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

Benefits from clinicians and healthcare organisations engaging in research

In Editor’s Choice, Godlee supports and re-emphasises the positive points about National Institute for Health Research (NIHR) clinical research networks that are made in Gulland’s article.1 2 We welcome this support for research networks and for the part they can play in a more fully integrated research and healthcare system. Research engagement by clinicians and healthcare organisations is widely held to improve health services performance. However, we found the issue to be complex in our review conducted for the NIHR Health Services and Delivery Research (HS&DR) Programme in 2012-13.3 Thirty three papers were included in the analysis, and 28 were positive about improved performance, although only seven identified improved outcomes rather than improved processes. Diverse mechanisms contributed to these improvements. In a subsequent article we consider more recent evidence,4 including that UK NHS trusts active in research have lower risk adjusted mortality for acute admissions.5 Increased attention to this issue covers not only clinician participation but also organisational developments in the NIHR and NHS, such as Collaborations for Leadership in Applied Health Research and Care (CLAHRC) and Academic Health Science Networks (AHSNs).6 7 These seek to promote better integration of research and healthcare systems by strengthening research networks, developing research capacity, and ensuring that healthcare organisations (both providers and commissioners) see research as an integral component of their overall structure. Such initiatives need to be linked to further empirical analysis that considers not only the research engagement of all relevant actors but also the organisational determinants of the impact on practice of such engagement

On the Exchange of Kinetic and Magnetic Energy Between Clouds and the Interstellar Medium

We investigate, through 2D MHD numerical simulations, the interaction of a uniform magnetic field oblique to a moving interstellar cloud. In particular we explore the transformation of cloud kinetic energy into magnetic energy as a result of field line stretching. Some previous simulations have emphasized the possible dynamical importance of a ``magnetic shield'' formed around clouds when the magnetic field is perpendicular to the cloud motion (Jones et al. 1996, Miniati et al. 1998). It was not clear, however, how dependent those findings were to the assumed field configuration and cloud properties. To expand our understanding of this effect, we examine several new cases by varing the magnetic field orientation angle with respect to the cloud motion (\theta), the cloud-background density contrast, and the cloud Mach number. We show that in 2D and with \theta large enough, the magnetic field tension can become dominant in the dynamics of the motion of high density contrast, low Mach number clouds. In such cases a significant fraction of cloud kinetic energy can be transformed into magnetic energy with the magnetic pressure at the cloud nose exceeding the ram pressure of the impinging flow. We derive a characteristic timescale for this process of energy ``conversion''. We find also that unless the cloud motion is highly aligned to the magnetic field, reconnection through tearing mode instabilities in the cloud wake limit the formation of a strong flux rope feature following the cloud. Finally we attempt to interpret some observational properties of the magnetic field in view of our results.Comment: 24 pages in aaspp4 Latex and 7 figures. Accepted for publication in The Astrophysical Journa

Stress and visual function in infantile nystagmus syndrome.

PURPOSE: Infantile nystagmus syndrome (INS) is an involuntary oscillation of the eyes that has been reported to impair vision and worsen under stress. This investigation aimed to measure visual function in terms of visual acuity (VA) and response time (RT), when INS subjects are placed under stress. METHODS: A total of 23 subjects with INS and 20 control subjects performed a 2-alternative forced choice (2AFC) staircase procedure identifying the gap in a Landolt C, under 4 experimental conditions: initial acclimatization (A); task demand (TD), during which subjects received a small electrical shock for every incorrect answer; anticipatory anxiety (AA), during which subjects received a small shock at random intervals; and relaxed (R). Arousal was monitored with galvanic skin conductance (SkC). In addition to VA and eye movements, RTs were recorded. RESULTS: The SkC was higher in the TD and AA periods and lower during A and R. Shock significantly increased nystagmus amplitude (P < 0.01) and intensity (P < 0.007), and reduced foveation periods (FPs, P < 0.022). In both groups, VA was not reduced, but showed a slight improvement. However, shock increased RT (P < 0.009), and INS subjects were slower than controls (P < 0.0005). CONCLUSIONS: Increased arousal ("stress") provoked more intense nystagmus eye movements. As seen in other studies, stress did not reduce VA despite the shorter FPs. Although VA and FP can correlate across subjects, there would appear to be little correlation, if any, within a subject. However, RTs did increase with stress and shorter FPs, which may have an adverse impact on the visual performance of those with INS

Fellow travellers: a concordance of colonization patterns between mice and men in the North Atlantic region

<p>Abstract</p> <p>Background</p> <p>House mice (<it>Mus musculus</it>) are commensals of humans and therefore their phylogeography can reflect human colonization and settlement patterns. Previous studies have linked the distribution of house mouse mitochondrial (mt) DNA clades to areas formerly occupied by the Norwegian Vikings in Norway and the British Isles. Norwegian Viking activity also extended further westwards in the North Atlantic with the settlement of Iceland, short-lived colonies in Greenland and a fleeting colony in Newfoundland in 1000 AD. Here we investigate whether house mouse mtDNA sequences reflect human history in these other regions as well.</p> <p>Results</p> <p>House mice samples from Iceland, whether from archaeological Viking Age material or from modern-day specimens, had an identical mtDNA haplotype to the clade previously linked with Norwegian Vikings. From mtDNA and microsatellite data, the modern-day Icelandic mice also share the low genetic diversity shown by their human hosts on Iceland. Viking Age mice from Greenland had an mtDNA haplotype deriving from the Icelandic haplotype, but the modern-day Greenlandic mice belong to an entirely different mtDNA clade. We found no genetic association between modern Newfoundland mice and the Icelandic/ancient Greenlandic mice (no ancient Newfoundland mice were available). The modern day Icelandic and Newfoundland mice belong to the subspecies <it>M. m. domesticus</it>, the Greenlandic mice to <it>M. m. musculus</it>.</p> <p>Conclusions</p> <p>In the North Atlantic region, human settlement history over a thousand years is reflected remarkably by the mtDNA phylogeny of house mice. In Iceland, the mtDNA data show the arrival and continuity of the house mouse population to the present day, while in Greenland the data suggest the arrival, subsequent extinction and recolonization of house mice - in both places mirroring the history of the European human host populations. If house mice arrived in Newfoundland with the Viking settlers at all, then, like the humans, their presence was also fleeting and left no genetic trace. The continuity of mtDNA haplotype in Iceland over 1000 years illustrates that mtDNA can retain the signature of the ancestral house mouse founders. We also show that, in terms of genetic variability, house mouse populations may also track their host human populations.</p

The role of hip abductor strength on the frontal plane of gait in subjects with medial knee osteoarthritis

Objective: This study aimed to investigate the relationship of hip abductor strength with external hip and knee adduction moments, pain and physical function, and trunk, pelvis, and hip kinematics in the frontal plane during walking in subjects with medial knee osteoarthritis. Methods: Twenty-five subjects with medial knee osteoarthritis were evaluated through an isokinetic strength test for hip abductor, three-dimensional gait analysis (kinetics and kinematics), pain and physical function scores. Regression models were used to control the influence of other parameters such as pain, age, gender, severity, walking speed, mass and height. Results: No relationship was found of hip abductor strength with peak of external knee adduction moment and knee adduction angular impulse. Hip abductor strength explained 17% of contralateral pelvic drop and 21% of hip adduction angle. In addition, hip abductor strength explained 4% and 1% of the variance in the WOMAC physical function score and 40 meter fast paced walk test, respectively. Conclusion: Considering the relationship of hip abductor strength with contralateral pelvic drop and hip adduction angle, specific exercises might improve physical function and lower limb dynamic alignment during gait