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BACKGROUND: Ectopic pregnancy (EP) is the implantation of an embryo outside the eutopic cavity with the most location of EP is in the fallopian tube (FT), known as tubal EP (TEP). The FT of TEP expresses higher levels of pro-inflammatory cytokines such as interleukin-1 (IL-1), IL-6, and IL-8. AIM: The study aimed to look systematically into the current literature and carefully analyze the results to explore the role of IL in EP. METHODS: Three independent reviewers conducted the literature search through some electronic databases searching for articles fulfilling inclusion and exclusion criteria. The lead author independently assessed the risk of bias of each of the 313 articles identified in database searching, 12 articles met the criteria for this review. CONCLUSION: IL-6 and IL-8 have diagnostic significance in predicting EP with the cutoff levels of IL-6 and IL-8 which were 26.48 and 40 pg/mL. Further, research is needed for the role of other interleukins in EP.

BACKGROUND: Presenting research at national and international meetings is an important aspect of the practice of respiratory care. Our department regularly presented abstracts but few projects were written up as manuscripts. We also noted that we did not have a centralized strategy to evaluate individual projects and provide mentorship. To address these challenges, we formed a Research Committee that meets monthly. We hypothesized that the formation of this committee would be associated with an increase in published manuscripts. METHODS: We evaluated all original research abstracts authored or co-authored by Duke respiratory therapists presented at the AARC Open Forum between 2009 and 2019. Abstracts were grouped into two time periods; 1) 2009–2013 (before the formation of the research committee) and 2) 2014–2019 (after the formation of the research committee). Abstracts were evaluated based on authors, type of study, patient population, and whether the abstract resulted in a manuscript. Primary outcome was the percentage of abstracts published as manuscripts. RESULTS: A total of 56 abstracts were presented by 23 different lead authors, with 16 (29%) published as manuscripts. After formation of the committee, fewer abstracts per year were presented, but these abstracts were more likely to be published as manuscripts (53% vs 18%, P = .02). For abstracts published as manuscripts, there was a significant difference in the type of study before and after committee formation (P = .042), but there were no differences in lead author credentials, senior author credentials, author gender, or patient population. CONCLUSIONS: The formation of a research committee was associated with an increase in the percentage of abstracts published as manuscripts.

A previous article sought to signpost papers that were considered helpful when starting on the journey of practicing evidence-based medicine (EBM).1 The lead author was invited to run a workshop at the Eighth Conference of the International Society for Evidence-Based Health Care run in collaboration with the Gruppo Italiano per la Medicina Basata sulle Evidenze from 6 November to 9 November 2019. The aim of the workshop was to challenge a group of teachers and educators to consider useful papers for the teaching of EBM/evidence-based healthcare (EBHC). The second aim was to start a database of such studies. The third aim was to share learning and foster discussion from the workshop through journal publication. EBM and EBHC are used interchangeable throughout this article. Working in eight small groups (three to five people), teachers and researchers of EBM/EBHC (n=29) first listed any articles that they considered useful for new teachers starting out their teaching journey. So that the challenge also acted as learning for the participants, they were deliberately not briefed on the full nature of the workshop (eg, the consideration and selection of specific articles). After 15 min, each group spent another 10 min selecting their top three articles from their original list (if this list had more than three papers). This was followed by another 5 min selecting their final article to put forward for this paper consensus and any disagreements resolved via discussion. Groups had to provide the following information for each paper: authors; year of publication; title; reason(s) for inclusion; link to paper/reference. Learning from previous experiences, the workshop lead (DN) instructed that a group could not select an article for which a group member was an author thus avoiding one possible source of conflict. As a group we felt that this specific rule of the article selection process …

A large study of children and young people who caught SARS-CoV-2 has found that as many as one in seven (14%) may still have symptoms 15 weeks later.1 However, this figure is lower than in some studies that have reported a prevalence of long covid as high as 51% in children and young people. Speaking at a Science Media Centre briefing, the study’s lead author, Terence Stephenson, who is Nuffield professor of child health at the UCL Great Ormond Street Institute of Child Health in London, said, “It is reassuring that the figures were lower than the worst case scenarios predicted last December. However, they are not of trivial importance.” The Children and Young People with Long Covid (Clock) study is published as a preprint and has not yet been peer reviewed. But its strengths are that it is nationally representative, relies on PCR proven covid …

This article summarizes the background, content and outcomes of a special meeting that was convened among oncologists and scientists to discuss the role of pharmacogenetic (PGx) testing in pediatric clinical oncology practice. This meeting provided an opportunity for what the lead author (AM Issa) refers to as the ‘voice of the clinician’ dynamic to be amplified in order to better understand how personalized or precision medicine applications such as PGx testing are adopted and incorporated into clinical settings and what we can learn from the experiences of current and ongoing implementation PGx approaches to further the implementation of precision medicine applications in real-world environments. Group dynamics and clinical experience with PGx testing and return of results shaped the discussion.

It was excellent, and poignant, to see that the results from the Animal Welfare Foundation-funded study of UK animal welfare priorities had been published in a peer-review paper in Vet Record .1 Among the four distinguished authors was lead author Fiona Rioja-Lang; a good friend and colleague who tragically died in 2019, before she could see the fruits of her labours. In a recent editorial ( VR , 11/18 July 2020, vol 187, …

A Cochrane systematic review has found that, when it comes to antibody testing for covid-19, timing is everything. The review of 54 studies found that antibody tests carried one week after a patient first developed symptoms detected only 30% of people who had covid-19. Accuracy increased in to 72% at two weeks and to 94% in the third week.1 “If you use them at the wrong time they don’t work,” said Jon Deeks, professor of biostatistics at the University of Birmingham and the review’s lead author. The duration of rises in antibodies is also currently unknown, and the researchers found very little data beyond 35 days after the start of symptoms. Another problem is that the data mainly came from …

The brain function and cognitive ability of a team of rugby players declined over the course of a single season, a UK study has found. A team of professional Rugby Union players were less able to remember, carry out mental tasks, and formulate ideas as the season went on, adding to growing evidence that head collisions in some sports could be making players more susceptible to neurodegenerative diseases in later life.1 The study, published in the Journal of Experimental Physiology , also found that players had reduced blood flow to the brain, particularly those who experienced more collisions. “We’ve provided a sniff of a potential underlying mechanism that could explain accelerated cognitive decline in later life,” said Damian Bailey, the study’s lead author and professor of physiology and biochemistry at the University of South Wales. Previous …

Good quality evidence is urgently needed to inform doctors on how to discontinue antidepressants safely and effectively, a Cochrane review has highlighted.1 An international team of researchers assessed randomised controlled trials comparing approaches to discontinuation and continuation of antidepressants in patients who had used them for depression or anxiety for at least six months. But the team reached no firm conclusions about the effects and safety of the approaches reviewed because of the low certainty of evidence from the existing studies. Ellen Van Leeuwen, lead author from the Clinical Pharmacology …

Rapid antigen (lateral flow) tests are better at identifying covid-19 infection in people with symptoms than in those with none, although the diagnostic accuracy of different brands of tests varies widely, a Cochrane review has found.1 The review’s lead author criticised the UK government for rolling out the lateral flow testing programme in the absence of empirical evidence. The latest report updates previous reviews2 and includes evidence from 64 studies up to November 2020. Most were conducted in Europe and the United States and assessed the accuracy of lateral flow tests in detecting current SARS-CoV-2 infection when compared with the standard laboratory genome testing. The World Health Organization’s performance standards require that tests correctly identify at least 80% of infected people (test sensitivity) and exclude infection in at least 97% of uninfected people (test specificity). The Cochrane analysis found that …

The gap in cancer outcomes between England and similar countries has not narrowed despite 20 years of well intended effort, says a new report from the Health Foundation.1 Although England’s outcomes have improved, other countries have improved as fast and have maintained their lead. “England is towards the bottom of the table, and not closing the gap,” said Rebecca Fisher, a GP and coauthor of the report. Mike Richards, former national cancer director and the report’s lead author, said that thousands of deaths could be avoided every year if England matched the outcomes achieved by the best in Europe. “This is the equivalent of a jumbo jet of people falling from the sky every two weeks.” The comparisons are stark. A person given a diagnosis of colon cancer in Australia, for example, has a 71% chance of survival after five years, while a British patient with the same disease has only a 60% …

Women who are obese should be supported to lose weight before conception and between pregnancies to ensure the healthiest possible outcome for mother and baby, says new clinical guidance from the Royal College of Obstetricians and Gynaecologists.1 Fiona Denison, chair of translational obstetrics at the University of Edinburgh and lead author of the guideline, said, “Pregnancy provides an opportunity for healthcare professionals to connect with women at a time when they are generally more concerned about their health. By making healthy changes to their diet and exercise, women who are obese may limit the amount of extra weight they gain during pregnancy. “Losing …

Cochrane has determined that the lead author of its review on human papillomavirus vaccine, Marc Arbyn, did not breach its rules on commercial sponsorship by not declaring his involvement in two organisations funded in whole or part by industry. The complaints about alleged conflicts of interest undisclosed by Arbyn, of the Belgian Cancer Centre in Brussels, were made by several organisations and individuals after the review was published in May 2018.1 The first complaint seems to have come from the Japanese organisation Yakugai, which published a critique of the review on 7 June.2 Yakugai has campaigned against use of the vaccine, holding meetings at which people claiming to have been injured by the vaccine …

The Cochrane Collaboration has asked its expert committee on financial links to consider whether the lead author of the review into the human papillomavirus (HPV) vaccine, Marc Arbyn of the Belgian Cancer Centre in Brussels, fully disclosed any conflicts of interest. The review, which found the vaccines to be effective and safe, has been the subject of complaints that it failed to include all relevant trials or to make clear their possible sources of bias. Cochrane has rejected the criticism, saying that only five trials were omitted and that including them would have made no difference to the review’s conclusions. In the declaration of interests Arbyn said that he had received travel grants from Sanofi-Pasteur-MSD and GlaxoSmithKline and that …

A directional microwave weapon was the most likely cause of debilitating neurological symptoms reported by US diplomats in Cuba who heard strange, unexplained sounds at the onset of their symptoms, says the lead author of a medical team that examined the diplomats and reported preliminary findings in JAMA in March.1 That article noted evidence of brain injury but did not offer an explanation of the cause. Microwave weapons were a recurring theme at a House Foreign Affairs Committee hearing on Cuba policy on 6 September, although State Department officials, while still characterising the events of November 2016 as an “attack,” were unwilling to support any particular theory of how it was carried …

Use of electronic cigarettes appears to be an independent risk factor for respiratory disease in addition to tobacco smoking, according to the first population based long term analysis to investigate the association.1 “We found that for e-cigarette users the odds of developing lung disease increased by about a third, even after controlling for their tobacco use and their clinical and demographic information,” said the lead author Stanton Glantz, professor of medicine at the University of California, San Francisco. “We concluded that e-cigarettes are harmful on their own, and the effects are independent of smoking conventional tobacco,” he added. The study, published in the American Journal of Preventive Medicine , analysed …

Cities with strong local leaders and devolved powers are able to drive improvements in public health, a report has found.1 Giving cities greater control over resources could help to reduce health inequalities, the authors said. The report’s lead author, Chris Naylor, senior fellow at the think tank the King’s Fund, said, “Around the world cities are looking at what they can do to help residents live longer, healthier lives. Increasingly, leaders in cities such as Amsterdam, New York, and Paris are using the powers and resources at their disposal to …

This study represents the PhD thesis research of the lead author. The greater study is designed as a mixed-methods explanatory case study. The overarching objective is to explore whether the CEAB graduate attributes are emphasized in the engineering programs in the Faculty of Engineering at the University of Manitoba in the most optimal way. The first phase of the study is designed to determine the relative importance and the levels of dependencies of the graduate attributes across three engineering stakeholder groups: faculty, students, and industry members. In this paper, the design and methodology of the first phase of this mixed methods research study are explained, and the preliminary findings from the participation rates and participants’ familiarity with the graduate attributes on the survey data are presented. Results show that a sizable percentage of students, faculty and industry members are not highly familiar with the CEAB graduate attributes. Therefore, work to develop a common knowledge about the CEAB graduate attributes needs to continue.

As the lead author of a recently published systematic review on hydrogel burn dressings in pre-hospital, I was alarmed to read the claim by the authors to the effect no one method of burn wound cooling was superior to any other; “There is no evidence to recommend a specific temperature or method of cooling”. The reputation and prominence of the ERC within the circle of resuscitation councils now delving into 1st Aid recommendations leads to the conclusion that misguided recommendations may cause confusion amongst first responders, may falsely misdirect 1st Aid providers to unsupported practices or alternatively create a window of opportunity for marketers or sellers of alternative burn 1st Aid technologies to make unsupported claims in respect of comparable efficacy of their own product versus “traditional” methods.

Adolescent depression is a silent epidemic in this country. Untreated depression has detrimental effects on physical health, psychosocial well-being, and academic productivity. It is important for school nurses to be able to recognize depression and refer students promptly for treatment. This article and its associated learning module will provide school nurses with updated information on adolescent depression, discuss barriers in depression screening, use of the PHQ-9 (Patient Health Questionaire-9 Item) as an evidence-based depression screening tool in the educational setting, and the important role of school nurses in depression screening. It is anticipated that by increasing awareness and knowledge about adolescent depression and providing training in the use of an evidence-based screening tool, school nurses will have greater confidence in identifying and referring students in need. (A free online depression screening education module developed by the lead author is available at https://sites.google.com/view/depressionscreeningtraining .)

The prevalence of eating disorders in women in midlife is higher than expected, a study published in BMC Medicine has found, as 3.6% of women in their 40s and 50s reported having experienced an eating disorder in the past 12 months.1 Eating disorders are often associated with adolescence and early adulthood, but the study, which assessed the prevalence of eating disorders in the fifth and sixth decades of life, found that they were surprisingly common and frequently went untreated. The study included 5320 UK women, of whom around 15.3% (95% confidence interval 13.5% to 17.4%) reported having had an eating disorder at some point in life, and less than 30% of those said that they had sought help or received treatment for it. Nadia Micali, lead author, …

Death rates from sepsis in New York state fell more quickly than in other states after a state wide mandatory treatment protocol was introduced, a study has shown. The retrospective study examined more than a million admissions to hospital of people with sepsis to evaluate the effect of New York state’s regulations. “Rarely in the US do we force hospitals to implement specific clinical protocols,” said the lead author, Jeremy Kahn, from the University of Pittsburgh. “For the first time, state officials are enshrining in regulations that hospitals must follow certain evidence based protocols when it comes to sepsis. …

Showing people ultrasound scan information enabling them to visualise their level of silent atherosclerosis is associated with reduced cardiovascular risk one year later compared with simply telling people about their risk factors, a pragmatic randomised study1 has shown. “This trial shows the power of using personalised images of atherosclerosis as a tool to potentially prompt behaviour change and reduce the risk of cardiovascular disease,” said lead author Ulf Naslund, professor and chief physician in public health and clinical medicine at Umea University, Sweden. The study included 3512 people aged 40, 50, or 60 years who were taking …

In order to design an effective and economical multi-point mooring system for the new concept FPSO IQFP (fillet inverted quadrangular frustum pyramid shaped FPSO, presented by the lead author), the effects of the mooring parameters on the performance of catenary mooring system and taut mooring system were investigated according to the initial design plans given in advance according to the steady environment forces and practical experiences. Then, the optimal mooring systems were developed on the basis of the static analysis results combined with the coupled calculations in time domain. Finally, the merits and demerits of the two mooring schemes were compared based on the mooring and static characteristic parameters as well as the curves of restoring force against horizontal displacement of the catenary and taut mooring systems respectively. The results verify that the taut mooring system is preferable to the catenary mooring system for IQFP deployed in shallow waters.

The Theory of Living Human Systems (TLHS) aims to explain individual and group behavior; Systems-Centered Training (SCT) translates TLHS into methods for practice. SCT integrates many psychological practices but its signature method is functional subgrouping (FS). FS is used to discriminate differences within and between individuals and groups and to integrate them as resources in a more diverse, functional system, instead of scapegoating differences in systems fraught with conflict. This paper introduces TLHS, SCT and FS plus related research. It also includes reflections from three SCT-experienced ACPE supervisors who have used FS to create a form of koinonia in CPE training and chaplaincy. Lead author Richard M. O'Neill will be a plenary speaker at the Association of Professional Chaplains' 2012 Annual Conference in Schaumburg, IL. He also will present a workshop titled “Working as a Systems-Centered Partner, Group Member and Leader.”

Gaining informed consent is a key element of safe and transparent patient care. Although cardiac surgery is considered gold standard in many cases of complex cardiac disease, it is associated with significant complications including mortality.

The purpose of this study was to verify the inter-rater agreement level as a means of obtaining an efficiency measure of a standard mastication evaluation through video recordings. The studied population included oral breathing children and teenagers with maxillary atresia. The chewing aspects studied were mode of chewing and preferential chewing side. A white tag was placed on half the subjects´ chins while the recordings were made. Two expert evaluators analyzed 54 video recordings at regular viewing speed. The lead author analyzed the same video recordings both at reduced speed and at reduced speed linked through graphical computing techniques. The analysis was conducted on chewing cycles with the viewing angle of the frontal plane. Findings indicated that when comparing the data for the three manners of watching the video recordings, the agreement level was higher for videos with the tag on the chin watched at reduced speed. It was also determined that alternating and bilateral mastication modes were prevalent (64.7%) in this sample.

A journal editor recently apologised for publishing a 2010 paper in which authors designated an enzyme as New Delhi metallo-β-lactamase-1 (NDM-1) and its related gene bla(NDM-1) after a city, New Delhi. This name had raised an outcry in India, with health authorities, media and medical practitioners demanding New Delhi be dropped from the name. The name was actually first given in another 2009 paper, whose corresponding author remains the same as the 2010 paper. There is a tradition of eponymous names in science. But those found derogatory to races, groups, cities, and countries have been changed. For example, "Mongolism" was changed to Down's syndrome; "Australia" antigen to HBsAg; "Mexican" Swine flu to H1N1; "GRID" (Gay Related Immune Deficiency) and 4H-Disease (Haitians, Homosexuals, Haemophiliacs and Heroin Users Disease) to AIDS. It is necessary that NDM-1 also be changed to a name based on scientific characteristics. NDM-1 must be changed to PCM (plasmid-encoding carbapenem-resistant metallo-β-lactamase). It is also necessary to review the tradition of naming organisms, diseases, genes, etc. after cities, countries and races. Often, such names giving amounts to names calling. It needs to be discarded by scientists in all new names giving from now on. "Geographical" and "racial" names giving must be replaced by "scientific" names giving. Journal editors must ensure that such scientific names giving is laid down as standard guideline in paper submissions. All such names still in currency need to be phased out by replacing them with names based on scientific characteristics, or in honour of their pioneering scientist/s or institutions. The lead author of the above 2010 paper has said he was not consulted about the final draft and did not agree with the conclusions of the paper. To ensure that corresponding authors do not ride roughshod over co-authors, and lead and other authors do not backtrack on papers, editors must ensure written concurrence of all authors, especially the lead author, to the final draft of a paper and include this in their guidelines for paper submissions.

Sweetened drinks pose a greater risk of type 2 diabetes than most other foods containing fructose because of their effect on blood glucose levels, an evidence review in The BMJ has found.1 Fruit and other foods containing fructose seemed to have no harmful effects. “These findings might help guide recommendations on important food sources of fructose in the prevention and management of diabetes,” said John Sievenpiper, the study’s lead author and a researcher at the Clinical Nutrition and Risk Factor Modification Centre of St Michael’s Hospital in Toronto, Canada. “But the level of evidence is low, and more high quality studies are needed.” …

In the article, Inhibition of DNA Methyltransferases and Histone Deacetylases Induces Bone Marrow-derived Multipotent Adult Progenitor Cells to Differentiate into Endothelial Cells, Ethn Dis. 2010;20:[Suppl 1]:S1-60-S1-64, the lead author’s name was spelled incorrectly. The corrected name is Saswati Mahapatra.The corrected citation is: Mahapatra S, Firpo MT, Bacanamwo M. Inhibition of DNA methyltransferases and histone deacetylases induces bone marrow-derived multipotent adult progenitor cells to differentiate into endothelial cells, Ethn Dis. 2010;20(1 Suppl 1):S1–60-S1-64.

People who consume more than two servings of dairy products each day have lower rates of cardiovascular disease and mortality than those with lower intakes, a global observational study has reported.1 “Our findings support that consumption of dairy products might be beneficial for mortality and cardiovascular disease, especially in low and middle income countries where dairy consumption is much lower than in North America or Europe,” said lead author Mahshid Dehghan, from McMaster University, Hamilton, Canada. Dietary guidelines currently recommend restricting consumption of whole fat dairy products because they contain saturated fats that are presumed to adversely affect lipid levels and increase cardiovascular risk. There is, however, limited evidence for this and the recommendation fails …

Self management training provided by peer workers with personal experience of mental illness significantly reduced readmission to mental health crisis units in patients discharged from acute mental healthcare, a randomised controlled trial has found.1 The lead author, Sonia Johnson, professor of social and community psychiatry at University College London, UK, said, “People discharged from community crisis services are often readmitted to acute care. Not only does this impede recovery but it also consumes resources that might otherwise be dedicated to longer term improvements in functioning and quality of life.” Over half of people currently admitted to acute mental healthcare in the UK are readmitted …

A randomised trial of use of adrenaline in patients who have a cardiac arrest outside hospital leaves paramedics with a dilemma. More patients were alive 30 days after their hearts had been restarted with adrenaline, but their chances of serious brain damage were almost doubled, show the findings, reported in the New England Journal of Medicine .1 The finding is likely to lead to a change in guidelines for treating cardiac arrest, though the trial’s lead author, Gavin Perkins of Warwick University, was reluctant to commit himself. Speaking at a briefing at the Science Media Centre in London, Perkins said it would need a broader consideration of the findings by bodies such as the …

In the recently published paper, “The Interplay Between the Microbiome and Cardiovascular Risk”, the last name of the lead author is listed incorrectly. The author’s name is Bre A. Minniefield.

Screening for abdominal aortic aneurysm has not contributed substantially to reductions in mortality associated with the condition and has increased the risk of avoidable surgery, a study analysing the nationwide screening programme in Sweden has found.1 The study’s lead author, Minna Johansson, from the University of Gothenburg, said, “Previously, the balance between the benefits and harms of screening programmes for abdominal aortic aneurysm was unclear, as the major harms had not been adequately considered. Our new findings suggest that this screening programme may be outdated, because the number of deaths from abdominal aortic aneurysm …

Fifty year olds with blood pressure that is higher than normal but below the conventional treatment threshold have increased risk of developing dementia in later life, latest findings from the long running UK Whitehall II study of civil servants1 have shown. “Our work confirms the detrimental effects of midlife hypertension for risk of dementia,” said lead author Archana Singh-Manoux, from the National Institute of Health and Medical Research in Paris (INSERM), France, and University College London, UK. She added, “It also suggests that at age 50, the risk of dementia may be increased in people who have raised levels of systolic blood …

Higher rates of premature births, lower birth weights, and more congenital abnormalities explain the much higher child mortality in England than in Sweden despite the two countries’ similar levels of economic development and universal healthcare, a comparative study has suggested.1 “While child deaths are still rare, the UK has one of the highest child mortality rates in western Europe,” said the lead author, Ania Zylbersztejn, from UCL Great Ormond Street Institute of Child Health in London, UK. She added, “Babies born prematurely or with low birth weight have an increased risk of early death, and those …

Early use of endovenous ablation to close varicose veins in patients with leg ulcers achieves significantly faster healing and more time free from ulcers than treatment with compression therapy alone followed by deferred endovascular ablation if required, a randomised trial has shown.1 “With this trial, we have shown that by intervening early you improve the healing of the leg ulcer, and help a patient recover quicker,” said lead author Alun Davies, from Imperial College London, UK. He added, “We recommend that patients are referred to a vascular clinic upon diagnosis with a venous ulcer, to see …

Using magnetic resonance imaging (MRI) to guide targeted biopsies increased the detection of clinically significant cancer by 12% when compared with standard transrectal ultrasonography guided biopsy, in the first large randomised trial to compare these two approaches in men with suspected prostate cancer.1 MRI revealed no sign of prostate cancer in more than one in four men, avoiding the need for unnecessary biopsy or treatment. “This is the first international multi-centre randomised trial to show the benefits of using MRI at the start of the prostate cancer diagnosis process,” said the lead author, Veeru Kasivisvanathan, from University College London, UK. He added, “In men who need to have investigation for prostate cancer for …

PurposeThe purpose of this paper is to further develop the recent discourse surrounding the mainstreaming of fairtrade (FT) products, particularly the concepts of “radical mainstreaming”, “clean‐wash” and “the Alternative High Street”. The research investigates the pros and cons of mainstreaming FT in the concentrated UK retail sector via the exemplar of The Day Chocolate Company.Design/methodology/approachThe paper draws on a longitudinal case study of one of the original “trail blazers” for FT in the mainstream, the 100 per cent FT social enterprise, The Day Chocolate Company (Day). The authors possess special insight to this pioneering FT model due to their unique experience of working at Day and the lead author's research, which includes findings from a series of in depth semi‐structured interviews with key informants.FindingsWith particular reference to the concepts Clean‐wash/ “Fair Trade Lite” the paper critically analyses the advantages and disadvantages of mainstreaming FT. The paper demonstrates how radical mainstreaming by 100 per cent FT companies can actually strengthen the transformative message of FT and not undermine the original ethical interest. Their ability to communicate a more complex deep message to a wider audience via unique FT brands allows radical mainstreaming companies to raise the bar and avoid the dangers of Clean‐wash. Finally the paper illustrates the significance of the Alternative High Street for radical mainstreaming companies.Research limitations/implicationsThe radical mainstreaming innovation in the paper demonstrates the value of intangibles such as relationships and networks. This means companies such as Day, could be better positioned than their private sector rivals to take advantage of the new dominant logic of marketing as it uses more operant resources to co‐create value between producers, retailers and consumers. Further research will investigate in more depth the nature of those operant resources.Originality/valueThis paper will be of interest to all key stakeholders within the FT movement including marketing professionals and other “values‐driven organisations” such as social enterprises. This research shows that sales in the UK mainstream retail market are not enough in maintaining the original ethical interests of FT; you need business models such as Day, that share power and value added between Southern and Northern partners. Further development of such radical mainstreaming business models is key to strengthening both sales and the original transformative message of FT.

Four influential rating systems that rank US hospitals use such different criteria and methods that they rarely agree, potentially confusing consumers and making it difficult for hospitals trying to use the ratings to improve the quality of their care, a new study concludes. The researchers looked at the criteria, methods, and rating results of four well known hospital rating systems: the US News “Best Hospitals” list, HealthGrades, the Leapfrog Group, and Consumer Reports. J Matthew Austin, an assistant professor at the Johns Hopkins Armstrong Institute for Patient Safety and Quality in Baltimore, Maryland, was the lead author of the paper, which …

There is a growing body of scientific support for the notion that an individual's attitudes toward aging and personal appearance (body image) have profound effects upon physical and mental wellbeing. But is it possible that such attitudes may, in measurable ways, impact the development of specific diseases? My attention was recently drawn to a study, utilizing data collected over decades from the Baltimore Longitudinal Study of Aging, in which the authors suggest that younger and middle-aged adults who held more-negative age stereotypes faced a higher risk for Alzheimer's later in life. The basis for this finding was a combination of magnetic resonance images and brain autopsies which showed significantly steeper hippocampal-volume loss and significantly greater accumulation of neurofibrillary tangles and amyloid plaques, adjusting for relevant covariates, in those participants who earlier had the more-negative attitudes toward aging.1 One hypothesis, according to the study's lead author Dr Becca Levy, associate professor of epidemiology and psychology at the Yale School of Public Health, is that pessimism regarding aging increases stress, which may be a critical factor in Alzheimer's risk.2 A wealth of information indicates that individuals often may suffer loss of self-esteem and a perceived diminishing of sexual identity, social power, social visibility, and position in the workplace as psychological effects of an aging appearance.3,4 …

The team leaders for both the USA1 and the UK2 mortality studies were S Ashley (veterinarian) and E Toland (biologist) respectively, and the respondent appears to have confused the findings of each study. As my colleagues and I cited in our Viewpoint, the Ashley and others ‘case’1 is far …

High blood pressure in early adulthood is associated with increased risk of mitral regurgitation in later life, a large UK study has reported.1 “Our research suggests this common and disabling valve disorder is not an inevitable consequence of ageing, as previously assumed, but may be preventable,” said lead author Kazem Rahimi, from the George Institute for Global Health, University of Oxford, UK. Until now, mitral valve regurgitation has largely been considered a degenerative disorder resulting from weakening of the valve with ageing. …

Patients admitted to intensive care units (ICUs) at weekends are at higher risk of death than those admitted on a weekday, even after adjusting for severity of illness, an Austrian registry study has found.1 But patients already on ICUs had lower mortality at weekends than weekdays. “This effect requires thoughtful considerations both by clinicians and policy makers, because in the 21st century the day of admission should not influence patient outcomes,” said Paul Zajic from the Medical University Graz, Austria, who was lead author of the study. The study analysed anonymised data for all 167 425 adult patients admitted to 119 ICUs in Austria between 2012 …

Positioning patients who have had an acute ischaemic stroke so that they lie flat does not improve outcomes more than sitting them up, a large randomised trial shows,1 after a debate about whether head position affects stroke recovery. Previous studies have found that laying patients flat in the 24 hours after an acute ischaemic stroke may improve recovery and reduce disability by increasing blood flow through the main arteries to the brain. Concerns were raised, however, that this could increase the risk of pneumonia. This uncertainty has resulted in ambiguous guidelines and variations in clinical practice. The lead author, …

The Cancer Drugs Fund (CDF) has not “delivered meaningful value” to patients with cancer and may have exposed them to “toxic side effects of drugs,” an analysis has found.1 The CDF was established in 2010 in England to provide “patients with faster access to the most promising new cancer treatments” and to ensure “value for money for taxpayers.” It funded drugs that were not available through the NHS because the drugs had not been appraised, were in the process of being appraised, or had been appraised but not recommended by the National Institute for Health and Care Excellence (NICE). The fund was overhauled last year. Ajay Aggarwal, academic clinical oncologist at the London School of Hygiene and Tropical Medicine and a lead author of the analysis, said, “From 2010 when it started to 2016 when it closed, the Cancer Drugs Fund cost the UK taxpayer a total of £1.27bn [€1.51bn; $1.64bn], the equivalent of one year’s total spend on all cancer drugs in the NHS. “The majority of …

Patients in Canada who have cystic fibrosis live almost 10 years longer than their counterparts in the US, a study by Canadian and US researchers has found.1 They wrote in Annals of Internal Medicine , “The risk for death was consistently lower in Canada after accounting for several patient demographic and clinical factors and persisted in patients with severe clinical phenotypes.” Lead author Anne L Stephenson, of St Michael’s Hospital in Toronto, and colleagues reviewed data on 5941 patients who were followed on the Canadian Cystic Fibrosis Registry …

PURPOSE To test the hypothesis that articles published as "preliminary" or "pilot" reports are followed by more definitive publications in only a minority of cases. METHOD A survey of Medline was performed for reports published in 1992 in journals listed in the Abridged Index Medicus that had the word "preliminary" or "pilot" in the title. For identified reports, a Medline search of publications in 1992 through 1999 was performed, using lead author's name, second author's name, and senior (last) author's name, and at least one keyword based on the publication title. Preliminary and pilot publications were subdivided by type of study (controlled clinical study, case series, laboratory or nonclinical) and by the report of either positive or negative results. Rates of publication based on study design and publication bias were compared using the chi-square test for statistical significance. RESULTS The rate of publication of follow-up reports within seven years of the initial publication was 27%. Follow-up studies of controlled clinical studies (40%) were published more frequently than were those of laboratory or nonclinical studies (31%) or case series (22%), but these differences were not significant (p >.10). There was no statistically significant difference in follow-up publication rates based on publication bias. CONCLUSION Only 27% of studies published as preliminary or pilot reports were subsequently followed by a more definitive publication. While the words preliminary and pilot suggest that publication of further, refined work is pending, this is often not the case.

A peer reviewer appointed by the Annals of Internal Medicine stole research submitted by a team from Tufts University, Boston, that was rejected by the Annals and published it six months later in a different journal under his own name. The theft came to light when the original lead author, the endocrinologist Michael Dansinger of Tufts, later chanced upon his plagiarized work in EXCLI Journal while searching the internet and contacted the corresponding author, who apologized for the plagiarism and had the article retracted.1 The current issue of Annals of Internal Medicine carries both a letter entitled “Dear plagiarist,” by Dansinger,2 and a biting commentary from the …