Related Articles

Objectives

(1) To assess endorsement of trial registration in author instructions of urology-related journals and (2) to assess whether randomised controlled trials (RCTs) in the field of urology were effectively registered.

Design

Cross-sectional study of author instructions and published trials.

Setting

Journals publishing in the field of urology.

Participants

First, the authors analysed author instructions of 55 urology-related journals indexed in ‘Journal Citation Reports 2009’ (12/2010). The authors divided these journals in two groups: those requiring and those not mentioning trial registration as a precondition for publication. Second, the authors chose the five journals with the highest impact factor (IF) from each group.

Intervention

MEDLINE search to identify RCTs published in these 10 journals in 2009 (01/2011); search of the clinical trials meta-search interface of WHO (International Clinical Trials Registry Platform) for RCTs that lacked information about registration (01–03/2011). Two authors independently assessed the information.

Outcome measures

Proportion of journals providing advice about trial registration and proportion of trials registered.

Results

Of 55 journals analysed, 26 (47.3%) provided some editorial advice about trial registration. Journals with higher IFs were more likely to mention trial registration explicitly (p=0.015). Of 106 RCTs published in 2009, 63 were registered (59.4%) with a tendency to an increase after 2005 (83.3%, p=0.035). 71.4% (30/42) of the RCTs that were published in journals mentioning and requiring registration, and 51.6% (33/64) of the RCTs that were published in journals that did not mention trial registration explicitly were registered. This difference was statistically significant (p=0.04).

Conclusions

The existence of a statement about trial registration in author instructions resulted in a higher proportion of registered RCTs in those journals. Journals with higher IFs were more likely to mention trial registration.

Article summary

Article focus

Trial registration can increase scientific transparency, but its implementation in specialty fields such as urology is unclear.

To assess the endorsement of trial registration in the author instructions of urology-related journals.

To assess whether randomised controlled trials in the field were effectively registered.

Key messages

A statement of trial registration in author instructions resulted in a higher proportion of registered randomised controlled trials.

Journals with high impact factors were more likely to mention trial registration.

We suggest, though, that ensuring trial registration is not the responsibility only of the editors. Medical scientists should realise that trial registration is necessary to contribute to transparency in research.

Strength and limitations of this study

Two authors independently assessed information regarding editorial advice about trial registration and identified the randomised controlled trials.

Potential bias occurred if registered randomised controlled trials were reported without giving a registration number and we could not identify them in the meta-search interface of WHO (International Clinical Trials Registry Platform).

Results might not be representative of the uro-nephrological field as a whole and reported figures may overestimate compliance with trial registration.

Context:

Scientific research output measured by the number and quality of publications reflects the research productivity of a certain community.

Aims:

To examine the quantity and quality of research produced by Syrian institutions with particular emphasis on the clinical and biomedical research.

Settings and Design:

Retrospective observational analysis of research originating from Syrian institutions indexed by Medline and Science Citation Index (SciVerse) Scopus bibliographic databases.

Materials and Methods:

Comprehensive review of the literature indexed by Medline and SciVerse was conducted including data from Jan 01, 1980 till February 2011 searching for authors affiliated with Syrian institutions. Clinical and biomedical research data were further analyzed quantitatively and qualitatively.

Results:

The total of manuscripts indexed by SciVerse originating from Syrian institutions during the last 3 decades is 3540. A total of 458 publications cover clinical and biomedical subject areas. The quality of these 458 publications was evaluated by the citation frequency and impact factor of publishing journals with h-index of 24.

Conclusions:

Although the spectrum of research originating from Syrian institutions is broad, the overall number of publications particularly in clinical and biomedical subjects is minuscule and of limited quality. The presented data indicate the need to promote research capabilities and to bridge the gap in research productivity by Syrian institutions.

Background

The h-index is a commonly used metric for evaluating the publication performance of researchers. However, in a multidisciplinary field such as medical informatics, interpreting the h-index is a challenge because researchers tend to have diverse home disciplines, ranging from clinical areas to computer science, basic science, and the social sciences, each with different publication performance profiles.

Objective

To construct a reference standard for interpreting the h-index of medical informatics researchers based on the performance of their peers.

Methods

Using a sample of authors with articles published over the 5-year period 2006–2011 in the 2 top journals in medical informatics (as determined by impact factor), we computed their h-index using the Scopus database. Percentiles were computed to create a 6-level benchmark, similar in scheme to one used by the US National Science Foundation, and a 10-level benchmark.

Results

The 2 benchmarks can be used to place medical informatics researchers in an ordered category based on the performance of their peers. A validation exercise mapped the benchmark levels to the ranks of medical informatics academic faculty in the United States. The 10-level benchmark tracked academic rank better (with no ties) and is therefore more suitable for practical use.

Conclusions

Our 10-level benchmark provides an objective basis to evaluate and compare the publication performance of medical informatics researchers with that of their peers using the h-index.

Background

Medical research productivity reflects the level of medical education and practice in a particular country. The objective of this study was to examine the quantity and quality of medical and biomedical research published from Palestine.

Findings

Comprehensive review of the literature indexed by Scopus was conducted. Data from Jan 01, 2002 till December 31, 2011 was searched for authors affiliated with Palestine or Palestinian authority. Results were refined to limit the search to medical and biomedical subjects. The quality of publication was assessed using Journal Citation Report. The total number of publications was 2207. A total of 770 publications were in the medical and biomedical subject areas. The annual rate of publication was 0.077 articles per gross domestic product/capita. The 770 publications have an h-index of 32. One hundred and thirty eight (18%) articles were published in 46 journals that were not indexed in the web of knowledge. Twenty two (22/770; 2.9%) articles were published in journals with an IF > 10.

Conclusions

The quantity and quality of research originating from Palestinian institutions is promising given the scarce resources of Palestine. However, more effort is needed to bridge the gap in medical research productivity and to promote better health in Palestine.

Abstract

Purpose

To summarize evidence on conservative, nondialytic management of end-stage renal disease regarding 1) prognosis and 2) symptom burden and quality of life (QOL).

Methods

Medline, Cinahl, and Cochrane were searched for records indexed prior to March 1, 2011. Bibliographies of articles and abstracts from recent meetings were reviewed. Authors and nephrologists were contacted to identify additional studies. Articles were reviewed by two authors and selected if they described stage 5 chronic kidney disease (CKD) patients managed without dialysis, including one or more of the following outcomes: prognosis, symptoms, or QOL. Levels of evidence ratings were assigned using the SORT (Strength of Recommendation Taxonomy) system. Data was abstracted independently by two authors for descriptive analysis.

Results

Thirteen studies were included. In studies of prognosis, conservative management resulted in median survival of at least six months (range 6.3 to 23.4 months). Findings are mixed as to whether dialysis prolongs survival in the elderly versus conservative, nondialytic management. Any survival benefit from dialysis decreases with comorbidities, especially ischemic heart disease. Patients managed conservatively report a high symptom burden, underscoring the need for concurrent palliative care. Additional head-to-head studies are needed to compare the symptoms of age-matched dialysis patients, but preliminary studies suggest that QOL is similar.

Conclusions

Conservative management is an important alternative to discuss when counseling patients and families about dialysis. Unlike withdrawal of dialysis in which imminent death is expected, patients who decline dialysis initiation can live for months to years with appropriate supportive care.

Objective To determine whether treatment with agonists of glucagon-like peptide-1 receptor (GLP-1R) result in weight loss in overweight or obese patients with or without type 2 diabetes mellitus.

Design Systematic review with meta-analyses.

Data sources Electronic searches (Cochrane Library, Medline, Embase, and Web of Science) and manual searches (up to May 2011).

Review methods Randomised controlled trials of adult participants with a body mass index of 25 or higher; with or without type 2 diabetes mellitus; and who received exenatide twice daily, exenatide once weekly, or liraglutide once daily at clinically relevant doses for at least 20 weeks. Control interventions assessed were placebo, oral antidiabetic drugs, or insulin.

Data extraction Three authors independently extracted data. We used random effects models for the primary meta-analyses. We also did subgroup, sensitivity, regression, and sequential analyses to evaluate sources of intertrial heterogeneity, bias, and the robustness of results after adjusting for multiple testing and random errors.

Results 25 trials were included in the analysis. GLP-1R agonist groups achieved a greater weight loss than control groups (weighted mean difference −2.9 kg, 95% confidence interval –3.6 to –2.2; 21 trials, 6411 participants). We found evidence of intertrial heterogeneity, but no evidence of bias or small study effects in regression analyses. The results were confirmed in sequential analyses. We recorded weight loss in the GLP-1R agonist groups for patients without diabetes (–3.2 kg, –4.3 to –2.1; three trials) as well as patients with diabetes (–2.8 kg, –3.4 to –2.3; 18 trials). In the overall analysis, GLP-1R agonists had beneficial effects on systolic and diastolic blood pressure, plasma concentrations of cholesterol, and glycaemic control, but did not have a significant effect on plasma concentrations of liver enzymes. GLP-1R agonists were associated with nausea, diarrhoea, and vomiting, but not with hypoglycaemia.

Conclusions The present review provides evidence that treatment with GLP-1R agonists leads to weight loss in overweight or obese patients with or without type 2 diabetes mellitus.

Background

In January 2011, human cases with hemorrhagic manifestations in the hospital staff were reported from a tertiary care hospital in Ahmadabad, India. This paper reports a detailed epidemiological investigation of nosocomial outbreak from the affected area of Ahmadabad, Gujarat, India.

Principal Findings

Samples from 3 suspected cases, 83 contacts, Hyalomma ticks and livestock were screened for Crimean-Congo hemorrhagic fever (CCHF) virus by qRT-PCR of which samples of two medical professionals (case C and E) and the husband of the index case (case D) were positive for CCHFV. The sensitivity and specificity of indigenous developed IgM ELISA to screen CCHFV specific antibodies in human serum was 75.0% and 97.5% respectively as compared to commercial kit. About 17.0% domestic animals from Kolat, Ahmadabad were positive for IgG antibodies while only two cattle and a goat showed positivity by qRT-PCR. Surprisingly, 43.0% domestic animals (Buffalo, cattle, sheep and goat) showed IgG antibodies in the adjoining village Jivanpara but only one of the buffalo was positive for CCHFV. The Hyalomma anatolicum anatolicum ticks were positive in PCR and virus isolation. CCHFV was isolated from the blood sample of case C, E in Vero E-6 cells and Swiss albino mice. In partial nucleocapsid gene phylogeny from CCHFV positive human samples of the years 2010 and 2011, livestock and ticks showed this virus was similar to Tajikistan (strain TAJ/H08966), which belongs in the Asian/middle east genetic lineage IV.

Conclusions

The likely source of CCHFV was identified as virus infected Hyalomma ticks and livestock at the rural village residence of the primary case (case A). In addition, retrospective sample analysis revealed the existence of CCHFV in Gujarat and Rajasthan states before this outbreak. An indigenous developed IgM ELISA kit will be of great use for screening this virus in India.

Author Summary

A nosocomial outbreak of CCHFV occurred in January 2011, in a tertiary care hospital in Ahmadabad, Gujarat State in western India. Out of a total five cases reported, contact transmission occurred to three treating medical professionals, all of whom succumbed to the disease. The only survivor was the husband of the index case. These results highlight the importance of considering CCHFV as a potential aetiology for Hemorrhagic fever (HF) cases in India. This also underlines the need for strict barrier nursing and patient isolation while managing these patients. During the investigation presence of CCHFV RNA in Hyalomma anatolicum ticks and livestock were detected in the village from where the primary case (case A) was reported. Further retrospective investigation confirmed two CCHF human cases in Rajkot village 20 kilometres to the west of Ahmadabad in 2010, and CCHFV presence in the livestock 200 kilometres to the north in the neighbouring State Rajasthan. This report shows the presence of CCHFV in human, ticks and animals in Gujarat, India. The fact of concern is the spread of this disease from one state to another due to trading of livestock.

Objective

Methicillin-resistant Staphylococcus aureus (MRSA) is associated with difficult-to-treat infections and high levels of morbidity. Manual practitioners work in environments where MRSA is a common acquired infection. The purpose of this review is to provide a practical overview of MRSA as it applies to the manual therapy professions (eg, physical and occupational therapy, athletic training, chiropractic, osteopathy, massage, sports medicine) and to discuss how to identify and prevent MRSA infections in manual therapy work environments.

Methods

PubMed and CINAHL were searched from the beginning of their respective indexing years through June 2011 using the search terms MRSA, methicillin-resistant Staphylococcus aureus, and Staphylococcus aureus. Texts and authoritative Web sites were also reviewed. Pertinent articles from the authors' libraries were included if they were not already identified in the literature search. Articles were included if they were applicable to ambulatory health care environments in which manual therapists work or if the content of the article related to the clinical management of MRSA.

Results

Following information extraction, 95 citations were included in this review, to include 76 peer-reviewed journal articles, 16 government Web sites, and 3 textbooks. Information was organized into 10 clinically relevant categories for presentation. Information was organized into the following clinically relevant categories: microbiology, development of MRSA, risk factors for infection, clinical presentation, diagnostic tests, screening tests, reporting, treatment, prevention for patients and athletes, and prevention for health care workers.

Conclusion

Methicillin-resistant S aureus is a health risk in the community and to patients and athletes treated by manual therapists. Manual practitioners can play an essential role in recognizing MRSA infections and helping to control its transmission in the health care environment and the community. Essential methods for protecting patients and health care workers include being aware of presenting signs, patient education, and using appropriate hand and clinic hygiene.

Introduction

The aim of this survey was to illustrate statistical information about endodontic research published in pubmed index journals from the different universities of Iran.

Materials and Methods

A PubMed search was performed to retrieve the endodontic publications of authors affiliated to different universities of Iran. Abstracts were reviewed and unrelated articles were omitted. Citation of each article was obtained from Scopus and Google scholar databases. Data were extracted and transferred to Microsoft Excel to determine the related scintometric indicators.

Results

A total of 307 papers were found according to the defined criteria which shows considerable increase from 2 papers in 1992 to 54 in 2011. The majority of the papers (48%) were related to in vitro studies; this number was 33% for in vivo surveys. Meta-analysis, systematic review and clinical trial constituted 10% of all publications. The average number of authors for the overall publications was 3.84; majority of articles (20%) were written by three authors. The average number of citation from Google Scholar (8.93) was higher than those from Scopus (4.74). Most of the endodontic articles originated from the Mashad University of Medical Sciences (16%).

Conclusion

Endodontic publication from different universities in Iran has considerably increased, showing that research is becoming more important.

Purpose

The aim of this study was to investigate whether the consequences of neurologic lesions are underestimated when the Barthel Index (BI) is used to assess the clinical outcome of botulinum toxin injection.

Patients and methods

The records for all in- and outpatients with various neurologic lesions (stroke, multiple sclerosis, spinal cord injury, traumatic brain injury, and so forth) who had been referred to the authors’ departments and who had received botulinum toxin type A (Botox®) for spasticity within a 4-year period (2008–2011) were examined retrospectively. BI data were collected and analyzed.

Results

The BI score was found to have increased in follow-up assessments (P = 0.048). No correlation was found between the degree of spasticity and the BI score.

Conclusion

The specific injection of Botox in patients with neurologic lesions was not strongly correlated with a significant functional outcome according to the BI. The results of this study suggest that clinicians need to look at other measurement scales for the assessment of significant outcomes of Botox in the rehabilitation process after neurologic lesions.

AIM: To assess the safety and efficacy of carbon dioxide (CO2) insufflation during endoscopic retrograde cholangiopancreatography (ERCP).

METHODS: The Cochrane Library, Medical Literature Analysis and Retrieval System Online, Excerpta Medica Database, Science Citation Index Expanded, Chinese Biomedical Literature Database, and references in relevant publications were searched up to December 2011 to identify randomized controlled trials (RCTs) comparing CO2 insufflation with air insufflation during ERCP. The trials were included in the review irrespective of sample size, publication status, or language. Study selection and data extraction were performed by two independent authors. The meta-analysis was performed using Review Manager 5.1.6. A random-effects model was used to analyze various outcomes. Sensitivity and subgroup analyses were performed if necessary.

RESULTS: Seven double-blind RCTs involving a total of 818 patients were identified that compared CO2 insufflation (n = 404) with air insufflation (n = 401) during ERCP. There were a total of 13 post-randomization dropouts in four RCTs. Six RCTs had a high risk of bias and one had a low risk of bias. None of the RCTs reported any severe gas-related adverse events in either group. A meta-analysis of 5 RCTs (n = 459) indicated that patients in the CO2 insufflation group had less post-ERCP abdominal pain and distension for at least 1 h compared with patients in the air insufflation group. There were no significant differences in mild cardiopulmonary complications [risk ratio (RR) = 0.43, 95% CI: 0.07-2.66, P = 0.36], cardiopulmonary (e.g., blood CO2 level) changes [standardized mean difference (SMD) = -0.97, 95% CI: -2.58-0.63, P = 0.23], cost analysis (mean difference = 3.14, 95% CI: -14.57-20.85, P = 0.73), and total procedure time (SMD = -0.05, 95% CI: -0.26-0.17, P = 0.67) between the two groups.

CONCLUSION: CO2 insufflation during ERCP appears to be safe and reduces post-ERCP abdominal pain and discomfort.

Purpose

We collected the data of Science Citation Index (SCI) and SCI Expended (SCIE) papers written by the members of the Korean Society of Radiation Oncology (KOSRO) to analyze the current status and the future trend.

Materials and Methods

We searched the database of SCIE for the period from 1981 to 2011 at the Web of Knowledge site. Articles, reviews or proceedings written by KOSRO members as the first or corresponding authors were included. Search terms were the following combination of subject headings: therapeut radiol, radiat oncol, Korea. For National Cancer Center, combined search terms such as natl canc ctr, Korea and the names of faculties were applied.

Results

The total number of SCIE papers was 547. Numbers of the published papers in 1995, 2000, 2005, and 2010, were increased continuously, which was 2, 14, 40, and 83, respectively. The average impact factor was 2.9. The papers were published at the 134 different journals. The proportion of "International Journal of Radiation Oncology Biology Physics" was 23.4% of all the papers. The number and proportions of papers by subject categories were 87 (15.9%) in biology, 73 (13.3%) in physics and 387 (70.6%) in clinics. The papers of the top five institutions, based on the number of published papers, occupied 66.3%.

Conclusion

The number of SCIE papers is increasing rapidly in the field of radiation oncology in Korea. To improve the quality of papers, multi-institutional retrospective or prospective randomized studies should be done for the common cancers in Korea.

This study was conducted to explore a bibliometric approach to quantitatively assess current research trends in cisplatin-containing chemotherapy for small cell lung cancer (SCLC), using related literature in the Science Citation Index Expanded database from 1992 to 2011. Articles were analyzed by the scientific output and research performances of countries and institutions. The distribution of key words in the article title and author-selected keywords were used to evaluate research trends. It was observed that the number of articles devoted to cisplatin-containing chemotherapy for SCLC did not increase with time. The USA and Japan were the top two countries with the highest number of articles devoted to cisplatin-containing chemotherapy for SCLC. In both countries, the number of articles did not increase with time, and a decreasing trend was identified in the USA over the last 10 years. This study demonstrates trends in cisplatin-containing chemotherapy for SCLC. The clinical application of novel drugs is required for successful SCLC treatment.

This systematic review of the Brazilian and worldwide literature aimed to evaluate the incidence and causes of perioperative and anesthesia-related mortality in pediatric patients. Studies were identified by searching EMBASE (1951-2011), PubMed (1966-2011), LILACS (1986-2011), and SciElo (1995-2011). Each paper was revised to identify the author(s), the data source, the time period, the number of patients, the time of death, and the perioperative and anesthesia-related mortality rates. Twenty trials were assessed. Studies from Brazil and developed countries worldwide documented similar total anesthesia-related mortality rates (<1 death per 10,000 anesthetics) and declines in anesthesia-related mortality rates in the past decade. Higher anesthesia-related mortality rates (2.4-3.3 per 10,000 anesthetics) were found in studies from developing countries over the same time period. Interestingly, pediatric perioperative mortality rates have increased over the past decade, and the rates are higher in Brazil (9.8 per 10,000 anesthetics) and other developing countries (10.7-15.9 per 10,000 anesthetics) compared with developed countries (0.41-6.8 per 10,000 anesthetics), with the exception of Australia (13.4 per 10,000 anesthetics). The major risk factors are being newborn or less than 1 year old, ASA III or worse physical status, and undergoing emergency surgery, general anesthesia, or cardiac surgery. The main causes of mortality were problems with airway management and cardiocirculatory events. Our systematic review of the literature shows that the pediatric anesthesia-related mortality rates in Brazil and in developed countries are similar, whereas the pediatric perioperative mortality rates are higher in Brazil compared with developed countries. Most cases of anesthesia-related mortality are associated with airway and cardiocirculatory events. The data regarding anesthesia-related and perioperative mortality rates may be useful in developing prevention strategies.

Background

Moroccan authorities carry out regular surveys on population and family health (NSFFP 1980, NSPH 1992, SPFH 2004, NSPFH 2011). These surveys constitute valuable resources for monitoring socio-economic and health indicators. They provide an evidence base for health decision makers to help them to optimize health strategies in order to improve the health conditions of the whole population. They also provide updated measures on geographic disparities, socio-economic inequalities and health inequity. The most recent Moroccan population and family health survey (NSPFH 2011) was carried out between November 2010 and March 2011. The final report and the database are not yet accessible, but a preliminary report was released early March 2012. This report does not allow for a complete evaluation of the present health situation in Morocco. A partial equity analysis can, however, be devoted to the comparison of health indicators especially in terms of rural–urban gaps.

Results

The 2011 survey shows that Moroccan population is in the last phase of the demographic transition. The total fertility rate decreased from 5.6 children per woman in 1980 to 2.5 per woman in 2011. The mean age of first marriage increased from 24 years for men and 17.5 years for women in 1960 to 31.5 years and 26.3 years in 2011 for men and women, respectively. The age structure shows a trend of ageing population. A comparison with the 1992 NSPH indicates that adult illiteracy has decreased from 53% in 1992 to 37.6% in 2011.

During the same time period, women’s access to maternal care and health services improved significantly. For instance, the proportion of deliveries assisted by skilled health personnel increased from 31% in 1992 to 73.6% in 2011. Between 1992 and 2011, neonatal, postnatal, infant and under-five mortality rates were reduced by 44%, 65%, 54% and 64%, respectively.

Conclusion

This paper shows that average health indicators improved noticeably during the last two decades but rural–urban disparities are still a challenge for health decision makers. Socio-economic indicators, like illiteracy rate and unemployment, also demonstrate large gender inequalities. This preliminary analysis is designed to assist Moroccan health authorities to evaluate the current health situation in order to adopt cost-effective strategies that improve “health for all” and reduce the gaps between advantaged and disadvantaged populations.

Background

In older adults, underweight (body mass index [BMI] <18.5) has been associated with increased mortality. This increased mortality risk may be associated with increased health care utilization. We evaluated the relationship between underweight and hospitalization, emergency room visits, and mortality.

Methods

An analysis of a retrospective cohort study was conducted at a multisite academic primary care medical practice in Minnesota. The patients were ≥60 years of age, impaneled within primary care on January 1, 2011, and had a BMI measurement recorded between January 1, 2011, and December 31, 2011. Individuals were excluded if they refused review of their medical record. The primary measurement was BMI, which was categorized as underweight (BMI < 18.5) or normal and obese (BMI ≥ 18.5). The outcomes were hospitalization, emergency room visits, and mortality in the 2011 calendar year. Associations between underweight and each outcome were calculated using logistic regression. Interactions between underweight and gender were assessed in the logistic regression models. The final results were adjusted for age, gender, comorbid health conditions, and single living status.

Results

The final cohort included 21,019 patients, of whom 220 (1%) were underweight. Underweight patients had a higher likelihood of hospitalization compared with patients with higher BMI (adjusted odds ratio [OR] 1.64; 95% confidence interval [CI] 1.21–2.22). Underweight patients were also more likely to visit the emergency room (adjusted OR 1.70; 95% CI 1.28–2.25) or to die (adjusted OR 3.64; 95% CI 2.33–5.69). Men with a BMI < 18.5 compared with those having a BMI ≥ 18.5 had the highest odds of hospitalization (OR 3.45; 95% CI 1.59–7.48).

Conclusion

Underweight older adults, especially men, have higher odds of hospitalization, emergency room visits, and mortality. Future work on underweight might involve improving weight status, which may reduce the risk of hospitalization, emergency room visits, and mortality.

Corrigenda for five articles.

The affiliation of one of the authors and a source of funding are both added in the following papers: Chiririwa & Meijboom [Acta Cryst. (2011a), E67, m1496; Acta Cryst. (2011b), E67, m1497; Acta Cryst. (2011c), E67, m1498] and Chiririwa & Muller [Acta Cryst. (2012a), E68, m49; Acta Cryst. (2012b), E68, m116–m117].

Background

Hyperuricemia is an independent risk factor of nephropathy, but its role in renal transplant recipients (RTRs) is controversial.

Methods

Based on the methods of Cochrane systematic reviews, we searched MEDLINE (1948–2011.6), EMBASE (1956–2011.6), CBM (Chinese Biomedicine Database) (1978–2011.6) to identify cohort studies assessing the association between uric acid level and kidney allograft. Two authors independently screened the studies, assessed the risk of bias of included studies and extracted data. Unadjusted odds ratio(OR), mean difference (MD), adjusted hazard ratio (aHR) and their corresponding 95%CI were pooled to assess the effects of hyperuricemia on kidney allograft.

Results

Twelve cohort studies were included and the quality was moderate to high based on the NEWCASTLE-OTTAWA quality assessment scale. RTRs with hyperuricemia had lower eGFR (P<0.0001, 95%CI−16.34∼6.14) and higher SCr (P<0.00001, 95%CI 0.17∼0.31) than those with normal uric acid level. Meta-analysis showed that hyperuricemia was a risk factor of chronic allograft nephropathy (Unadjusted OR = 2.85, 95%CI 1.84∼4.38, adjusted HR = 1.65, 95%CI 1.02∼2.65) and graft loss (Unadjusted OR = 2.29, 95%CI 1.55∼3.39; adjusted HR = 2.01, 95%CI 1.39∼2.94).

Conclusions

Current evidence suggests that hyperuricemia may be an independent risk factor of allograft dysfunction. Hyperuricemia may modestly increase the risk of poor outcomes of RTRs. Future research is needed to verify whether lowering uric acid level could improve the kidney function and prognosis of RTRs with hyperuricemia.

Objective: The objective of this paper is to analyze which pharmaceutical policies European countries applied during the global financial crisis.

Methods: We undertook a survey with officials from public authorities for pharmaceutical pricing and reimbursement of 33 European countries represented in the PPRI (Pharmaceutical Pricing and Reimbursement Information) network based on a questionnaire. The survey was launched in September 2010 and repeated in February 2011 to obtain updated information.

Results: During the survey period from January 2010 to February 2011, 89 measures were identified in 23 of the 33 countries surveyed which were implemented to contain public medicines expenditure. Price reductions, changes in the co-payments, in the VAT rates on medicines and in the distribution margins were among the most common measures. More than a dozen countries reported measures under discussion or planned, for the remaining year 2011 and beyond. The largest number of measures were implemented in Iceland, the Baltic states (Estonia, Latvia, Lithuania), Greece, Spain and Portugal, which were hit by the crisis at different times.

Conclusions: Cost-containment has been an issue for high-income countries in Europe – no matter if hit by the crisis or not. In recent months, changes in pharmaceutical policies were reported from 23 European countries. Measures which can be implemented rather swiftly (e.g. price cuts, changes in co-payments and VAT rates on medicines) were among the most frequent measures. While the “crisis countries” (e.g. Baltic states, Greece, Spain) reacted with a bundle of measures, reforms in other countries (e.g. Poland, Germany) were not directly linked to the crisis, but also aimed at containing public spending. Since further reforms are under way, we recommend that the monitoring exercise is continued.

The authors revise last year's predictions and project for the next 3 years, outlining a conceptual framework for contemplating the data based on an ecological model of the oncology delivery system.

In 2011, we made predictions on the basis of data from the National Practice Benchmark (NPB) reports from 2005 through 2010. With the new 2011 data in hand, we have revised last year's predictions and projected for the next 3 years. In addition, we make some new predictions that will be tracked in future benchmarking surveys. We also outline a conceptual framework for contemplating these data based on an ecological model of the oncology delivery system. The 2011 NPB data are consistent with last year's prediction of a decrease in the operating margins necessary to sustain a community oncology practice. With the new data in, we now predict these reductions to occur more slowly than previously forecast. We note an ease to the squeeze observed in last year's trend analysis, which will allow more time for practices to adapt their business models for survival and offer the best of these practices an opportunity to invest earnings into operations to prepare for the inevitable shift away from historic payment methodology for clinical service. This year, survey respondents reported changes in business structure, first measured in the 2010 data, indicating an increase in the percentage of respondents who believe that change is coming soon, but the majority still have confidence in the viability of their existing business structure. Although oncology practices are in for a bumpy ride, things are looking less dire this year for practices participating in our survey.

Background

The simian parasite Plasmodium knowlesi is a common cause of human malaria in Malaysian Borneo and threatens the prospect of malaria elimination. However, little is known about the emergence of P. knowlesi, particularly in Sabah. We reviewed Sabah Department of Health records to investigate the trend of each malaria species over time.

Methods

Reporting of microscopy-diagnosed malaria cases in Sabah is mandatory. We reviewed all available Department of Health malaria notification records from 1992–2011. Notifications of P. malariae and P. knowlesi were considered as a single group due to microscopic near-identity.

Results

From 1992–2011 total malaria notifications decreased dramatically, with P. falciparum peaking at 33,153 in 1994 and decreasing 55-fold to 605 in 2011, and P. vivax peaking at 15,857 in 1995 and decreasing 25-fold to 628 in 2011. Notifications of P. malariae/P. knowlesi also demonstrated a peak in the mid-1990s (614 in 1994) before decreasing to ≈100/year in the late 1990s/early 2000s. However, P. malariae/P. knowlesi notifications increased >10-fold between 2004 (n = 59) and 2011 (n = 703). In 1992 P. falciparum, P. vivax and P. malariae/P. knowlesi monoinfections accounted for 70%, 24% and 1% respectively of malaria notifications, compared to 30%, 31% and 35% in 2011. The increase in P. malariae/P. knowlesi notifications occurred state-wide, appearing to have begun in the southwest and progressed north-easterly.

Conclusions

A significant recent increase has occurred in P. knowlesi notifications following reduced transmission of the human Plasmodium species, and this trend threatens malaria elimination. Determination of transmission dynamics and risk factors for knowlesi malaria is required to guide measures to control this rising incidence.

Author Summary

The simian parasite Plasmodium knowlesi is a common cause of malaria in Malaysian Borneo; however, little is known about its emergence over time, particularly in Sabah. We reviewed all available Sabah Department of health malaria notification records from 1992–2011, and considered notifications of P. malariae and P. knowlesi as a single group due to their microscopic similarity. We found that malaria notifications in Sabah have decreased dramatically, with P. falciparum and P. vivax notifications peaking at 33,153 and 15,877 respectively during 1994–1995, and falling to 605 and 628 respectively in 2011. Notifications of P. malariae/P. knowlesi fell from a peak of 614 in 1994 to ≈100/year in the late 1990s/early 2000s, however increased >10-fold between 2004 (n = 59) and 2011 (n = 703). In 1992 P. falciparum, P. vivax and P. malariae/P. knowlesi monoinfections accounted for 70%, 24% and 1% respectively of malaria notifications, compared to 30%, 31% and 35% in 2011. The increase in P. malariae/P. knowlesi notifications occurred state-wide, appearing to have begun in the southwest and progressed north-easterly. This significant recent increase in P. knowlesi notifications following reduced transmission of the human Plasmodium species threatens malaria elimination; further research is required to determine transmission dynamics and risk factors for knowlesi malaria.

Background

In Latin America, there are 13 geographically isolated endemic foci distributed among Mexico, Guatemala, Colombia, Venezuela, Brazil and Ecuador. The communities of the three endemic foci found within Mexico have been receiving ivermectin treatment since 1989. In this study, we predicted the trend of occurrence of cases in Mexico by applying time series analysis to monthly onchocerciasis data reported by the Mexican Secretariat of Health between 1988 and 2011 using the software R.

Results

A total of 15,584 cases were reported in Mexico from 1988 to 2011. The data of onchocerciasis cases are mainly from the main endemic foci of Chiapas and Oaxaca. The last case in Oaxaca was reported in 1998, but new cases were reported in the Chiapas foci up to 2011. Time series analysis performed for the foci in Mexico showed a decreasing trend of the disease over time. The best-fitted models with the smallest Akaike Information Criterion (AIC) were Auto-Regressive Integrated Moving Average (ARIMA) models, which were used to predict the tendency of onchocerciasis cases for two years ahead. According to the ARIMA models predictions, the cases in very low number (below 1) are expected for the disease between 2012 and 2013 in Chiapas, the last endemic region in Mexico.

Conclusion

The endemic regions of Mexico evolved from high onchocerciasis-endemic states to the interruption of transmission due to the strategies followed by the MSH, based on treatment with ivermectin. The extremely low level of expected cases as predicted by ARIMA models for the next two years suggest that the onchocerciasis is being eliminated in Mexico. To our knowledge, it is the first study utilizing time series for predicting case dynamics of onchocerciasis, which could be used as a benchmark during monitoring and post-treatment surveillance.

Author Summary

Mexico is one of the countries where human onchocerciasis (river blindness) can be found in Latin America. In 1989, the onchocerciasis program in Mexico started the treatment with ivermectin only for symptomatic individuals and then mass distribution of ivermectin was initiated for all eligible residents from 1994, either annually, twice or four times a year in endemic foci, coordinated by Mexican Secretariat of Health (MSH). In our study, we used a statistical method to analyse the cases of the disease reported by MSH from 1988 to 2011. The analysis showed that the cases of the disease have marginally decreased since 1999. The results also predicted an extremely low number (absence) of cases between 2012 and 2013 in the Chiapas region, the last endemic area, suggesting that disease is on a trend towards elimination in Mexico. Meanwhile, it could provide a benchmark for surveillance after mass treatment has been halted in 2012.

As an information retrieval system, PubMed® aims at providing efficient access to documents cited in MEDLINE®. For this purpose, it relies on matching representations of documents, as provided by authors and indexers to user queries. In this paper, we describe the growth of author keywords in biomedical journal articles and present a comparative study of author keywords and MeSH® indexing terms assigned by MEDLINE indexers to PubMed Central Open Access articles. A similarity metric is used to assess automatically the relatedness between pairs of author keywords and indexing terms. A set of 300 pairs is manually reviewed to evaluate the metric and characterize the relationships between author keywords and indexing terms. Results show that author keywords are increasingly available in biomedical articles and that over 60% of author keywords can be linked to a closely related indexing term. Finally, we discuss the potential impact of this work on indexing and terminology development.

Background:

Continuous evaluation of research performance is an effective tool for financial and human resource allocation to promote knowledge production by academic institutions. The aim of this study was to evaluate the scientific performance of Isfahan University of Medical Sciences (IUMS) from April 2010 to April 2011 in the national medical research ranking.

Methods:

This cross sectional study was carried out through running advanced searches in the national, local and international information databases and other websites. Then the data were analyzed in order to demonstrate IUMS scientific production and research status at a national level.

Results:

From April 2010 to April 2011, about 9% of total Iranian medical articles, 6% of total Iranian ISI indexed articles in medical science and 12% of Iranian PubMed indexed articles affiliated to Isfahan University of Medical Sciences. Although Isfahan University of Medical Sciences stood at the third place in the annual national research ranking, but it was first in the scientific growth among Iranian medical universities.

Conclusions:

The study indicated that Isfahan University of Medical Sciences witnessed striking improvement in scientific productivity, research performance and national research grade during 2010-2011.

Objective

To estimate the effect of online adverts on the probability of finding online cognitive behavioural therapy (CBT) for depression.

Design

Exploratory online cross-sectional study of search experience of people in the UK with depression in 2011. (1) The authors identified the search terms over 6 months entered by users who subsequently clicked on the advert for online help for depression. (2) A panel of volunteers across the UK recorded websites presented by normal Google search for the term ‘depression’. (iii) The authors examined these websites to estimate probabilities of knowledgeable and naive internet users finding online CBT and the improved probability by addition of a Google advert.

Participants

(1) 3868 internet users entering search terms related to depression into Google. (2) Panel, recruited online, of 12 UK participants with an interest in depression.

Main outcome measures

Probability of finding online CBT for depression with/without an advert.

Results

The 3868 users entered 1748 different search terms but the single keyword ‘depression’ resulted in two-thirds of the presentations of, and over half the ‘clicks’ on, the advert. In total, 14 different websites were presented to our panel in the first page of Google results for ‘depression’. Four of the 14 websites had links enabling access to online CBT in three clicks for knowledgeable users. Extending this approach to the 10 most frequent search terms, the authors estimated probabilities of finding online CBT as 0.29 for knowledgeable users and 0.006 for naive users, making it unlikely CBT would be found. Adding adverts that linked directly to online CBT increased the probabilities to 0.31 (knowledgeable) and 0.02 (naive).

Conclusions

In this case, online CBT was not easy to find and online adverts substantially increased the chance for naive users. Others could use this approach to explore additional impact before committing to long-term Google AdWords advertising budgets.

Trial registration

This exploratory case study was a substudy within a cluster randomised trial, registered on http://www.clinicaltrials.gov (reference: NCT01469689). (The trial will be reported subsequently).

Article summary

Article focus

In 2011 in the UK, what is the chance of finding online CBT for depression?

Does online advertising increase that chance?

Key messages

Online CBT for depression is recommended by the National Institute for Health and Clinical Excellence for people with depression, but we did not know how easy it is to find or if online adverts help find it.

People with depression are unlikely to find online CBT by chance: the probabilities of finding online CBT using Google was 0.29 for knowledgeable users and 0.006 for naive users. Adding adverts that linked directly to online CBT increased the probabilities to 0.31 (knowledgeable) and 0.02 (naive).

This method of assessing probability of finding topics should be used before committing to long-term online advertising.

Strengths and limitations of this study

The results are likely to be typical for anyone with depression in the UK in 2011. The approach of identifying typical search terms and simulating knowledgeable and naive user experience, with and without adverts, is generalisable to other conditions and populations.

Search results will change over time.