Impact factor and the future of Acta Pædiatrica and other European medical journals

Most European medical journals attain very low impact factors, as reported in Journal Citation Reports, and from the European point of view the depressing outlook is continually falling values. Among many reasons behind the low impact factor of European journals is citation bias as a consequence of the low prestige of European journals. In the case of Acta Paediatrica, which has published between 4 and 15 supplements annually during the period 1994-98, the low impact factor of the articles included in these supplements reduces the overall impact factor to less than half of what it would be had no supplements been published, i.e. from 1.88 to 0.81. It is obvious that by refusing to publish supplements the impact factor of Acta Paediatrica would be dramatically elevated. Some of the supplements, such as the one on persistent diarrhoeal disease which had to be reprinted as the original edition was sold out (1), are undoubtedly of great educational value and have an important role as sources of references. However, it is difficult for Acta Paediatrica to continue to publish supplements because of the load imposed on the impact factor of the journal.

It is suggested that a scientific committee within the European Union seriously considers the importance of supporting European Biomedical Science, and that one way of doing so is to improve the prestige and quality of European journals.     

The 10th anniversary of the Junior Members and Affiliates of the European Academy of Allergy and Clinical Immunology

This year is the 10th anniversary of the European Academy of Allergy and Clinical Immunology (EAACI) Junior Members and Affiliates (JMAs). The aim of this review is to highlight the work and activities of EAACI JMAs. To this end, we have summarized all the initiatives taken by JMAs during the last 10 yr. EAACI JMAs are currently a group of over 2380 clinicians and scientists under the age of 35?yr, who support the continuous education of the Academy's younger members. For the past decade, JMAs enjoy a steadily increasing number of benefits such as free online access to the Academy's journals, the possibility to apply for Fellowships and the Mentorship Program, travel grants to attend scientific meetings, and many more. In addition, JMAs have been involved in task forces, cooperation schemes with other scientific bodies, organization of JMA focused sessions during EAACI meetings, and participation in the activities of EAACI communication platforms. EAACI JMA activities represent an ideal example of recruiting, training, and educating young scientists in order for them to thrive as future experts in their field. This model may serve as a prototype for other scientific communities, several of which have already adapted similar policies.     

Preventing accidents in childhood: A European perspective

Accidental injury is a principal public health issue with important individual, societal and economic consequences. Crude figures show that 2.7 million deaths from injury and poisoning are reported worldwide. In developing and industrialized countries 10–30% of all hospital admissions are due to accidental injuries. In particular, children and adolescents are at risk. In all industrialized countries accidental injuries are the major cause of death and morbidity among children above the age of one. In the domestic safety area much effort has to be invested in improving the safety of the environment and products. In the European region, collaboration among authorities in the framework of the European Community (EC) has been shown to be productive in the area of safety. Although trade interest is predominant in the EC objectives, the need to harmonize national regulations and standards towards common European standards has appeared to be an important vehicle for establishing standards at an optimum level of safety. It has also fostered some collaboration in data collection and analysis and in implementing prevention measures. An even stronger international collaboration is needed for ensuring that appropriate priorities are being set and prevention measures are effectively being implemented.     

Bibliometric Analysis of Research Studies Based on Federally Funded Children's Health Surveys

ObjectiveBibliometric analyses are commonly used to measure the productivity of researchers or institutions but rarely used to assess the scientific contribution of national surveys/datasets. We applied bibliometric methods to quantify the contributions of the National Survey of Children's Health (NSCH) and the National Survey of Children with Special Health Care Needs (NS-CSHCN) to the body of pediatric health-related research. We also examined dissemination to nonresearch audiences by analyzing media coverage of statistics and research produced from the surveys.MethodsWe conducted a search of the Web of Science database to identify peer-reviewed articles related to the NSCH and NS-CSHCN published between 2002 and 2019. We summarized information about citation counts, publishing journals, key research areas, and institutions using the surveys. We used the Lexis Advance database Nexis to assess media coverage.ResultsThe publication set included 716 NSCH/NS-CSHCN journal articles published between 2002 and June 2019. These publications have in turn been cited 22,449 times, including in 1614 review articles. Over 180 journals have published NSCH/NS-CSHCN articles, and the most commonly covered research areas are in pediatrics; public, environmental and occupational health; psychology; and health care sciences and services. Over 500 institutions have used NSCH/NS-CSHCN data to publish journal articles, and over 950 news media articles have cited statistics or research produced by the surveys.ConclusionsNSCH/NS-CSHCN data are widely used by government, academic, and media institutions. Bibliometric methods provide a systematic approach to quantify and describe the contributions to the scientific literature made possible with these data.     

Do presenters to paediatric meetings get their work published?

BACKGROUND: Research presented to a scientific meeting is inaccessible to clinicians, unless it is also published in a cited journal. AIMS: To assess the publication rate of studies presented to two UK national paediatric meetings: the Paediatric Research Society (PRS) and the British Paediatric Association (BPA). METHODS: A Medline search in December 1999 for the first authors of all plenary abstracts presented in 1996. If not found, authors contacted by postal questionnaire. RESULTS: Information was obtained on 88/89 presentations. Twenty five of 48 PRS and 31 of 40 BPA studies were published in Medline listed journals. The major reason for non-publication was that they had not been submitted (PRS 15/48, BPA 6/40). Some authors were still hoping to do so (PRS 7, BPA 2). Other reasons were: publication in other forms (theses, book chapters, non-Medline journals) (PRS 5, BPA 2), or still being reviewed (PRS 3, BPA 1). Ten of 11 randomised, controlled trials were published, but only 20 of 37 observational studies were submitted and published. CONCLUSION: Presenters to paediatric meetings need help in submitting and publishing their work.     

Whether and why pediatric researchers report race and ethnicity

BACKGROUND: Recently, specific policy statements have been published in pediatric journals that question the use of race and ethnicity (R/E) in health care research. OBJECTIVES: To determine why researchers may or may not collect R/E data and to find out their opinion on the importance of R/E and SMs to their research. METHODS: All full-length articles published in the print edition of 3 general pediatric journals published between July 1, 1999, through June 30, 2000, were collected and reviewed. Articles were excluded if they did not include at least 1 US researcher, all subjects at US institutions, some prospective data collection, or enrolled less than 8 or more than 10 000 subjects. We recorded whether the articles documented R/E, socioeconomic markers (SMs), or both in the "Results" section and whether they discussed their significance. Corresponding authors (or researchers) were surveyed to clarify the R/E data, to determine why they had or had not collected R/E data, and to elicit their opinion on the importance of R/E and SMs to their research. RESULTS: One hundred ninety-two studies qualified for further review. One hundred fourteen (59%) reported R/E but only 44 (23%) discussed it. Even fewer 74 (39%) reported both R/E and SMs, and only 33 (17%) discussed both. Researchers collected R/E data because they thought it was relevant and because it described the subject population. Seventy-five percent of the researchers who responded to the survey thought R/E and 63% thought SMs were relevant to their research, and this influenced whether they reported and discussed R/E (P<.001, chi2 test) and whether they discussed SMs (P<.001, chi2 test). CONCLUSIONS: Pediatric statements will require that researchers not mention R/E or explore the extent to which R/E disparities are confounded by other SMs. This will require a cultural shift because many researchers believe that R/E is relevant to their research, and yet, they infrequently report SMs.     

Publication of research presented at the pediatric meetings. Change in selection

The adequacy of research presented in abstract form for presentation at scientific meetings remains a concern, as indicated by the proportion of such research appearing in scientific journals after peer review. This report examines the publication of research presented at the pediatrics meetings and the effect of a change in selection procedure for abstracts presented at the Ambulatory Pediatric Association meetings for the years 1979 and 1980. Throughout the period, about half of the presentations were published, usually in general pediatric journals, with an average time to publication of about 20 months. The change in selection procedure resulted in little change in the proportion published among either presentations or abstracts submitted but not selected for presentation, but it did lead to a reduction in time to publication. This experience suggests a mechanism for enhancing the timeliness of publication of research presented at scientific meetings without adversely affecting the process of selection.     

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.     

Editorial: A double‐edged sword: advantages and disadvantages to the current emphasis on biogenetic causes of child psychopathology

Research on child psychopathology is a largely biogenetic endeavor these days, at least according to current funding priorities at the National Institutes of Health in the US. This heavy focus on genetic contributions to child psychopathology has some real advantages. Available research has conclusively indicated that child and adolescent mental health problems are partially genetic in origin and, moreover, are related to neural structure and function (as an example, see Plomin et al.). Moreover, these genetic effects may be responsible for some previously reported ‘environmental’ effects, such that, what appear to be direct environmental risk factors may in fact reflect genetic/familial risks. As one example, Sengupta et al. (this issue) found that maternal smoking during pregnancy was in fact a marker of maternal and paternal psychopathology. Put another way, the association between ADHD and maternal smoking during pregnancy may index a genetic/familial risk for a more severe form of ADHD, rather than a direct effect of uterine exposure to cigarettes. A final, more subtle reason for the current trend towards biogenetic research is that it has the rarely‐discussed but all‐too‐important ‘allure of the unknown’. We have only just recently been able to directly explore the biological underpinnings of psychopathology; and as technology advances, so too will the insights gained (presumably). This offers both funding agencies and individual scientists the very real possibility of making a major new discovery – a siren's call for most of us. In sharp contrast, decades of research have explored putatively environmental contributions to child and adolescent psychopathology. New paradigm‐shifting discoveries are thus likely to be fewer in number and farther between (if we continue using traditional study designs that omit joint consideration of biology, that is). In short, biogenetic research just feels more cutting edge at the moment. The clear merits of such work notwithstanding, there are a number of critical disadvantages to the current emphasis on genetics. These issues are presented below, not necessarily in order of importance.     

Survey on scientific research activity in Spanish neonatal divisions between 2000 and 2004

Research is an essential activity in neonatology. Following the recommendation of the Spanish Neonatal Society (SEN), a questionnaire on the state of research activity was sent to all Spanish neonatal divisions belonging to all public and private institutions with structured neonatal activity. The following items were included: (i) clinical level of the units; (ii) academic degrees and professional qualifications of the staff members; (iii) characteristics of the scientific activity performed, and (iv) financial and technical aid supporting research. Of a total of 115 eligible hospitals, 86 hospitals (74.8 %), including most of the referral centers, participated in the survey. Notable among the positive results were the findings that a significant number of neonatologists have doctoral degrees (17.4 %), are active members of the SEN (74.9 %), and wish to participate in scientific research (100 %). In addition, the presence of epidemiologists (100 %), research support units (85 %) and ethical committees (93 %) in the hospitals is widespread. Negative aspects include the lack of a specific budget to initiate research (74 %), lack of protected time even with research grants (86 %), and lack of interrelation with other groups of basic or clinical researchers (43 %). Analysis of scientific production revealed that most of the abstracts presented are restricted to Spanish national meetings, and only a small number of consolidated groups publish regularly in peer-reviewed international journals with impact factor. Measures that could help to improve the current situation are the formation of multi-hospital groups, participation in comprehensive databases (SEN 1500), and joint meetings for basic and clinical scientists, among others. The results of this survey were presented at the Congress of Perinatal Medicine held in Las Palmas (November, 2005).     

Reading a Journal Article

Journal reading is an important continuing educational activity in terms of physician preference, frequency of use amount of time devoted to it and impact in changing practice. Clinicians trying to obtain information from journals face several tasks, including the need to assess both the quality and the applicability of the information found in published articles. This article describes the general principles for reading, critically, scientific papers that report clinical research results, which include establishing the kind of question that the authors were trying to answer, the type of study done, if the research design was appropriate for the question, and if it was conducted correctly. According to several available guidelines, once the reader has a clear idea of the study question it is necessary to assess the methods described by the authors in order to evaluate whether the research strategy used is likely to have errors resulting from bias and chance (random) variation. If the paper methodology seems to be adequate, the reader should proceed to determine the results of the article and their potential clinical impact. Finally. the reader must establish the extent to which the results are helpful in caring for his or her own patients, which means assessing the external validity and other related issues. The use of these strategies will improve the efficiency of readers for incorporating research results to their practice.     

Neonatal Research in India: Current Status,Challenges, and the Way Forward

The present article systematically reviews the current status of neonatal research in India by examining the research articles published by Indian authors in the last 10 years. It also enlists the major challenges and proposes a few potential solutions to improve the status of neonatal research in the country. The systematic review of 574 eligible articles indicates that majority of the studies were observational in nature, facility-based, and primarily investigator-driven with no external funding, had small sample size, and were published in journals with low impact factor. Only a few select government and non-government academic institutions contributed to most studies. The major challenges include shortage of faculty, no provision for dedicated research time, inadequate knowledge/skills in research methods, lack of funding opportunities, limited access to literature, non-existence of research administrative cell, inappropriately low perks to research staff, and poor support for data management and statistical analysis. The recently revised guidelines on clinical trials involving drugs have further increased the researcher’s dilemma. The potential solutions are to increase the faculty strength in medical colleges, allow dedicated research time to them, appoint dedicated research cadre with emoluments at par with clinical faculty, initiate formal training in research methods, create nationwide free portal for access to literature, facilitate development of good protocols through technical guidance at all stages, make the process of funding quick and transparent, and to promote collaborative trans-disciplinary research. Experts from different domains should come together and formulate evidence based research priorities. Regulatory mechanisms should be kept proportionate to plausible risks of research, and detailed ethical guidelines for research in children should be formulated. And last but not least, harnessing postgraduate thesis potential to answer simple and relevant clinical questions in a methodologically rigorous way is the need of the hour.     

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.     

Structure, use, and risks of biomaterial repositories of embryonal tumors

Availability of statistically sufficient numbers of tumor samples and other biomaterials in high quality together with corresponding clinical data is crucial for biomedical research. Tumor repositories from individual scientists are mostly not sufficient to satisfy these criteria, especially since pediatric tumors are rare. In 2000 three centralized tumor repositories (neuroblastoma in Cologne, nephroblastoma in Würzburg, hepatoblastoma, brain tumors in Bonn) have been established by the "German Competence Net Pediatric Oncology und Hematology". The aim was to collect biomaterial including tumor samples, normal tissue, and blood in high quality for research and diagnostic purposes at a central institution. Informed consent of the parents or patients is a prerequisite for scientific use of the samples and is requested by the therapy trial. The samples are collected according to accepted standards and shipped in the specially designed Tumorbox. The tumor repository organizes the distribution of the samples to the cooperating diagnostic laboratories. The number of collected tumor samples has increased over the years. In 2000, samples from 200 patients were collected while the patient number increased to 321 in 2005. Over the years the tumor repositories collected more than 7,150 samples (fresh frozen tumor, fresh frozen normal tissue, and blood). Through links with clinical trial databases the samples can be connected with clinical data. 12 of 14 applications for tumor material to be used in specific scientific projects have been approved by an independent supervisory board. The establishment of central tumor repositories represents a major step for biomedical research activities and quality control in pediatric oncology.     

Growth curve for girls with Turner syndrome.

A growth chart for girls with Turner syndrome has been prepared using data from four published series of European patients, and evaluated using retrospective data on the heights of girls with Turner syndrome seen at this hospital. The results indicate that calculation of height standard deviation score from this chart allows a reasonable prediction of adult stature in any patient with Turner syndrome. In addition, the results indicate that while oestrogen treatment causes an initial acceleration of growth, it has no significant effect on adult height.     

A special conditions register.

A special conditions register (SCR) linked to the child health system's register of all children has been in use in West Sussex since 1977. This paper describes the aims, organisation, and use of the SCR and gives examples of the aggregated data that may be obtained. Of the 155,000 children aged 0-17 resident in West Sussex in 1990, 4.3% were included on the SCR. Altogether 45.7% of children on the SCR had physical conditions with mild or no disability and 17.2% had moderate educational problems. The prevalence of severe hearing loss as defined was 1.7 per 1000 aged 5-17. The prevalence of diabetes mellitus was 1.2 per 1000 children aged 0-17. Validation of the SCR for diabetes mellitus found 35/36 of the eligible children were correctly registered and no child was incorrectly included. The conflicting priorities for maintaining a register for the care of individual children, for service planning, and for epidemiological research are discussed.