The reporting standards of randomised controlled trials in leading medical journals between 2019 and 2020: a systematic review

Randomised controlled trials (RCTs) are the gold standard study design used to evaluate the safety and effectiveness of healthcare interventions. The reporting quality of RCTs is of fundamental importance for readers to appropriately analyse and understand the design and results of studies which are often labelled as practice changing papers. The aim of this article is to assess the reporting standards of a representative sample of randomised controlled trials (RCTs) published between 2019 and 2020 in four of the highest impact factor general medical journals. A systematic review of the electronic database Medline was conducted. Eligible RCTs included those published in the New England Journal of Medicine, Lancet, Journal of the American Medical Association, and British Medical Journal between January 1, 2019, and June 9, 2020. The study protocol was registered on medRxiv (https://doi.org/10.1101/2020.07.06.20147074). Of a total eligible sample of 498 studies, 50 full-text RCTs were reviewed against the CONSORT 2010 statement and relevant extensions where necessary. The mean adherence to the CONSORT checklist was 90% (SD 9%). There were specific items on the CONSORT checklist which had recurring suboptimal adherence, including in title (item 1a, 70% adherence), randomisation (items 9 and 10, 56% and 30% adherence) and outcomes and estimation (item 17b, 62% adherence). Amongst a sample of RCTs published in four of the highest impact factor general medical journals, there was good overall adherence to the CONSORT 2010 statement. However there remains significant room for improvement in areas such as description of allocation concealment and implementation of randomisation

The B∗BπB^*B\pi coupling with relativistic heavy quarks

We report on a calculation of the $B^*B\pi$ coupling in lattice QCD. The strong matrix element $\langle B \pi | B^*\rangle$ is directly related to the leading order low-energy constant in heavy meson chiral perturbation theory (HM$\chi$PT) for $B$-mesons. We carry out our calculation directly at the $b$-quark mass using a non-perturbatively tuned clover action that controls discretisation effects of order $|\vec{p}a|$ and $(ma)^n$ for all $n$. Our analysis is performed on RBC/UKQCD gauge configurations using domain wall fermions and the Iwasaki gauge action at two lattice spacings of $a^{-1}=1.73(3)$ GeV, $a^{-1}=2.28(3)$ GeV, and unitary pion masses down to 290 MeV. We achieve good statistical precision and control all systematic uncertainties, giving a final result for the HM$\chi$PT coupling $g_b = 0.569(48)_{stat}(59)_{sys}$ in the continuum and at the physical light-quark masses. This is the first calculation performed directly at the physical $b$-quark mass and lies in the region one would expect from carrying out an interpolation between previous results at the charm mass and at the static point.Comment: 7 pages, 2 figures, presented at the 31st International Symposium on Lattice Field Theory (Lattice 2013), 29 July - 3 August 2013, Mainz, German

Traits and land transformation change the fortunes of grasshopper generalists vs. specialists in a biodiversity hotspot

Understanding the link between species traits and how they use various elements in a heterogeneous agro-natural landscape is essential for conservation planning. Land-use and season affect the availability of resources for herbivorous insects such as grasshoppers. Also, the level at which these herbivores utilise these resources on the landscape depend on their traits. We focus here on the Cape Floristic Region biodiversity hotspot, which is rich in both endemic plants and narrow-range grasshoppers. We assessed dispersion patterns and abundance of the grasshopper species across the agro-natural mosaic, while specifically focusing on species traits and how they change over two seasons (spring and summer). We found that land-use and species traits played major roles in grasshopper spatial dispersion across the landscape, with season a highly significant variable. Not surprisingly, highly mobile, generalist feeders were abundant and widely dispersed across the landscape. Importantly however, this was especially the case in late season, when they could take advantage of high plant productivity in the vineyards. In contrast, low mobility, specialist feeders were limited to occupying only natural fynbos vegetation in both seasons. Generally, the highly mobile generalists benefitted in two ways: occupation of transformed areas, and receiving a population boost late season. This was not the case for the low-mobility specialists, which were doubly disadvantaged: not able to move far, and lacking their specific host plants in the transformed areas. From a conservation perspective, our results indicate the importance of improving functional connectivity using natural fynbos for conservation of the endemic specialists, while the generalists can largely look after themselves across this agro-natural mosaic

The search for common anthropogenic impacts on biodiversity : a global network

We introduce an initiative to assess and compare landscape changes related to human activities on a global scale, using a single group of invertebrates. The GLOBENET programme uses common field methodology (pitfall trapping), to appraise assemblages of ground beetles (Coleoptera, Carabidae) in visually-similar land-mosaics (urban-rural gradients). Carabids were selected as the focal taxon as they are sufficiently varied (both taxonomically and ecologically), abundant and sensitive to the environment. However, work on other taxa is comparable with the GLOBENET framework. The continuum of decreasing human pressure from city centres into the surrounding countryside was selected to represent human-caused disturbance for this initial stage of GLOBENET because these gradients can be found virtually all over the world. Through the broad-scale assessment envisioned in the GLOBENET programme, we seek to separate general, repeated effects on biodiversity from those that depend on local environments or particular biotic assemblages. Based on this understanding we aim to develop simple tools and protocols for assessing ecological effects of human-caused landscape changes, which could help to sustainably manage landscapes for biodiversity and for human requirements. For instance, the response of different functional groups of carabids to these landscape changes may help guide management practices. Further GLOBENET developments and information are available at our website: http://www.helsinki.fi/science/globenet

Climate-Driven Oceanic Range Shift of Saint John River Atlantic Salmon Revealed by Multidecadal Stable Isotope Trends

Publisher site: David X. Soto, Michael J. Dadswell, Kurt M. Samways, Richard A. Cunjak, and Tom McDermott "Climate-Driven Oceanic Range Shift of Saint John River Atlantic Salmon Revealed by Multidecadal Stable Isotope Trends," Northeastern Naturalist 30(4), 521-539, (2 January 2024). https://doi.org/10.1656/045.030.0414Marine migration patterns of unique or regional stocks of Salmo salar (Atlantic Salmon) are poorly known. Atlantic Salmon (AS) utilizing the North Atlantic Subpolar Gyre (NASpG) for foraging and growth consist of stocks from the United States (41°N) to Greenland (64°N) in the western Atlantic and from Spain (41°N) to Norway (70°N) in the eastern Atlantic. Wide latitudinal range and unique riverine characteristics probably result in stocks selecting differing suites of marine sea-surface temperatures (SST) within the species' known selection range (i.e., their Grinnellian niche). We analyzed trends in stable carbon isotope (δ13C) composition from archived scale tissues in relation to long-term variation of SST for the North Atlantic Ocean to identify marine feeding regions used by adult AS successfully returning to the Saint John River, Canada, during the period 1982–2011. Marine foraging regions were determined for individuals that spent 1 winter (1SW) or multiple winters (MSW) at sea. During 1982–1991 and 1992–2001, AS which successfully returned, exploited more southern regions of the NASpG, while returning adults from 2002–2011 exploited more northern regions. Historically presumed marine feeding regions, which were identified by the isotopic model as probable during 1982–2001, have experienced a warming trend, and data suggests that AS returning to the Saint John River have been migrating further north in the NASpG in response to recent global climate change. The northward range shift as the North Atlantic warmed is consistent with recent biogeographical changes found among other marine species also following their Grinnellian niche

Smartphone-based remote monitoring for chronic heart failure: mixed methods analysis of user experience from patient and nurse perspectives

BACKGROUND: Community-based management by heart failure specialist nurses (HFSNs) is key to improving self-care in heart failure with reduced ejection fraction. Remote monitoring (RM) can aid nurse-led management, but in the literature, user feedback evaluation is skewed in favor of the patient rather than nursing user experience. Furthermore, the ways in which different groups use the same RM platform at the same time are rarely directly compared in the literature. We present a balanced semantic analysis of user feedback from patient and nurse perspectives of Luscii, a smartphone-based RM strategy combining self-measurement of vital signs, instant messaging, and e-learning. OBJECTIVE: This study aims to (1) evaluate how patients and nurses use this type of RM (usage type), (2) evaluate patients' and nurses' user feedback on this type of RM (user experience), and (3) directly compare the usage type and user experience of patients and nurses using the same type of RM platform at the same time. METHODS: We performed a retrospective usage type and user experience evaluation of the RM platform from the perspective of both patients with heart failure with reduced ejection fraction and the HFSNs using the platform to manage them. We conducted semantic analysis of written patient feedback provided via the platform and a focus group of 6 HFSNs. Additionally, as an indirect measure of tablet adherence, self-measured vital signs (blood pressure, heart rate, and body mass) were extracted from the RM platform at onboarding and 3 months later. Paired 2-tailed t tests were used to evaluate differences between mean scores across the 2 timepoints. RESULTS: A total of 79 patients (mean age 62 years; 35%, 28/79 female) were included. Semantic analysis of usage type revealed extensive, bidirectional information exchange between patients and HFSNs using the platform. Semantic analysis of user experience demonstrates a range of positive and negative perspectives. Positive impacts included increased patient engagement, convenience for both user groups, and continuity of care. Negative impacts included information overload for patients and increased workload for nurses. After the patients used the platform for 3 months, they showed significant reductions in heart rate (P=.004) and blood pressure (P=.008) but not body mass (P=.97) compared with onboarding. CONCLUSIONS: Smartphone-based RM with messaging and e-learning facilitates bilateral information sharing between patients and nurses on a range of topics. Patient and nurse user experience is largely positive and symmetrical, but there are possible negative impacts on patient attention and nurse workload. We recommend RM providers involve patient and nurse users in platform development, including recognition of RM usage in nursing job plans

Smartphone-based remote monitoring in heart failure with reduced ejection fraction: retrospective cohort study of secondary care use and costs

BACKGROUND: Despite effective therapies, the economic burden of heart failure with reduced ejection fraction (HFrEF) is driven by frequent hospitalizations. Treatment optimization and admission avoidance rely on frequent symptom reviews and monitoring of vital signs. Remote monitoring (RM) aims to prevent admissions by facilitating early intervention, but the impact of noninvasive, smartphone-based RM of vital signs on secondary health care use and costs in the months after a new diagnosis of HFrEF is unknown. OBJECTIVE: The purpose of this study is to conduct a secondary care health use and health-economic evaluation for patients with HFrEF using smartphone-based noninvasive RM and compare it with matched controls receiving usual care without RM. METHODS: We conducted a retrospective study of 2 cohorts of newly diagnosed HFrEF patients, matched 1:1 for demographics, socioeconomic status, comorbidities, and HFrEF severity. They are (1) the RM group, with patients using the RM platform for >3 months and (2) the control group, with patients referred before RM was available who received usual heart failure care without RM. Emergency department (ED) attendance, hospital admissions, outpatient use, and the associated costs of this secondary care activity were extracted from the Discover data set for a 3-month period after diagnosis. Platform costs were added for the RM group. Secondary health care use and costs were analyzed using Kaplan-Meier event analysis and Cox proportional hazards modeling. RESULTS: A total of 146 patients (mean age 63 years; 42/146, 29% female) were included (73 in each group). The groups were well-matched for all baseline characteristics except hypertension (P=.03). RM was associated with a lower hazard of ED attendance (hazard ratio [HR] 0.43; P=.02) and unplanned admissions (HR 0.26; P=.02). There were no differences in elective admissions (HR 1.03, P=.96) or outpatient use (HR 1.40; P=.18) between the 2 groups. These differences were sustained by a univariate model controlling for hypertension. Over a 3-month period, secondary health care costs were approximately 4-fold lower in the RM group than the control group, despite the additional cost of RM itself (mean cost per patient GBP £465, US $581 vs GBP £1850, US$2313, respectively; P=.04). CONCLUSIONS: This retrospective cohort study shows that smartphone-based RM of vital signs is feasible for HFrEF. This type of RM was associated with an approximately 2-fold reduction in ED attendance and a 4-fold reduction in emergency admissions over just 3 months after a new diagnosis with HFrEF. Costs were significantly lower in the RM group without increasing outpatient demand. This type of RM could be adjunctive to standard care to reduce admissions, enabling other resources to help patients unable to use RM

A strategy for the next decade to address data deficiency in neglected biodiversity

Measuring progress toward international biodiversity targets requires robust information on the conservation status of species, which the International Union for Conservation of Nature (IUCN) Red List of Threatened Species provides. However, data and capacity are lacking for most hyperdiverse groups, such as invertebrates, plants, and fungi, particularly in megadiverse or high-endemism regions. Conservation policies and biodiversity strategies aimed at halting biodiversity loss by 2020 need to be adapted to tackle these information shortfalls after 2020. We devised an 8-point strategy to close existing data gaps by reviving explorative field research on the distribution, abundance, and ecology of species; linking taxonomic research more closely with conservation; improving global biodiversity databases by making the submission of spatially explicit data mandatory for scientific publications; developing a global spatial database on threats to biodiversity to facilitate IUCN Red List assessments; automating preassessments by integrating distribution data and spatial threat data; building capacity in taxonomy, ecology, and biodiversity monitoring in countries with high species richness or endemism; creating species monitoring programs for lesser-known taxa; and developing sufficient funding mechanisms to reduce reliance on voluntary efforts. Implementing these strategies in the post-2020 biodiversity framework will help to overcome the lack of capacity and data regarding the conservation status of biodiversity. This will require a collaborative effort among scientists, policy makers, and conservation practitioners.Peer reviewe

CycLing and EducATion (CLEAT): protocol for a single centre randomised controlled trial of a cycling and education intervention versus standard physiotherapy care for the treatment of hip osteoarthritis

This is the final version. Available on open access from BMC via the DOI in this recordData availability: Once the research has been completed, the data will be made freely available. The dataset analysed in the study will be made available from the corresponding author on reasonable request.BACKGROUND: Osteoarthritis (OA) is a chronic degenerative joint disorder for which there is no known cure. Non-surgical management for people with mild-to-moderate hip OA focuses mainly on alleviating pain and maximising function via the National Institute for Health and Care Excellence (NICE) recommended combination of education and advice, exercise, and, where appropriate, weight loss. The CHAIN (Cycling against Hip pAIN) intervention is a group cycling and education intervention conceived as a way of implementing the NICE guidance. METHODS: CycLing and EducATion (CLEAT) is a pragmatic, two parallel arm, randomised controlled trial comparing CHAIN with standard physiotherapy care for the treatment of mild-to-moderate hip OA. We will recruit 256 participants referred to the local NHS physiotherapy department over a 24-month recruitment period. Participants diagnosed with hip OA according to NICE guidance and meeting the criteria for GP exercise referral will be eligible to participate. Primary outcome is the difference in Hip Disability and Osteoarthritis Outcome Score (HOOS) function, daily living subscale between those receiving CHAIN and standard physiotherapy care. Secondary outcomes include performance-based functional measures (40 m walking, 30s chair stand and stair climb tests), ability for patient to self-care (patient activation measure) and self-reported health-related resource use including primary and secondary care contacts. The primary economic endpoint is the number of quality adjusted life years (QALYs) at 24 weeks follow-up. The study is funded by the National Institute for Health Research, Research for Patient Benefit PB-PG-0816-20033. DISCUSSION: The literature identifies a lack of high-quality trials which inform on the content and design of education and exercise in the treatment of patients with hip OA and explore cost-effectiveness. CLEAT is a pragmatic trial which seeks to build further evidence of the clinical benefits of the CHAIN intervention compared to standard physiotherapy care within a randomised, controlled trial setting, and examine its cost-effectiveness. TRIAL REGISTRATION NUMBER: ISRCTN19778222. Protocol v4.1, 24th October 2022.National Institute for Health and Care Research (NIHR

Oil Palm Research in Context: Identifying the Need for Biodiversity Assessment

Oil palm cultivation is frequently cited as a major threat to tropical biodiversity as it is centered on some of the world's most biodiverse regions. In this report, Web of Science was used to find papers on oil palm published since 1970, which were assigned to different subject categories to visualize their research focus. Recent years have seen a broadening in the scope of research, with a slight growth in publications on the environment and a dramatic increase in those on biofuel. Despite this, less than 1% of publications are related to biodiversity and species conservation. In the context of global vegetable oil markets, palm oil and soyabean account for over 60% of production but are the subject of less than 10% of research. Much more work must be done to establish the impacts of habitat conversion to oil palm plantation on biodiversity. Results from such studies are crucial for informing conservation strategies and ensuring sustainable management of plantations