[Guide to write a scientific article]

Publishing a scientific article is challenging for early-career researchers and clinicians. Success is not solely determined by robust research methods, but also by clear and logical presentation of results. Without clear communication, disruptive findings can be overlooked. A well-structured manuscript leads the reader logically from the introduction to the conclusion. Maintaining a consistent narrative ensures lasting impact. In this paper, we provide practical guidelines for drafting an effective scientific manuscript. Carefully crafted articles increase the chance of acceptance and improve comprehension among diverse specialists. We emphasize the importance of presenting a clear, relevant, and engaging story within a structured framework, highly valued by editors, reviewers, and readers.

Tips and tricks for successfully conducting a multicenter study

Multicenter studies play a crucial role in medical research and advancement, facilitating the application of new knowledge to clinical practice. These studies are associated with multiple benefits but are more complex than those involving a single center. With the philosophy that most of the qualities required to lead a multicenter study depend on attitude and can be learned, developed, and improved, in this manuscript, we share with the reader a series of recommendations that we consider important for successfully conducting such studies. The tips and tricks that will be discussed in detail are as follows: effectively leading the project; clearly defining viable and relevant objectives; designing a clear and detailed protocol; carefully selecting centers and collaborating investigators; meticulously designing the case report form; centrally managing the project efficiently; maintaining fluent communication with investigators; and, finally, designing a clear authorship policy and ensuring the appropriate publication of the study results. We hope that these suggestions encourage potential researchers to conduct multicenter studies, thereby collectively enhancing the quality of research and its application to clinical practice.

Bibliometric and thematic characterization of the research on HIV-AIDS in Spain (2010-2019)

INTRODUCTION

The establishment of the Spanish AIDS Research Network (RIS) was a milestone for the promotion of HIV research in Spain. We analyse Spanish HIV research, assessing the role that RIS has played in it.

METHODS

We identified publications on HIV-AIDS with the participation of Spanish institutions in the Web of Science over the period 2010-2019, characterising research activity by means of bibliometrics and identifying the thematic areas of research through a cluster analysis.

RESULTS

A total of 3960 documents have been identified (average of 396 documents/year), 42% of which have been signed in international collaboration. RIS researchers have participated in 60% of the documents, presenting a scientific production and citation significantly higher than authors not linked to the RIS. Five thematic clusters articulate the research, focusing on the clinical and therapeutic approach to people living with HIV, co-infection and co-morbidity with other diseases, the genetic characterisation of the virus, the development of vaccines and the study of its transmission in specific groups or associated with sexual behaviour.

CONCLUSION

Spanish HIV research, largely driven by RIS groups, has reached a stage of maturity, with a notable increase in scientific production, participation in international cooperative networks and an outstanding impact and visibility.

[Clinician and researcher at the time. Is it possible?]

Research in clinical practice arises as a constant need for improvement to provide better care to patients, train better human resources and make a daily reflection on the amount of scientific information we receive every day. We want to reflect on how the Centro de Adiestramiento en Investigación Clínica (CAIC) from our healthcare activity changed our practice.

[Survey on the state of investigation in rehabilitation in Spain: Results]

The research, training and innovation committee of the Spanish Society of Physical Medicine and Rehabilitation (SERMEF) wanted to know the state of research in our speciality. To this end, an online survey was developed and distributed among rehabilitation doctors in Spain, which obtained 253 responses. Of these, 65% stated that research activity in rehabilitation does take place in their work centre; the number of active projects in their centres as stated by them was: none in 35.7%; one in 17.7%, two in 23.3%, three in 8.4% and four or more in 14.9%. Among the main difficulties encountered, 89% highlight that there is no staff hired for research and 95% that in their centres part of the working day is not allocated to research. In terms of personal research activity, 56% reported that they were involved in research, with the most common role being that of principal investigator (58%). Ninety-five percent of respondents report that the main obstacle to developing a research project is the pressure of care and lack of time, and correspondingly, a large majority (83%) claim that having stipulated time for research in their working day would be a motivation.

Research ethics: From principles to practical aspects

Any research conducted on human beings or human biological samples requires a prior ethical assessment to avoid risks and problems for all involved parties. The legislation in this regard is very broad and emphasizes the safeguarding of patient rights in relation to the universal principles of autonomy, beneficence and justice. The present article reviews the regulations applicable to clinical trials, observational studies with drugs, biobank projects or any other type of study that may be conducted in the health care field. It also addresses the role of research ethics committees, data protection and the foundations of scientific integrity.

[The Research Network on Preventive Activities and Health Promotion (redIAPP): a reference network and promoter of primary care research]

The Research Network on Preventive Activities and Health Promotion (redIAPP), a reference network and promoter of primary care research was created in 2003 thanks to the program Thematic Networks for Cooperative Research in Health (RETICS) of the Instituto de Salud Carlos III (ISCIII). Its creation has meant a radical change in the situation of research in primary care. Throughout its 19 years (2003-2021), different research groups and autonomous communities have participated, and different lines of research have been developed with numerous projects and publications. Despite the difficulties suffered, it has created a collaborative research experience between different autonomous communities with great vitality and with important results for primary care. The redIAPP, therefore, has been a great reference for research in primary care and for the deepening of its area of knowledge. Several lines of improvement are suggested for the future of primary care research.

Attitudes, capacities and perceived barriers in research of nurses of the Canary Health Service

OBJECTIVE

To evaluate the attitudes, capacities and perceived barriers associated with research among nurses and midwives of the Canary Health Service (SCS).

METHODS

Descriptive observational cross-sectional study with an analytical component carried out in the different SCS departments by means of an online survey in which sociodemographic and specific variables, the Spanish version of the Attitudes towards Research and Development within Nursing Questionnaire (ATRDNQ-e) instrument and the BARRIERS scale were collected. Authorisation was obtained from the two provincial ethics committees. A descriptive and inferential analysis (Mann-Whitney U test and Kruskal-Wallis test, post hoc contrast by Dwass-Steel-Critchlow-Fligne test) was performed with JAMOVI® v.2.3.24 software.

RESULTS

A total of 512 nurses and midwives with a mean age of 41.82 years participated in the study. Regarding the scores with the ATRDNQ-e instrument, the dimension with the lowest score was «Language of research» (mean = 3.55/SD = 0.84) and the highest «Assessment of nursing research and development of the nursing discipline» (mean = 4.54/SD = 0.52). The total mean score with the BARRIERS scale was 54.33 (SD = 16.52), with «Organizational characteristics» being the highest scoring subscale (mean = 17.25/SD = 5.90). The two highest perceived barriers were «Not enough time at work to implement new ideas» (mean = 2.55/SD = 1.11) and «Nursing does not have time to read research» (mean = 2.46/ SD = 1.11).

CONCLUSIONS

SCS nurses have a positive attitude towards research, although there are some barriers where improvement actions for nursing research should be implemented.

[The need for university links for public health professionals]

There needs to be a bidirectional relationship between the public health profession and academia. This will enhance their professional practice and the academy will be able to carry out practice-based teaching and research. This field note explains a legislative advance in this direction. So that professionals from public health institutions can access permanent positions as university professors, as well as the professionals in the clinical field, we ask several deputies from some parliamentary groups of the Universities Commission to include a reform that modifies article 70 of the project of Organic Law of the University System (LOSU in Spanish acronym) with this possibility. Ultimately, LOSU was approved in March 2023 with the requested amendment, providing a great opportunity for both public health institutions and academia to advance a bidirectional relationship.

Research priorities in perioperative fluid therapy and hemodynamic monitoring: A Delphi Consensus Survey from the Fluid Therapy and Hemodynamic Monitoring Subcommittee of the Hemostasis, Transfusion Medicine and Fluid Therapy Section (SHTF) of the Spanish Society of Anesthesiology and Critical Care (SEDAR)

BACKGROUND

Research in fluid therapy and perioperative hemodynamic monitoring is difficult and expensive. The objectives of this study were to summarize these topics and to prioritize these topics in order of research importance.

METHODS

Electronic structured Delphi questionnaire over three rounds among 30 experts in fluid therapy and hemodynamic monitoring identified through the Fluid Therapy and Hemodynamic Monitoring Subcommittee of the Hemostasis, Transfusion Medicine and Fluid Therapy Section of the Spanish Society of Anesthesiology and Critical Care.

RESULTS

77 topics were identified and ranked in order of prioritization. Topics were categorized into themes of crystalloids, colloids, hemodynamic monitoring and others. 31 topics were ranked as essential research priority. To determine whether intraoperative hemodynamic optimization algorithms based on the invasive or noninvasive Hypotension Prediction Index versus other management strategies could decrease the incidence of postoperative complications. As well as whether the use of renal stress biomarkers together with a goal-directed fluid therapy protocol could reduce hospital stay and the incidence of acute kidney injury in adult patients undergoing non-cardiac surgery, reached the highest consensus.

CONCLUSIONS

The Fluid Therapy and Hemodynamic Monitoring Subcommittee of the Hemostasis, Transfusion Medicine and Fluid Therapy Section of the Spanish Society of Anesthesiology and Critical Care will use these results to carry out the research.

Tips and guidelines for being a good peer reviewer

Publication is the key means by which science spreads. The purpose of scientific journals is to publish novel and quality articles. The editors of the journals evaluate the content of the manuscripts by submitting them to a process called «peer review», considered today the gold standard to guarantee the adequate publication of scientific articles. A well-crafted and critical peer-review report is a treasure for both authors and editors. In the present manuscript we will examine the key aspects of the peer review process. We will begin by explaining what exactly this process consists of and since when it has existed, and then clarifying why it is so important. Then we will argue why we should want to be reviewers of scientific papers. We will then review what are the fundamental rules to carry out a good review of a manuscript and what aspects of it we should focus on. Later we will see what format a peer review report should have and how to write its different sections, as well as the options for its final resolution. We will pay special attention to commenting on the ethical aspects and the most frequent errors that are made in the evaluation of manuscripts. Finally, we will recognize what the fundamental limitations of peer review are, and we will end by proposing some suggestions for their improvement. Our ultimate goal is to stimulate researchers -and authors- to go one step further and undertake the challenge of being peer reviewers of scientific manuscripts.

Towards objectivity in ethical assessment: legibility as part of informed consent form comprehension

BACKGROUND

The experience on informed consent form (ICF) readability at the Research Ethics Committee of the National Institute of Cancerology of Mexico (INCan) is described.

OBJECTIVE

To evaluate the readability of a randomly-selected sample of ICFs submitted for review between March 1, 2022 and March 31, 2023. The number of pages, the time the reader takes to read the text and the level of education necessary to understand it were determined.

RESULTS

More than half the ICFs from internal investigations were shown to be somewhat or very difficult to read; the level of education required to understand them was up to 9.9 years, and the reading time was short. The ICF texts from international multicenter investigations were aimed at an average education level of 5.5 years and had normal readability. Most ICFs from external trials require a reading time of more than 60 minutes per ICF.

CONCLUSION

It is necessary to have tools that provide objectivity to the evaluation of ICFs under investigation by ethics committees, which should be indicators of their comprehension, such as readability of the documents.

Educational and research needs in hypothyroidism of primary care physicians in the Community of Madrid

AIM

To document the opinion of primary care physicians on hypothyroidism and explore their educational and research needs.

METHODS

A web-based survey was released through Healthcare Management offices in Madrid to be answered anonymously by the doctors at the health centers.

RESULTS

Five hundred and forty-six out of 3897 (14%) physicians completed the survey. More than 90% of respondents agreed that hypothyroidism is a common and easily managed health problem and that its poor control increases healthcare costs. This percentage was higher in older doctors and those with longer professional experience. 88.1% of respondents showed interest in educational activities (86.6% in receiving and 20.9% in providing education). The preference for clinical sessions in the health center (71.5%) exceeded that of sessions in the hospital (20.2%), while the preference for online courses (67.8%) exceeded that of face-to-face courses (50.9%). 53.5% of interviewees expressed interest in research on hypothyroidism. Women and professionals with a higher number of hypothyroid patients under their care were more likely to be interested in educational and research activities.

CONCLUSION

Primary care physicians in the Community of Madrid are aware of the health problem posed by thyroid hormone deficiency and are clearly in favour of participating in educational and research activities in this area of knowledge.

[Biomedical research and innovation and COVID-19 syndemic. SESPAS Report 2022]

Objetivo

Describir críticamente la respuesta en investigación e innovación (I + I) contra la sindemia por COVID-19 en el ámbito nacional, contextualizada internacionalmente.

Método

Revisión narrativa dirigida.

Resultados

En la sindemia por COVID-19 se ha pasado la presión a la comunidad científica en general, e innovadora biomédica en particular, para aportar soluciones sobre todo de productos biotecnológicos. La mayoría de las recomendaciones de paneles expertos no van orientadas a una respuesta biotecnológica (que también debe existir), sino de gobernanza, organizativa, socioeconómica y de apoyo a las infraestructuras de salud pública. Existe un déficit importante en la inclusión de la perspectiva de género en la I + I por COVID-19. La sindemia ha ofrecido una oportunidad (desaprovechada) para potenciar la I + I desde la perspectiva epidemiológica contra brotes infecciosos con potencial de provocar crisis en salud pública reivindicando el liderazgo desde la epidemiología. Hace falta evaluar si la gran inversión en I + I biomédica orientada a la medicina personalizada puede integrarse eficientemente en los proveedores públicos de salud ante crisis sanitarias.

Conclusiones

Es urgente diseñar una estrategia de I + I en España en línea con los fondos disponibles internacionalmente y que se beneficie de ellos, pero que provea al país del máximo de independencia de cara a afrontar situaciones críticas para la salud pública.

Fourteen Crutches for Mediocrity. The logismoi that jeopardize good research and publication

Publications are used widely as a measure of academic quality. Many investigators have difficulty publishing in this competitive field. After coming across a religious lecture on the "Fourteen Crutches for Mediocrity", our team adapted this approach to life to the science of publishing: (1) what is the problem of doing it?; (2) there are worse!; (3) everybody does it!; (4) why exaggerate?; (5) I will do it tomorrow!; (6) maybe if …; (7) it is not used anymore!; (8) be a cousin not a brother!; (9) I need to be thanked!; (10) don't eat your own head, let it be!; (11) I can't possibly accomplish it!; (12) I don't feel like doing it!; (13) I am fed up!; (14) I am not worthwhile! These crutches jeopardize good research and thoughtful learned publications.

[Search strategies for health professionals.]

An adequate search strategy is necessaryfor all health professionals, from the trainingprocess to the moments of expertise in their area.The generation of the strategy must be a methodicaland rigorous process, which begins with the researchquestion, then the databases are chosen, the specificdesign of the strategy is continued to finally managethe result in an organized and transparent manner. The ability to perform these strategies is not acquiredovernight, and probably will require the help of someoneexpert at the beginning, however, it is clear that wecan all apply it in our lives as health professionals.

Surgical multicenter collaborative studies: ¿What happen in Latin America?

BACKGROUND

GlobalSurg is an international group of researchers whose purpose is to conduct and disseminate robust collaborative, international and multicenter studies.

OBJECTIVE

To expose the necessary strategies and the barriers crossed in conducting massive multicenter studies in surgery.

METHOD

During the second semester of 2020, the study Surg-Week Prospective International Cohort Study was carried out. Surg-Week has been the largest international study in the field of surgery to date, with 141,582 patients included. A total of 4975 mini-teams, of between 1 and 5 members, collected data from 116 countries on all continents.

RESULTS

The creation of an official website for the study, reports with relevant information via email or groups via WhatsApp, formation of a Dissemination Committee of the protocol, delivery of webinars on recent team publications, appointment of leaders at the national and international level, and outreach through partnerships, were the strategies used for the development of the research. However, the barriers turned out to involve different aspects.

CONCLUSIONS

Collaborative work allows establishing networks between different professionals with the goal of improving the quality of management, health policies and care of our patients in a timely manner of constant change.

Fourteen Crutches for Mediocrity. The logismoi that jeopardize good research and publication

Publications are used widely as a measure of academic quality. Many investigators have difficulty publishing in this competitive field. After coming across a religious lecture on the "Fourteen Crutches for Mediocrity", our team adapted this approach to life to the science of publishing: (1) what is the problem of doing it?; (2) there are worse!; (3) everybody does it!; (4) why exaggerate?; (5) I will do it tomorrow!; (6) maybe if …; (7) it is not used anymore!; (8) be a cousin not a brother!; (9) I need to be thanked!; (10) don't eat your own head, let it be!; (11) I can't possibly accomplish it!; (12) I don't feel like doing it!; (13) I am fed up!; (14) I am not worthwhile! These crutches jeopardize good research and thoughtful learned publications.

A bibliometric study of the journal Radiología during the period 2010-2019

BACKGROUND AND AIMS

Bibliometrics makes it possible to measure the relative importance of a scientific journal in its field. The current study analyzed the scientific publications in Radiología and the bibliometric parameters of the journal in the period comprising 2010 through 2019.

MATERIALS AND METHODS

We reviewed the bibliometrics for Radiología through information obtained from three sources: Scopus, the online version of the journal, and the publisher (Elsevier). We retrospectively analyzed aspects related to the editorial process (final decision and speed), the articles published (type, subspecialty of radiology, and imaging technique), the trends in citation and various indices (CiteScore, SNIP, and SJR), visibility, downloads, author characteristics (geographical origin and institutional collaboration), and the most cited articles.

RESULTS

The number of articles published in Radiología gradually decreased during the decade, and the time to publication increased. Original research articles account for the largest share of the articles published. The most common subject areas were radiology of the digestive tract and neuroradiology. Nevertheless, the bibliometric indicators and the number of downloads of articles increased every year. Regarding the authorship of the articles published, although authors from Spain predominate, the participation of authors from other countries became increasingly common. Collaboration among different institutions also became increasingly common in the period analyzed.

CONCLUSIONS

This review shows the progression of the journal's scientific work and some aspects that must be addressed to favor the growth of Radiología.

The rise of #SocialMedia in the Nephrology world

Social media (SoMe) use has increased exponentially in the last decade and is having a profound impact on the Nephrology world. The use of these platforms is contributing to continuous educational and professional development by exposing nephrologists to new research, allowing them to connect with experts, to exchange experiences, or to engage in scientific debates. Here, we introduce the basics of SoMe, focusing on Twitter because it is the most popular SoMe platform used by the medical community for professional purposes. We will review the main education platforms and tools available, such as visual abstracts, blogs, tweetorials, videos, and podcasts. We will also focus on their different applications for educational purposes such as online journal clubs, webinars, or online games. The role of SoMe in academic promotion, dissemination of research, expansion of nephrology societies and coverage of scientific events will also be discussed. In the end, we will reflect on SoMe risks and limitations, much-needed developments in SoMe platforms and the challenges ahead of us.

Tips and guidelines for being a successful researcher

This article aims to share our experience with those who consider dedicating themselves to research. In this way, the characteristics, qualities or competences that, in our opinion, a good researcher should fulfill are listed, and therefore the keys that can help you achieve a successful research career. The intention of this article is not to simply list a series of theoretical recommendations but to share some personal suggestions based on our experience and, therefore, of an eminently practical nature. The fundamental qualities to be discussed are: Ethics and honesty. Curiosity, passion, enthusiasm and motivation. Persistence, dedication and discipline. Ambition and leadership. Compromise and responsibility. Organization and planning. Acquire knowledge of research methodology. Critical and positive attitude towards difficulties and failure. Prioritization of objectives and time management. The importance of a good mentor. Establishment of a network of collaborators and teamwork. Maintain a balance between clinical and research activity. Combine public and private investigation. Balance between professional and personal life. And, finally, humility, generosity and thanks. Research represents a fundamental pillar of medical activity and it is evident that the highest quality of care arises from the integration of excellent clinical practice and research activity. With the philosophy that most of the qualities to develop an excellent research activity depend on attitude, and can be learned, developed and improved, in this manuscript we share with the reader a series of recommendations that we consider essential to be a good researcher.

[Impact assessment on data protection in research projects]

Recent changes in European regulations for personal data protection still allow the use of health data for research purposes, but they have set the Impact Assessment on Data Protection as an instrument for reflection and risk analysis in the process of data processing. The publication of a guide for facilitates this impact assessment, although it is not directly applicable to research projects. Experience in a specific project is detailed, showing how the context of the treatment becomes relevant with respect to the data characteristics. Carrying out an impact assessment is an opportunity to ensure compliance with the principles of data protection in an increasingly complex environment with greater ethical challenges.

Experimental rat model of chronic cerebral hypoperfusion-reperfusion mimicking normal perfusion pressure breakthrough phenomenon

BACKGROUND

Normal perfusion pressure breakthrough (NPPB) phenomenon is a major life-threatening complication that restricts the treatment of complex intracranial arteriovenous malformations. The aim of the study it to develop a rat model mimicking NPPB phenomenon that enables the evaluation of any therapy to prevent such complication.

METHODS

Twenty Wistar male rats were randomly assigned to either a study or a control group. Study animals underwent an end-to-side left external jugular vein-common carotid artery anastomosis and ligation of bilateral external carotid arteries. Control animals only underwent ligation of bilateral external carotid arteries. All animals were sacrificed sixty days after the procedure. Hemodynamic parameters [mean arterial pressure (MAP), intracranial pressure (ICP) and cerebral perfusion pressure (CPP)], blood-brain barrier (BBB) permeability (measured by fluorescein staining) and histological features were then compared between both groups.

RESULTS

A significant decrease in MAP and CPP was confirmed in the study group. An increase in ICP was also observed. A significant decrease in MAP and CPP was also present in the study group when comparing preoperative values with those recorded on days 0 (postoperative), 7 and 60. Fluorescein staining findings were consistent with signs of BBB disruption in study animals. Histological analysis demonstrated an increased number of pyknotic neurons in the ipsilateral hemisphere of rat brains included in the study group.

CONCLUSION

These results confirm that this model mimics a vascular steal state with chronic cerebral hypoperfusion comparable to patients with AVMs behavior and disruption of the BBB after fistula closure comparable to NPPB phenomenon disorders.

Evaluation of the Integrated Tuberculosis Research Program Sponsored by the Spanish Society of Pulmonology and Thoracic Surgery: 11 Years on

OBJECTIVE

The objective of the study was to determine the trend of variables related to tuberculosis (TB) from the Integrated Tuberculosis Research Program (PII-TB) registry of the Spanish Society of Pulmonology and Thoracic Surgery (SEPAR), and to evaluate the PII-TB according to indicators related to its scientific objectives.

METHOD

Cross-sectional, population-based, multicenter study of new TB cases prospectively registered in the PII-TB between 2006 and 2016. The time trend of quantitative variables was calculated using a lineal regression model, and qualitative variables using the χy test for lineal trend.

RESULTS

A total of 6,892 cases with an annual median of 531 were analyzed. Overall, a significant downward trend was observed in women, immigrants, prisoners, and patients initially treated with 3 drugs. Significant upward trends were observed in patients aged 40-50 and > 50 years, first visit conducted by a specialist, hospitalization, diagnostic delay, disseminated disease and single extrapulmonary location, culture(+), sensitivity testing performed, drug resistance, directly observed treatment, prolonged treatment, and death from another cause. The scientific objectives of the PII-TB that showed a significant upward trend were publications, which reached a maximum of 8 in 2016 with a total impact factor of 49,664, numbers of projects initiated annually, presentations at conferences, and theses.

CONCLUSIONS

PII-TB provides relevant information on TB and its associated factors in Spain. A large team of researchers has been created; some scientific aspects of the registry were positive, while others could have been improved.

[Glass ceiling and gender inequalities in the careers of women academics in biomedical sciences]

OBJECTIVE

To identify in the international scientific literature the obstacles and potential promoters for the advancement of women academics and researchers in biomedical sciences during their professional careers.

METHOD

PubMed, Scopus, CinahlPlus, Cochrane Database of Systematic Reviews, PsycInfo and Sociological Abstracts were systematically searched for articles published in English and Spanish between January 2006 and December 2016 on the phenomenon of the glass ceiling in women academics and researchers in biomedical sciences. The screening was carried out by independent reviewers.

RESULTS

A total of 2254 studies were found, of which 23 were included in the review. The obstacles identified for the promotion of women academics and/or researchers in biomedical sciences are: gender bias in the evaluation of research results, individualism and lack of collaboration, women's lack of influence, the existence of gender inequalities in access to employment. The perception of sexism and discrimination in the work environment, and the difficulties in reconciling work and family life. The promoting elements are: examples of women in leadership positions, mentoring, facilitating conciliation, transparency in recruitment, participation in decision-making, gender assessment of research, awareness of gender inequalities in institutions, promoting collaboration, and pay equity.

CONCLUSIONS

By enhancing the elements favouring the promotion of academic women in biomedical sciences would help to reduce the glass ceiling in the career paths of women academics and health science researchers by increasing their participation, leadership and representation. A change of organizational and institutional values is required to achieve this.

Current situation of HIV research in Spain

Prevention, early detection, clinical follow-up, organisation and management are key elements in the chal-lenges to be addressed in the field of HIV infection in Spain. In addition to these aspects, research repre-sents a transversal element that is highly relevant for building up a comprehensive response against HIV infection. The evolution of HIV/AIDS research in Spain, major milestones and the development of scientific structures are analysed. An economic description of HIV/AIDS research funding in the context of the whole Spanish R&D system is made. In particular, the impact of the economic crisis and budget restrictions and their con-sequences on medical research are considered. Finally, different perspectives on the future of HIV/AIDS research in the global scientific situation are discussed.

Scientific social media, a new way to expand knowledge. What do urologists need to know?

INTRODUCTION AND AIMS

Nowadays, it is almost impossible not to link most of the sources of modern knowledge to information of 2.0 technologies. The aim of this review is to analyse the role of scientific social media (Sc-SoMe) and its potential applications in urology.

MATERIAL AND METHODS

A literature search was carried out using the PubMed database until July 2018. The research was performed with the following terms: "Social Media", "urology", "science", "research".

RESULTS

Social media (SoMe) offers integrated services and easy tools for communication, collaboration and participation. Popular prototypical platforms of SoMe are Facebook, Twitter or Instagram. SoMe not only influence private life and personal communication, but these also affect business and science sectors. In this sense, the term Sc-SoMe describes the impact and usage of 2.0 technologies platforms on scientific work. There are different models of Sc-SoMe such as author identifiers which are unique identifiers that allow managing the professional identity of each researcher, distinguishing them from other researchers and unequivocally associating their work and author profiles. This helps us manage our own academic profile and control the information available about us and ensure that other researchers are finding correct and complete information about our research and career. Examples of Sc-SoMe are: ResearchGate, ORCID, Mendeley among others.

CONCLUSIONS

Sc-SoMe should not only provide important information and services for literature and literature search. These could also be an important catalyst for promoting appropriate and helpful services in the context of a new concept of science, the science 2.0.

[Health record linkage: Andalusian health population database]

OBJECTIVE

To describe the development of an information system that connects data from multiple health records to improve assistance to patients, health services administration, management, evaluation, and inspection, as well as public health and research.

METHOD

Deterministic connection of pseudonymized data from a population of 8.5 million inhabitants provided by: a users database, DIRAYA electronic medical records, minimum basic data sets (inpatients, outpatient mayor surgery, hospital emergencies and medical day hospital), mental health information systems, analytical and image tests, vaccines, renal patients, and pharmacy. An automatic coder was used to code clinical diagnoses and 80 chronic pathologies were identified to follow-up. The architecture of the information system consisted of three layers: data (Oracle Database 11g), applications (MicroStrategy BI) and presentation (MicroStrategy Web, JavaScript libraries, HTML 5 and CSS style sheets). Measures for the governance of the system were implemented.

RESULTS

Data from 12.5 million health system users between 2001 and 2017 were gathered, including 435.5 million diagnoses, 88.7% of which were generated by the automatic coder. Data can be accessed through predefined reports or dynamic queries, both exportable to CSV files for processing outside the system. Expert analysts can directly access the databases and perform queries using SQL or directly treat the data with external tools.

CONCLUSION

The work has shown that the connection of health records opens new possibilities for data analysis.

[Public participation in research from the perspective of primary health care researchers]

OBJECTIVE

Explore the strengths, weaknesses, opportunities and threats (SWOT) for development of public involvement in research by Institut Universitari d'Investigació en Atenció Primària Jordi Gol (IDIAPJGol) according to primary health care researchers in Catalonia (Spain).

METHODS

Cross-sectional study carried out in 2017 with 36 primary health care research teams accredited by IDIAPJGol and its management staff. An open questionnaire (paper and online) was designed and piloted to develop a SWOT technique, and 65 answers were obtained (14 in paper and 51 online). A thematic content analysis was carried out.

RESULTS

Most informants consider public involvement in research a useful, innovative, viable and essential strategy, but it requires a change of mentality and a move away from the hierarchical paradigm. It can be difficult to execute and can complicate studies. They are concerned about which citizens should be involve, how to select them, possible conflicts of interest and training needs. The main proposals for its implementation are to disseminate previous strategies, encourage motivation and synergies among citizens, researchers and institutions, and to clarify the roles of the actors involved. IDIAPJGol should develop recommendations for the public involvement in research, encourage their inclusion, have a mentor and advise the research teams.

CONCLUSIONS

Despite the challenges, developing public involvement in research in primary health care is essential and feasible, what it is more should be based on a participatory strategy with all actors. The citizens can participate in any kind of design and phase of the research, adapting each project, being the primary health care a privileged area to develop the public involvement in research.

Presentations at 29 conferences of the Spanish Society of Emergency Medicine (SEMES) from 1988 to 2017: a descriptive analysis

OBJECTIVES

To gain greater understanding of the development of emergency medicine in Spain by analyzing the presentations at conferences of the Spanish Society of Emergency Medicine (SEMES) over the past 30 years (1988-2017).

MATERIAL AND METHODS

We examined the programs of all SEMES conferences and described the characteristics of both presentations and presenters. We also analyzed changes occurring between 1988 and 2017 of some of the characteristics observed. The Web of Science was searched to evaluate the scientific productivity of the most frequent presenters and to calculate h-indexes for those presenters to assesstheir scientific relevance.

RESULTS

SEMES did not hold a conference in 1992. The total of 29 conferences included 2182 presentations (112 listing presenters from abroad) given by 1410 presenters (89 from abroad). The presenters' affiliations named 616 centers. The number of presentations and presenters increased linearly during the first period and then leveled off. The number increased exponentially in the final phase. Men gave 79.6% of the presentations; 70.6% of the presenters were physicians, 11.9% were nurses and 4.0% were ambulance staff. Specialists in emergency medicine accounted for 60.8% of the presenters who were physicians. Presenters from the Spanish autonomous community organizing the conference gave 29.8% of the presentations. The contributions of presenters from the local organizing community were nearly always more numerous than the average number of contributions from that community in all 29 conferences overall. Conference contributions from some autonomous communities (Extremadura, Andalusia, and Catalonia) were considerably fewer than would be expected given the scientific productivity of those communities. However, communities (Murcia, Balearic Islands, Asturias, Castile-Leon, Madrid), gave many more presentations than their productivity metrics would predict. Analysis of the 59 most frequent presenters (at 5 conferences or more) showed that 64.4% of them had published at least 20 articles and that 71.2% had an h-index of 5 or higher. The number of women on the program increased significantly between 1988 and 2017. Likewise, geographic diversity increased significantly (presentations from centers outside the local organizing area) as did the participation of hospitalbased emergency medicine specialists.

CONCLUSION

SEMES conference programs have attracted significantly more presentations and presenters over the years. We also detected changes in descriptive characteristics. The analysis of those characteristics can help future SEMES conference planners to plan ways to correct aspects such as scarce geographic diversity, low international participation, and few women among presenters.

Ethics Committees and Mental Health

Although research processes are covered by the objectivity of science, they are still influenced by the interests of those who conduct them. This is why high level committees have been tasked with defining the scope of the studies and performing a thorough assessment of them, since these imply great dilemmas. This premise leads to the emergence of Ethics Committees, where liaison psychiatry has an important place due to its communication abilities and knowledge of the human behavior. This paper attempts to provide some observations to take into account when discussing the link between ethics and mental health. In this work, the authors approach the question of ethics committees and the importance that psychiatrist performance has within them. This is done through a review of relevant papers on the subject. A detailed description on research ethics is provided in terms of justification, purpose and duties. Likewise, emphasis is placed on each of the areas in which psychiatrists are involved and bear great responsibilities in the medical decision-making process. Similarly, this description also includes the moment in which participants give their informed consent when taking part in medical research. Finally, we conclude that there are several questions regarding the relevance given to these committees in the methodological and ethical assessment of research projects. This in turn implies greater effort in the search for a culture of quality which highlights the emphasis on research subjects.

Ethics research in critically ill patients

Research in critical care patients is an ethical obligation. The ethical conflicts of intensive care research arise from patient vulnerability, since during ICU admission these individuals sometimes lose all or part of their decision making capacity and autonomy. We therefore must dedicate effort to ensure that neither treatment (sedation or mechanical ventilation) nor the disease itself can affect the right to individual freedom of the participants in research, improving the conditions under which informed consent must be obtained. Fragility, understood as a decrease in the capacity to tolerate adverse effects derived from research must be taken into account in selecting the participants. Research should be relevant, not possible to carry out in non-critical patients, and a priori should offer potential benefits that outweigh the risks that must be known and assumable, based on principles of responsibility.

[Analysis of Spanish research collaboration in emergency medicine: 2010-2014]

OBJECTIVES

To describe the structure of the Spanish emergency medicine research network or networks, researchers' roles, and patterns of collaboration between hospitals.

MATERIAL AND METHODS

The search for publications was carried out in the SCOPUS database for the 5-year period of 2010 to 2014. We used network analysis software to map ties between researchers and hospitals that had established at least 5 and 10 relationships, respectively, during the period under study. We calculated indicators of degree of centrality for individual scientists and hospitals and tabulated data for the main authors and centers.

RESULTS

We identified 2626 articles with 12 372 different authors at 1134 hospitals in 75 countries. The largest number of international relations were with France, the United States, and the United Kingdom. Authors had established 93 687 connections that allowed us to identify 23 collaborating groups, the largest of which was comprised of 30 individuals. We also found 12 855 connections between hospitals that identified a single subnetwork of collaboration comprised of 19 hospitals, 1 of which was in Switzerland. Measures of centrality, intermediation, and proximity led to classification of the most important members of author and hospital networks.

CONCLUSION

This analysis of research networks in emergency medicine has afforded the first details describing the relationships maintained by Spanish scientists and hospitals.

Are neurology residents interested in headache?

INTRODUCTION

The years of residency are the pillars of the subsequent practice in every medical specialty. The aim of our study is to evaluate the current situation, degree of involvement, main interests, and perceived quality of the training received by Spanish residents of neurology, specifically in the area of headache.

METHODS

A self-administered survey was designed by the Headache Study Group of the Spanish Society of Neurology (GECSEN) and was sent via e-mail to all residents who were members of the Society as of May 2015.

RESULTS

Fifty-three residents completed the survey (N = 426, 12.4%): 6% were first year residents, 25.5% second year, 23.5% third year, and 45% fourth year residents, all from 13 different Spanish autonomous communities. The areas of greatest interest are, in this order: Vascular neurology, headache, and epilepsy. Of them, 85% believe that the area of headache is undervalued. More than half of residents (52.8%) do not rotate in specific Headache Units and only 35.8% complete their training dominating anaesthetic block and toxin infiltration techniques. Of them, 81.1% believe that research is scarce or absent; 69.8% have never made a poster/presentation, 79.3% have not published and only 15% collaborate on research projects in this area. Lastly, 40% believe that they have not received adequate training.

CONCLUSIONS

Headache is among the areas that interest our residents the most; however, we believe that we must improve their training both at a patient healthcare level and as researchers. Thus, increasing the number of available courses, creating educational web pages, involving residents in research, and making a rotation in a specialised unit mandatory are among the fundamental objectives of the GECSEN.

[Productivity of Spanish emergency physicians: comparison of the 5-year periods 2010-2014 and 2005-2009]

OBJECTIVES

To study the publication productivity of Spanish emergency physicians in the 5-year period from 2010 through 2014 and compare it with the previous period (2005-2009).

MATERIAL AND METHODS

Articles authored by emergency physicians affiliated with institutions in Spain were selected from the Science Citation Index-Expanded; conference presentations were excluded. We collected data for year of publication, author information, journal, the journal's impact factor (IF), type of article, cites received, and area of research. We searched at 2010-2014 period, and these data were compared with historic data from the 2005-2009 period.

RESULTS

A total of 1433 articles were published in 2010-2014; 52.4% were original research articles (56% more than in 2005-2009, P=.01). The mean journal IF associated with the publications was slightly higher in 2010-2014 (2.587 vs 2.483 for 2005-2009). The median was slightly lower (2.295 vs 3.085 in the earlier period), but the 90th percentile was higher (4.036 vs 3.085, P=0.01), reflecting an increase in the number of publications in journals with high IFs. Most articles continue to be published in Castilian Spanish (67.8%), although the percentage of articles published in English increased significantly, from 25.2% in the previous period to 32.1% in 2010-2014; P=.001). Scientific publications in emergency medicine come mainly from specialists working in hospital emergency departments (89%). Authors affiliated with a university are in the minority, although their percentage increased significantly from 10.9% in the previous period to 16.2% in the recent one (P=.001). Collaboration increased in the recent period in all categories: between hospitals in the same Spanish autonomous community (from 24.7% to 36%), in different communities (from 10.9% to 19%), or in different countries (from 2.3% to 8.4%) (P=.001, all comparisons). The most productive research areas were cardiovascular conditions (accounting for 13.1% of the publications), infectious diseases (13.0%), toxicology and pharmacology (9.2%), pediatric emergencies (8.0%), respiratory diseases (7.4%), cardiopulmonary resuscitation (6.7%), and management (6.0%). Catalonia produced the largest number of papers (427 [29.8%]). Hospital Clínic de Barcelona ranked first among hospitals publishing research, with 145 articles (11.4% of the total in this category); the emergency services of Madrid (SUMMA-112) ranked first among out-of-hospital research groups, with 43 publications (36.7% of the total in this category). Catalonia, Madrid, Castile-La Mancha, the Canary Islands, Murcia, the Balearic Islands, and La Rioja increased their contributions to Spanish productivity by 20% or more over their output in the earlier 5-year period. Nine of the 2010-2014 articles have already attracted enough cites to be considered citation classics.

CONCLUSION

The productivity of Spanish emergency physicians continued to grow at a good pace in the 2010-2014 period. Publications in journals with IFs increased and there were significant changes in the dynamics of publication and the subjects covered.

Correlation Between Insight and Capacity to Consent to Research in Subjects With Bipolar Disorder Type I and Schizophrenia

INTRODUCTION

Schizophrenia and bipolar disorder type I (BD-I) can affect patient autonomy and capacity to consent to participate in research. Other variables associated with the autonomy of patients must be explored in order to improve the quality of the currently available tools.

OBJECTIVE

To evaluate the relationship between insight and the capacity to consent to participate in research in patients with BD-I and schizophrenia.

METHODS

A cross-sectional and longitudinal study was conducted with 120 subjects (40 subjects with schizophrenia, 40 with BD-I, and 40 healthy controls). The tools used were the Scale Assessment Insight-Expanded (SAI-E) and the MacArthur Competence Assessment Tool-Treatment (MacCAT-CR), which was first adapted culturally, and its validity and reliability assessed. The results obtained on each scale were compared and the association between them were evaluated.

RESULTS

There is a direct correlation between the capacity to consent to research, measured using the MacCAT-CR tool, and the degree of insight, measured using the SAI-E scale, with an effect size of 1.3 for BD-I and 2.03 for schizophrenia.

CONCLUSIONS

The results suggest that there is a correlation between the degree of insight and the capacity to consent to research in subjects with schizophrenia and BD-I. Insight should therefore be included as a relevant variable to assess the capacity to consent, and future studies should include it when researching on or designing new tools which aim at a greater respect of patient autonomy.

Increase in Mexican and Latin American scientific articles on irritable bowel syndrome

BACKGROUND

There is an implied perception that little scientific information on irritable bowel syndrome (IBS) comes out of Mexico and Latin America in the international medical literature, but the number and tendencies of articles from the region on IBS are not known.

AIMS

To determine the number and type of Mexican and Latin American articles on IBS published between 1990-2015.

METHODS

A systematic search of Medline was carried out employing the terms « Irritable Bowel Syndrome » or its abbreviation (IBS). Mexico and every other Latin American country were added to specify the search. The articles were selected if they were published in Mexico and/or the rest of Latin America, if they were international papers on IBS in the region, or if they were written by Mexican and/or Latin American authors. In addition, the articles were classified into the following categories: Reviews/Editorials/Letters to the Editor (REV/ED), Epidemiology/Quality of Life/Psychosocial Factors (EPI/QOL), Diagnostic (DX), Treatment (TX), and Translational/Pathophysiologic (TRANS) studies.

RESULTS

A total of 66 articles from Mexico and 47 from Latin America were identified, but only 87.7 and 48.9%, respectively, fit the selection criteria. Category distribution was: EPI/QOL: 36.2%, REV/ED: 27.5%, TRANS: 18.8, TX: 10%, and DX: 7.5% and was similar between Mexico and Latin America (p=0.33). The year 2005 saw an increase in the number of articles in Mexico, with a peak in 2010. The figures for Latin American articles remained stable over the years, with a peak in 2012.

CONCLUSIONS

A noticeable increase has been observed over the last decade in the research conducted on IBS in Mexico and Latin America. Even though the EPI/QOL studies predominate, the sophistication of research is reflected in the TRANS studies that are in third place of frequency. The information referred to herein demonstrates maturity in the field, making it possible to carry out consensuses based on local data.

Research: Why and how to write a paper?

In this article, an internationally renowned pulmonologist with extensive experience in teaching and publishing gives practical advice to young physicians and/or residents on the importance of doing research, the steps for planning a project and also some do's and don'ts of writing and publishing a scientific paper.

[Key aspects in interpreting clinical trials in radiology]

A clinical trial is an experimental study to evaluate the efficacy and safety of a treatment or diagnostic technique in human beings. To ensure the methodological quality of a clinical trial and the validity of its results, various checklists have been elaborated to identify biases that could invalidate its conclusions. This article focuses on the points we need to consider in the critical evaluation of a clinical trial. We can usually find this information in the "materials and methods" and "results" sections of articles. Randomization, follow-up (or analysis of losses), blinding, and equivalence between groups (apart from the intervention itself) are some key aspects related to design. In the "results" section, we need to consider what measures of clinical efficacy were used (relative risk, odds ratio, or number needed to treat, among others) and the precision of the results (confidence intervals). Once we have confirmed that the clinical trial fulfills these criteria, we need to determine whether the results can be applied in our environment and whether the benefits obtained justify the risks and costs involved.

[Analysis of highly cited articles published in Emergencias]

A journal is generally considered to be of higher quality to the extent that it publishes articles that are cited. A journal's articles are not all cited equally, however; rather, citations of only a select group of titles accounts for most of a journal's impact factor. This study aimed to identify the characteristics of Emergencias's most highly cited articles and compare their impact to that of papers by other authors in Spain, in Spanish, and internationally in the field of emergency medicine. Between 2008 and 2015, Emergencias published 975 articles, which received 2207 citations. The most-cited article received 52, and the group of 20 most-cited articles accumulated a total of 519 cites (23.5%). Even though Emergencias is published in Spanish and was included in Journal Citation Reports only recently (2008), some of the published articles have had considerable impact. The most-cited article (EVADUR Study) was in the top 2% (98th percentile) of all publications by authors in Spain, and in the top 1% of articles published in Spanish or in emergency medicine.

A tool to assess sex-gender when selecting health research projects

Objective

To validate the questionnaire “Gender Perspective in Health Research” (GPIHR) to assess the inclusion of gender perspective in research projects.

Design

Validation study in two stages. Feasibility was analysed in the first, and reliability, internal consistence and validity in the second.

Where

Aragón Institute of Health Science, Aragón, Spain.

Participants

GPIHR was applied to 118 research projects funded in national and international competitive tenders from 2003 to 2012.

Main measurements

Analysis of inter- and intra-observer reliability with Kappa index and internal consistency with Cronbach's alpha. Content validity analysed through literature review and construct validity with an exploratory factor analysis.

Results

Validated GPIHR has 10 questions: 3 in the introduction, 1 for objectives, 3 for methodology and 3 for research purpose. Average time of application was 13 min Inter-observer reliability (Kappa) varied between 0.35 and 0.94 and intra-observer between 0.40 and 0.94. Theoretical construct is supported in the literature. Factor analysis identifies three levels of GP inclusion: “difference by sex”, “gender sensitive” and “feminist research” with an internal consistency of 0.64, 0.87 and 0.81, respectively, which explain 74.78% of variance.

Conclusions

GPIHR questionnaire is a valid tool to assess GP and useful for those researchers who would like to include GP in their projects.

[Research and Post-graduate in Psychiatry]

The research component and the acquisition of skills related to the generation of knowledge in the training of medical and surgical specialists in the country is an issue that has recently begun to be discussed. For over 50 years this training has included only the area of professionalism as a copy of an educational model from the mid-twentieth century. Currently the country requires specialists with critical and analytical skills to question their actions and knowledge and generate alternative clinical care to apply to the general population in the search of bettering their own welfare. This article is a review in which the current situation of the teaching of psychiatry and the inclusion of research in the academic processes of our medical specialties in the country are analyzed.