Response to letter to editor: 'Comment on Arch et al., Trials. 2016;17:517'.

In October 2015 we published the paper 'Measurement of HbA1c in multicentre diabetes trials - should blood samples be tested locally or sent to a central laboratory: an agreement analysis'. Chatterjee and Pradhan have submitted a letter to the editor asking critical questions regarding the methods we used. We offer this letter in response. TRIAL REGISTRATION: Eudract No. 2010-023792-25. Registered on 4 November 2010. ISRCTN No. ISRCTN29255275 . Registered on 12 November 2010.

Exploring overweight and obesity in pre-school children using routinely collected data: a case study of Halton, Northwest England.

BACKGROUND: A growing body of evidence suggests that childhood overweight may have its roots in early life. This study aimed to explore patterns of weight in children from birth to 40 months, born between 1994 and 2006, in Halton, Northwest England. METHODS: Halton infants were compared with the UK-90 reference population at four time points (birth, 2 months, 8 months and 40 months) by converting heights and weights into age-sex adjusted SD scores. The mean and SD of Halton SD scores were calculated for each time point and sex. Cohort trends and gender differences in rates of children above the 85th and 95th centiles at each time point were tested for using Poisson regression modelling. RESULTS: A total of 16 381 births were analysed. At birth, 8 months and 40 months, proportions of Halton children above the 85th and 95th centiles were consistently higher than reference data. Proportions above the 85th and 95th centiles at birth did not change significantly year on year, but for all other time points the proportions increased with subsequent cohorts. CONCLUSIONS: This study may provide evidence that the development of overweight and obesity has its roots in very early life and has highlighted patterns of infant overweight and obesity not previously reported.

An assessment of the impact of home safety assessments on fires and fire-related injuries: a case study of Cheshire Fire and Rescue Service.

BACKGROUND: Deaths and injuries related to fires are largely preventable events. In the UK, a plethora of community-based fire safety initiatives have been introduced over the last 25 years, often led by fire and rescue services, to address this issue. This paper focuses on one such initiative--home safety assessments (HSAs). Cheshire Fire and Rescue Service (in England) implemented a uniquely large-scale HSA intervention. This paper assesses its effectiveness. METHODS: The impact of HSAs was assessed in relation to three outcomes: accidental dwelling fires (ADFs), ADFs contained and injuries arising from ADFs. A two-period comparison in fire-related rates of incidences in Cheshire between 2002 and 2011 was implemented, using Poisson regression and adjusting for the national temporal trend using a control group comprising the 37 other English non-metropolitan fire-services. RESULTS: Significant reductions were observed in rates of ADFs [incidence rate ratios (IRR): 0.79, 95% confidence interval (CI): 0.74-0.83, P < 0.001, 2002/03-2007/08 versus 2008/09-2010/11] and associated injuries (IRR: 0.49, 95% CI: 0.39-0.60, P < 0.001, 2002/03-2006/07 versus 2007/08-2010/11), but not in the proportion of fires contained to room of origin. CONCLUSIONS: There is strong evidence to suggest that the intervention was successful in reducing domestic fires and related injuries.

The influence of religious beliefs on general practitioners' attitudes towards termination of pregnancy--a pilot study.

We set out to examine the attitudes of general practitioners in the West Norfolk area towards requests for abortion for various reasons and explore the factors that may influence their views, particularly their religious beliefs. This cross-sectional survey was conducted using a questionnaire, targeting 140 general practitioners. A response rate of 51.4% was achieved. All respondents were older than 30, and were mostly males (84.6%), married (93.8%) with children (90.9%). Most were either Church of England Christians (C of E) (48.5%) or had no stated religion (35.3%). The former were significantly less likely to agree with abortion than the latter for social reasons (P = 0.02) or in the case of teenage pregnancy (P = 0.006). A total of 73.8% of respondents followed-up patients after termination. Other associations were indicated, but were not statistically significant. Larger studies are needed to verify these associations for general practitioners in general.

Cemented or uncemented hemiarthroplasty for displaced intracapsular femoral neck fractures.

The aim of this study was to establish whether or not to cement the hemiarthroplasty for displaced intracapsular femoral neck fractures in the elderly. Consecutive patients treated by hemiarthroplasty in adjacent hospitals were reviewed. The same monoblock prosthesis was used; in hospital A they were uncemented (121 patients), and in hospital B they were cemented (123 patients). Notes were reviewed retrospectively. Surviving patients (50 and 56 respectively) were assessed prospectively for pain and functional ability using validated scoring systems. Follow-up was 32-36 months. Patient demographics were similar. Fewer of the cemented group had been revised or were awaiting revision ( P=0.036). There was no difference in general complication or mortality rates. There was a highly statistically significant greater deterioration in pain ( P=0.003), walking ability ( P=0.002), use of walking aids ( P=0.003) and activities of daily living ( P=0.009) in the uncemented group. Our findings support the use of cemented hemiarthroplasty in the elderly.

Imaging atherosclerotic plaque inflammation with [18F]-fluorodeoxyglucose positron emission tomography.

BACKGROUND: Atherosclerotic plaque rupture is usually a consequence of inflammatory cell activity within the plaque. Current imaging techniques provide anatomic data but no indication of plaque inflammation. The glucose analogue [18F]-fluorodeoxyglucose (18FDG) can be used to image inflammatory cell activity non-invasively by PET. In this study we tested whether 18FDG-PET imaging can identify inflammation within carotid artery atherosclerotic plaques. METHODS AND RESULTS: Eight patients with symptomatic carotid atherosclerosis were imaged using 18FDG-PET and co-registered CT. Symptomatic carotid plaques were visible in 18FDG-PET images acquired 3 hours post-18FDG injection. The estimated net 18FDG accumulation rate (plaque/integral plasma) in symptomatic lesions was 27% higher than in contralateral asymptomatic lesions. There was no measurable 18FDG uptake into normal carotid arteries. Autoradiography of excised plaques confirmed accumulation of deoxyglucose in macrophage-rich areas of the plaque. CONCLUSIONS: This study demonstrates that atherosclerotic plaque inflammation can be imaged with 18FDG-PET, and that symptomatic, unstable plaques accumulate more 18FDG than asymptomatic lesions.