The burden of predatory journal and congress requests in foot and ankle surgery

IntroductionIn recent years the proportion of predatory invitations by email of the total number of emails received has grown dramatically. The aim of the current study was to objectify the increase in predatory journal and congress requests per email over a 5.5-year period and their relatedness to the receivers’ speciality in Foot and Ankle surgery.Material and methodA comprehensive Microsoft Outlook^® analysis of 5.5 years’ worth of junk email from one surgical Foot & Ankle specialist working at a Level-1 trauma centre was evaluated. The topic of each email from the last year was scored according to the ‘degree-of-relatedness’.ResultsBetween July 1^st 2013 and December 31^th 2018 a total of 41,687 emails were collected in the junk email folder of Microsoft Outlook^®. A total of 17.0 percent was attributed to emails from predatory journals and congresses. Over the 5.5-year period the percentage of total emails that consisted of invitations from predatory journals and congresses rose from 4.5% to 40.8%. Only an insignificant amount (2.3%) was directly related to the authors medical sub-speciality of Foot and Ankle surgery.ConclusionThis is the first study showing the individual burden of unsolicited emails from predatory publishers and journals. The authors acknowledge the risk that this publication, like all others, will likely result in yet even more invitations from predatory journals and congress invitations. All should be warned of a huge increase in emails from predatory journals and congresses, which has likely not peaked yet. Appropriate action is needed, as we urge foot–ankle interested scientists to publish in indexed journals with proper peer review.     

Custom 3-Dimensional Printed Ultrasound-Compatible Vascular Access Models: Training Medical Students for Vascular Access

PurposeTo generate 3-dimensional (3D) printed ultrasound (US)-compatible vascular models (3DPVAM) and test them for noninferiority in training medical students in femoral artery access.Materials and MethodsA 3DPVAM of normal femoral artery (FA) anatomy was developed from an anonymized computerized tomography (CT) examination. Students were randomized to a 3DPVAM or a commercial model (CM) simulation experience (SE) for US-guided FA access. Students completed a pre-SE questionnaire ranking their self-confidence in accessing the artery on a 5-point Likert scale. A standardized SE was administered by interventional radiology faculty or trainees. Students completed a post-SE questionnaire ranking comfort with FA access on a Likert scale. Student questionnaire results from the 3DPVAM group were compared with those from the CM group by using chi-square, Wilcoxon signed-rank, and noninferiority analyses.ResultsTwenty-six and twenty-three students were randomized to 3DPVAM and commercial model training, respectively. A total of 76.9% of 3DPVAM trainees and 82.6% of CM trainees did not feel confident performing FA access prior to the SE. In both groups, training increased student confidence by 2 Likert points (3DPVAM: P < 0.001; CM P < 0.001). The confidence increase in 3DPVAM trainees was noninferior to that in CM trainees (P < 0.001).ConclusionsGeneration of a custom-made 3DPVAM is feasible, producing comparable subjective training outcomes to those of CM. Custom-made 3D-printed training models, including incorporation of more complex anatomical configurations, could be used to instruct medical students in procedural skills.     

Transradial Approach to Cardiovascular Interventions: An Update

Background Since the first cardiac catheterization in 1929, the procedure has continually evolved with advances in understanding, capabilities, and ease of operation. Though historically performed by cut down of the brachial artery, cardiologists soon learned that transfemoral access was both easier to perform and more efficacious with regard to patient outcome. In the last 20 years, the transradial approach has been adopted, and is being utilized with increasing frequency. Methods We conducted a survey of literature published concerning safety, efficacy, cost-effectiveness, and global uptake of transradial catheterization with specific attention to how transradial interventions compare with transfemoral interventions. Results This review of literature indicates that when performed by an experienced interventionalist, radial catheterization is as effective as femoral catheterization and has additional benefits of shorter length of hospital stay and reduced patient costs. Transradial access is superior to transfemoral access in some, but not all, clinical scenarios; in addition, it is an effective alternative for catheterization in patients contraindicated for transfemoral procedures. Adoption of radial access in the United States is at a faster rate than previously expected, though rate of use varies drastically worldwide. Conclusion The transradial approach is an excellent option for carrying out cardiovascular interventions, and will be adopted by more cardiologists in the upcoming years.     

Oven melting encapsulization of hypodermic needles by syringes

The results of a study to determine the time and temperature conditions necessary to melt standard injection syringes are presented. The polypropylene syringes are melted to form a solid block of material encapsulating the attached stainless steel hypodermic needles, making them appropriate for further processing into other products. The desired result was obtained after two hours at 200°C and can be replicated easily in a location such as a rural clinic in a developing nation.     

Health workers' perceptions of access to care for children and pregnant women with precarious immigration status: Health as a right or a privilege?

The Canadian government's recent cuts to healthcare coverage for refugee claimants has rekindled the debate in Canada about what medical services should be provided to individuals with precarious immigration status, and who should pay for these services. This article further explores this debate, focussing on the perceptions of healthcare workers in Montreal, a large multiethnic Canadian city. In April–June 2010, an online survey was conducted to assess how clinicians, administrators, and support staff in Montreal contend with the ethical and professional dilemmas raised by the issue of access to healthcare services for pregnant women and children who are partially or completely uninsured. Drawing on qualitative analysis of answers (n = 237) to three open-ended survey questions, we identify the discursive frameworks that our respondents mobilized when arguing for, or against, universal access to healthcare for uninsured patients. In doing so, we highlight how their positions relate to their self-evaluations of Canada's socioeconomic situation, as well as their ideological representations of, and sense of social connection to, precarious status immigrants. Interestingly, while abstract values lead some healthcare workers to perceive uninsured immigrants as “deserving” of universal access to healthcare, negative perceptions of these migrants, coupled with pragmatic considerations, pushed most workers to view the uninsured as “underserving” of free care. For a majority of our respondents, the right to healthcare of precarious status immigrants has become a “privilege”, that as taxpayers, they are increasingly less willing to contribute to. We conclude by arguing for a reconsideration of access to healthcare as a right, and offer recommendations to move in this direction.     

瑞芬太尼在镇痛分娩中的运用研究

目的：研究探讨瑞芬太尼在镇痛分娩中运用的有效性、安全性。方法：选择单胎、头位、自然分娩、无病理性妊娠因素孕妇102例，随机分为两组：瑞芬太尼组（A组）50例，导乐法组（B组）52例。A组在孕妇进入活跃期后，缓慢静注瑞芬太尼0．5μg/kg ，后持续微量注射泵注入0．04μg/（kg · min），孕妇述疼痛加剧时，单次静脉追加0．5μg/kg。B组采用常规非药物镇痛-导乐法分娩。记录宫缩疼痛视觉模拟评分（VAS）、呼吸循环指标、胎心监测情况、新生儿Apgar评分、催产素应用及器械助产情况等指标。结果：A组镇痛后VAS评分各时段均低于B组（P＜0．05），其他呼吸循环、胎心监测、Apgar评分等指标两组无显著差异（P＞0．05）。结论：瑞芬太尼静注0．5μg/kg复合泵注背景剂量0．04μg/（kg · min）用于分娩镇痛安全有效。     

基于OA及免费全文链接的期刊影响力指数优势

【目的】 为开放获取政策的制定提供理论参考,给学术搜索引擎免费全文链接的建设提供依据。【方法】 对图书馆、情报与文献学领域的26种中文社会科学引文索引来源期刊的开放获取状况与免费全文链接情况进行调查。根据期刊的开放获取状态和免费全文链接获得程度将期刊分为4类,分别在不同的时间视窗下比较4类期刊的各项评价指标的变化趋势,并进行相关性分析。【结果】 所选的26种期刊的开放获取程度为61.5%,这些期刊在百度学术中平均每篇论文拥有2.17个免费全文链接。开放获取和有高免费全文链接获得程度的期刊在不同时间视窗影响力指数下的表现都较占优势。【结论】 期刊开放获取和有较多的免费全文链接有助于期刊的被引用和影响力的提升。