IntroductionThe emergence of the novel respiratory SARS-CoV-2 and subsequent COVID-19 pandemic have required rapid assimilation of population-level data to understand and control the spread of infection in the general and vulnerable populations. Rapid analyses are needed to inform policy development and target interventions to at-risk groups to prevent serious health outcomes. We aim to provide an accessible research platform to determine demographic, socioeconomic and clinical risk factors for infection, morbidity and mortality of COVID-19, to measure the impact of COVID-19 on healthcare utilisation and long-term health, and to enable the evaluation of natural experiments of policy interventions.Methods and analysisTwo privacy-protecting population-level cohorts have been created and derived from multisourced demographic and healthcare data. The C20 cohort consists of 3.2 million people in Wales on the 1 January 2020 with follow-up until 31 May 2020. The complete cohort dataset will be updated monthly with some individual datasets available daily. The C16 cohort consists of 3 million people in Wales on the 1 January 2016 with follow-up to 31 December 2019. C16 is designed as a counterfactual cohort to provide contextual comparative population data on disease, health service utilisation and mortality. Study outcomes will: (a) characterise the epidemiology of COVID-19, (b) assess socioeconomic and demographic influences on infection and outcomes, (c) measure the impact of COVID-19 on short -term and longer-term population outcomes and (d) undertake studies on the transmission and spatial spread of infection.Ethics and disseminationThe Secure Anonymised Information Linkage-independent Information Governance Review Panel has approved this study. The study findings will be presented to policy groups, public meetings, national and international conferences, and published in peer-reviewed journals.
Concussion incidence increased, while severity remained unchanged, during the 4 years of this study. Playing more than 25 matches in the 2015/2016 season meant that sustaining concussion was more likely than not sustaining concussion. The 38% greater injury risk after concussive injury (compared with non-concussive injury) suggests return to play protocols warrant investigation.
We study real time correlators in strongly coupled N = 4 supersymmetric Yang-Mills theory on dS 3 × S 1 , with antiperiodic boundary conditions for fermions on the circle. When the circle radius is larger than a critical value, the dual geometry is the so-called "topological AdS 5 black hole". Applying the Son-Starinets recipe in this background we compute retarded glueball propagators which exhibit an infinite set of poles yielding the quasinormal frequencies of the topological black hole. The imaginary parts of the propagators exhibit thermal effects associated with the Gibbons-Hawking temperature due to the cosmological horizon of the de Sitter boundary. We also obtain R-current correlators and find that after accounting for a small subtlety, the Son-Starinets prescription yields the retarded Green's functions. The correlators do not display diffusive behaviour at late times. Below the critical value of the circle radius, the topological black hole decays to the AdS 5 "bubble of nothing". Using a high frequency WKB approximation, we show that glueball correlators in this phase exhibit poles on the real axis. The tunnelling from the black hole to the bubble is interpreted as a hadronization transition.
Artificial rugby union playing surface installation is increasing. This prospective cohort study aimed to examine the effect of playing surface on match injury types within 157 players of two UK professional rugby union clubs playing 209 matches (96 on artificial surfaces and 113 on grass) over three seasons. There was no difference in overall injury risk between the two playing surfaces with injury incidence on artificial 80.2 (CI 69.9-91.7) and on grass 81.9 per 1000 match-hours (CI 72.2-92.5), with an incidence rate ratio (RR) of 0.98 (CI 0.82-1.17). There was a higher rate of concussion (RR 0.52, CI 0.34 - 0.78) and chest injuries on grass (RR 0.26 CI 0.07, 0.95), and a higher rate of thigh haematoma (RR 2.25, CI 1.05-4.82) foot injuries (RR 4.12, CI 1.10, 15.40) and injury to players being tackled (RR 1.46, CI 1.00, 2.15) on artificial. Whilst there was no higher injury risk for matches played on artificial versus natural grass surfaces, the higher incidence of concussion and chest injury on grass, and the higher rate of foot injuries on artificial surfaces may be related to tackle and footwear-to-surface interface factors.
We investigate N = 4 SYM coupled to fundamental flavours at nonzero imaginary quark chemical potential in the strong coupling and large N limit, using gauge/gravity duality applied to the D3-D7 system, treating flavours in the probe approximation. The interplay between Z N symmetry and the imaginary chemical potential yields a series of first-order Roberge-Weiss transitions. An additional thermal transition separates phases where quarks are bound/unbound into mesons. This results in a set of Roberge-Weiss endpoints: we establish that these are triple points, determine the Roberge-Weiss temperature, give the curvature of the phase boundaries and confirm that the theory is analytic in µ 2 when µ 2 ≈ 0.
Aims To understand factors associated with repeat non‐attendance at screening for diabetes‐related retinopathy. Methods Retrospective observational study using anonymised data from Diabetic Eye Screening Wales for people with a full history of screening invitations and attendances was linked with primary and secondary care records held in the Secure Anonymised Information Linkage Databank. Repeat non‐attendance was defined as no record of attendance during any 36‐month period despite three cycles of annual screening invitations. The associations between repeat non‐attendance and potential risk factors were examined using multivariable logistic regression analysis, stratified according to type 1 and type 2 diabetes. Results A total of 18% with type 1 diabetes (1146/6513) and 8% with type 2 diabetes (12,475/156,525) were repeat non‐attenders. Participants attending their very first appointment were least likely to become repeat non‐attenders [odds ratio (95% confidence interval)]: type 1 diabetes: 0.12 (0.09, 0.17) and type 2 diabetes: 0.08 (0.07, 0.09). For both types of diabetes, those of a younger age, living in areas of higher deprivation and subject to multiple house moves were at greater risk of becoming repeat non‐attenders. Conclusion/interpretation A more tailored approach is needed for the younger population, those living in areas of higher deprivation and/or undergoing multiple residential relocation and to ensure attendance at their initial appointment to minimise future repeat non‐attendance.
IntroductionMultimorbidity is widely recognised as the presence of two or more concurrent long-term conditions, yet remains a poorly understood global issue despite increasing in prevalence.We have created the Wales Multimorbidity e-Cohort (WMC) to provide an accessible research ready data asset to further the understanding of multimorbidity. Our objectives are to create a platform to support research which would help to understand prevalence, trajectories and determinants in multimorbidity, characterise clusters that lead to highest burden on individuals and healthcare services, and evaluate and provide new multimorbidity phenotypes and algorithms to the National Health Service and research communities to support prevention, healthcare planning and the management of individuals with multimorbidity.Methods and analysisThe WMC has been created and derived from multisourced demographic, administrative and electronic health record data relating to the Welsh population in the Secure Anonymised Information Linkage (SAIL) Databank. The WMC consists of 2.9 million people alive and living in Wales on the 1 January 2000 with follow-up until 31 December 2019, Welsh residency break or death. Published comorbidity indices and phenotype code lists will be used to measure and conceptualise multimorbidity.Study outcomes will include: (1) a description of multimorbidity using published data phenotype algorithms/ontologies, (2) investigation of the associations between baseline demographic factors and multimorbidity, (3) identification of temporal trajectories of clusters of conditions and multimorbidity and (4) investigation of multimorbidity clusters with poor outcomes such as mortality and high healthcare service utilisation.Ethics and disseminationThe SAIL Databank independent Information Governance Review Panel has approved this study (SAIL Project: 0911). Study findings will be presented to policy groups, public meetings, national and international conferences, and published in peer-reviewed journals.
OBJECTIVE To quantify associations of educational outcomes with type 1 diabetes status and glycemic management (HbA1c). RESEARCH DESIGN AND METHODS This was a record linkage study of schools and higher (college) education data sets linked to national diabetes audits. The population includes all Welsh children attending school between 2009 and 2016, yielding eight academic cohorts with attainment data, including 263,426 children without diabetes and 1,212 children diagnosed with type 1 diabetes. Outcomes include standardized educational attainment for those aged 16 years, higher education participation for those aged ≥18 years, and school absences among those aged 6–16 years. RESULTS Comparison between children with type 1 diabetes and children without diabetes showed no strong evidence of associations for student attainment (0.001 SD, 95% CI −0.047 to 0.049, P < 0.96, n = 1,212 vs. 263,426) or higher education entry rates (odds ratio 1.067, 95% CI 0.919–1.239, P < 0.39, n = 965 vs. 217,191), despite nine more sessions of absence from school annually (P < 0.0001). However, attainment in children in the most optimal HbA1c quintile was substantially better than for children without diabetes (0.267 SD, 95% CI 0.160–0.374, P < 0.001) while being worse than for children without diabetes in the least optimal quintile (−0.395 SD, 95% CI −0.504 to −0.287, P < 0.001). Attainment did not differ by duration of “exposure” to diabetes based on age at diagnosis. CONCLUSIONS Despite more school absences, diabetes diagnosis is not associated with educational attainment or entry into higher education, although attainment does vary by HbA1c level, which may be explained in part (or wholly) by unobserved shared personal, family, or socioeconomic characteristics associated with both success in education and effective glycemic self-management.
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