Prevalence of cervical disease at age 20 after immunisation with bivalent HPV vaccine at age 12-13 in Scotland: retrospective population study

The manuscript was reviewed by Jo’s Trust, which supports the conclusions. It made the following statement: We think (it has) massive implications for the screening programme, vaccine and also impact on diagnoses in the future. It gives weight for activity to increase vaccine uptake, has implications on screening intervals. The clinically relevant herd protection is very interesting too. It also feeds into our policy calls for a new IT infrastructure (for the screening programme in England) to record and enable invitations based on whether someone has at the vaccine if intervals can be extended. Funding: This study has been undertaken as part of the programme of surveillance of immunisation against human papillomavirus in Scotland, included within the routine work of Health Protection Scotland, a part of the Scottish National Health Service. No funding has been received from industry.Peer reviewedPublisher PD

Two-color double-cloth development in alignment with subtractive CMYK color theory by deploying digital technology

This study aims to introduce new aesthetic values of modern double-cloth by resolving the current restriction in woven textile coloration. Previously, realizing pictorial images on both sides of a fabric was experimented with two weft yarns and further possibility was suggested to extend an applicable number of weft yarns for which a prototype of two-color double-cloth was tested and fabricated by employing four weft yarns. In this study, therefore, reproduction of highly complicated patterns in a two-color shading effect is aimed to further develop the current double-cloth design capability. The core principle lies on weave structure design to interweave two sets of warps and wefts into separate layers whilst two distinctive images are designed in alignment with CMYK color theory to enlarge a feasible weave color scope by using the subtractive primary yarn colors. Details of digital weave pattern design and weave structure development are explained based on empirical experiment results

A pilot study of the use of near-patient C-Reactive Protein testing in the treatment of adult respiratory tract infections in one Irish general practice

<p>Abstract</p> <p>Background</p> <p>New approaches are being sought to safely reduce community antibiotic prescribing. A recent study demonstrated that CRP testing resulted in decreased antibiotic prescribing for lower respiratory tract infection in primary care. There is little other published primary care data available evaluating CRP in the treatment of lower respiratory tract infections in routine clinical practice. This pilot study aims to describe the performance of near-patient CRP testing, in a mixed payments health system. Specific areas to be reviewed included the integrity of the study protocol, testing of data collection forma and acceptability of the intervention.</p> <p>Patients</p> <p>Patients over the age of 18 years, with acute cough and/or sore throat with a duration of one month or less, in routine clinical practice.</p> <p>Method</p> <p>Design: A pilot with a cross-sectional design. The first 60 recruited patients were treated with routine clinical management, and GP's had no access to a CRP test. For the subsequent 60 patients, access to CRP testing was available.</p> <p>Participants: 3 GP's in one Irish primary care practice recruited 120 patients, fulfilling the above criteria over five months, from January 1 to May 31, 2010.</p> <p>Main outcome measures: The primary outcome was antibiotic prescription at the index consultation. Secondary outcomes were the numbers of delayed prescriptions issued, patient satisfaction immediately after consultation and re-consultations and antibiotic prescriptions during 28 days follow-up.</p> <p>Results</p> <p>The protocol and data collection forms worked well and the intervention of CRP testing appeared acceptable. Thirty-five (58%) patients in the no-test group received antibiotic prescriptions compared to 27 (45%) in the test group. Both groups demonstrated similarly high level of patient satisfaction (85%). Fourteen (23%) patients in the CRP test group re-attended within 28 days compared to 9 (15%) in the no-CRP test group.</p> <p>Conclusion</p> <p>This pilot study confirms the potential feasibility of a full trial in Irish general practice. Further consideration of possible increased re-attendance rates in a mixed payments health system is appropriate. We intend to pursue a larger trial in a newly established regional primary care research network.</p

Data linkage and statistical modelling to provide stratified risk assessment for HAI

Objectives: The use of “real-time” data to support individual patient management and outcome assessment requires the development of risk assessment models. This could be delivered through a learning health system by the building robust statistical analysis tools onto the existing linked data held by NHS Scotland’s Infection Intelligence Platform (IIP) and developed within the Scottish Healthcare Associated Infection Prevention Institute (SHAIPI). This project will create prediction models for the risk of acquiring a healthcare associated infection (HAI), and particular outcomes, at the point of GP consultation/ hospital admission which could aid clinical decision making. Approach: We demonstrate the capability using the HAI Clostridium difficile (CDI) from 2010-2013. Using linked national individual level data on community prescribing, hospitalisations, infections and death records we extracted all cases of CDI and by comparing to matched population-based controls, examined the impact of prior hospital admissions, care home residence, comorbidities, exposure to gastric acid suppressive drugs and antibiotic exposure, defined as both cumulative (total defined daily dose (DDD)) and temporal antimicrobial exposure in the previous 6 months, to the risk of CDI acquisition. Antimicrobial exposure was considered for all drugs and the higher risk broad spectrum antibiotics (4Cs). Associations are assessed using conditional logistic regression. Using cross-validation we assess the ability of the model to accurately predict CDI infection. Risk scores for acquisition of CDI are estimated by combining these predictions with age and gender population incidence. Results: In the period 2010-2013 there were 1446 cases of CDI with matched 7964 controls. A significant dose-response relationship for exposure to any antimicrobial (1-7 DDDs OR=2.3 rising to OR=4.4 for 29+ DDDs) and, with elevated risk, to the 4C group (1-7 DDDs OR=3.8 rising to OR=17.9 for 29+ DDDs). Exposure elevates CDI risk most in the month after prescription but for 4C antimicrobials the elevated risk remains 6 months later (4C OR=12.4 within 1 month, OR=2.6 4-6 months later). The risk of CDI was also increased with more co-morbidities, previous hospitalisations, care home residency, increased number of prescriptions, and gastric acid suppression. Conclusion: Despite limitations to current application in practice,(paucity of patient level in-hospital prescribing data and constraints of the timeliness of the data), when fully developed this system will enable risk classification to identify patients most at risk of HAI and adverse outcomes to aid clinical decision making

Data linkage and statistical modelling to provide stratified risk assessment for HAI

Objectives: The use of “real-time” data to support individual patient management and outcome assessment requires the development of risk assessment models. This could be delivered through a learning health system by the building robust statistical analysis tools onto the existing linked data held by NHS Scotland’s Infection Intelligence Platform (IIP) and developed within the Scottish Healthcare Associated Infection Prevention Institute (SHAIPI). This project will create prediction models for the risk of acquiring a healthcare associated infection (HAI), and particular outcomes, at the point of GP consultation/ hospital admission which could aid clinical decision making. Approach: We demonstrate the capability using the HAI Clostridium difficile (CDI) from 2010-2013. Using linked national individual level data on community prescribing, hospitalisations, infections and death records we extracted all cases of CDI and by comparing to matched population-based controls, examined the impact of prior hospital admissions, care home residence, comorbidities, exposure to gastric acid suppressive drugs and antibiotic exposure, defined as both cumulative (total defined daily dose (DDD)) and temporal antimicrobial exposure in the previous 6 months, to the risk of CDI acquisition. Antimicrobial exposure was considered for all drugs and the higher risk broad spectrum antibiotics (4Cs). Associations are assessed using conditional logistic regression. Using cross-validation we assess the ability of the model to accurately predict CDI infection. Risk scores for acquisition of CDI are estimated by combining these predictions with age and gender population incidence. Results: In the period 2010-2013 there were 1446 cases of CDI with matched 7964 controls. A significant dose-response relationship for exposure to any antimicrobial (1-7 DDDs OR=2.3 rising to OR=4.4 for 29+ DDDs) and, with elevated risk, to the 4C group (1-7 DDDs OR=3.8 rising to OR=17.9 for 29+ DDDs). Exposure elevates CDI risk most in the month after prescription but for 4C antimicrobials the elevated risk remains 6 months later (4C OR=12.4 within 1 month, OR=2.6 4-6 months later). The risk of CDI was also increased with more co-morbidities, previous hospitalisations, care home residency, increased number of prescriptions, and gastric acid suppression. Conclusion: Despite limitations to current application in practice,(paucity of patient level in-hospital prescribing data and constraints of the timeliness of the data), when fully developed this system will enable risk classification to identify patients most at risk of HAI and adverse outcomes to aid clinical decision making

The Astrophysical S-Factor of the Reaction 7^7be(p,γ\gamma)8^8B in the Direct Capture Model

The astrophysical $S$-factor for the reaction $^7$Be(p,$\gamma$)$^8$B up to an energy of 2~MeV (c.m.) and the capture cross section of $^7$Li(n,$\gamma$)$^8$Li up to 1~MeV (c.m.) are calculated using the Direct Capture model (DC). Both calculations are in good agreement with experimental data.Comment: 18 pages, 5 figures (available from author on request), Annalen der Physik in press, 199

Multi-frequency study of DEM L299 in the Large Magellanic Cloud

We have studied the HII region DEM L299 in the Large Magellanic Cloud to understand its physical characteristics and morphology in different wavelengths. We performed a spectral analysis of archived XMM-Newton EPIC data and studied the morphology of DEM L299 in X-ray, optical, and radio wavelengths. We used H alpha, [SII], and [OIII] data from the Magellanic Cloud Emission Line Survey and radio 21 cm line data from the Australia Telescope Compact Array (ATCA) and the Parkes telescope, and radio continuum data from ATCA and the Molonglo Synthesis Telescope. Our morphological studies imply that, in addition to the supernova remnant SNR B0543-68.9 reported in previous studies, a superbubble also overlaps the SNR in projection. The position of the SNR is clearly defined through the [SII]/H alpha flux ratio image. Moreover, the optical images show a shell-like structure that is located farther to the north and is filled with diffuse X-ray emission, which again indicates the superbubble. Radio 21 cm line data show a shell around both objects. Radio continuum data show diffuse emission at the position of DEM L299, which appears clearly distinguished from the HII region N 164 that lies south-west of it. We determined the spectral index of SNR B0543-68.9 to be alpha=-0.34, which indicates the dominance of thermal emission and therefore a rather mature SNR. We determined the basic properties of the diffuse X-ray emission for the SNR, the superbubble, and a possible blowout region of the bubble, as suggested by the optical and X-ray data. We obtained an age of 8.9 (3.5-18.1) kyr for the SNR and a temperature of 0.64 (0.44-1.37) keV for the hot gas inside the SNR, and a temperature of the hot gas inside the superbubble of 0.74 (0.44-1.1) keV. We conclude that DEM L299 consists of a superposition of SNR B0543-68.9 and a superbubble, which we identified based on optical data.Comment: Accepted for publication in Astronomy and Astrophysics. 17 pages, 16 figure

Structure Effects on Coulomb Dissociation of 8^8B

Coulomb Dissociation provides an alternative method for determining the radiative capture cross sections at astrophysically relevant low relative energies. For the breakup of $^8$B on $^{58}$Ni, we calculate the total Coulomb Dissociation cross section and the angular distribution for E1, E2 and M1. Our calculations are performed first within the standard first order semiclassical theory of Coulomb Excitation, including the correct three body kinematics, and later including the projectile-target nuclear interactions.Comment: 6 pages, proceedings from International Workshop on RNB, Puri, India, January 1998 - to be published in J. Phys.

Cost burden of Clostridioides difficile infection to the health service:A retrospective cohort study in Scotland

BACKGROUND:Clostridioides difficile infection (CDI) is associated with high healthcare demands and related costs. AIM:To evaluate the healthcare and economic burden of CDI in hospitalised patients with community- (HOCA-CDI) or hospital-associated CDI (HOHA-CDI) in the National Health Service in Scotland. METHODS:A retrospective cohort study was conducted, examining data between August 2010 and July 2013 from four patient-level Scottish datasets, linked to death data. Data examined included prior antimicrobial prescriptions in the community, hospitalisations, length of stay and mortality. Each CDI case was matched to three hospital-based controls on the basis of age, gender, hospital and date of admission. Descriptive economic evaluations were based on bed-day costs for different types of wards. FINDINGS:Overall, 3304 CDI cases were included in the study. CDI was associated with additional median lengths of stay of 7.2 days for HOCA-CDI and 12.0 days for HOHA-CDI compared with their respective, matched controls. The 30-day mortality rate was 6.8% for HOCA-CDI and 12.4% for HOHA-CDI. Overall, recurrence within 90 days of the first CDI episode occurred in 373/2740 (13.6%) survivors. The median additional expenditure for each initial CDI case compared with matched controls was £1713. In the 6 months after the index hospitalisation, the cost associated with a CDI case was £5126 higher than for controls. CONCLUSION:Using routinely collected national data, we demonstrate the substantial burden of CDI on healthcare services, including lengthy hospital stays and readmissions, which increase the costs of managing patients with CDI compared with matched controls