Co-production practice and future research priorities in United Kingdom-funded applied health research: a scoping review

Background Interest in and use of co-production in healthcare services and research is growing. Previous reviews have summarized co-production approaches in use, collated outcomes and effects of co-production, and focused on replicability and reporting, but none have critically reflected on how co-production in applied health research might be evolving and the implications of this for future research. We conducted this scoping review to systematically map recent literature on co-production in applied health research in the United Kingdom to inform co-production practice and guide future methodological research. Methods This scoping review was performed using established methods. We created an evidence map to show the extent and nature of the literature on co-production and applied health research, based on which we described the characteristics of the articles and scope of the literature and summarized conceptualizations of co-production and how it was implemented. We extracted implications for co-production practice or future research and conducted a content analysis of this information to identify lessons for the practice of co-production and themes for future methodological research. Results Nineteen articles reporting co-produced complex interventions and 64 reporting co-production in applied health research met the inclusion criteria. Lessons for the practice of co-production and requirements for co-production to become more embedded in organizational structures included (1) the capacity to implement co-produced interventions, (2) the skill set needed for co-production, (3) multiple levels of engagement and negotiation, and (4) funding and institutional arrangements for meaningful co-production. Themes for future research on co-production included (1) who to involve in co-production and how, (2) evaluating outcomes of co-production, (3) the language and practice of co-production, (4) documenting costs and challenges, and (5) vital components or best practice for co-production. Conclusion Researchers are operationalizing co-production in various ways, often without the necessary financial and organizational support required and the right conditions for success. We argue for accepting the diversity in approaches to co-production, call on researchers to be clearer in their reporting of these approaches, and make suggestions for what researchers should record. To support co-production of research, changes to entrenched academic and scientific practices are needed. Protocol registration details: The protocol for the scoping review was registered with protocols.io on 19 October 2021: https://dx.doi.org/10.17504/protocols.io.by7epzje

Biocatalytic routes to stereo-divergent iridoids

Thousands of natural products are derived from the fused cyclopentane-pyran molecular scaffold nepetalactol. These natural products are used in an enormous range of applications that span the agricultural and medical industries. For example, nepetalactone, the oxidized derivative of nepetalactol, is known for its cat attractant properties as well as potential as an insect repellent. Most of these naturally occurring nepetalactol-derived compounds arise from only two out of the eight possible stereoisomers, 7S-cis-trans and 7R-cis-cis nepetalactols. Here we use a combination of naturally occurring and engineered enzymes to produce seven of the eight possible nepetalactol or nepetalactone stereoisomers. These enzymes open the possibilities for biocatalytic production of a broader range of iridoids, providing a versatile system for the diversification of this important natural product scaffold

Effectiveness of a national quality improvement programme to improve survival after emergency abdominal surgery (EPOCH): a stepped-wedge cluster-randomised trial

BACKGROUND: Emergency abdominal surgery is associated with poor patient outcomes. We studied the effectiveness of a national quality improvement (QI) programme to implement a care pathway to improve survival for these patients. METHODS: We did a stepped-wedge cluster-randomised trial of patients aged 40 years or older undergoing emergency open major abdominal surgery. Eligible UK National Health Service (NHS) hospitals (those that had an emergency general surgical service, a substantial volume of emergency abdominal surgery cases, and contributed data to the National Emergency Laparotomy Audit) were organised into 15 geographical clusters and commenced the QI programme in a random order, based on a computer-generated random sequence, over an 85-week period with one geographical cluster commencing the intervention every 5 weeks from the second to the 16th time period. Patients were masked to the study group, but it was not possible to mask hospital staff or investigators. The primary outcome measure was mortality within 90 days of surgery. Analyses were done on an intention-to-treat basis. This study is registered with the ISRCTN registry, number ISRCTN80682973. FINDINGS: Treatment took place between March 3, 2014, and Oct 19, 2015. 22 754 patients were assessed for elegibility. Of 15 873 eligible patients from 93 NHS hospitals, primary outcome data were analysed for 8482 patients in the usual care group and 7374 in the QI group. Eight patients in the usual care group and nine patients in the QI group were not included in the analysis because of missing primary outcome data. The primary outcome of 90-day mortality occurred in 1210 (16%) patients in the QI group compared with 1393 (16%) patients in the usual care group (HR 1·11, 0·96-1·28). INTERPRETATION: No survival benefit was observed from this QI programme to implement a care pathway for patients undergoing emergency abdominal surgery. Future QI programmes should ensure that teams have both the time and resources needed to improve patient care. FUNDING: National Institute for Health Research Health Services and Delivery Research Programme

Evidence of underestimation in microplastic research: A meta-analysis of recovery rate studies

Research on microplastics in the environment is of high interest to many scientists and industries globally. Key to the success of this research is the accuracy, efficiency, reliability, robustness and repeatability of the method (s) used to isolate the microplastics from environmental media. However, with microplastics now being found in new complex media, many multifaceted methods have been developed to research the quantities of these pollutants. To validate new methods, recovery studies can be undertaken by spiking the test medium with known quantities of plastics. The method is typically run as normal, and the recovered plastics counted to give a recovery rate. A current issue in this field is that methods are rarely or poorly validated in this way. Here, we conducted a meta-analysis on 71 recovery rate studies. We found sediment was the most studied medium and saline solutions were the most used reagents. Polyethylene and polystyrene were the most used spiking polymers, which is relevant to the most common polymers in the environment. We found that recovery rates were highest from plant material, whole organisms and excrement (>88%), and lowest from fishmeal, water and soil (58–71%). Moreover, all reagents but water were able to recover more than 80% of the spiked plastics. We believe we are the first (to our knowledge) to provide an overarching indication for the underestimation of microplastics in the environment of approximately 14% across the studies we reviewed, varying with the methods used. Furthermore, we recommend that the quality, use and reporting of recovery rate studies should be improved to aid the standardisation and replication of microplastic research

Assessing the effectiveness of microplastic extraction methods on fishmeal with different properties

Microplastic presence in fishmeal is an emerging research area because of its potential to enter food chains, and the importance of fishmeal within global food security. However, fishmeal is a complex medium dependant on fish composition. This study measured properties (organics, carbonates, protein and density) of five fishmeal types (trimmings, sardine and anchovy, krill, tuna and salmon), sourced from locations worldwide (Norway, South America, Antarctica, Spain and Scotland). Microplastic recovery rates were compared for existing methodologies using sodium chloride overflows and potassium hydroxide digestions and then compared to newly developed methods. These methods included dispersants and calcium chloride density separations which were developed and designed to be environmentally conscious and affordable, which we argue should become an international standard approach for researchers. A calcium chloride overflow with dispersant and potassium hydroxide digestion provided the highest recovery rate in sardine and anchovy fishmeal (66.3%). Positive correlations with recovery rate were found with protein content, and negative correlations with organic content. Low recovery rates found here suggest microplastics in fishmeal reported in the literature are underestimated. With complex media such as fishmeal, attention must be paid to variation between types and composition when choosing methods and interpreting results

Beyond the semi-synthetic artemisinin: metabolic engineering of plant-derived anti-cancer drugs

International audienc

Additional file 2 of Co-production practice and future research priorities in United Kingdom-funded applied health research: a scoping review

Additional file 2: Conceptualization and implementation of co-production in the included papers

Additional file 1 of Co-production practice and future research priorities in United Kingdom-funded applied health research: a scoping review

Additional file 1: Example search strategy for MEDLINE (adapted for other databases)

Co-production practice and future research priorities in United Kingdom-funded applied health research: a scoping review

Abstract Background Interest in and use of co-production in healthcare services and research is growing. Previous reviews have summarized co-production approaches in use, collated outcomes and effects of co-production, and focused on replicability and reporting, but none have critically reflected on how co-production in applied health research might be evolving and the implications of this for future research. We conducted this scoping review to systematically map recent literature on co-production in applied health research in the United Kingdom to inform co-production practice and guide future methodological research. Methods This scoping review was performed using established methods. We created an evidence map to show the extent and nature of the literature on co-production and applied health research, based on which we described the characteristics of the articles and scope of the literature and summarized conceptualizations of co-production and how it was implemented. We extracted implications for co-production practice or future research and conducted a content analysis of this information to identify lessons for the practice of co-production and themes for future methodological research. Results Nineteen articles reporting co-produced complex interventions and 64 reporting co-production in applied health research met the inclusion criteria. Lessons for the practice of co-production and requirements for co-production to become more embedded in organizational structures included (1) the capacity to implement co-produced interventions, (2) the skill set needed for co-production, (3) multiple levels of engagement and negotiation, and (4) funding and institutional arrangements for meaningful co-production. Themes for future research on co-production included (1) who to involve in co-production and how, (2) evaluating outcomes of co-production, (3) the language and practice of co-production, (4) documenting costs and challenges, and (5) vital components or best practice for co-production. Conclusion Researchers are operationalizing co-production in various ways, often without the necessary financial and organizational support required and the right conditions for success. We argue for accepting the diversity in approaches to co-production, call on researchers to be clearer in their reporting of these approaches, and make suggestions for what researchers should record. To support co-production of research, changes to entrenched academic and scientific practices are needed. Protocol registration details: The protocol for the scoping review was registered with protocols.io on 19 October 2021: https://dx.doi.org/10.17504/protocols.io.by7epzje