The journals of importance to UK clinicians: A questionnaire survey of surgeons

Background: Peer-reviewed journals are seen as a major vehicle in the transmission of research findings to clinicians. Perspectives on the importance of individual journals vary and the use of impact factors to assess research is criticised. Other surveys of clinicians suggest a few key journals within a specialty, and sub-specialties, are widely read. Journals with high impact factors are not always widely read or perceived as important. In order to determine whether UK surgeons consider peer-reviewed journals to be important information sources and which journals they read and consider important to inform their clinical practice, we conducted a postal questionnaire survey and then compared the findings with those from a survey of US surgeons. Methods: A questionnaire survey sent to 2,660 UK surgeons asked which information sources they considered to be important and which peer-reviewed journals they read, and perceived as important, to inform their clinical practice. Comparisons were made with numbers of UK NHSfunded surgery publications, journal impact factors and other similar surveys. Results: Peer-reviewed journals were considered to be the second most important information source for UK surgeons. A mode of four journals read was found with academics reading more than non-academics. Two journals, the BMJ and the Annals of the Royal College of Surgeons of England, are prominent across all sub-specialties and others within sub-specialties. The British Journal of Surgery plays a key role within three sub-specialties. UK journals are generally preferred and readership patterns are influenced by membership journals. Some of the journals viewed by surgeons as being most important, for example the Annals of the Royal College of Surgeons of England, do not have high impact factors. Conclusion: Combining the findings from this study with comparable studies highlights the importance of national journals and of membership journals. Our study also illustrates the complexity of the link between the impact factors of journals and the importance of the journals to clinicians. This analysis potentially provides an additional basis on which to assess the role of different journals, and the published output from research

Discrete Event Simulation for Decision Modeling in Health Care: Lessons from Abdominal Aortic Aneurysm Screening

Markov models are often used to evaluate the cost-effectiveness of new healthcare interventions but they are sometimes not flexible enough to allow accurate modeling or investigation of alternative scenarios and policies. A Markov model previously demonstrated that a one-off invitation to screening for abdominal aortic aneurysm (AAA) for men aged 65 y in the UK and subsequent follow-up of identified AAAs was likely to be highly cost-effective at thresholds commonly adopted in the UK (£20,000 to £30,000 per quality adjusted life-year). However, new evidence has emerged and the decision problem has evolved to include exploration of the circumstances under which AAA screening may be cost-effective, which the Markov model is not easily able to address. A new model to handle this more complex decision problem was needed, and the case of AAA screening thus provides an illustration of the relative merits of Markov models and discrete event simulation (DES) models. An individual-level DES model was built using the R programming language to reflect possible events and pathways of individuals invited to screening v. those not invited. The model was validated against key events and cost-effectiveness, as observed in a large, randomized trial. Different screening protocol scenarios were investigated to demonstrate the flexibility of the DES. The case of AAA screening highlights the benefits of DES, particularly in the context of screening studies

Characterization of the definitive classical calpain family of vertebrates using phylogenetic, evolutionary and expression analyses

Peer reviewedPublisher PD

Metastable Flux Configurations and de Sitter Spaces

We derive stability conditions for the critical points of the no-scale scalar potential governing the dynamics of the complex structure moduli and the axio-dilaton in compactifications of type IIB string theory on Calabi-Yau three-folds. We discuss a concrete example of a T^6 orientifold. We then consider the four-dimensional theory obtained from compactifications of type IIB string theory on non-geometric backgrounds which are mirror to rigid Calabi-Yau manifolds and show that the complex structure moduli fields can be stabilized in terms of H_{RR} only, i.e. with no need of orientifold projection. The stabilization of all the fields at weak coupling, including the axio-dilaton, may require to break supersymmetry in the presence of H_{NS} flux or corrections to the scalar potential.Comment: 24 page

Direct photons in d+Au and p+p collisions

Results are presented from an ongoing analysis of direct photon production with the STAR experiment at RHIC. The direct photon measurement in d+Au collisions and the neutral pion spectrum in p+p collisions are found to be in agreement with NLO pQCD calculations.Comment: 4 pages, 3 figures, proceedings of Quark Matter 200

Smart Content Recognition from Images Using a Mixture of Convolutional Neural Networks

With rapid development of the Internet, web contents become huge. Most of the websites are publicly available, and anyone can access the contents from anywhere such as workplace, home and even schools. Nevertheless, not all the web contents are appropriate for all users, especially children. An example of these contents is pornography images which should be restricted to certain age group. Besides, these images are not safe for work (NSFW) in which employees should not be seen accessing such contents during work. Recently, convolutional neural networks have been successfully applied to many computer vision problems. Inspired by these successes, we propose a mixture of convolutional neural networks for adult content recognition. Unlike other works, our method is formulated on a weighted sum of multiple deep neural network models. The weights of each CNN models are expressed as a linear regression problem learned using Ordinary Least Squares (OLS). Experimental results demonstrate that the proposed model outperforms both single CNN model and the average sum of CNN models in adult content recognition.Comment: To be published in LNEE, Code: github.com/mundher/NSF

The Benefits of a Challenge Approach on Match Day: Investigating Cardiovascular Reactivity in Professional Academy Soccer Players.

This study assessed physiological (cardiovascular) and psychological (confidence, control, and approach focus) data in professional academy soccer players prior to performance in competitive matches. A challenge state is characterised by an increase in cardiac output (CO), and a decrease in total peripheral vascular resistance (TPR). Data were collected from 37 participants, with 19 of these providing data on two separate occasions. Performance was measured using coach and player self-ratings. Challenge reactivity was positively, and significantly, associated with performance. Participants who demonstrated blunted cardiovascular (CV) responses performed significantly worse than participants who displayed either challenge or threat reactivity. There was mixed consistency in CV reactivity for those participants whose data were collected on more than one occasion, suggesting that some participants responded differently across the competitive matches. The association between self-report data and CV responses was weak. This study supports previous research demonstrating that challenge reactivity is associated with superior performance

Alternating strain regimes for failure propagation in flexural systems

We consider both analytical and numerical studies of a steady-state fracture process inside a discrete mass-beam structure, composed of periodically placed masses connected by Euler-Bernoulli beams. A fault inside the structure is assumed to propagate with a constant speed and this occurs as a result of the action of a remote sinusoidal, mechanical load. The established regime of fracture corresponds to the case of an alternating generalised strain regime. The model is reduced to a Wiener-Hopf equation and its solution is presented. We determine the minimum feeding wave energy required for the steady-state fracture process to occur. In addition, we identify the dynamic features of the structure during the steady-state fracture regime. A transient analysis of this problem is also presented, where the existence of steady-state fracture regimes, revealed by the analytical model, are verified and the associated transient features of this process are discussed

Disease prevention versus data privacy : using landcover maps to inform spatial epidemic models

The availability of epidemiological data in the early stages of an outbreak of an infectious disease is vital for modelers to make accurate predictions regarding the likely spread of disease and preferred intervention strategies. However, in some countries, the necessary demographic data are only available at an aggregate scale. We investigated the ability of models of livestock infectious diseases to predict epidemic spread and obtain optimal control policies in the event of imperfect, aggregated data. Taking a geographic information approach, we used land cover data to predict UK farm locations and investigated the influence of using these synthetic location data sets upon epidemiological predictions in the event of an outbreak of foot-and-mouth disease. When broadly classified land cover data were used to create synthetic farm locations, model predictions deviated significantly from those simulated on true data. However, when more resolved subclass land use data were used, moderate to highly accurate predictions of epidemic size, duration and optimal vaccination and ring culling strategies were obtained. This suggests that a geographic information approach may be useful where individual farm-level data are not available, to allow predictive analyses to be carried out regarding the likely spread of disease. This method can also be used for contingency planning in collaboration with policy makers to determine preferred control strategies in the event of a future outbreak of infectious disease in livestock

An audit of the quality of inpatient care for adults with learning disability in the UK

OBJECTIVES: To audit patient hospital records to evaluate the performance of acute general and mental health services in delivering inpatient care to people with learning disability and explore the influence of organisational factors on the quality of care they deliver. SETTING: Nine acute general hospital Trusts and six mental health services. PARTICIPANTS: Adults with learning disability who received inpatient hospital care between May 2013 and April 2014. PRIMARY AND SECONDARY OUTCOME MEASURES: Data on seven key indicators of high-quality care were collected from 176 patients. These covered physical health/monitoring, communication and meeting needs, capacity and decision-making, discharge planning and carer involvement. The impact of services having an electronic system for flagging patients with learning disability and employing a learning disability liaison nurse was assessed. RESULTS: Indicators of physical healthcare (body mass index, swallowing assessment, epilepsy risk assessment) were poorly recorded in acute general and mental health inpatient settings. Overall, only 34 (19.3%) patients received any assessment of swallowing and 12 of the 57 with epilepsy (21.1%) had an epilepsy risk assessment. For most quality indicators, there was a non-statistically significant trend for improved performance in services with a learning disability liaison nurse. The presence of an electronic flagging system showed less evidence of benefit. CONCLUSIONS: Inpatient care for people with learning disability needs to be improved. The work gives tentative support to the role of a learning disability liaison nurse in acute general and mental health services, but further work is needed to confirm these benefits and to trial other interventions that might improve the quality and safety of care for this high-need group