Association between continuity of provider-adjusted regularity of general practitioner contact and unplanned diabetes-related hospitalisation: A data linkage study in New South Wales, Australia, using the 45 and Up Study cohort

© Author(s) (or their employer(s)) 2019. Re-use permitted under CC BY-NC. No commercial re-use. See rights and permissions. Published by BMJ. Objective To assess the association between continuity of provider-adjusted regularity of general practitioner (GP) contact and unplanned diabetes-related hospitalisation or emergency department (ED) presentation. Design Cross-sectional study. Setting Individual-level linked self-report and administrative health service data from New South Wales, Australia. Participants 27 409 survey respondents aged ≥45 years with a prior history of diabetes and at least three GP contacts between 1 July 2009 and 30 June 2015. Main outcome measures Unplanned diabetes-related hospitalisations or ED presentations, associated costs and bed days. Results Twenty-one per cent of respondents had an unplanned diabetes-related hospitalisation or ED presentation. Increasing regularity of GP contact was associated with a lower probability of hospitalisation or ED presentation (19.9% for highest quintile, 23.5% for the lowest quintile). Conditional on having an event, there was a small decrease in the number of hospitalisations or ED presentations for the low (-6%) and moderate regularity quintiles (-8%), a reduction in bed days (ranging from -30 to -44%) and a reduction in average cost of between -23% and -41%, all relative to the lowest quintile. When probability of diabetes-related hospitalisation or ED presentation was included, only the inverse association with cost remained significant (mean of A3798 to A6350 less per individual, compared with the lowest regularity quintile). Importantly, continuity of provider did not significantly modify the effect of GP regularity for any outcome. Conclusions Higher regularity of GP contact - that is more evenly dispersed, not necessarily more frequent care - has the potential to reduce secondary healthcare costs and, conditional on having an event, the time spent in hospital, irrespective of continuity of provider. These findings argue for the advocacy of regular care, as distinct from solely continuity of provider, when designing policy and financial incentives for GP-led primary care

Immune Antibodies and Helminth Products Drive CXCR2-Dependent Macrophage-Myofibroblast Crosstalk to Promote Intestinal Repair.

Helminth parasites can cause considerable damage when migrating through host tissues, thus making rapid tissue repair imperative to prevent bleeding and bacterial dissemination particularly during enteric infection. However, how protective type 2 responses targeted against these tissue-disruptive multicellular parasites might contribute to homeostatic wound healing in the intestine has remained unclear. Here, we observed that mice lacking antibodies (Aid-/-) or activating Fc receptors (Fcrg-/-) displayed impaired intestinal repair following infection with the murine helminth Heligmosomoides polygyrus bakeri (Hpb), whilst transfer of immune serum could partially restore chemokine production and rescue wound healing in Aid-/- mice. Impaired healing was associated with a reduced expression of CXCR2 ligands (CXCL2/3) by macrophages (MΦ) and myofibroblasts (MF) within intestinal lesions. Whilst antibodies and helminths together triggered CXCL2 production by MΦ in vitro via surface FcR engagement, chemokine secretion by intestinal MF was elicited by helminths directly via Fcrg-chain/dectin2 signaling. Blockade of CXCR2 during Hpb challenge infection reproduced the delayed wound repair observed in helminth infected Aid-/- and Fcrg-/- mice. Finally, conditioned media from human MΦ stimulated with infective larvae of the helminth Ascaris suum together with immune serum, promoted CXCR2-dependent scratch wound closure by human MF in vitro. Collectively our findings suggest that helminths and antibodies instruct a chemokine driven MΦ-MF crosstalk to promote intestinal repair, a capacity that may be harnessed in clinical settings of impaired wound healing

Current Distribution in the Three-Dimensional Random Resistor Network at the Percolation Threshold

We study the multifractal properties of the current distribution of the three-dimensional random resistor network at the percolation threshold. For lattices ranging in size from $8^3$ to $80^3$ we measure the second, fourth and sixth moments of the current distribution, finding {\it e.g.\/} that $t/\nu=2.282(5)$ where $t$ is the conductivity exponent and $\nu$ is the correlation length exponent.Comment: 10 pages, latex, 8 figures in separate uuencoded fil

Neutron EDM from Electric and Chromoelectric Dipole Moments of Quarks

Using QCD sum rules, we calculate the electric dipole moment of the neutron d_n induced by all CP violating operators up to dimension five. We find that the chromoelectric dipole moments of quarks \tilde d_i, including that of the strange quark, provide significant contributions comparable in magnitude to those induced by the quark electric dipole moments d_i. When the theta term is removed via the Peccei-Quinn symmetry, the strange quark contribution is also suppressed and d_n =(1\pm 0.5)[1.1e(\tilde d_d + 0.5\tilde d_u)+1.4(d_d-0.25d_u)].Comment: 4 pages, revtex, v2: missing overall factor of two reinstate

Numerical Solutions of ideal two-fluid equations very closed to the event horizon of Schwarzschild black hole

The 3+1 formalism of Thorne, Price and Macdonald has been used to derive the linear two-fluid equations describing transverse and longitudinal waves propagating in the two-fluid ideal collisionless plasmas surrounding a Schwarzschild black hole. The plasma is assumed to be falling in radial direction toward the event horizon. The relativistic two-fluid equations have been reformulate, in analogy with the special relativistic formulation as explained in an earlier paper, to take account of relativistic effects due to the event horizon. Here a WKB approximation is used to derive the local dispersion relation for these waves and solved numerically for the wave number k.Comment: 16 pages, 15 figures. arXiv admin note: text overlap with arXiv:0902.3766, arXiv:0807.459

Hadron Production in Heavy Ion Collisions

We review hadron production in heavy ion collisions with emphasis on pion and kaon production at energies below 2 AGeV and on partonic collectivity at RHIC energies.Comment: 31 pages, 26 figures, accepted for publication in Landolt-Boernstein Volume 1-23

A Study of the S=1/2 Alternating Chain using Multiprecision Methods

In this paper we present results for the ground state and low-lying excitations of the $S=1/2$ alternating Heisenberg antiferromagnetic chain. Our more conventional techniques include perturbation theory about the dimer limit and numerical diagonalization of systems of up to 28 spins. A novel application of multiple precision numerical diagonalization allows us to determine analytical perturbation series to high order; the results found using this approach include ninth-order perturbation series for the ground state energy and one magnon gap, which were previously known only to third order. We also give the fifth-order dispersion relation and third-order exclusive neutron scattering structure factor for one-magnon modes and numerical and analytical binding energies of S=0 and S=1 two-magnon bound states.Comment: 16 pages, 9 figures. for submission to Phys.Rev.B. PICT files of figs available at http://csep2.phy.ornl.gov/theory_group/people/barnes/barnes.htm

Ecological management of cereal stemborers in African smallholder agriculture through behavioural manipulation

1. Africa faces serious challenges in feeding its rapidly growing human population owing to the poor productivity of maize and sorghum, the most important staple crops formillions of smallholder farmers in the continent,with yields being among the lowest in the world. 2. A complex of lepidopterous stemborers attack cereals in Africa. However, their effective control is difficult, largely as a result of the cryptic and nocturnal habits of moths, and protection provided by host stem for immature pest stages.Moreover, current control measures are uneconomical and impractical for resource-poor farmers. 3. An ecological approach, based on companion planting, known as ‘push–pull’, provides effective management of these pests, and involves combined use of inter- and trap cropping systems where stemborers are attracted and trapped on trap plants with added economic value (‘pull’), and are driven away from the cereal crop by antagonistic intercrops (‘push’). 4. Novel defence strategies inducible by stemborer oviposition have recently been discovered, leading to the attraction of egg and larval parasitoids, in locally adapted maize lines but not in elite hybrids. We also established that landscape complexity did not improve the ecosystem service of biological control, but rather provided a disservice by acting as a ‘source’ of stemborer pests colonising the crop. 5. Here we review and provide new data on the direct and indirect effects of the push–pull approach on stemborers and their natural enemies, including the mechanisms involved, and highlight opportunities for exploiting intrinsic plant defences and natural ecosystem services in pest management in smallholder farming systems in Africa

Sum rules and energy scales in the high-temperature superconductor YBa2Cu3O6+x

The Ferrell-Glover-Tinkham (FGT) sum rule has been applied to the temperature dependence of the in-plane optical conductivity of optimally-doped YBa_2Cu_3O_{6.95} and underdoped YBa_2Cu_3O_{6.60}. Within the accuracy of the experiment, the sum rule is obeyed in both materials. However, the energy scale \omega_c required to recover the full strength of the superfluid \rho_s in the two materials is dramatically different; \omega_c \simeq 800 cm^{-1} in the optimally doped system (close to twice the maximum of the superconducting gap, 2\Delta_0), but \omega_c \gtrsim 5000 cm^{-1} in the underdoped system. In both materials, the normal-state scattering rate close to the critical temperature is small, \Gamma < 2\Delta_0, so that the materials are not in the dirty limit and the relevant energy scale for \rho_s in a BCS material should be twice the energy gap. The FGT sum rule in the optimally-doped material suggests that the majority of the spectral weight of the condensate comes from energies below 2\Delta_0, which is consistent with a BCS material in which the condensate originates from a Fermi liquid normal state. In the underdoped material the larger energy scale may be a result of the non-Fermi liquid nature of the normal state. The dramatically different energy scales suggest that the nature of the normal state creates specific conditions for observing the different aspects of what is presumably a central mechanism for superconductivity in these materials.Comment: RevTeX 4 file, 9 pages with 7 embedded eps figure