 1.11, 95% CI 1.04 to 1.19) and woman not in paid employment (aOR 1.15, 95% CI 1.07 to 1.24). Women from minority religious groups were at higher risk than the Hindu majority (Muslim (aOR 1.33, 95% CI 1.25 to 1.43); Christian (aOR 1.42, 95% CI 1.19 to 1.70)). While a few women smoked (<1%), around 9% reported chewing tobacco, which was associated with an increased odds of stillbirth (aOR 1.11, 95% CI 1.02 to 1.21). Adverse pregnancy and birth characteristics were also associated with stillbirth: antenatal care visits <4 (aOR 1.08, 95% CI 1.01 to 1.15), maternal age <25 years (aOR 1.29, 95% CI 1.21 to 1.37) and ≥35 years (aOR 1.16, 95% CI 1.04 to 1.29), multigravida (aOR 3.06, 95% CI 2.42 to 3.86), multiple pregnancy (aOR 1.77, 95% CI 1.47 to 2.15), assisted delivery (aOR 3.45, 95% CI 3.02 to 3.93), caesarean section (aOR 1.73, 95% CI 1.58 to 1.89), as were pregnancy complications (aOR 1.42, 95% CI 1.33 to 1.51).

Conclusion

India is an emerging market economy experiencing a rapid health transition, yet these findings demonstrate the marked disparity in risk of stillbirth by women’s socioeconomic status. Tobacco chewing and maternal and fetal complications were each found to be important modifiable risk factors. Targeting the ‘at-risk’ population identified here, improved recording of stillbirths and the introduction of local reviews would be important steps to reduce the high burden of stillbirths in India.
Effectiveness of a free maternal healthcare programme under the National Health Insurance Scheme on skilled care: evidence from a cross-sectional study in two districts in Ghana
Authors: Twum Peter , Qi Jing , Aurelie Kasangye Kangoy , Xu Lingzhong
Published: November 2018

Objectives

In her quest to reduce maternal mortality, Ghana introduced a free maternal healthcare programme under the National Health Insurance Scheme. This study aimed to evaluate if women registered with the insurance had a better chance of accessing maternal healthcare services in two districts in Ghana.

Setting

We conducted a cross-sectional quantitative study involving household interviews of all women of the reproductive age group (15–49 years) residing in Kintampo North Municipality and Kintampo South District in Ghana from May to July 2015. Logistics regression analysis at 95% CI was used to determine the independent associations between maternal health insurance and use of antenatal care, facility-based delivery and postnatal care services.

Participants

Women who had children aged 3–12 months were selected to take part in the study.

Results

We observed that women with insurance are 39.5 times more likely to have a maximum of six antenatal care visits and 2.6 times more likely to have an average of four antenatal care visits than those without insurance. Additionally, they are 5.3 times more likely to have facility-based delivery than those without insurance. An association was also found between postnatal care use and insurance as women who do not have insurance are 12.0 (1/0.083) times more likely to receive postnatal care than those with insurance.

Conclusions

Pregnant women who registered with health insurance had at least four antenatal care visits and delivered in a health facility. However majority of them did not go for postnatal care.
HIV self-test performance among female sex workers in Kampala, Uganda: a cross-sectional study
Authors: Ortblad Katrina F , Kibuuka Musoke Daniel , Ngabirano Thomson , Nakitende Aidah , Taasi Geoffrey , Barresi Leah G , Bärnighausen Till , Oldenburg Catherine E
Published: November 2018

Objective

To evaluate HIV self-testing performance and results interpretation among female sex workers (FSWs) in Kampala, Uganda, who performed unassisted HIV self-testing.

Methods

In October 2016, 104 participants used an oral HIV self-test while under observation by research assistants. Participants were not assisted on HIV self-test use prior to or during testing, and were only given the manufacturer’s pictorial and written instructions to guide them. Research assistants recorded if participants completed and/or had difficulties with steps in the HIV self-testing process on a prespecified checklist. Randomly drawn, used HIV self-tests were interpreted by FSWs. We calculated the concordance between FSWs’ interpretations of self-test results with those indicated in the manufacturer’s instructions.

Results

Only 33% (34/104) of participants completed all of the key steps in the HIV self-testing process, and the majority (86%, 89/104) were observed having difficulties with at least one of these steps. Misinterpretation of HIV self-test results were common among FSWs: 23% (12/56) of FSWs interpreted HIV-negative self-test results as HIV positive and 8% (3/37) of FSWs interpreted HIV-positive self-test results as HIV negative. The concordance between FSWs’ interpretations of self-test results and that indicated in the instructions was 73% (95% CI 56% to 86%) for HIV-positive self-tests and 68% (95% CI 54% to 80%) for HIV-negative self-tests.

Conclusions

FSWs in Kampala, who performed unassisted HIV self-testing, skipped steps in the HIV self-testing process and had difficulties correctly interpreting self-test results. Training on use and interpretation of HIV self-tests may be necessary to prevent errors in the HIV self-testing process and to avoid the negative consequences of false-positive and false-negative HIV self-test results among FSWs.

Trial registration number

NCT02846402.
Observational retrospective study of US national utilisation patterns and live birth rates for various ovarian stimulation protocols for in vitro fertilisation
Authors: Kushnir Vitaly A , Darmon Sarah K , Barad David H , Gleicher Norbert
Published: November 2018

Objective

Alternative ovarian stimulation protocols for in vitro fertilisation (IVF) have grown in popularity. Yet, patient populations best suited for these protocols have not been defined. Our objective was, therefore, to determine national IVF utilisation patterns and live birth rates of various ovarian stimulation protocols.

Design

Retrospective cohort study.

Setting

Academic-affiliated private fertility centre.

Participants

Aggregate data published by Society for Assisted Reproductive Technology for autologous IVF cycles performed in the USA during 2014 and 2015 were analysed. IVF cycles were stratified based on ovarian stimulation protocol: 205 705 conventional stimulations, 4397 minimal stimulations, 2785 natural cycles and 514 in vitro maturation (IVM) cycles. Repeat cycles could not be determined in this analysis.

Outcome measures

Utilisation patterns and age-specific live birth rates for various ovarian stimulation protocols.

Results

With advancing female age, utilisation of conventional stimulation protocols decreased, while minimal stimulation and natural cycle IVF increased. Diminished ovarian reserve diagnoses were in all age groups less prevalent in patients undergoing conventional stimulation than with all other protocols. Live birth rates were highest with conventional stimulation at 42.4%, 33.1%, 22.1%, 11.7% and 3.9% for <35, 35–37, 38–40, 41–42 and >42 female age groups, respectively. The difference in live birth rates between conventional stimulation and other protocols widened with advancing age from 1.6-fold to 3.9-fold among women <35 years of age, reaching 4.4-fold to 6.6-fold among women >42 years of age.

Conclusions

In comparison to conventional stimulation IVF—minimal stimulation, natural cycle IVF and IVM protocols offer lower but still acceptable live birth rates among young women. These alternative protocols are frequently used in older women and those with diminished ovarian reserve, despite their lower live birth rates. The reasons for this apparent incongruity warrant further careful exploration.
Efficacy and safety of sodium-glucose cotransporter 2 inhibitors (SGLT-2is) and glucagon-like peptide-1 receptor agonists (GLP-1RAs) in patients with type 2 diabetes: a systematic review and network meta-analysis study protocol
Authors: Hussein Humaira , Zaccardi Francesco , Dhalwani Nafeesa N , Davies Melanie J , Khunti Kamlesh , Gray Laura J
Published: November 2018

Introduction

Sodium-glucose cotransporter 2 inhibitors (SGLT-2is) and glucagon-like peptide-1 receptor agonists (GLP-1RAs) are two classes of glucose-lowering drugs gaining popularity in the treatment of type 2 diabetes mellitus (T2DM). Current guidelines suggest patient-centred approaches when deciding between available hyperglycaemia drugs with no indication to which specific drug should be administered. Despite systematic reviews and meta-analyses being conducted within SGLT-2is and GLP-1RAs, differences across these classes of drugs have not been investigated. Therefore, this systematic review and network meta-analysis (NMA) will aim to compare the efficacy and safety profiles across and within SGLT-2is and GLP-1RAs.

Methods

PubMed, the Cochrane Central Register of Controlled Trials and ISI Web of Science will be searched from inception for published randomised controlled trials conducted in patients with T2DM, with at least two arms consisting of SGLT-2is, GLP-1RAs or control/placebo. Title and abstracts will be screened by two independent reviewers with conflicts resolved by a third. Data will be extracted by the primary researcher, a random sample will be checked by an independent reviewer. Risk of bias will be assessed using the Cochrane Risk of Bias Tool and overall quality of evidence will be assessed using the Grading of Recommendations Assessment, Development and Evaluation approach.

Study characteristics, participants baseline characteristics, mean change in cardiometabolic outcomes and number of adverse events will be extracted for each study. Primary outcome will be the mean change in glycated haemoglobin (HbA1c) (%, mmol/mol). Initial random-effects pairwise meta-analysis will be conducted for each unique treatment comparison where heterogeneity will be assessed. A Bayesian NMA approach will be adopted where random-effects generalised linear models will be fitted in WinBUGS. Sensitivity analysis will be conducted to assess choices of prior distributions and length of burn-in and sample.

Ethics and dissemination

Ethics approval is not required for this study. Results from this study will be published in a peer-review journal.

PROSPERO registration number

CRD42018091306.
Educational disparities in perinatal health in Denmark in the first decade of the 21st century: a register-based cohort study
Authors: Bilsteen Josephine Funck , Andresen Josefine Bernhard , Mortensen Laust Hvas , Hansen Anne Vinkel , Andersen Anne-Marie Nybo
Published: November 2018

Objective

To investigate socioeconomic differences in six perinatal health outcomes in Denmark in the first decade of the 21st century.

Design

A population-based cohort study.

Setting

Danish national registries.

Participants

A total of 646 829 live born children and 3076 stillborn children (≥22+0 weeks of gestation) born in Denmark from 2000 to 2009. We excluded children with implausible relations between birth weight and gestational age (n=644), children without information on maternal country of origin (n=138) and implausible values of maternal year of birth (n=36).

Main outcome measures

We investigated the following perinatal health outcomes: stillbirth, neonatal and postneonatal mortality, small-for-gestational age, preterm birth grated into moderate preterm, very preterm and extremely preterm, and congenital anomalies registered in the first year of life.

Results

Maternal educational level was inversely associated with all adverse perinatal outcomes. For all examined outcomes, the risk association displayed a clear gradient across the educational levels. The associations remained after adjustment for maternal age, maternal country of origin and maternal year of birth. Compared with mothers with vocational education, mothers with more than 15 years of education had an adjusted risk ratio for stillbirth of 0.64(95% CI 0.56 to 0.72). The corresponding adjusted risk ratios for neonatal mortality, postneonatal mortality, congenital anomalies, moderate preterm birth and small-for-gestational age were, respectively, 0.79(95% CI 0.67 to 0.93), 0.57(95% CI 0.42 to 0.78), 0.87(95% CI 0.83 to 0.91), 0.80(95% CI 0.77 to 0.83) and 0.83(95% CI 0.81 to 0.85).

Conclusion

Substantial educational inequalities in perinatal health were still present in Denmark in the first decade of the 21st century.
‘People like you?’: how people with hypertension make sense of future cardiovascular risk—a qualitative study
Authors: Marshall Iain J , Wolfe Charles D A , McKevitt Christopher
Published: November 2018

Objectives

Cardiovascular disease (CVD) prevention guidelines recommend that patients’ future CVD risk (as a percentage) is estimated and used to inform shared treatment decisions. We sought to understand the perspectives of patients with hypertension on their future risk of CVD.

Design

Qualitative, semistructured interviews and thematic analysis.

Participants

People with hypertension who had not experienced a cardiovascular event recruited from primary care.

Setting

Participants were purposively sampled from two primary care practices in South London. Interviews were transcribed, and a thematic analysis was conducted.

Results

24 people participated; participants were diverse in age, sex, ethnicity and socioeconomic status. Younger working-aged people were under-represented. Contrasting with probabilistic risk, many participants understood future CVD as binary and unknowable. Roughly half of participants avoided contemplating future CVD risk; for some, lifestyle change and medication obviated the need to think about CVD risk. Some participants identified with one portion of the probability fraction (‘I’d be one ofthoseones.’). Comparison with peers (typically partners, siblings and friends of a similar age, including both ‘healthy’ and ‘unhealthy’ people) was most frequently used to describe risk, both among those who engaged with and avoided risk discussion. This contrasts with current risk scores, which describe probabilities in people with similar risk factors; many participants did not identify with such a group, and hence did not find these probabilities meaningful, even where correctly understood.

Conclusions

Risk as typically calculated and communicated (eg, the risk of ‘100 people like you’) may not be meaningful for patients who do not identify with the denominator. Comparing an individual’s risk with their peers could be more meaningful.
Assessing the impact of care pathways on potentially preventable complications and costs for spinal trauma patients: protocol for a data linkage study using cohort study and administrative data
Authors: Vaikuntam Bharat Phani , Middleton James W , McElduff Patrick , Pearse Jim , Walsh John , Cameron Ian D , Sharwood Lisa Nicole
Published: November 2018

Introduction

Traumatic spinal cord injuries have significant consequences both for the injured individual and the healthcare system, usually resulting in lifelong disability. Evidence has shown that timely medical and surgical interventions can lead to better patient outcomes with implicit cost savings. Potentially preventable secondary complications are therefore indicators of the effectiveness of acute care following traumatic injury. The extent to which policy and clinical variation within the healthcare service impact on outcomes and acute care costs for patients with traumatic spinal cord injury (TSCI) in Australia is not well described.

Methods and analysis

A comprehensive data set will be formed using record linkage to combine patient health and administrative records from seven minimum data collections (including costs), with an existing data set of patients with acute TSCI (Access to Care Study), for the time period June 2013 to June 2016. This person-level data set will be analysed to estimate the acute care treatment costs of TSCI in New South Wales, extrapolated nationally. Subgroup analyses will describe the associated costs of secondary complications and regression analysis will identify drivers of higher treatment costs. Mapping patient care and health service pathways of these patients will enable measurement of deviations from best practice care standards and cost-effectiveness analyses of the different pathways.

Ethics and dissemination

Ethics approval has been obtained from the New South Wales Population and Health Services Research Ethics Committee. Dissemination strategies include peer-reviewed publications in scientific journals and conference presentations to enable translation of study findings to clinical and policy audiences.
Randomised controlled trial to assess the impact of a lifestyle intervention (ActWELL) in women invited to NHS breast screening
Authors: Anderson Annie S , Craigie Angela Mary , Gallant Stephanie , McAdam Chloe , Macaskill E Jane , Mutrie Nanette , Neilson Aileen Rae , O’Carroll Ronan E , Rauchhaus Petra , Sattar Naveed , Stead Martine , Treweek Shaun
Published: November 2018

Introduction

In Scotland, the incidence of breast cancer is predicted to rise significantly in the next few decades and while there are measures to support reductions in morbidity and mortality, the breast cancer community is currently exploring preventative opportunities including supporting weight management programmes in postmenopausal women. This study aims to assess the effectiveness and cost-effectiveness of a theory-based, community delivered, minimal contact, weight management (diet, physical activity and behaviour change techniques) programme (ActWELL) in women with a body mass index (BMI) >25 kg/m2attending routine breast cancer screening appointments.

Methods and analysis

The study will be a four-centre, 1:1 parallel group randomised controlled trial of a 12-month weight management intervention initiated in breast cancer screening centres, delivered by trained Breast Cancer Now lifestyle coaches in community settings. The intervention programme involves two intervention meetings with coaches plus (up to) nine telephone contacts over 12 months. The programme will focus on personalised diet (including alcoholic and sugary drinks) and physical activity habits. Behaviour change techniques include self-monitoring, goal setting, implementation intentions, action and coping plans. The study has a sample size of 414 women with a BMI >25 kg/m2attending routine National Health Service breast cancer screening appointments. Measures will be taken at baseline, 12 weeks and at 12-month follow-up, complemented by qualitative interviews exploring perceived acceptability and impact on habitual behaviours. The two co-primary outcomes are mean change in measured body weight and change in physical activity between groups to 12 months. Secondary outcomes are changes in eating habits, alcohol intake, sedentary time, quality of life, waist circumference, lipid, haemoglobin A1c and insulin profiles, blood pressure and cost-effectiveness of the intervention.

Ethics and dissemination

The protocol has been approved by East of Scotland Research Ethics Committee (17/ES/0073). All participants provide written informed consent. Dissemination will be through peer-reviewed publication and conference presentations.

Trial registration number

ISRCTN11057518; Pre-results.
Cohort profile of the Biomarkers of Acute Serious Illness in Children (BASIC) study: a prospective multicentre cohort study in critically ill children
Authors: Feinstein Yael , Walker Jennifer Claire , Peters Mark J , Nadel Simon , Pathan Nazima , Edmonds Naomi , Herberg Jethro , Kaforou Myrsini , Wright Victoria , Levin Michael , Ramnarayan Padmanabhan
Published: November 2018

Purpose

Despite significant progress, challenges remain in the management of critically ill children, including early identification of infection and organ failure and robust early risk stratification to predict poor outcome. The Biomarkers of Acute Serious Illness in Children study aims to identify genetic and biological pathways underlying the development of critical illness in infections and organ failure and those leading to poor outcome (death or severe disability) in children requiring emergency intensive care.

Participants

We recruited a prospective cohort of critically ill children undergoing emergency transport to four paediatric intensive care units (PICUs) in Southeast England between April 2014 and December 2016.

Findings to date

During the study period, 1017 patients were recruited by the regional PICU transport team, and blood and urine samples were obtained at/around first contact with the patient by the transport team. Consent for participation in the study was deferred until after PICU admission and 674 parents/carers were consented. Further samples (blood, urine, stool and throat swabs) were collected after consent. Samples were processed and stored for genomic, transcriptomic, proteomic and metabolomic analyses. Demographic, clinical and laboratory data at first contact, during PICU stay and at discharge, were collected, as were detailed data regarding infectious or non-infectious aetiology. In addition, 115 families have completed 12-month validated follow-up questionnaires to assess quality of life and child behaviour.

The first phase of sample analyses (transcriptomic profiling) is currently in progress.

Future plans

Stored samples will be analysed using genomic, proteomic and metabolic profiling. Advanced bioinformatics techniques will be used to identify biomarkers for early diagnosis of infection, identification of organ failure and risk stratification to predict poor outcome (death/severe disability).

Trial registration number

NCT03238040.
Smartphone problem-solving and behavioural activation therapy to reduce fear of recurrence among patients with breast cancer (SMartphone Intervention to LEssen fear of cancer recurrence: SMILE project): protocol for a randomised controlled trial
Authors: Akechi Tatsuo , Yamaguchi Takuhiro , Uchida Megumi , Imai Fuminobu , Momino Kanae , Katsuki Fujika , Sakurai Naomi , Miyaji Tempei , Horikoshi Masaru , Furukawa Toshi A , Iwata Hiroji , Uchitomi Yosuke
Published: November 2018

Introduction

One of the most common distressing conditions experienced by breast cancer survivors is fear of cancer recurrence (FCR). There is, however, no standard intervention for ameliorating FCR. Our clinical experience and previous studies have suggested the potential benefits of problem-solving therapy (PST) and behavioural activation (BA). Given the huge number of cancer survivors and limited number of therapists to competently conduct PST and BA, we have developed PST and BA smartphone applications. This study aimed to evaluate the efficacy of the smartphone-based PST (Kaiketsu-App) and BA (Genki-App) apps in reducing FCR in patients with breast cancer.

Methods and analysis

The SMartphone Intervention to LEssen fear of cancer recurrence project is an open-label, individually randomised, parallel-group trial. Allocation will be managed by a central server using a computer-generated random allocation sequence provided by an independent data centre. Participants will be randomised to smartphone-based intervention plus treatment as usual (TAU) or waitlist control with TAU alone. The primary endpoint of the study is the Japanese version of the Concerns About Recurrence Scale, which will be administered as an electronic patient-reported outcome on the patients’ smartphone after 8 weeks.

Ethics and dissemination

The present study is subject to the ethical guidelines for clinical studies published by Japan’s Ministry of Education, Science and Technology and Ministry of Health, Labour and Welfare and the modified Act on the Protection of Personal Information as well as the ethical principles established for research on humans stipulated in the Declaration of Helsinki and further amendments thereto. The protocol was approved by the Institutional Review Board of Nagoya City University on 15 January 2018 (ID: 60-00-1171).

Trial status

The randomised trial, which commenced on 2 April 2018, currently enrols participants. The estimated end date for this study is in March 2020.

Trial registration number

UMIN000031140; Pre-results.
Establishing the prevalence of healthcare-associated infections in Australian hospitals: protocol for the Comprehensive Healthcare Associated Infection National Surveillance (CHAINS) study
Authors: Russo Philip L , Stewardson Andrew , Cheng Allen C , Bucknall Tracey , Marimuthu Kalisvar , Mitchell Brett G
Published: November 2018

Introduction

A healthcare-associated infection (HAI) data point prevalence study (PPS) conducted in 1984 in Australian hospitals estimated the prevalence of HAI to be 6.3%. Since this time, there have been no further national estimates undertaken. In the absence of a coordinated national surveillance programme or regular PPS, there is a dearth of national HAI data to inform policy and practice priorities.

Methods and analysis

A national HAI PPS study will be undertaken based on the European Centres for Disease Control method. Nineteen public acute hospitals will participate. A standardised algorithm will be used to detect HAIs in a two-stage cluster design, random sample of adult inpatients in acute wards and all intensive care unit patients. Data from each hospital will be collected by two trained members of the research team. We will estimate the prevalence of HAIs, invasive device use, single room placement and deployment of transmission-based precautions.

Ethics and dissemination

Ethics approval was obtained from the Alfred Health Human Research Ethics Committee (HREC/17/Alfred/203) via the National Mutual Assessment. A separate approval was obtained from the Tasmanian Health and Medical Human Research Committee (H0016978) for participating Tasmanian hospitals. Findings will be disseminated in individualised participating hospital reports, peer-reviewed publications and conference presentations.
Variations in hospital inpatient palliative care service use: a retrospective cohort study
Authors: Assareh Hassan , Stubbs Joanne M , Trinh Lieu T T , Greenaway Sally , Agar Meera , Achat Helen M
Published: November 2018

Objective

Use of palliative care in hospitals for people at end of life varies. We examined rate and time of in-hospital palliative care use and associated interhospital variations.

Methods

We used admissions from all hospitals in New South Wales, Australia, within a 12-month period, for a cohort of adults who died in 73 public acute care hospitals between July 2010 and June 2014. Receiving palliative care and its timing were based on recorded use.

Results

Among 90 696 adults who died, 27% received palliative care, and the care was initiated 7.6 days (mean; SD: 3.3 days) before death. Over the 5-year period, the palliative care rate rose by 58%, varying extent across chronic conditions. The duration of palliative care before death declined by 7%. Patient (demographics, morbidities and service use) and hospital factors (size, location and availability of palliative care unit) explained half of the interhospital variation in outcomes: adjusted IQR in rate and duration of palliative care among hospitals were 23%–39% and 5.2–8.7 days, respectively. Hospitals with higher rates often initiated palliative care earlier (correlation: 0.39; p<0.01).

Conclusion

Despite an increase over time in the palliative care rate, its initiation was late and of brief duration. Palliative care use was associated with patient and hospital characteristics; however, half of the between hospital variation remained unexplained. The observed suboptimal practices and variability indicate the need for expanded and standardised use of palliative care supported by assessment tools, service enhancement and protocols.
Storage of prescription veterinary medicines on UK dairy farms: a cross‐sectional study
Authors: Rees Gwen M , Barrett David C , Buller Henry , Mills Harriet L , Reyher Kristen K
Published: November 2018

Prescription veterinary medicine (PVM) use in the UK is an area of increasing focus for the veterinary profession. While many studies measure antimicrobial use on dairy farms, none report the quantity of antimicrobials stored on farms, nor the ways in which they are stored. The majority of PVM treatments occur in the absence of the prescribing veterinarian, yet there is an identifiable knowledge gap surrounding PVM use and farmer decision making. To provide an evidence base for future work on PVM use, data were collected from 27 dairy farms in England and Wales in Autumn 2016. The number of different PVMs stored on farms ranged from 9 to 35, with antimicrobials being the most common therapeutic group stored. Injectable antimicrobials comprised the greatest weight of active ingredient found, while intramammary antimicrobials were the most frequent unit of medicine stored. Antimicrobials classed by the European Medicines Agency as critically important to human health were present on most farms, and the presence of expired medicines and medicines not licensed for use in dairy cattle was also common. The medicine resources available to farmers are likely to influence their treatment decisions; therefore, evidence of the PVM stored on farms can help inform understanding of medicine use.
Cross‐sectional study on viraemia and shedding of porcine circovirus type 2 in a subclinically infected multiplier sow herd
Authors: Eddicks Matthias , Beuter Bettina , Stuhldreier Ralf , Nolte Thomas , Reese Sven , Sutter Gerd , Ritzmann Mathias , Fux Robert
Published: November 2018

Vertical and horizontal transmission of porcine circovirus type 2 (PCV2) plays an important role for the spread of PCV2 within piglet‐producing farms and following production steps. Further information is crucial to learn about the principles of PCV2 circulation among sows in piglet‐producing farms to improve preventive healthcare concerning porcine circovirus diseases (PCVD) in downstream production steps. The present study was conducted as a cross‐sectional study in a 400 sow multiplier herd in Germany with no PCV2 vaccination. Blood, faeces and saliva of the sows in all stages of production were tested for PCV2‐DNA by real‐time PCR. Results were analysed under respect of the parity and stage of production of the sows. PCV2‐DNA in faeces or saliva was observed especially in young sows. Highest rates of viraemia in productive sows were found in the early stages of pregnancy. The results revealed that particularly gilts from the quarantine and rearing area and sows up to the second parity play a major role for the spread of PCV2 and thus for the maintenance of PCV2 infection in sow herds. Furthermore, the stage of production had a significant influence on the detection rate of PCV2‐DNA in serum, saliva or faeces of the sows.
Exploratory metagenomic analyses of periweaning failure‐to‐thrive syndrome‐affected pigs
Authors: Franzo Giovanni , Kekarainen Tuija , Llorens Anna , Correa‐Fiz Florencia , Segalés Joaquim
Published: November 2018

Modern pig farming is characterised by the emergence of several syndromes whose aetiology is unclear or has a multifactorial origin, including periweaning failure‐to‐thrive syndrome (PFTS). In fact, its specific aetiology remains elusive, although several causes have been investigated over time. The present study aimed to investigate the potential role of viral agents in PFTS‐affected and healthy animals by evaluating the virome composition of different organs using a metagenomic approach. This analysis allowed demonstrating a higher abundance of Porcine parvovirus 6 (PPV6) in healthy subjects while Ungulate bocaparvovirus 2 (BoPV2), Ungulate protoparvovirus 1 (PPV) and Porcine circovirus 3 (PCV‐3) were increased in pigs with PFTS. No differential abundance of RNA viruses was found between PFTS‐affected and control pigs. Remarkably, this is the first molecular characterisation of PPV6 and BoPV2 in Spain and one of the few all around the world, supporting their apparent widespread circulation. Interestingly, PCV‐3 has been recently identified in several clinical‐pathological conditions as well as in healthy pigs, while BoPV2 pathogenic potential is unknown. Although obtained results must be taken as preliminary, they open the door for further studies on the potential role of these viruses or their combination as predisposing factor/s for PFTS occurrence.
Linking anglers, fish, and management in a catch-and-release steelhead trout fishery
Authors: Pitman Kara J. , Wilson Samantha M. , Sweeney-Bergen Elissa , Hirshfield Paddy , Beere Mark C. , Moore Jonathan W.
Published: November 2018

Fisheries are complex social–ecological systems with multiple potential linkages between fish and anglers. Understanding these linkages helps to support effective fisheries management. We examine the social–ecological dynamics of a recreational fishery by assessing relationships between fish, anglers, and a management intervention. We focus on catch-and-release steelhead trout (Oncorhynchus mykiss) fisheries on six rivers within the Skeena River watershed, British Columbia, Canada, the location of a recent management intervention. First, based on analyses of annual steelhead trout abundance and annual angler effort information, we found that years with a higher abundance of returning steelhead trout were associated with years of higher catch rates and angler effort. Second, based on analyses of nonresident angler effort, we discovered that a new management intervention provided periods of lower angler effort, but effort was apparently redistributed to other rivers and time periods. Third, responses from angler interviews post-management intervention revealed that anglers were more satisfied if they caught more fish and experienced less crowding; at higher crowding levels, higher catch rates were required to increase angler satisfaction. In conclusion, we found that this recreational fishery is influenced by both human dimensions and natural ecological dynamics such as fish population fluctuations.
Biogeography and adaptations of torquaratorid acorn worms (Hemichordata: Enteropneusta) including two new species from the Canadian Arctic
Authors: Jabr Noura , Archambault Philippe , Cameron Christopher B.
Published: November 2018

The enteropneust family Torquaratoridae, discovered in 2005, has the fewest species of the four living families. It is composed of seven species that live on the cold, deep-sea floor. Torquarator bullocki Holland, Clague, Gordon, Gebruk, Pawson and Vecchione, 2005 was the first species described and collected from the Northeastern Pacific. Two new species of Torquaratoridae were collected from the Eastern Pacific and described as Tergivelum baldwinae Holland, Jones, Ellena, Ruhl and Smith, 2009 and Allapasus aurantiacus Holland, Kuhnz and Osborn, 2012. A further three species have been collected from the North Atlantic: Yoda purpurata Priede, Osborn, Gebruk, Jones, Shale, Rogacheva and Holland, 2012, Allapasus isidis Priede, Osborn, Gebruk, Jones, Shale, Rogacheva and Holland, 2012, and Tergivelum cinnabarinum Priede, Osborn, Gebruk, Jones, Shale, Rogacheva and Holland, 2012. The latest Torquaratoridae species was collected from the Russian Arctic in 2013. We add two new species to the Torquaratoridae from Baffin Bay and Viscount Melville Sound, in the eastern Arctic of Canada. Terminstomo arcticus gen. nov. and sp. nov. was collected at a depth of 505 m and is characterized by lacking a heart and a stomochord that extends from the posterior end of the proboscis through the entire length of the collar. Allapasus fuscus sp. nov. was collected from a depth of 444 m and is characterized by a typhlosole process along the dorsal midline of the collar buccal cavity.
Textural Region Denoising: Application in Agriculture
Authors: Kittisuwan Pichid
Published: November 2018

Geo-science and remote sensing technologies play enormous roles in agriculture nowadays, especially in analysis of data from aerial images such as satellite images and drone images. Most agricultural images contain more textural regions than non-textural regions. Therefore, data management in terms of textural regions is very important. Indeed, additive white Gaussian noise (AWGN) is the fundamental problem in digital image analysis. In wavelet transform, Bayesian estimation is useful in several noise reduction methods. The Bayesian technique requires a prior modeling of noise-free wavelet coefficients. In non-textural regions, the wavelet coefficients might be better modeled by super-Gaussian density such as Laplacian, Pearson type VII, Cauchy, and two-sided gamma distributions. However, the statistical model of textural regions is Gaussian model. Therefore, in agricultural images, we require flexible model between super-Gaussian and Gaussian models. In fact, the generalized Gaussian distribution (GGD) is the suitable model for this problem. Therefore, we present new maximum a posteriori (MAP) estimator for spacial case of GGD in AWGN. Here, we obtained the analytical form solution. Moreover, this research work will also describe limitations of GGD application in Bayesian estimator. The simulation results illustrate that our presented method outperforms the state-of-the-art methods qualitatively and quantitatively.
Peridynamics with Corrected Boundary Conditions and Its Implementation in Multiscale Modeling of Rolling Contact Fatigue
Authors: Ghaffari Mir Ali , Gong Yanjue , Attarian Siamak , Xiao Shaoping
Published: November 2018

There is a boundary effect due to incomplete horizons of boundary or near-boundary points in peridynamics. In this paper, we propose to attach “fictitious walls” to boundary surfaces so that the boundary effect can be reduced or eliminated. Differing from the concept of “fictitious material layers”, which is only attached to displacement boundary surfaces, “fictitious walls” are attached to both displacement and force boundary surfaces. Three types of fictitious walls are considered in this paper: undeformed, deformed, and periodic. It is recommended to attach “undeformed fictitious walls” to displacement boundaries and “deformed fictitious walls” to force boundaries. “Periodic fictitious walls” are suggested for use in peristatics only. In addition, peridynamics with corrected boundary conditions is then implemented in a hierarchical multiscale method to study rolling contact fatigue. In this hierarchical multiscale framework, the coefficient of friction is passed from molecular dynamics simulations to peridynamics, which models crack initiation and propagation in rolling contact simulations.
Global Stabilization for a class of nonlinear fractional-order systems
Authors: Liu Taide , Wang Feng , Lu Wanchun , Wang Xuhuan
Published: November 2018

The problem of Mittag–Leffler stabilization (MLS) is studied for a class of nonlinear non-integer order systems. The stabilizer is constructed by using the Lyapunov function and backstepping algorithm. The continuous controller is designed to ensure that the state of the nonlinear fractional-order closed-loop system converges to the equilibrium. Two simulation examples are given to illustrate the effectiveness of the method.
Raiders of the Lost Mud: the geology behind drilling incidents within the Balder Formation around the Corona Ridge, West of Shetland
Authors: Watson Douglas , Schofield Nick , Maguire Alistair , Telford Christine , Mark Niall , Archer Stuart , Hardman Jonathon
Published: November 2018

The Faroe–Shetland Basin, NE Atlantic continental margin, hosts a number of important hydrocarbon fields; although deep water and narrow weather windows mean that drilling costs are considerably higher than for other parts of the UK Continental Shelf. Any additional drilling complications are therefore important to predict and negate as such issues can result in avoidable multi-million pound cost implications. This study focuses on the Corona Ridge, an intrabasinal high which contains the Rosebank Field, where a plethora of drilling issues, of enigmatic origin, are common within a key stratigraphic marker known as the Balder Formation. Drilling fluid loss, bit balling, wellbore breakouts and wellbore ‘ballooning’, where lost drilling fluid returns to the wellbore, are all recognized within the Balder Formation along the Corona Ridge. We find that many of the drilling incidents can be traced back to both the lithological character of the Balder Formation and the mid-Miocene tectonic inversion of the Corona Ridge. Moreover, we find that this geological explanation has wider implications for exploration in the region, including the mitigation of drilling incidents in future wells through drill-bit selection.

Supplementary material
: A table detailing the drilling acronyms and terminology used in this study (adapted from Mark
et al.
2018) is available at
https://doi.org/10.6084/m9.figshare.c.4290602
SmartTransfer
Authors: Du Bowen , Cui Yifeng , Fu Yanjie , Zhong Runxing , Xiong Hui
Published: November 2018

In urban transportation systems, transfer stations refer to hubs connecting a variety of bus and subway lines and, thus, are the most important nodes in transportation networks. The pervasive availability of large-scale travel traces of passengers, collected from automated fare collection (AFC) systems, has provided unprecedented opportunities for understanding citywide transfer patterns, which can benefit smart transportation, such as smart route recommendation to avoid crowded lines, and dynamic bus scheduling to enhance transportation efficiency. To this end, in this article, we provide a systematic study of the measurement, patterns, and modeling of spatiotemporal dynamics of passenger transfers. Along this line, we develop a data-driven analytical system for modeling the transfer volumes of each transfer station. More specifically, we first identify and quantify the discriminative patterns of spatiotemporal dynamics of passenger transfers by utilizing heterogeneous sources of transfer related data for each station. Also, we develop a multi-task spatiotemporal learning model for predicting the transfer volumes of a specific station at a specific time period. Moreover, we further leverage the predictive model of passenger transfers to provide crowdedness-aware route recommendations. Finally, we conduct the extensive evaluations with a variety of real-world data. Experimental results demonstrate the effectiveness of our proposed modeling method and its applications for smart transportation.