The Prevalence and Epidemiological Features of Ischaemic Heart Disease in Sri Lanka

Background: There is limited evidence on the prevalence of ischaemic heart disease (IHD) and its association with risk factors and socioeconomic status (SES) in low- and middle-income countries (LMICs). Given the relatively high levels of access to healthcare in Sri Lanka, the association of IHD with SES may be different from that observed in other LMICs. Objectives: To estimate the prevalence of IHD in Sri Lanka, determine its associated risk factors and its association with SES. Methods: We analysed data from 6,513 adults aged ≥18 years examined in the 2018/19 Sri Lanka Health and Ageing Study. We used the Rose angina questionnaire to classify participants as having angina (Angina+) and used self-report or medical records to identify participants with a history of IHD (History+). The association of Angina+ and History+ with age, ethnicity, sector of residence, education level, household SES wealth quintile, area SES wealth quintile, hypertension, diabetes, smoking, total cholesterol, cholesterol-to-HDL ratio, waist-to-hip ratio and body mass index were analysed in unadjusted and adjusted models. Additional analyses were performed to investigate sensitivity to correction for missing data and to benchmark estimates against evidence from other studies. Conclusions: We estimated prevalence of History+ of 3.9% (95% CI 3.3%-4.4%) and Angina+ of 3.0% (95% CI 2.4%-3.5%) in adults aged 18 years and over. The prevalence of Angina+ was higher in women than men (3.9% vs. 1.9%, p &lt; 0.001) whilst prevalence of History+ was lower (3.8% vs. 4.0%, p = 0.8), which may suggest a higher rate of undiagnosed IHD in women. A history of IHD was strongly associated with age, hypertension and diabetes status even after adjusting for sociodemographic factors. Though the prevalence of History+ was higher in the most developed area SES tertile and urban areas, History+ was also associated with less education but not household SES, consistent with patterns emerging from other LMICs.</p

The Prevalence and Epidemiological Features of Ischaemic Heart Disease in Sri Lanka

Background: There is limited evidence on the prevalence of ischaemic heart disease (IHD) and its association with risk factors and socioeconomic status (SES) in low- and middle-income countries (LMICs). Given the relatively high levels of access to healthcare in Sri Lanka, the association of IHD with SES may be different from that observed in other LMICs. Objectives: To estimate the prevalence of IHD in Sri Lanka, determine its associated risk factors and its association with SES. Methods: We analysed data from 6,513 adults aged ≥18 years examined in the 2018/19 Sri Lanka Health and Ageing Study. We used the Rose angina questionnaire to classify participants as having angina (Angina+) and used self-report or medical records to identify participants with a history of IHD (History+). The association of Angina+ and History+ with age, ethnicity, sector of residence, education level, household SES wealth quintile, area SES wealth quintile, hypertension, diabetes, smoking, total cholesterol, cholesterol-to-HDL ratio, waist-to-hip ratio and body mass index were analysed in unadjusted and adjusted models. Additional analyses were performed to investigate sensitivity to correction for missing data and to benchmark estimates against evidence from other studies. Conclusions: We estimated prevalence of History+ of 3.9% (95% CI 3.3%-4.4%) and Angina+ of 3.0% (95% CI 2.4%-3.5%) in adults aged 18 years and over. The prevalence of Angina+ was higher in women than men (3.9% vs. 1.9%, p &lt; 0.001) whilst prevalence of History+ was lower (3.8% vs. 4.0%, p = 0.8), which may suggest a higher rate of undiagnosed IHD in women. A history of IHD was strongly associated with age, hypertension and diabetes status even after adjusting for sociodemographic factors. Though the prevalence of History+ was higher in the most developed area SES tertile and urban areas, History+ was also associated with less education but not household SES, consistent with patterns emerging from other LMICs.</p

A review of staging chest CT in trunk and extremity soft tissue sarcoma

OBJECTIVES: To determine the incidence of pulmonary metastases on chest CT in trunk and extremity soft tissue sarcoma based on two size criteria, and to identify factors associated with metastases. METHODS: Retrospective review of chest CT studies in patients with trunk and extremity soft tissue sarcoma over an 18-month period. Data collected included patient age/sex, tumour location, size and relationship to fascia. All chest CTs were reviewed for the presence of metastases which were diagnosed according to two size criteria: multiple nodules > 5 mm in size or multiple nodules > 10 mm in size. Follow-up CT studies were reviewed in cases initially considered indeterminate. RESULTS: 127 males and 73 females were included (mean age 57.1 years; range 10–90 years). 147 (73.5%) tumours were deep to the fascia and 53 (26.5%) superficial. Tumour size classified according to the 12 AJCC 2019 criteria was: T1 = 52, T2 = 76, T3 = 39, T4 = 33. Based on nodule size >5 mm, 73 (36.5%) patients had no metastases, 42 (21%) had metastases, while 85 (42.5%) studies were indeterminate. Based on nodule size >10 mm, 73 (36.5%) patients had no metastases, 28 (14%) had metastases, while 99 (49.5%) studies were indeterminate. Larger maximum dimension of the primary tumour was a risk factor for pulmonary metastases using both size criteria. CONCLUSION: The incidence of pulmonary metastases at presentation in trunk and extremity soft tissue sarcoma is 14–21%. 42.5–49.5% of chest CTs were indeterminate. ADVANCES IN KNOWLEDGE: The incidence of pulmonary metastases at presentation in trunk and extremity soft tissue sarcoma is 14–21%. Indeterminate pulmonary nodules are also very common

Indirect excitation of Eu3+ in GaN codoped with Mg and Eu

Temperature-dependent Eu3+ luminescence spectra in GaN(Mg):Eu can be assigned to, at least, two distinct Eu3+ centres, denoted by Eu0 and Eu1. The splitting energy levels of the 7FJ (J=1,2) multiplets for the Eu0 and Eu1 centres have been calculated using the equivalent operator Hamiltonian for C3v crystal field with the addition of an odd parity distortion

Weak Decays in the light--front Quark Model

We study the form factors of heavy--to--heavy and heavy--to--light weak decays using the light--front relativistic quark model. For the heavy--to--heavy B \ra D^{(\ast)} semileptonic decays we calculate the corresponding Isgur--Wise function for the whole kinematic region. For the heavy--to--light B\ra P and B\ra V semileptonic decays we calculate the form factors at $q^2 = 0$; in particular, we have derived the dependence of the form factors on the $b$--quark mass in the m_b \ra \infty limit. This dependence can not be produced by extrapolating the scaling behavior of the form factors at $q^2_{max}$ using the single--pole assumption. This shows that the $q^2$ dependence of the form factors in regions far away from the zero--recoil could be much more complicated than that predicted by the single--pole assumption.Comment: 24 pages, Latex, Postscript figure included at the en

Research shapes policy: but the dynamics are subtle

Major policy initiatives such as the Quality and Outcomes Framework (QOF) in the national contract for UK general practitioners might variably be informed by evidence at their inception, implementation and subsequent evolution. But what evidence gets admitted into these policy debates—and what is left out? Using QOF as an example, this article demonstrates what an analysis of the relationship between policy and the associated research can tell us about the underlying policy assumptions and about the role of evidence in policy debates

Spin measurements for 147Sm+n resonances: Further evidence for non-statistical effects

We have determined the spins J of resonances in the 147Sm(n,gamma) reaction by measuring multiplicities of gamma-ray cascades following neutron capture. Using this technique, we were able to determine J values for all but 14 of the 140 known resonances below En = 1 keV, including 41 firm J assignments for resonances whose spins previously were either unknown or tentative. These new spin assignments, together with previously determined resonance parameters, allowed us to extract separate level spacings and neutron strength functions for J = 3 and 4 resonances. Furthermore, several statistical test of the data indicate that very few resonances of either spin have been missed below En = 700eV. Because a non-statistical effect recently was reported near En = 350 eV from an analysis of 147Sm(n,alpha) data, we divided the data into two regions; 0 < En < 350 eV and 350 < En < 700 eV. Using neutron widths from a previous measurement and published techniques for correcting for missed resonances and for testing whether data are consistent with a Porter-Thomas distribution, we found that the reduced-neutron-width distribution for resonances below 350 eV is consistent with the expected Porter-Thomas distribution. On the other hand, we found that reduced-neutron-width data in the 350 < En < 700 eV region are inconsistent with a Porter-Thomas distribution, but in good agreement with a chi-squared distribution having two or more degrees of freedom. We discuss possible explanations for these observed non-statistical effects and their possible relation to similar effects previously observed in other nuclides.Comment: 40 pages, 13 figures, accepted by Phys. Rev.

Species Diversity Enhances Predator Growth Rates

Predators can be important top-down regulators of community structure and are known to have both positive and negative effects on species diversity. However, little is known about the reciprocal effects of species diversity on predators. Across a set of 80 lakes in Connecticut, USA, we found a strong positive correlation between prey species diversity (using the Shannon-Weiner Diversity Index) and growth rates of largemouth bass (Micropterus salmoides). This correlation was strongest for small predators and decreased with body size. Although the underlying mechanisms are not known, the correlation is not driven by total fish abundance, predator abundance, or productivity

H3F3A (Histone 3.3) G34W Immunohistochemistry: A Reliable Marker Defining Benign and Malignant Giant Cell Tumor of Bone

Giant cell tumor of bone (GCTB) is a locally aggressive subarticular tumor. Having recently reported that H3.3 G34W mutations are characteristic of this tumor type, we have now investigated the sensitivity and specificity of the anti-histone H3.3 G34W rabbit monoclonal antibody in a wide variety of tumors including histologic mimics of GCTB to assess its value as a diagnostic marker. We also determined the incidence of H3.3 G34 mutations in primary malignant bone tumors as assessed by genotype and H3.3 G34W immunostaining. A total of 3163 tumors were tested. Totally, 213/235 GCTB (90.6%) showed nuclear H3.3 p.G34W immunoreactivity. This was not the case for the rare variants, p.G34L, M, and V, which occurred most commonly in the small bones of the hands, patella, and the axial skeleton. If these sites were excluded from the analysis, H3.3 G34W expression was found in 97.8% of GCTB. Malignant bone tumors initially classified as osteosarcomas were the only other lesions (n=11) that showed G34W expression. Notably an additional 2 previously reported osteosarcomas with a p.G34R mutation were not immunoreactive for the antibody. A total of 11/13 of these malignant H3.3-mutant tumors exhibited an osteoclast-rich component: when imaging was available all but one presented at a subarticular site. We propose that subarticular primary malignant bone sarcoma with H3.3 mutations represent true malignant GCTB, even in the absence of a benign GCTB component