Surgical trainee research collaboratives in the UK: an observational study of research activity and publication productivity.

OBJECTIVES: To analyse the research activity and publication output of surgical trainee research collaboratives in the UK. SETTING: Surgical trainee research collaboratives in the UK. PARTICIPANTS: A total of 24 collaboratives were included in this study from 33 identified organisations. We excluded one group that focused purely on systematic review of the literature and eight groups for which we could not identify suitable data sources (website or trainee committee contact). PRIMARY AND SECONDARY OUTCOME: Primary data-points were identified for each collaborative including surgical subspeciality, numbers and types of projects. For published articles, secondary outcomes including study population size, journal impact factor, number of citations and evidence level were collected. RESULTS: A total of 24 collaboratives met our inclusion criteria with a portfolio of 80 projects. The project types included audit (46%), randomised clinical trial (16%), surveys (16%), cohort studies (10%), systematic reviews (2.5%) and other or unidentifiable (9.5%). A total of 35 publications were identified of which just over half (54%) were original research articles. The median size of studied population was 540 patients with a range from 108 to 3138. The published works provided a varied compilation of evidence levels ranging from 1b (individual RCT) to 5 (expert opinion) with a median level of 2b (individual cohort study). The West Midlands Research Collaborative had the highest number of publications (13), citations (130) and h-index (5). CONCLUSIONS: The experience of UK-based trainee research collaboratives provides useful insights for trainees and policymakers in global healthcare systems on the value and feasibility of trainee-driven high quality surgical research.AABJ is funded by the Wellcome Trust (grant number R43608). PJH is supported by the National Institute for Health Research (NIHR) Cambridge Biomedical Research Centre and by an NIHR Research Professorship.This is the final version of the article. It first appeared from BMJ Publishing Group via http://dx.doi.org/10.1136/bmjopen-2015-01037

Management of Acute COPD Exacerbations in Australia: Do we Follow the Guidelines?

Objective: We aimed to assess adherence to the Australian national guideline (COPD-X) against audited practice, and to document the outcomes of patients hospitalised with an acute exacerbation of chronic obstructive pulmonary disease (COPD) at discharge and 28 days after. Methods: A prospective clinical audit of COPD hospital admission from five tertiary care hospitals in five states of Australia was conducted. Post-discharge follow-up was conducted via telephone to assess for readmission and health status. Results: There were 207 admissions for acute exacerbation (171 patients; mean 70.2 years old; 50.3%males). Readmission rates at 28 days were 25.4%, with one (0.6%) death during admission and eight(6.1%) post-discharge within 28 days. Concordance to the COPD-X guidance was variable; 22.7% performed spirometry, 81.1% had blood gases collected when forced expiratory volume in 1 s was \u3c1 \u3eL,99.5% had chest radiography performed, 95.1% were prescribed systemic corticosteroids and 95% were prescribed antibiotic therapy. There were 89.1% given oxygen therapy and 92.6% when arterial oxygen tension was \u3c80 \u3emmHg; 65.6% were given ventilatory assistance when pH was Conclusion: When compared against clinical practice guidelines, we found important gaps in management of patients admitted with COPD throughout tertiary care centres in Australia. Strategies to improve guideline uptake are needed to optimise care

Dynamical tunneling in molecules: Quantum routes to energy flow

Dynamical tunneling, introduced in the molecular context, is more than two decades old and refers to phenomena that are classically forbidden but allowed by quantum mechanics. On the other hand the phenomenon of intramolecular vibrational energy redistribution (IVR) has occupied a central place in the field of chemical physics for a much longer period of time. Although the two phenomena seem to be unrelated several studies indicate that dynamical tunneling, in terms of its mechanism and timescales, can have important implications for IVR. Examples include the observation of local mode doublets, clustering of rotational energy levels, and extremely narrow vibrational features in high resolution molecular spectra. Both the phenomena are strongly influenced by the nature of the underlying classical phase space. This work reviews the current state of understanding of dynamical tunneling from the phase space perspective and the consequences for intramolecular vibrational energy flow in polyatomic molecules.Comment: 37 pages and 23 figures (low resolution); Int. Rev. Phys. Chem. (Review to appear in Oct. 2007

Varietal differences influence arsenic and lead contamination of rice grown in mining impacted agricultural fields of Zamfara State, Nigeria.

In Zamfara state, Nigeria, rice is cultivated in fields contaminated with Pb (lead) from artisanal and illicit mining activities. Rice grown in such contaminated agricultural areas risks not only Pb contamination but also contamination from other toxic elements, like arsenic (As); co-contamination of Pb and As in rice cultivated in mining impacted areas has been previously reported and rice is a hyperaccumulator of As. A field study was conducted with ten different commonly-cultivated Nigerian rice varieties in the mining-impacted farmlands of Dareta village, Zamfara State. The aim was to determine the optimal rice variety for cultivation on these contaminated farmlands; an optimal variety would have the lowest contaminant concentrations and highest essential elements concentrations in the rice grains. A total of 300 paired soil and rice plants were collected. The mean As and Pb concentrations in paddy soils were 0.91 ± 0.82 mg kg-1 and 288.5 ± 464.2 mg kg-1, respectively. Mean As (30.4 ± 15.1 μg kg-1) content in rice grains was an order of magnitude lower than the Codex recommendation of 200 μg kg-1 (for milled rice) while the Pb content in all the rice varieties (overall mean of 743 ± 327 μg kg-1) was approximately four times higher than the Codex recommendation of 200 μg kg-1. Contrary to previous studies, a negative correlation was observed between As and Pb in rice grains across all the varieties. Rice variety Bisalayi was the variety with the lowest Pb transfer factor (TF = 0.08), but the average Pb concentration in rice grain was still above the Codex recommendation. Bisalayi also had the highest TF for iron. Variety ART_15, which had the lowest As uptake (TF = 0.10), had the highest TF for essential elements (magnesium, potassium, manganese, zinc, and copper). In areas of Pb contamination, Bisalayi rice may therefore be a suitable variety to choose for cultivation

Performance of Monolayer Graphene Nanomechanical Resonators with Electrical Readout

The enormous stiffness and low density of graphene make it an ideal material for nanoelectromechanical (NEMS) applications. We demonstrate fabrication and electrical readout of monolayer graphene resonators, and test their response to changes in mass and temperature. The devices show resonances in the MHz range. The strong dependence of the resonant frequency on applied gate voltage can be fit to a membrane model, which yields the mass density and built-in strain. Upon removal and addition of mass, we observe changes in both the density and the strain, indicating that adsorbates impart tension to the graphene. Upon cooling, the frequency increases; the shift rate can be used to measure the unusual negative thermal expansion coefficient of graphene. The quality factor increases with decreasing temperature, reaching ~10,000 at 5 K. By establishing many of the basic attributes of monolayer graphene resonators, these studies lay the groundwork for applications, including high-sensitivity mass detectors

Cost-Effectiveness of Pooled Nucleic Acid Amplification Testing for Acute HIV Infection after Third-Generation HIV Antibody Screening and Rapid Testing in the United States: A Comparison of Three Public Health Settings

Angela Hutchinson and colleagues conducted a cost-effectiveness analysis of pooled nucleic acid amplification testing following HIV testing and show that it is not cost-effective at recommended antibody testing intervals for high-risk persons except in very high-incidence settings

Time-Ordered Networks Reveal Limitations to Information Flow in Ant Colonies

BACKGROUND: An important function of many complex networks is to inhibit or promote the transmission of disease, resources, or information between individuals. However, little is known about how the temporal dynamics of individual-level interactions affect these networks and constrain their function. Ant colonies are a model comparative system for understanding general principles linking individual-level interactions to network-level functions because interactions among individuals enable integration of multiple sources of information to collectively make decisions, and allocate tasks and resources. METHODOLOGY/FINDINGS: Here we show how the temporal and spatial dynamics of such individual interactions provide upper bounds to rates of colony-level information flow in the ant Temnothorax rugatulus. We develop a general framework for analyzing dynamic networks and a mathematical model that predicts how information flow scales with individual mobility and group size. CONCLUSIONS/SIGNIFICANCE: Using thousands of time-stamped interactions between uniquely marked ants in four colonies of a range of sizes, we demonstrate that observed maximum rates of information flow are always slower than predicted, and are constrained by regulation of individual mobility and contact rate. By accounting for the ordering and timing of interactions, we can resolve important difficulties with network sampling frequency and duration, enabling a broader understanding of interaction network functioning across systems and scales

Prospective, multicentre study of external ventricular drainage-related infections in the UK and Ireland.

OBJECTIVES: External ventricular drain (EVD) insertion is a common neurosurgical procedure. EVD-related infection (ERI) is a major complication that can lead to morbidity and mortality. In this study, we aimed to establish a national ERI rate in the UK and Ireland and determine key factors influencing the infection risk. METHODS: A prospective multicentre cohort study of EVD insertions in 21 neurosurgical units was performed over 6 months. The primary outcome measure was 30-day ERI. A Cox regression model was used for multivariate analysis to calculate HR. RESULTS: A total of 495 EVD catheters were inserted into 452 patients with EVDs remaining in situ for 4700 days (median 8 days; IQR 4-13). Of the catheters inserted, 188 (38%) were antibiotic-impregnated, 161 (32.5%) were plain and 146 (29.5%) were silver-bearing. A total of 46 ERIs occurred giving an infection risk of 9.3%. Cox regression analysis demonstrated that factors independently associated with increased infection risk included duration of EVD placement for ≥8 days (HR=2.47 (1.12-5.45); p=0.03), regular sampling (daily sampling (HR=4.73 (1.28-17.42), p=0.02) and alternate day sampling (HR=5.28 (2.25-12.38); p<0.01). There was no association between catheter type or tunnelling distance and ERI. CONCLUSIONS: In the UK and Ireland, the ERI rate was 9.3% during the study period. The study demonstrated that EVDs left in situ for ≥8 days and those sampled more frequently were associated with a higher risk of infection. Importantly, the study showed no significant difference in ERI risk between different catheter types

Brain and Spinal Cord Interaction: Protective Effects of Exercise Prior to Spinal Cord Injury

We have investigated the effects of a spinal cord injury on the brain and spinal cord, and whether exercise provided before the injury could organize a protective reaction across the neuroaxis. Animals were exposed to 21 days of voluntary exercise, followed by a full spinal transection (T7–T9) and sacrificed two days later. Here we show that the effects of spinal cord injury go beyond the spinal cord itself and influence the molecular substrates of synaptic plasticity and learning in the brain. The injury reduced BDNF levels in the hippocampus in conjunction with the activated forms of p-synapsin I, p-CREB and p-CaMK II, while exercise prior to injury prevented these reductions. Similar effects of the injury were observed in the lumbar enlargement region of the spinal cord, where exercise prevented the reductions in BDNF, and p-CREB. Furthermore, the response of the hippocampus to the spinal lesion appeared to be coordinated to that of the spinal cord, as evidenced by corresponding injury-related changes in BDNF levels in the brain and spinal cord. These results provide an indication for the increased vulnerability of brain centers after spinal cord injury. These findings also imply that the level of chronic activity prior to a spinal cord injury could determine the level of sensory-motor and cognitive recovery following the injury. In particular, exercise prior to the injury onset appears to foster protective mechanisms in the brain and spinal cord

Cultural adaptation and validation of an instrument on barriers for the use of research results

ABSTRACT Objective: to culturally adapt The Barriers to Research Utilization Scale and to analyze the metric validity and reliability properties of its Brazilian Portuguese version. Method: methodological research conducted by means of the cultural adaptation process (translation and back-translation), face and content validity, construct validity (dimensionality and known groups) and reliability analysis (internal consistency and test-retest). The sample consisted of 335 nurses, of whom 43 participated in the retest phase. Results: the validity of the adapted version of the instrument was confirmed. The scale investigates the barriers for the use of the research results in clinical practice. Confirmatory factorial analysis demonstrated that the Brazilian Portuguese version of the instrument is adequately adjusted to the dimensional structure the scale authors originally proposed. Statistically significant differences were observed among the nurses holding a Master's or Doctoral degree, with characteristics favorable to Evidence-Based Practice, and working at an institution with an organizational cultural that targets this approach. The reliability showed a strong correlation (r ranging between 0.77 and 0.84, p<0.001) and the internal consistency was adequate (Cronbach's alpha ranging between 0.77 and 0.82). Conclusion: the Brazilian Portuguese version of The Barriers Scale was valid and reliable in the group studied