Why do healthcare researchers in South Asia publish in predatory journals? A scoping review

Predatory journals offer the promise of prompt publication to those willing to pay the article submission or processing fee. However, these journals do not offer rigorous peer review. Studies have shown that a substantial share of corresponding authors in predatory journals come from South Asia, particularly India. This scoping review aims to assess what is known about the reasons why healthcare researchers working in South Asia publish in predatory journals. 66 reports (14 editorials, 20 letters, 5 research reports, 10 opinion articles, 14 reviews, 2 commentaries and 1 news report) were included in the data charting and analysis. The analysis of the reports identified three main reasons that made South Asian healthcare researchers publish in predatory journals: pressure to publish, lack of research support, and pseudo benefits. The review shows that predatory publishing in South Asia is a complex phenomenon. Combating predatory publications requires a holistic strategy that supersedes merely blacklisting these journals or listing criteria for journals that do meet academic standards.

Cuts to high-profile NIH efforts leave researchers reeling

Drop in 21st Century Cures Act funding will slow BRAIN and All of Us projects.

Research prioritization in paediatric orthopaedics and the impact on funding

In 2017, the British Society for Children's Orthopaedic Surgery engaged the profession and all relevant stakeholders in two formal research prioritization processes. In this editorial, we describe the impact of this prioritization on funding, and how research in children's orthopaedics, which was until very recently a largely unfunded and under-investigated area, is now flourishing. Establishing research priorities was a crucial step in this process.

Comparison of Availability of Trial Results in ClinicalTrials.gov and PubMed by Data Source and Funder Type

This study examines the dissemination of trial results by data source (ie, ClinicalTrials.gov and PubMed) and funder type (ie, industry and nonindustry).

Perceived Barriers to Serving on National Institutes of Health Scientific Review Groups Experienced by Black and African American Scientists

IMPORTANCE

African American and Black scientists are awarded disproportionately fewer National Institutes of Health (NIH) grants than White scientists. Increasing Black representation on NIH scientific review groups (SRGs) likely will contribute to increased equity in funding rates because research topics of Black and African American scientists' submitted applications will be more highly valued; however, Black and African American scientists often perceive barriers that prevent them from serving on NIH SRGs.

OBJECTIVE

To examine perceived barriers that prevent Black and African American scientists from serving on NIH SRGs.

DESIGN, SETTING, AND PARTICIPANTS

This qualitative study used a mixed methods online approach with a convenience sample of Black and African American scientists to identify barriers to NIH grant review participation. Eligible participants were recruited online from professional organizations with primarily Black and African American membership. From February through April 2021, participants were asked to identify barriers to serving on NIH SRGs using concept mapping. Participants brainstormed statements describing barriers to serving on NIH SRGs, sorted statements into content themes, and rated statements on how true they were. Multidimensional scaling and a hierarchical cluster analysis identified content themes. Data analysis was conducted in May and June of 2021.

MAIN OUTCOMES AND MEASURES

Self-reported barriers to serving on an NIH SRG among Black and African American scientists.

RESULTS

A total of 52 scientists participated in both phases of the study (mean [SD] age, 42.3 [8.2] years; 46 women [88.5%]). Participants provided 68 unique statements that were organized into 9 thematic clusters describing barriers to serving on NIH SRGs. Themes included structural racism, diversity not valued, toxic environment, review workload demand, lack of reward, negative affect about the review process, competing demands at home institution, lack of opportunity, and perceptions of being unqualified.

CONCLUSIONS AND RELEVANCE

Black and African American scientists reported many barriers to serving on NIH SRGs that are unique to Black and African American scientists, as well as barriers that transcend race but are exacerbated by structural racism. This study provides NIH with concrete opportunities to address realized barriers to increase inclusion of Black and African American scientists on NIH SRGs, fund more Black and African American scientists, and ultimately reduce health inequities in the US.

Inadequacy and underreporting of study subjects' race and ethnicity in federally funded pelvic floor research

BACKGROUND

The inclusion of participants who are Black, Indigenous people of color, and participants of various ethnicities is a priority of federally sponsored research.

OBJECTIVE

This study aimed to describe the reporting of race and ethnicity in federally funded research published by the Eunice Kennedy Shriver National Institute of Child Health and Human Development-funded Pelvic Floor Disorders Network.

STUDY DESIGN

Pelvic Floor Disorders Network publications were reviewed to determine whether race or ethnicity was reported. The number of participants included in each manuscript who were identified as White, Black, Asian, American Indian or Alaska Native, Native Hawaiian or Other Pacific Islander, and "other," and the number of participants who identified as having Hispanic ethnicity were recorded. Data were analyzed by publication and by the pelvic floor disorder investigated, including urinary incontinence, pelvic organ prolapse, fecal incontinence, pregnancy-related pelvic floor disorders, and multiple pelvic floor disorders. Many publications reported on overlapping patient populations, which included primary trials and secondary analyses and studies. Data were analyzed both by counting participants every time they were reported in all papers and by counting the unique number of participants in only the original trials (primary paper published).

RESULTS

A total of 132 Pelvic Floor Disorders Network publications were published between 2003 and 2020. Of these, 21 were excluded because they were methods papers or described research without participants. Of the 111 remaining articles, 90 (81%) included descriptions of race and 55 (50%) included descriptions of ethnicity. All 13 primary trials described race and 10 of 13 (76.9%) described ethnicity. Of those publications that described race, 50 of 90 (56%) included only the categories of "White," "Black," and "Other," and 14 of 90 (16%) only described the percentage of White patients. Of the 49,218 subjects, there were 43,058 (87%) with reported race and 27,468 (56%) with reported ethnicity. Among subjects with race and ethnicity reported, 79% were reported as White, 9.9% as Black, 0.4% as Asian, 0.1% as American Indian or Alaska Native, and 4% as "other," whereas 13% were reported to be of Hispanic ethnicity. The racial and ethnic diversity varied based on the pelvic floor disorder studied (P<.01), which was driven by pregnancy-related and fecal incontinence studies because these had lower proportions of White patients than studies of other pelvic floor disorders.

CONCLUSION

Federally funded Pelvic Floor Disorders Network research does not consistently report the race and ethnicity of participants. Even in the publications that report these characteristics, Black, Indigenous people of color, and people of Hispanic ethnicity are underrepresented. Consistent reporting and recruitment of a diverse population of women is necessary to address this systemic inequity.

Bart De Strooper

In an interview with Neuron, Bart De Strooper charts how support from unconventional leaders has informed his inclusive mentorship style. He discusses the need for science literacy and advocacy to combat existential crises, and his optimism around the ongoing revolution in dementia research.

Returning to Growth: One Academic Medical Center's Successful Five-Step Approach to Change Management

The University of Alabama at Birmingham academic medical center (UAB AMC) had achieved great success and growth during the 50 years since its founding. However, the challenging and more competitive environment of the 2000s left the UAB AMC on a downward trajectory. The UAB AMC had to overcome difficult internal cultural and structural barriers that stood in the way of the transformational change needed to remain competitive. Competition rather than collaborative and strategic financial investment were the primary cultural barriers for the UAB AMC, while people were the primary structural barrier. Leadership identified 5 steps that were critical for the transformation that occurred between 2013 and 2018: alignment of leadership; creating a compelling and credible shared vision; identifying cultural and structural barriers; creating a thoughtful, data-driven intervention; and improved communication and accountability. Following these steps enabled the UAB AMC to transform its institutional structure and culture. As a result, the UAB AMC thrived, returning to substantial growth in research and clinical care. UAB AMC School of Medicine grew by $100 million in National Institutes of Health funding and moved up 10 spots in ranking. In 2018, UAB Hospital had 10 specialties ranked by U.S. News & World Report, 7 more than in 2013. This article outlines the approach taken and provides a conceptual framework for other AMCs eager to transform their structure and culture and position themselves for growth.

National Institutes of Health Career Development (K) Awards to Young Surgeons: An Academic Milestone or One-hit Wonder?

OBJECTIVE

To assess contemporary trends in the National Institutes of Health (NIH) Career Development (K) Awards within the Departments of Surgery and its impact on the likelihood of achieving independent R01 grants.

BACKGROUND

The NIH provides K-type Career Development Awards to nurture young clinicians toward a productive academic career, thereby maintaining a pipeline of physician-scientists. However, the impact of K awards on career trajectory of surgeons remains unclear.

METHODS

The NIH grant data was queried for all new K08/K23 grants awarded to Departments of Surgery (1999-2019). Principal Investigators' data and grant-related information was obtained.

RESULTS

The NIH awarded 298 K08/23 surgical grants ($41,893,170) over the last 2 decades. Median budget increased from $116,370 to $167,508 (P<0.001). Of grantees, 83.2% were MDs, 15.1% MD/PhD, and 1.7% PhDs, with 25.2% being women. Principal Investigators' were mostly practicing surgeons (91.1%) with fellowship training (82.4%) and young in their careers {4 [interquartile ranges (IQR) 4] years of experience}. Vascular surgery (15.9%), Complex General Surgical Oncology (15.1%), and Trauma/Critical Care (14.6%) were the most frequent specialties. Awards were associated with 3,336 publications [median 8/project (IQR 13)]. The majority of K grantees (77.2%) currently hold an academic faculty position. Only 32.2% of awardees received independent R01 grant funding, at a median of 5.5 years (IQR 5) after their K awards. Sex (P = 0.71), previous fellowship training (P = 0.63), type of surgical specialty (P = 0.72), or MD/PhD degree (P = 0.75) were not associated with increased likelihood of achieving a subsequent R01 award.

CONCLUSION

Although the majority of K awardees maintain an academic career, only a limited number of grantees progress to obtain NIH R01 funding. Increased mentorship, financial support, and infrastructure are needed to facilitate career development awardees opportunities to enhance their ability to achieve independent funding.

Large study will probe Long Covid

[Figure: see text].

Engaging surgeons among clinician-scientists

Since completion of the Human Genome Project at the turn of the century, there have been significant advances in genomic technologies together with genomics research. At the same time, the gap between biomedical discovery and clinical application has narrowed through translational medicine, so establishing the era of personalised medicine. In bridging these two disciplines, the clinician-scientist has become an integral part of modern practice. Surgeons and surgical diseases have been less represented than physicians and medical conditions among clinician-scientists and research. Here, we explore the possible reasons for this and propose strategies for moving forward. Discovery-driven personalised medicine is both the present and the future of clinical patient care worldwide, and South Africa is uniquely placed to build capacity for biomedical discovery in Africa. Diverse engagement across clinical disciplines, including surgery, is necessary in order to integrate modern medicine into a developing-world contextualised perspective.

UEG position paper on pancreatic cancer. Bringing pancreatic cancer to the 21st century: Prevent, detect, and treat the disease earlier and better

BACKGROUND

Pancreatic ductal adenocarcinoma is the deadliest cancer worldwide with a 98% loss-of-life expectancy and a 30% increase in the disability-adjusted life years during the last decade in Europe. The disease cannot be effectively prevented nor being early detected. When diagnosed, 80% of patients have tumors that are in incurable stages, while for those who undergo surgery, 80% of patients will present with local or distant metastasis. Importantly, chemotherapies are far from being effective.

OBJECTIVE

Pancreatic cancer represents a great challenge and, at the same time, a huge opportunity for advancing our understanding on the basis of the disease, the molecular profiles, that would lead to develop tools for early detection and effective treatments, thus, boosting patient survival.

RESULTS

Research on pancreatic cancer has being receiving little or minimal funds from European funding bodies. UEG is calling for public-private partnerships that would effectively fund research on pancreatic cancer.

CONCLUSION

This would increase our understanding of this disease and better treatment, through pan-European efforts that take advantage of the strong academic European research landscape on pancreatic cancer, and the contribution by the industry of all sizes.

Do authors of research funded by the Canadian Institutes of Health Research comply with its open access mandate?: A meta-epidemiologic study

BACKGROUND

Since 2008, the Canadian Institutes of Health Research (CIHR) has mandated that studies it funds either in whole or in part are required to publish their results as open access (OA) within 12 months of publication using either online repositories and/or OA journals. Yet, there is evidence that authors are poorly compliant with this mandate. Specifically, there has been an apparent decrease in OA publication after 2015, which coincides with a change in the OA policy during the same year. One particular policy change that may have contributed to this decline was lifting the requirement that authors deposit their article in an OA repository immediately upon publication. We investigated the proportion of OA compliance of CIHR-funded studies in the period before and after the policy change of 2015 with manual confirmation of both CIHR funding and OA status.

METHODS AND FINDINGS

We identified CIHR-funded studies published between the years 2014 to 2017 using a comprehensive search in the Web of Science (WoS). We took a stratified random sample from all four years (i.e. 2014 to 2017), with 250 studies from each year. Two authors independently reviewed the final full-text publications retrieved from the journal web page to determine to confirm CIHR funding, as indicated in the acknowledgements or elsewhere in the paper. For each study, we also collected bibliometric data that included citation count and Altmetric attention score Statistical analyses were conducted using two-tailed Fisher's exact test with relative risk (RR). Among the 851 receiving CIHR funding published from 2014 to 2017, the percentage of CIHR-funded studies published as OA significantly decreased from 79.6% in 2014 to 70.3% in 2017 (RR = 0.88, 95% CI: 0.79-0.99, P = 0.028). When considering all four years, there was no significant difference in the percentage of CIHR-funded studies published as OA in both 2014 and 2015 compared to both 2016 and 2017 (RR = 0.97, 95% CI: 0.90-1.05, P = 0.493). Additionally, OA publications had significantly higher citation count (both in year of publication and in total) and higher attention scores (P<0.05).

CONCLUSIONS

Overall, we found that there was a significant decrease in the proportion of CIHR funded studies published as OA from 2014 compared to 2017, though this difference did not persist when comparing both 2014-2015 to 2016-2017. The primary limitation was the reliance of self-reported data from authors on CIHR funding status. We posit that this decrease may be attributable to CIHR's OA policy change in 2015. Further exploration is warranted to both validate these studies using a larger dataset and, if valid, investigate the effects of potential interventions to improve the OA compliance, such as use of a CIHR publication database, and reinstatement of a policy for authors to immediately submit their findings to OA repositories upon publication.

Kidney-Related Research in the United States: A Position Statement From the National Kidney Foundation and the American Society of Nephrology

Kidney disease is an important US public health problem because it affects over 37 million Americans, and Medicare expenditures for patients with chronic kidney disease now alone exceed $130 billion annually. Kidney disease is characterized by strong racial, ethnic, and socioeconomic disparities, and reducing kidney disease incidence will positively impact US health disparities. Due to the aging of the US population and an unabated obesity epidemic, the number of patients receiving treatment for kidney failure is anticipated to increase, which will escalate kidney disease health expenditures. The historical and current investment in kidney-related research via the National Institute of Diabetes and Digestive and Kidney Diseases has severely lagged behind ongoing expenditures for kidney disease care. Increasing research investment will identify, develop, and increase implementation of interventions to slow kidney disease progression, reduce incidence of kidney failure, enhance survival, and improve quality of life. This perspective states the urgent reasons why increasing investment in kidney-related research is important for US public health. The National Kidney Foundation and the American Society of Nephrology are working together to advocate for increased funding for the National Institute of Diabetes and Digestive and Kidney Diseases. The long-term goal is to reduce the burden of kidney disease in the US population and improve the quality of life of patients living with kidney disease.

Career Development Considerations for Academic Physician Mentees and Mentors in the Time of COVID-19: Jump in or Just Dip a Toe?

The COVID-19 pandemic has disrupted medical research, pushing mentors and mentees to decide if COVID-19 research would be germane to the early career investigator's developing research portfolio. With COVID-19 halting hundreds of federal trials involving non-COVID-19 research, mentors and mentees must also consider the broader moral calling of contributing to COVID-19 research. At the time of writing, the National Institutes of Health had responded to the pandemic with significant funding for COVID-19 research. However, because this pandemic is a new phenomenon, few mentors have expertise in the disease and relevant established resources. As a result, many mentors are unable to provide insight on COVID-19 research to early career investigators considering a pivot toward research related to this disease. The authors suggest 4 ways for mentees and mentors to respond to the changes the pandemic has brought to research funding and opportunities: (1) include COVID-19 research in existing portfolios to diversify intellectual opportunities and reduce funding risks; (2) negotiate the mentor-mentee relationship and roles and expectations early in project discussions-considering, as relevant, the disproportionate burden of home responsibilities often borne by early career faculty members who are women and/or from a minority group; (3) address any mentor limitations in content expertise; and (4) if the decision is to pivot to COVID-19 research, select projects with implications generalizable beyond this pandemic to other infectious outbreaks or to the redesign of health care delivery. Mentors and mentees must weigh the relevance of COVID-19 research projects to the postpandemic world and the amount of available funding against the developing interests of early career investigators. Academic medical centers nationwide must enable seasoned and early career researchers to contribute meaningfully to COVID-19 and non-COVID-19 research.

Is There a Replication Crisis in Medical Education Research?

Scholars are increasingly aware that studies-across many disciplines-cannot be replicated by independent researchers. Here, the authors describe how medical education research may be vulnerable to this "replication crisis," explain how researchers can act together to reduce risks, and discuss the positive steps that can increase confidence in research findings. Medical education research contributes to policy and influences practitioner behavior. Findings that cannot be replicated suggest that the original research was not credible. This risk raises the possibility that unhelpful or even harmful changes to medical education have been implemented as a result of research that appeared defensible but was not. By considering these risk factors, researchers can increase the likelihood that studies are generating credible results. The authors discuss and provide examples of 6 factors that may endanger the replicability of medical education research: (1) small sample sizes, (2) small effect sizes, (3) exploratory designs, (4) flexibility in design choices, analysis strategy, and outcome measures, (5) conflicts of interest, and (6) very active fields with many competing research teams. Importantly, medical education researchers can adopt techniques used successfully elsewhere to improve the rigor of their investigations. Researchers can improve their work through better planning in the development stage, carefully considering design choices, and using sensible data analysis. The wider medical education community can help by encouraging higher levels of collaboration among medical educators, by routinely evaluating existing educational innovations, and by raising the prestige of replication and collaborative medical education research. Medical education journals should adopt new approaches to publishing. As medical education research improves, so too will the quality of medical education and patient care.

Information Opacity in Biopharmaceutical Innovation Through the Lens of COVID-19

The COVID-19 pandemic has revealed myriad and complex challenges for our national health care system spanning preparedness, response, access, costs, infrastructure, coordination, and medical innovation. These challenges implicate federal, state, and local agencies and actors, as well as international collaborative bodies. One constant throughout the pandemic has been the pressing need for safe and effective diagnostics, prophylactic vaccines, and drug treatments to counter the virus.1 Inarguably, significant problems with the multi-faceted system of drug and vaccine innovation and regulation manifested long before the COVID-19 pandemic.2 The pandemic, however, has laid bare the inextricable connections among federal funding, patents, product review and approval mechanisms, and the eventual medical products and resulting costs.

Diversifying the Research Workforce as a Programmatic Priority for a Career Development Award Program at Duke University

The National Institutes of Health (NIH) has prioritized efforts to increase diversity in the biomedical research workforce. NIH-funded institutional career development awards may serve as one mechanism to facilitate these efforts. In 2013, the Duke University KL2 program, an internal career development program funded by the National Center for Advancing Translational Sciences, set a goal to increase the number of investigators from underrepresented racial and ethnic groups (UREGs) to ≥ 50% of KL2 awardees. From 2013 to 2019, 133 KL2 applications were received, 38% from UREG investigators. Of the 21 scholars selected, 10 (47.6%) were UREG investigators; all were Black/African American. This represents a threefold increase in the proportion of UREG applications and a sixfold increase in the proportion of UREG KL2 scholars compared with Duke's previous KL2 cycles (2003-2012), during which only 13% of applicants and 8.3% of funded scholars were UREGs. Of the 12 KL2 scholars (7 UREG) who completed the program, 5 have received NIH funding as principal investigators of an external K award or R01, and 4 of them are UREG investigators; this constitutes a post-KL2 NIH funding success rate of 57% (4/7) for UREG scholars. Achieving this programmatic priority was facilitated by institutional support, clear communication of goals to increase the proportion of UREG KL2 awardees, and intentional strategies to identify and support applicants. Strategies included targeted outreach to UREG investigators, partnerships with other institutional entities, structured assistance for investigators with preparing their applications, and a KL2 program structure addressing common barriers to success for UREG investigators, such as lack of consistent mentorship, protected research time, and peer support. The authors' experience suggests that KL2 and other internal career development programs may represent a scalable, national strategy to increase diversity in the biomedical research workforce.

Moving Forward in the Next Decade: Radiation Oncology Sciences for Patient-Centered Cancer Care

In a time of rapid advances in science and technology, the opportunities for radiation oncology are undergoing transformational change. The linkage between and understanding of the physical dose and induced biological perturbations are opening entirely new areas of application. The ability to define anatomic extent of disease and the elucidation of the biology of metastases has brought a key role for radiation oncology for treating metastatic disease. That radiation can stimulate and suppress subpopulations of the immune response makes radiation a key participant in cancer immunotherapy. Targeted radiopharmaceutical therapy delivers radiation systemically with radionuclides and carrier molecules selected for their physical, chemical, and biochemical properties. Radiation oncology usage of “big data” and machine learning and artificial intelligence adds the opportunity to markedly change the workflow for clinical practice while physically targeting and adapting radiation fields in real time. Future precision targeting requires multidimensional understanding of the imaging, underlying biology, and anatomical relationship among tissues for radiation as spatial and temporal “focused biology.” Other means of energy delivery are available as are agents that can be activated by radiation with increasing ability to target treatments. With broad applicability of radiation in cancer treatment, radiation therapy is a necessity for effective cancer care, opening a career path for global health serving the medically underserved in geographically isolated populations as a substantial societal contribution addressing health disparities. Understanding risk and mitigation of radiation injury make it an important discipline for and beyond cancer care including energy policy, space exploration, national security, and global partnerships.

Getting to the bottom of research funding: Acknowledging the complexity of funding dynamics

Research funding is an important factor for public science. Funding may affect which research topics get addressed, and what research outputs are produced. However, funding has often been studied simplistically, using top-down or system-led perspectives. Such approaches often restrict analysis to confined national funding landscapes or single funding organizations and instruments in isolation. This overlooks interlinkages, broader funding researchers might access, and trends of growing funding complexity. This paper instead frames a 'bottom-up' approach that analytically distinguishes between increasing levels of aggregation of funding instrument co-use. Funding of research outputs is selected as one way to test this approach, with levels traced via funding acknowledgements (FAs) in papers published 2009-18 by researchers affiliated to Denmark, the Netherlands or Norway, in two test research fields (Food Science, Renewable Energy Research). Three funding aggregation levels are delineated: at the bottom, 'funding configurations' of funding instruments co-used by individual researchers (from single-authored papers with two or more FAs); a middle, 'funding amalgamations' level, of instruments co-used by collaborating researchers (from multi-authored papers with two or more FAs); and a 'co-funding network' of instruments co-used across all researchers active in a research field (all papers with two or more FAs). All three levels are found to include heterogenous funding co-use from inside and outside the test countries. There is also co-funding variety in terms of instrument 'type' (public, private, university or non-profit) and 'origin' (domestic, foreign or supranational). Limitations of the approach are noted, as well as its applicability for future analyses not using paper FAs to address finer details of research funding dynamics.

Creating collaboration by breaking down scientific barriers

The scientific world rewards the individual while often discouraging collaboration. However, times of crisis show us how much more we can accomplish when we work together. Here, we describe our approach to breaking down silos and fostering global collaborations and share the lessons we have learned, especially pertaining to research on SARS-CoV-2.

Advancing science or advancing careers? Researchers' opinions on success indicators

The way in which we assess researchers has been under the radar in the past few years. Critics argue that current research assessments focus on productivity and that they increase unhealthy pressures on scientists. Yet, the precise ways in which assessments should change is still open for debate. We circulated a survey with Flemish researchers to understand how they work, and how they would rate the relevance of specific indicators used in research assessments. We found that most researchers worked far beyond their expected working schedule. We also found that, although they spent most of their time doing research, respondents wished they could dedicate more time to it and spend less time writing grants and performing other activities such as administrative duties and meetings. When looking at success indicators, we found that indicators related to openness, transparency, quality, and innovation were perceived as highly important in advancing science, but as relatively overlooked in career advancement. Conversely, indicators which denoted of prestige and competition were generally rated as important to career advancement, but irrelevant or even detrimental in advancing science. Open comments from respondents further revealed that, although indicators which indicate openness, transparency, and quality (e.g., publishing open access, publishing negative findings, sharing data, etc.) should ultimately be valued more in research assessments, the resources and support currently in place were insufficient to allow researchers to endorse such practices. In other words, current research assessments are inadequate and ignore practices which are essential in contributing to the advancement of science. Yet, before we change the way in which researchers are being assessed, supporting infrastructures must be put in place to ensure that researchers are able to commit to the activities that may benefit the advancement of science.

Human Health Risks of Conducted Electrical Weapon Exposure: A Systematic Review

IMPORTANCE

Conducted electrical weapons (CEWs) are used broadly as a less-lethal force option for police officers. However, there is no clear picture of the possible health risks in humans on the basis of rigorously assessed scientific evidence from the international peer-reviewed literature.

OBJECTIVE

To synthesize and systematically evaluate the strength of published evidence for an association between exposure to different models of CEWs and adverse acute as well as chronic conditions.

EVIDENCE REVIEW

Following a preregistered review protocol, the literature search strategy was based on a search of reviews published between January 1, 2000, and April 24, 2020, of PubMed, MEDLINE, EMBASE, Web of Science, PsycINFO, and Cochrane Library, as well as relevant online databases and bibliographic sources, such as reference sections of recent publications. The identified studies were independently assessed in terms of scope, relevance, methodologic bias, and quality. Peer-reviewed publications of human studies were included, using original data and with a focus on the use of taser CEWs in the context of law enforcement. Eligible studies examined clearly defined health outcomes as dependent variables following exposure to a CEW. The review followed the relevant sections of the Preferred Reporting Items for Systematic Reviews and Meta-analyses reporting guideline. A meta-analysis could not be conducted.

FINDINGS

Of the 1081 unique records screened, 33 relevant studies were identified, all of them of experimental design and conducted in the US. Eleven studies had a low risk of bias and 22 had a higher bias risk. Studies focused on outcomes such as physiologic stress responses, heart rate, blood pressure, arrhythmias, or cognitive performance. Independently of bias risk, the studies reported few or no acute health problems, apart from the wounds caused by the darts. Furthermore, no long-term outcomes were studied. Most of the studies were performed on healthy, physically fit individuals (eg, police officers) in a controlled setting, with short exposure duration (5 seconds). Half of the studies, mainly those with a higher risk of bias, were at least partly funded by the manufacturer.

CONCLUSIONS AND RELEVANCE

Based on the findings of the reviewed studies, the risk for adverse health outcomes due to CEW exposure can be currently estimated as low. However, most of the reviewed studies had methodologic limitations. Considering that recruited participants were not representative of the population that usually encounters a CEW deployment, it is not possible to draw conclusions regarding exposure outcomes in potentially vulnerable populations or high-risk groups, such as those under the influence of substances.

Synthesis of systematic reviews of percutaneous device closure of patent foramen ovale (PFO) for prevention of recurrent cryptogenic stroke: Redundant publications and methodological deficiencies

Critical assessments of systemic reviews and meta-analyses have found them to often be redundant, lacking in novel perspectives, of poor methodological quality, and written by authors with potential conflicts of interest. We sought to investigate these issues as they relate to systemic reviews and meta-analyses of percutaneous patent foramen ovale closure for the prevention of recurrent cryptogenic stroke.

Congress Approves Increase in Cancer Funding

The federal spending bill enacted by the U.S. Congress in December for fiscal year 2021 totals $1.4 trillion, plus another $900 billion in emergency COVID-19 relief funding. The $1.4 trillion includes budget increases for the NIH, NCI, and FDA that help the agencies keep pace with inflation. Research advocates say more than $10 billion in emergency supplemental funds for the NIH is urgently needed to support medical research affected by the COVID-19 pandemic.

What Biden's Presidency Will Mean for Cancer

As vice president, Joe Biden was the cancer advocate-in-chief. As president, he has a different public health crisis to deal with-COVID-19-but given Biden's passion for cancer research, many expect he will build on the previous Moonshot initiative with another push to accelerate the pace of progress in cancer control.

Prioritizing knowledge translation in low- and middle-income countries to support pandemic response and preparedness

The COVID-19 pandemic has created urgent demand around the world for knowledge generation about a novel coronavirus, its transmission, and control, putting academic institutions at the frontline of politics. While many academic institutions are well poised to conduct research, there are well-documented barriers for these institutions, particularly in low- and middle-income countries (LMICs), to further conduct strategic synthesis and dissemination to promote knowledge utilization among policy-makers. These systemic barriers to knowledge translation (KT) pose significant challenges for academic institutions seeking to take advantage of unprecedented policy windows to inform evidence-based decision-making. Global health funding organizations should prioritize the support of academic institutions' activities along the KT pathway, including both knowledge generation and strategic dissemination, to improve knowledge uptake for decision-making to improve health. Institutional capacity-building initiatives for KT have the potential to profoundly impact responses to this and future pandemics.

Opportunities and Challenges in Translational Research: The Development of Photodynamic Therapy and Anti-Vascular Endothelial Growth Factor Drugs

The development of photodynamic therapy and anti-vascular endothelial growth factor agents have revolutionized the treatment of retinal diseases, transforming the retina subspecialty by ushering in an age of pharmacological treatments for a wide range of diseases, including age-related macular degeneration (AMD).

The Future of the Pharmaceutical Industry: Beyond Government-Granted Monopolies

Just as tariffs lead to economic distortions and provide incentives for corruption, so do patent monopolies on prescription drugs, except the impact is often an order of magnitude larger.