Chlamydia diagnosis rate in England in 2012: an ecological study of local authorities

Objectives Local authorities (LAs) in England commission chlamydia screening as part of the National Chlamydia Screening Programme. It is recommended that LAs achieve a chlamydia diagnosis rate of ≥2300 cases per 100 000 population aged 15–24. We describe national patterns in attainment of the chlamydia diagnosis rate recommendation and possible implications of using it to measure LA-level performance. Methods We used publicly available data sets from England (2012) to explore the association between LAs attaining the recommended chlamydia diagnosis rate and population size, socioeconomic deprivation, test setting and sex. Results We used data from 1 197 121 recorded chlamydia tests in females and 564 117 in males. The chlamydia diagnosis rate recommendation was achieved by 22% (72/324) of LAs overall (43% female population; 8% male population). LAs in the highest deprivation quintile were more likely to reach the recommendation than those in the least-deprived quintile for both sexes (women: unadjusted prevalence ratio (UPR) 7.43, 95% CI 3.65 to 15.11; men: UPR 7.00, 95% CI 1.66 to 29.58). The proportion of tests performed in genitourinary medicine clinics was negatively associated with attainment of the recommended diagnosis rate (UPR 0.95, 0.93 to 0.97). Conclusions Chlamydia diagnosis rate recommendations that reflect local area deprivation (as a proxy for disease burden) may be more appropriate than a single national target if the aim is to reduce health inequalities nationally. We suggest LAs monitor their chlamydia diagnosis rate, test coverage and test positivity across a range of measures (including setting and sex) and pre/post changes to commissioned services. Critical evaluation of performance against the recommendation should be reflected in local commissioning decisions

Spurious Eccentricities of Distorted Binary Components

I discuss the effect of physical distortion on the velocities of close binary components and how we may use the resulting distortion of velocity curves to constrain some properties of binary systems, such as inclination and mass ratio. Precise new velocities for 5 Cet convincingly detect these distortions with their theoretically predicted phase dependence. We can even use such distortions of velocity curves to test Lucy's theory of convective gravity darkening. The observed distortions for TT Hya and 5 Cet require the contact components of those systems to be gravity darkened, probably somewhat more than predicted by Lucy's theory but clearly not as much as expected for a radiative star. These results imply there is no credible evidence for eccentric orbits in binaries with contact components. I also present some speculative analyses of the observed properties of a binary encased in a non-rotating common envelope, if such an object could actually exist, and discuss how the limb darkening of some recently calculated model atmospheres for giant stars may bias my resuts for velocity-curve distortions, as well as other results from a wide range of analyses of binary stars.Comment: 14 pp, 2 tables, 12 fig; under review by Ap

Validation of chronic obstructive pulmonary disease recording in the Clinical Practice Research Datalink (CPRD-GOLD)

Objectives: The optimal method of identifying people with chronic obstructive pulmonary disease (COPD) from electronic primary care records is not known. We assessed the accuracy of different approaches using the Clinical Practice Research Datalink, a UK electronic health record database. Setting: 951 participants registered with a CPRD practice in the UK between 1 January 2004 and 31 December 2012. Individuals were selected for ≥1 of 8 algorithms to identify people with COPD. General practitioners were sent a brief questionnaire and additional evidence to support a COPD diagnosis was requested. All information received was reviewed independently by two respiratory physicians whose opinion was taken as the gold standard. Primary outcome measure: The primary measure of accuracy was the positive predictive value (PPV), the proportion of people identified by each algorithm for whom COPD was confirmed. Results: 951 questionnaires were sent and 738 (78%) returned. After quality control, 696 (73.2%) patients were included in the final analysis. All four algorithms including a specific COPD diagnostic code performed well. Using a diagnostic code alone, the PPV was 86.5% (77.5-92.3%) while requiring a diagnosis plus spirometry plus specific medication; the PPV was slightly higher at 89.4% (80.7-94.5%) but reduced case numbers by 10%. Algorithms without specific diagnostic codes had low PPVs (range 12.2-44.4%). Conclusions: Patients with COPD can be accurately identified from UK primary care records using specific diagnostic codes. Requiring spirometry or COPD medications only marginally improved accuracy. The high accuracy applies since the introduction of an incentivised disease register for COPD as part of Quality and Outcomes Framework in 2004

A new method for monitoring global volcanic activity

The ERTS Data Collection System makes it feasible for the first time to monitor the level of activity at widely separated volcanoes and to relay these data rapidly to one central office for analysis. While prediction of specific eruptions is still an evasive goal, early warning of a reawakening of quiescent volcanoes is now a distinct possibility. A prototypical global volcano surveillance system was established under the ERTS program. Instruments were installed in cooperation with local scientists on 15 volcanoes in Alaska, Hawaii, Washington, California, Iceland, Guatemala, El Salvador and Nicaragua. The sensors include 19 seismic event counters that count four different sizes of earthquakes and six biaxial borehole tiltmeters that measure ground tilt with a resolution of 1 microradian. Only seismic and tilt data are collected because these have been shown in the past to indicate most reliably the level of volcano activity at many different volcanoes. Furthermore, these parameters can be measured relatively easily with new instrumentation

The 1979 Southeastern Virginia Urban Plume Study (SEV-UPS): Surface and airborne studies

The operation of two surface monitoring stations (one in downtown Norfolk, Virginia, one south of the city near the Great Dismal Swamp) and the collection of 40 hours of airborne measurements is described. Surface site measurements of ozone, oxides of nitrogen, sulfur dioxide, temperature, dew point, b sub seat, and condensation nuclei were made. Instrument calibrations, quality assurance audits, and preliminary data analysis in support of the Urban Plume Study were also made. The air pollution problems that were addressed are discussed. Data handling procedures followed for the surface stations are presented. The operation of the aircraft sampling platform is described. Aircraft sampling procedures are discussed. A preliminary descriptive analysis of the aircraft data is given along with data or plots for surface sites, airborne studies, hydrocarbon species, and instrument performance audits. Several of the aircraft flights clearly show the presence of an urban ozone plume downwind of Norfolk in the direction of the mean wind flow

In situ sensors for measurements in the global trosposphere

Current techniques available for the in situ measurement of ambient trace gas species, particulate composition, and particulate size distribution are reviewed. The operational specifications of the various techniques are described. Most of the techniques described are those that have been used in airborne applications or show promise of being adaptable to airborne applications. Some of the instruments described are specialty items that are not commercially-available. In situ measurement techniques for several meteorological parameters important in the study of the distribution and transport of ambient air pollutants are discussed. Some remote measurement techniques for meteorological parameters are also discussed. State-of-the-art measurement capabilities are compared with a list of capabilities and specifications desired by NASA for ambient measurements in the global troposphere

Development and evaluation of a prototype global volcano surveillance system utilizing the ERTS-1 satellite data collection system

There are no author-identified significant results in this report

Frontostriatal Maturation Predicts Cognitive Control Failure to Appetitive Cues in Adolescents

Adolescent risk-taking is a public health issue that increases the odds of poor lifetime outcomes. One factor thought to influence adolescents' propensity for risk-taking is an enhanced sensitivity to appetitive cues, relative to an immature capacity to exert sufficient cognitive control. We tested this hypothesis by characterizing interactions among ventral striatal, dorsal striatal, and prefrontal cortical regions with varying appetitive load using fMRI scanning. Child, teen, and adult participants performed a go/no-go task with appetitive (happy faces) and neutral cues (calm faces). Impulse control to neutral cues showed linear improvement with age, whereas teens showed a nonlinear reduction in impulse control to appetitive cues. This performance decrement in teens was paralleled by enhanced activity in the ventral striatum. Prefrontal cortical recruitment correlated with overall accuracy and showed a linear response with age for no-go versus go trials. Connectivity analyses identified a ventral frontostriatal circuit including the inferior frontal gyrus and dorsal striatum during no-go versus go trials. Examining recruitment developmentally showed that teens had greater between-subject ventral-dorsal striatal coactivation relative to children and adults for happy no-go versus go trials. These findings implicate exaggerated ventral striatal representation of appetitive cues in adolescents relative to an intermediary cognitive control response. Connectivity and coactivity data suggest these systems communicate at the level of the dorsal striatum differentially across development. Biased responding in this system is one possible mechanism underlying heightened risk-taking during adolescence

Acute Hypoxia Alters Extracellular Vesicle Signatures and the Brain Citrullinome of Naked Mole-Rats (Heterocephalus glaber)

Peptidylarginine deiminases (PADs) and extracellular vesicles (EVs) may be indicative biomarkers of physiological and pathological status and adaptive responses, including to diseases and disorders of the central nervous system (CNS) and related to hypoxia. While these markers have been studied in hypoxia-intolerant mammals, in vivo investigations in hypoxia-tolerant species are lacking. Naked mole-rats (NMR) are among the most hypoxia-tolerant mammals and are thus a good model organism for understanding natural and beneficial adaptations to hypoxia. Thus, we aimed to reveal CNS related roles for PADs in hypoxia tolerance and identify whether circulating EV signatures may reveal a fingerprint for adaptive whole-body hypoxia responses in this species. We found that following in vivo acute hypoxia, NMR: (1) plasma-EVs were remodelled, (2) whole proteome EV cargo contained more protein hits (including citrullinated proteins) and a higher number of associated KEGG pathways relating to the total proteome of plasma-EVs Also, (3) brains had a trend for elevation in PAD1, PAD3 and PAD6 protein expression, while PAD2 and PAD4 were reduced, while (4) the brain citrullinome had a considerable increase in deiminated protein hits with hypoxia (1222 vs. 852 hits in normoxia). Our findings indicate that circulating EV signatures are modified and proteomic content is reduced in hypoxic conditions in naked mole-rats, including the circulating EV citrullinome, while the brain citrullinome is elevated and modulated in response to hypoxia. This was further reflected in elevation of some PADs in the brain tissue following acute hypoxia treatment. These findings indicate a possible selective role for PAD-isozymes in hypoxia response and tolerance