The number of authors of scientific publications

As in most other scientific journals, the number of authors per paper published in Acta Paediatrica is gradually increasing. In the 2003 volume, the number of authors was six or more in about one-third of the Regular papers and Clinical observations. The editorial board has handled several conflicts of interest due to disputes about authorship.

Conclusion: Editors of scientific journals should promote a policy with the aim of creating a true balance between authorship and originality of papers.     

Parental assessment of developmental delay in children: some limitations and hazards

According to a study published in the present issue of Acta Paediatrica, mothers' reports of developmental delays in children of preschool age were associated with socio-economic factors.

Conclusion: For the present, developmental screening procedures using parental assessments cannot be considered evidence based. National health service systems ensuring preventive health care for all children, regardless of socio-economic background, will form a more solid basis for early detection and treatment.     

Can cry in the newborn be used as an assessment of pain?

Pain in the neonate is a complex subject. The assessment of pain should be simple and clinically usable. So far, the scales that have been used to assess pain are too time consuming and complex. The analysis of cry in a simple manner, as described in this issue of Acta Paediatrica by Bellieni et al., could be used in a simple and effective way at the bedside.

Conclusion: Since sick and premature newborns are not studied, the scale needs further confirmation.     

Psychiatric and psychosomatic symptoms are increasing problems among Swedish schoolchildren

Paediatricians and other professionals in Sweden note that the amount of children with psychiatric and psychosomatic symptoms is growing in number. Suicide attempts among the young (15-24 y) increased by more than 30% from 1998-2003. The Swedish National Board for Health and Welfare's 2004 guidelines for school healthcare shed light on this increasing problem among schoolchildren. An article in this issue of Acta Paediatrica, “Living conditions and psychosomatic complaints in Swedish schoolchildren”, analyses economic stress as a causative factor leading to psychosomatic symptoms such as headache, abdominal pain and difficulty in falling asleep. Living conditions, however, most likely include other factors related to our modern and ever-changing society that also have an impact on the growing child.

Conclusion: Psychiatric health is changing for the worse among Swedish schoolchildren. The cause is multifactorial. Economic stress is one factor, but there are also other possible causes related to modern society that correlate to the increase of psychosomatic problems among schoolchildren. Three major problems are among those suspected: impaired education and deficient working environment in Swedish schools, a general lack of adult contact and guidance, and excessive computer and TV use.     

Which place for bismuth subsalicylate in the treatment of enteric infections?

ORS has led to improved outcome of acute gastroenteritis in both industrialised and developing countries. In both settings there is an increasing demand for active therapy to reduce the duration of diarrhoea and its complications. Persistent diarrhoea is a major consequence of intestinal infections and is responsible for a high number of deaths in poor countries. Bismuth subsalicylate has been used for treatment of acute diarrhoea, with preliminary promising results. In this issue of Acta Paediatrica, a trial with BSS is essential. However the results were marginal and did not justify a mass scale use of BSS, also because of poor cost efficacy rate.     

Focus on neonatal resuscitation--NOW

The paper by Saugstad et al. in this issue of Acta Paediatrica presents new and provocative data on the development of the child's physiological status during the first minutes of life. The data were extracted from the database of the Resair 2 study designed to investigate the outcome of resuscitation with air or 100% oxygen. The potential of these variables to predict the outcome of asphyxiated infants was evaluated.

Conclusion: The data—in spite of some technical limitations and lack of representative reference measurements—point out the potential value of sequential physiological observations in the early identification of newborn infants at risk of poor outcome, challenge the routine habit of giving ample oxygen to depressed neonates, and call for further studies.     

Recurrent abdominal pain. A world-wide problem of organic, functional and psychosomatic aetiology

This spring, Acta Paediatrica is publishing five original articles underlining the importance of recurrent abdominal pain (RAP) and illustrating the scientific and diagnostic difficulties involved in understanding it. Our knowledge of organic causes is increasing with improved instruments for investigation, including 24-h pH monitoring and endoscopy, but the difficulty in how to link findings of organic abnormalities conclusively to the symptom RAP has to be further elaborated and discussed. There is an old belief that many cases of RAP have a psychogenic aetiology. Psychometric tests in past decades, however, have not supported this belief, but if the reaction primarily is one of negative stress, than we should be looking for negative stress reactions, not for psychopathology. RAP of psychosomatic origin is not just a matter of excluding organic disease, but a diagnosis that must be built on firm positive diagnostic criteria, criteria that have not yet been elaborated for a broader public.     

Does nitric oxide prevent oxidative mediated lung injury?

The US Food and Drug Administration recently approved nitric oxide (NO) inhalation therapy for newborn infants >34 wk of gestation with hypoxic respiratory failure associated with pulmonary hypertension. In clinical trials, this therapy has reduced the need for extracorporeal membrane oxygenation. It has not reduced mortality, however. A body of accumulating data indicates that NO may act as an antioxidant as well as a prooxidant, depending on a number of known and unknown factors, e.g. the concentration of NO itself and the concentration of other oxidants. In low doses, NO is an antioxidant and in high doses its prooxidant effects are more pronounced. In this issue of Acta Paediatrica, new information regarding this question has come to light. Turanlanthi et al. have found that NO in relatively high doses induces free radical mediated injury in the lungs of 10-wk-old Wistar rats, while in combination with hyperoxia it attenuates the oxidative stress of hyperoxia alone. Recently, it has also become clear that NO acts as a second messenger activating a number of cytokines and inducing apoptosis. There therefore seems to be a close relation between NO, oxidative stress, regulation of growth and inflammation. For these reasons, long-term follow-up studies of newborn infants treated with NO inhalation are needed. So far, NO therapy has not been successful in premature infants. Conclusions: NO inhalation has a number of both short-term and long-term potential adverse effects, and is still at the experimental stage in premature infants. Consequently, there is a need for further clinical studies monitoring also the long-term consequences of this therapy.     

Bibliometric data: a disaster for many non-American biomedical journals

Bibliometric data published by the Institute of Scientific Information in Philadelphia (ISI), and which was previously discussed in Acta Paediatrica , has increasingly been used despite all the relevant and severe criticism that has been raised against this method of evaluating individual research results and grading scientific journals. It is obvious that the present trend regarding the use of bibliometric data as a basis for priorities and funding of research and for the promotion of individual scientists favours American-oriented research projects at the expense of those that are based on concepts of predominantly European relevance.

Conclusion: For the future of non-American research, it is important that no single super-power, i.e. the USA, should dominate scientific priorities. The condition for efficient European competition is that European Centres with high levels of competence for creative research and training of scientists from all over the world are established. In addition, it is important that the results of European research are published in prestigious European journals, as was the situation before World War II.     

Using online databases to find journal articles on injury prevention and safety promotion research: key journals and the databases that index them.

OBJECTIVES: (1) To determine the trends of the number of journals that publish injury prevention and safety promotion (IPSP) articles and the number of articles published each year from 1900 through 2006; (2) to determine the coverage of key IPSP journals in widely used literature databases. METHODS: Journals were identified through a structured procedure that included hand-searching selected classification categories of two major listings of periodicals that publish four or more IPSP-relevant articles per year. Article relevance was assessed using the inclusion criteria for SafetyLit (a database of scholarly literature selected for its relevance to the IPSP field). Each identified journal was hand-searched from its first issue, and IPSP-relevant articles were added to the SafetyLit archive database. A MySQL database was used to perform basic queries and statistical summary analyses for journals published 1900-2006. The number of IPSP journals and journal articles was plotted for these years to identify publication trends. The publication year range of each IPSP journal was compared with the coverage, if any, of the journals in each of the five databases. RESULTS: Of the 17 839 journals assessed, 597 met the threshold for inclusion in this study. This amounts to thousands of IPSP-related articles published each year: 6100 in 2006. Only 160 (26.8%) of the journals are included in all five databases, and none have all publication years included in all of the databases. CONCLUSIONS: Some key IPSP journals are completely excluded from some of the databases. Thus, a search in a single database may miss key information from one of the many disciplines that publish IPSP-relevant information.     

Negative results and impact factor: a lesson from neonatology

OBJECTIVE: To test the hypothesis that articles with negative results are more likely than articles with positive results to be published in journals with lower impact factor. DESIGN AND SETTING: We selected all of the randomized, placebo-controlled trials conducted during the neonatal period between October 1, 1998, and October 1, 2003. Trials were classified as having positive results or negative results (significant or no significant difference, respectively). Only studies dealing with primary outcomes (efficacy) were included. MAIN OUTCOME MEASURES: The impact factor of each journal was determined, and the sample size for each study was noted. RESULTS: There were 233 articles that fulfilled the inclusion criteria. There was a significant difference between the 2 groups in terms of impact factor (P = .03) but not sample size (P = .30). Impact factor correlated with both sample size and the type of study results (positive results vs negative results; P<.05). CONCLUSION: Articles with negative results are more likely than articles with positive results to be published in journals with lower impact factor.     

Type 2 diabetes mellitus in European children and adolescents

Aim: The aim of the study was to review the published and unpublished data on type 2 diabetes in European children in order to determine how common this problem is in the dominantly Caucasian population. Methods: The MEDLINE database was searched and a questionnaire was distributed among European Childhood Obesity Group (ECOG) representatives from 16 countries. Results: One hundred and eighty-four children with type 2 diabetes were diagnosed in Europe, 144 of them of Caucasian origin. The majority of them were overweight females and, had positive family history for type 2 diabetes mellitus.

Conclusion: Because of the significant rates of type 2 diabetes in Europe, screening for it in obese children and adolescents is highly recommended.     

Secular trends in impact factor of neonatology publications over a 10-year period

Aim: To test the hypotheses that published randomized clinical trials (RCTs) in neonatology with negative results (NR) are more likely to be published in journals with lower impact factor (IF) than those with positive results (PR); that there is an increase in the number of yearly published RCTs; that studies with large sample sizes are likely to be published in journals with higher IF. Methods: We used all English‐written RCTs registered in MEDLINE between 1/1/2001–31/12/2010 in the field of neonatology. Each RCT was classified as having a PR or NR. IF of each journal was determined for the year of publication. Results: We identified 329 RCTs. Yearly number of RCTs varied between 19 and 46, with no significant consistent linear increase over the years. There was no significant change over the years in average IF or in average patient size. IF and sample size of the studies were not significantly higher in studies with PR than in studies with NR. Conclusion: The number of RCTs per year in the field of neonatology has stabilized in the past 10 years, and RCTs with positive or negative results are published in journals of similar IF.     

Abstracts presented at the European Society for Pediatric Urology (ESPU) meetings (2003–2010): Characteristics and outcome

ObjectiveTo determine the characteristics and outcome of abstracts presented to the meetings of the European Society for Pediatric Urology (ESPU).Material and methodsAbstract books from 2003 to 2010 were reviewed and subsequent publication of presented abstracts determined by MEDLINE/PubMed search.ResultsOf 1194 abstracts, 50–78% per year originated from 15 to 20 European countries and 50–22% from 8 to 13 non-European countries; 233 (19%) were basic science and 961 (81%) clinical. Clinical abstracts included 135 (14%) multicenter/prospective/randomized trials. These figures did not change significantly over time. A total of 564 (47%) abstracts were subsequently published, 65% within 1 year of the meeting, mostly in the Journal of Urology (33%) and the Journal of Pediatric Urology (21%). Multicenter/prospective/randomized trials studies (OR 2.03; 95% CI 1.37–2.96) and abstracts originating from outside Europe (OR 1.61; 95% CI 1.26–2.05) were significantly more likely to be subsequently published in full.ConclusionThe ESPU meetings are a true occasion for international exchange of scientific endeavors. Almost half of the abstracts are subsequently published. The Journal of Urology and the Journal of Pediatric Urology are consistently the two major target journals for publication. Non-European countries, irrespective of whether English-speaking or not, seem significantly more likely to publish their abstracts.     

The effects of antimalarials and folate supplements on haematological indices and red cell folate levels in Gambian children

Haematological indices and red cell folate levels (RCF) were measured during two annual surveys in a group of Gambian children aged 3 months-5 years who were participating in a trial of malaria chemoprophylaxis with Maloprim or chlorproguanil given with or without folate supplements. Chlorproguanil was given in an adult dose of 20 mg, Maloprim as one quarter or one half of the adult dose of 25 mg pyrimethamine and 100 mg dapsone. Antimalarials and folate supplements were given fortnightly. About 20% of children had low RCF levels (less than 100 ng/ml). Among children who did not receive supplementation with folate there were no significant differences in mean RCF levels between children who received Maloprim, chlorproguanil or placebo. Among children who received folate supplements, the mean RCF was significantly lower among those receiving chlorproguanil than among the controls. Mean RCF values were similar in children who received Maloprim or placebo. If chlorproguanil is used for malaria chemoprophylaxis in young children an age-related dose should be used.