Direct-acting antivirals are highly effective in curing hepatitis C virus (HCV) infection but linkage to care remains a barrier to population-wide treatment. Hospitalisation for any cause may be an opportunity to identify candidates for treatment. Here, we present the test characteristics of an electronic medical record (EMR) alert system to identify hospitalised patients with HCV infection.

We created two alerts based on HCV antibody and RNA values and HCV-specific International Classification of Diseases codes: an ever-alert designed to detect patients with any history of HCV infection (resolved or active) and an active-alert designed to only detect active infections. We performed manual chart review of alerted patients to determine positive predictive value (PPV). We reviewed consecutively hospitalised patients to determine sensitivity.

Two affiliated academic tertiary care hospitals in Baltimore, Maryland, USA.

Primary and secondary outcome measures: PPV and sensitivity of the alerts for patients with active HCV infection.

Hospitalised adults (aged ≥18 years).

During 12 weeks in 2022 and 2023, the ever-alert fired for 1218 hospitalisations. The ever-alert detected 438 active infections among 1218 alerted hospitalisations (PPV 36.0% (95% CI 33.3% to 38.7%)) compared with 415 active infections among 591 alerts (PPV 70.1% (95% CI 66.4% to 73.8%)) for the active-alert. Both alerts detected 37 of 44 active cases (sensitivity 81.4% (95% CI 70.6% to 92.1%)) among 1115 consecutively hospitalised patients.

The active-alert demonstrated a higher PPV than the ever-alert with a negligible decrease in case detection and similar sensitivity for active infection.

The active-alert may represent an efficient method of identifying candidates for HCV linkage to care using hospital EMR data. Future directions include deploying the active-alert with a formal linkage to care team.

The return to work after arthroplasty (REWARD) study was established to address knowledge gaps regarding factors influencing return to work and long-term workability following hip and knee arthroplasty. The study investigates how variables such as sex, occupational workload and prior treatments affect sick leave patterns across regions and healthcare providers in Sweden. By analysing trajectories of sick leave and disability pension before and after surgery, the study aims to identify determinants for successful return to work.

Initially, we identified two separate cohorts comprising all individuals registered in the Swedish Arthroplasty Register who received a primary hip or knee arthroplasty between 2012 and 2022. Eligible individuals were 18–69 years of age and had osteoarthritis (OA) as the indication for surgery. For each of the arthroplasty cohorts, Statistics Sweden created a reference cohort by randomly selecting three individuals from the general population for each arthroplasty case, matched on age, sex and municipality.

Using linked nationwide registers, we identified 64 370 individuals who received primary hip arthroplasty and 60 683 who received knee arthroplasty during 2012–2022, all aged 18–69 years and diagnosed with OA. Median age was 62 years (IQR 56–66) for hip and 63 years (IQR 58–66) for knee arthroplasty; 52% and 55% were women respectively.

The corresponding matched cohorts consisted of 193 110 and 182 049 individuals respectively.

The dataset includes patient and surgical characteristics, 1-year patient-reported outcomes, first-line treatment participation, socioeconomic data, occupational exposures and sick leave and disability pension data (5 years before and after surgery). Data collection is complete.

The REWARD cohort is intended for longitudinal analysis of return to work and long-term workability following hip and knee arthroplasty, and for quantifying associated societal costs. Data collection is anticipated to be completed in 2027, pending potential linkage of comorbidity and prescribed medication data. Findings from REWARD will inform national guidelines and decision support tools for sick leave and work-related rehabilitation. Future work includes co-developing individualised, work-oriented interventions in collaboration with patients and healthcare professionals.

Preterm infants frequently receive support for inadequate breathing at birth. Though current guidelines recommend using tactile stimulation to promote breathing, guidance on its use is limited. There are few studies on the effects of tactile stimulation with a high risk of bias in these studies. We aim to generate robust evidence by comparing the effects of repeated to selective tactile stimulation of preterm infants at birth in a stepped-wedge cluster randomised study.

This stepped-wedge cluster randomised trial is being conducted from 11 March 2024 in 43 centres across Europe. All centres begin in the selective stimulation (control) arm, where stimulation is applied only when breathing effort is judged inadequate by treating clinicians. Every fortnight, one centre switches to the repeated stimulation (intervention) arm, where stimulation is provided for 10 s, alternated with 10-second pauses for at least the first 5 min after birth. Once centres switch, they continue in the repeated stimulation arm until study completion. The order of switching is prospectively and randomly assigned, with the last switch occurring on 24 November 2025. The primary outcome is achievement of a pre-ductal oxygen saturation ≥80% at 5 min after birth. Analyses will use generalised linear mixed models to compare outcomes between groups at the individual level.

Ethical approval was obtained at all participating centres. The study adheres to the Declaration of Helsinki, the principles of Good Clinical Practice and the General Data Protection Regulation. Results will be shared with investigators, published in a peer-reviewed journal and presented at national and international conferences.

NCT05942924.

This study aims at exploring longitudinal trends in the onset of type 2 diabetes in the disadvantaged urban neighbourhood of Tingbjerg before and during implementation of interventions within the Danish health promotion initiative Tingbjerg Changing Diabetes. The findings are compared with trends in the national population.

Using Poisson regression, trends in age-specific incidence rates were estimated in both populations during the full timespan with adjustments for gender and educational attainment. We used anonymised national registers to obtain sociodemographic and health information about all residents in Tingbjerg. Likewise, information from the remaining national population was analysed for comparison.

Tingbjerg is a disadvantaged neighbourhood with approximately 7000 residents located in the outskirts of Copenhagen.

The full national adult population in Denmark, from 2003 to the end of 2022, was included in the study.

Tingbjerg Changing Diabetes is a long-term complex community-based health promotion initiative that started in 2015 and aims at enhancing well-being, promoting healthy living and preventing type 2 diabetes and other chronic diseases among residents of the local community.

The outcome measure was onset of type 2 diabetes assessed by clinical register data.

Estimated trends show relatively higher age-adjusted incidence rates of type 2 diabetes in Tingbjerg compared with the national population with an almost two-fold higher rate in Tingbjerg in 2015. From 2015, a decline in the incidence rate was observed in Tingbjerg whereas an increase was observed in the national population, resulting in almost similar rates in 2022.

Exploration of type 2 diabetes incidence rates from 2003 to 2022 shows relative improvements in Tingbjerg after 2015. It is unknown to what extent the interventions have impacted the observed trends.