Most UK scientists who publish extremely highly-cited papers do not secure funding from major public and charity funders: A descriptive analysis

The UK is one of the largest funders of health research in the world, but little is known about how health funding is spent. Our study explores whether major UK public and charitable health research funders support the research of UK-based scientists producing the most highly-cited research. To address this question, we searched for UK-based authors of peer-reviewed papers that were published between January 2006 and February 2018 and received over 1000 citations in Scopus. We explored whether these authors have held a grant from the National Institute for Health Research (NIHR), the Medical Research Council (MRC) and the Wellcome Trust and compared the results with UK-based researchers who serve currently on the boards of these bodies. From the 1,370 papers relevant to medical, biomedical, life and health sciences with more than 1000 citations in the period examined, we identified 223 individuals from a UK institution at the time of publication who were either first/last or single authors. Of those, 164 are still in UK academic institutions, while 59 are not currently in UK academia (have left the country, are retired, or work in other sectors). Of the 164 individuals, only 59 (36%; 95% CI: 29-43%) currently hold an active grant from one of the three funders. Only 79 (48%; 95% CI: 41-56%) have held an active grant from any of the three funders between 2006-2017. Conversely, 457 of the 664 board members of MRC, Wellcome Trust, and NIHR (69%; 95% CI: 65-72%) have held an active grant in the same period by any of these funders. Only 7 out of 655 board members (1.1%) were first, last or single authors of an extremely highly-cited paper. There are many reasons why the majority of the most influential UK authors do not hold a grant from the country’s major public and charitable funding bodies. Nevertheless, the results are worrisome and subscribe to similar patterns shown in the US. We discuss possible implications and suggest ways forward

Υellow sticky rectangle with ammonium acetate slow-release dispenser: an efficient long-lasting trap for Dacus oleae

Ο συνδυασμός κίτρινου παραλληλεπίπεδου (14x20 εκ.) με κόλλα και κάψουλα οξεικού αμμωνίου βραδείας απελευθέρωσης (ΚΟΑ) συγκρίθηκε με ίδια παγίδα χωρίς οξεικό αμμώνιο (Κ), καθώς και με παγίδες γυάλινες McPhail με προσελκυστικό Buminal (MB) ή Entomozyl (ΜΕ) ή θειική αμμωνία (ΜΘΑ) σε 2% διάλυμα νερού, από τις αρχές Αυγούστου μέχρι τις αρχές Δεκεμβρίου. Όταν συγκρίθηκαν οι συνολικές συλλήψεις δάκου ελιάς σε όλη την περίοδο, δεν βρέθηκαν μεγάλες διαφορές ανάμεσα στις παγίδες ΚΟΑ, MB και ΜΕ, ενώ οι παγίδες Κ και ΜΘΑ έπιασαν πολύ λιγότερα έντομα. Όταν οι συνολικές συλλήψεις εκφράστηκαν σαν λόγος κάθε παγίδας προς την παγίδα ΚΟΑ τότε η αποδοτικότητα των παγίδων ήταν: 1 (ΚΟΑ)-0,95 (ΜΒ)-0,7 (ΜΕ)-0,33 (Κ)-0,08 (ΜΘΑ). Το φθινόπωρο (μεγάλος δακοπληθυσμός), οι παγίδες ΚΟΑ και Κ έπιασαν πάρα πολλά έντομα ενώ οι παγίδες McPhail είχαν συγκριτικά μειωμένη απόδοση προφανώς λόγω χαμηλών θερμοκρασιών και υψηλής υγρασίας. Το αντίθετο συνέβη τον Αύγουστο-Σεπτέμβριο (θερμός-ξηρός καιρός, μικρός δακοπληθυσμός).Οι παγίδες McPhail εφοδιάζοντο με φρέσκο διάλυμα προσελκυστικού κάθε περίπου μέρες το καλοκαίρι και 7 μέρες το φθινόπωρο. Οι κίτρινες παγίδες αντικαταστάθηκαν με καινούργιες μια φορά μόνο, στις αρχές Οκτωβρίου. Η κάψουλα οξεικού αμμωνίου μπορούσε να διαρκέσει πολύ περισσότερο (συνολικά περί τους 4 μήνες) αλλά οι επιφάνειες των παγίδων είχαν ήδη καλυφτεί με έντομα και άλλα αντικείμενα (φύλλα, κλαδάκια κ.λπ.).The combination of a yellow color sticky rectangle with an ammonium acetate slow-release dispenser (YAA) was compared to a yellow sticky rectangle (Y) and to a McPhail glass trap with BuminalTM(MB), EntomozylTM(ME), or ammonium sulfate (MAS) odor lure in a 2% water solution, from the beginning of August till December in an olive grove. When total olive fruit fly, Dacus oleae (Gmelin) (Diptera: Tephritidae), captures were compared, no large differences were detected among YAA, MB and ME traps, while Y and MAS ones were found much inferior. When expressed as a ratio to YAA, total captures were: 1 (YAA), 0.95 (MB), 0.70 (ME), 0.33 (Y) and 0.08 (MAS). In the fall (high population density), both yellow traps showed very high catches, while McPhail odor traps had comparatively reduced effectiveness, apparently due to cool humid weather. The opposite was true in August-September (hot dry weather, low population density). McPhail traps were serviced every 5 days (summer) or 7 days (fall), while YAA and Y traps were replaced by new ones only once, at the beginning of October. The am­monium acetate dispenser could last much longer but traps had been covered by insects and debris

Hydro-mechanichal characterisation of bentonite/steel interfaces

The hydromechanical response of a Wyoming-type bentonite (MX-80) and its interface with steel was studied in terms of shear resistance under different hydration levels. A series of shear tests under constant normal stress were performed in total suction controlled conditions. In the case of bentonite samples, higher shear resistance was obtained for higher levels of applied suction. The shear properties of the bentonite/steel interface were overall lower than the internal properties of the bentonite, and they were not affected in a significant way by the hydration level. All samples presented a compactive response during shearing

Health outcomes during the 2008 financial crisis in Europe: systematic literature review

OBJECTIVE:  To systematically identify, critically appraise, and synthesise empirical studies about the impact of the 2008 financial crisis in Europe on health outcomes. DESIGN:  Systematic literature review. DATA SOURCES:  Structural searches of key databases, healthcare journals, and organisation based websites. REVIEW METHODS:  Empirical studies reporting on the impact of the financial crisis on health outcomes in Europe, published from January 2008 to December 2015, were included. All selected studies were assessed for risk of bias. Owing to the heterogeneity of studies in terms of study design and analysis and the use of overlapping datasets across studies, studies were analysed thematically per outcome, and the evidence was synthesised on different health outcomes without formal meta-analysis. RESULTS:  41 studies met the inclusion criteria, and focused on suicide, mental health, self rated health, mortality, and other health outcomes. Of those studies, 30 (73%) were deemed to be at high risk of bias, nine (22%) at moderate risk of bias, and only two (5%) at low risk of bias, limiting the conclusions that can be drawn. Although there were differences across countries and groups, there was some indication that suicides increased and mental health deteriorated during the crisis. The crisis did not seem to reverse the trend of decreasing overall mortality. Evidence on self rated health and other indicators was mixed. CONCLUSIONS:  Most published studies on the impact of financial crisis on health in Europe had a substantial risk of bias; therefore, results need to be cautiously interpreted. Overall, the financial crisis in Europe seemed to have had heterogeneous effects on health outcomes, with the evidence being most consistent for suicides and mental health. There is a need for better empirical studies, especially those focused on identifying mechanisms that can mitigate the adverse effects of the crisis

A multichannel feature-based approach for longitudinal lung CT registration in the presence of radiation induced lung damage

Quantifying parenchymal tissue changes in the lungs is imperative in furthering the study of radiation-induced lung damage (RILD). Registering lung images from different time-points is a key step of this process. Traditional intensity-based registration approaches fail this task due to the considerable anatomical changes that occur between timepoints. This work proposes a novel method to successfully register longitudinal pre- and post-radiotherapy (RT) lung CT scans that exhibit large changes due to RILD, by extracting consistent anatomical features from CT (lung boundaries, main airways, vessels) and using these features to optimise the registrations. Pre-RT and 12-month post-RT CT pairs from fifteen lung cancer patients were used for this study, all with varying degrees of RILD, ranging from mild parenchymal change to extensive consolidation and collapse. For each CT, signed distance transforms from segmentations of the lungs and main airways were generated, and the Frangi vesselness map was calculated. These were concatenated into multi-channel images and diffeomorphic multichannel registration was performed for each image pair using NiftyReg. Traditional intensity-based registrations were also performed for comparison purposes. For the evaluation, the pre- and post-registration landmark distance was calculated for all patients, using an average of 44 manually identified landmark pairs per patient. The mean (standard deviation) distance for all datasets decreased from 15.95 (8.09) mm pre-registration to 4.56 (5.70) mm post-registration, compared to 7.90 (8.97) mm for the intensity-based registrations. Qualitative improvements in image alignment were observed for all patient datasets. For four representative subjects, registrations were performed for 3 additional follow-up timepoints up to 48-months post-RT and similar accuracy was achieved. We have demonstrated that our novel multichannel registration method can successfully align longitudinal scans from RILD patients in the presence of large anatomical changes such as consolidation and atelectasis, outperforming the traditional registration approach both quantitatively and through thorough visual inspection

Early versus Late Tracheostomy Promotes Weaning in Intensive Care Unit Patients

Background and aim of the study: The time interval between the patients’ intubation and the performance of a tracheostomy has been considered as critical for the disease prognosis and outcome. The aim of the present study was to compare and contrast the outcomes of early vs late tracheostomy with regard to intensive care unit (ICU) patients’ weaning from respiratory support. Methods: This retrospective observational study, involved patients who were hospitalized in two general and one Covid-19 ICUs of two tertiary hospitals in Athens and were subjected to tracheostomy. Data were collected from the patients’ medical records in order to estimate the duration of patient weaning and the number of days from the patients’ intubation until the time of tracheostomy. In the present study the term early tracheostomy denotes tracheostomy performed within 14 days from patient intubation and late tracheostomy defines the tracheostomy carried out after 14 days. For Covid-19 patients, guidelines suggested that tracheostomies should be performed 21 days following intubation, due to the high risk of virus transmission. Results: One hundred and thirty-one patients who underwent tracheostomy participated in the study. Most tracheostomies were performed using the percutaneous technique. The group of patients tracheostomized within 14 days after their admission in ICU weaned faster from respiratory support compared to ones who were tracheostomized after 14 days. Conclusions: The most common distinction between early and late tracheostomy is 14 days, with early tracheostomy being more beneficial in terms of patients’ outcomes, and specifically ICU patients’ weaning. (www.actabiomedica.it)

Mobilizing pilot-based evidence for the spread and sustainability of innovations in healthcare: The role of innovation intermediaries

An endemic challenge facing healthcare systems around the world is how to spread innovation more widely and sustainably. A common response to this challenge involves conducting pilot implementation studies to generate evidence of the innovation's benefits. However, despite the key role that such studies play in the local adoption of innovation, their contribution to the wider spread and sustainability of innovation is relatively under-researched and under-theorized. In this paper we examine this contribution through an empirical examination of the experiences of an innovation intermediary organization in the English NHS (National Health Service). We find that their work in mobilizing pilot-based evidence involves three main strands; configuring to context; transitioning evidence; and managing the transition. Through this analysis we contribute to theory by showing how the agency afforded by intermediary roles can support the effective transitioning of pilot-based evidence across different phases in the innovation journey, and across different occupational groups, and can thus help to create a positive feedback loop from localized early implementers of an innovation to later more widespread adoption and sustainability. Based on these findings, we develop insights on the reasons for the unnecessary repetition of pilots – so-called ‘pilotitis’- and offer policy recommendations on how to enhance the role of pilots in the wider spread and sustainability of innovation

Acceptability and feasibility of an isometric resistance exercise program for abdominal cancer surgery: An embedded qualitative study

Although it is recognized in the early stages of cancer recovery that changes in lifestyle including increases in physical activity improves physical function, there are no clear findings whether low versus moderate intensity activity or home or gym exercise offer optimal benefit. Isometric-resistance exercises can be carried out with very little equipment and space and can be performed while patients are bed-bound in hospital or at home. This embedded qualitative study, based in an English hospital trust providing specialist cancer care, was undertaken as a component of a feasibility trial to evaluate the acceptability and feasibility of an isometric-resistance exercise program and explore the suitability of functional assessments by drawing from the experiences of abdominal cancer patients following surgery. Telephone interviews were undertaken with 7 participants in the intervention group, and 8 interviews with the usual care group (n¼ 15). The gender composition consisted of 11 females and 4 males. Participants’ ages ranged from 27 to 84 (M¼ 60.07, SD ¼ 15.40). Interviews were conducted between August 2017 and May 2018, with audio files digitally recorded and data coded using thematic framework analysis. Our results show that blinding to intervention or usual care was a challenge, participants felt the intervention was safe and suitable aided by the assistance of a research nurse, yet, found the self-completion questionnaire tools hard to complete. Our study provides an insight of trial processes, participants’ adherence and completion of exercise interventions, and informs the design and conduct of larger RCTs based on the experiences of abdominal cancer surgery patients