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Critical evaluation of previously published data on the fractional urinary fluoride excretion in young children.

BACKGROUND: There have been several investigations comparing total fluoride intake and the urinary fluoride excretion in young children. Average results of the fractional urinary fluoride excretion (FUFE) reported for this age group are controversial. OBJECTIVE: To analyse previously published results exploring the influence that some metabolic variables, such as the F-dose (mg F/kg body weight), rate of urinary fluoride excretion, age and body weight, might have on FUFE values. DESIGN: Previously published results on average FUFE values in young children were analysed by means of bivariate correlations and when available, individual FUFE values were studied using multiple linear regression models. RESULTS: Published average FUFE values for young children are linearly correlated with the inverse of daily F-dose (r = 0.90; p < 0.0005). Individual FUFE values can be predicted by means of a multiple regression model using (dose)(-1), rate of F urinary excretion and age as significant predictors; multiple R2 = 0.947, and p < 0.0001, for all of the partial regression coefficients. CONCLUSIONS: Young children appear not to have a single average value for FUFE. A high proportion of its variability (81%) is explained by the inverse of the F-dose. About 95% of the variability of individual FUFE values for this age group is explained by (dose)(-1), rate of urinary F-excretion and age.

Age Factors↗

Scope for regulation of cigarette smoke toxicity according to brand differences in published toxicant emissions.

AIMS: To explore the scope for regulating to reduce the toxicity of manufactured cigarettes sold in New Zealand (NZ), based on published toxicant emissions by brand. METHODS: Internet searches of published cigarette smoke emissions of 13 toxicants chosen on risk assessment principles, for 20 British Columbian, 15 Australian brands, and one NZ brand, Holiday Extra-mild (HEM), tested by Health Canada intensive smoke machine method at Labstat Inc, Kitchener, Ontario, as a ratio of toxicant to nicotine yield. We estimated relative overall smoke toxicity per disease group and per brand, after adjusting for the published cigarette-attributed mortality fractions for cancer, cardiovascular, and respiratory disease. RESULTS: After allowing for nicotine yield, filter ventilation, and compensatory over-smoking, there were significant differences between brands, with the NZ brand estimated to be the most toxic. Low-yield cigarettes (<0.9 mg nicotine ISO) were estimated to be on average 19% more potent overall than medium-yield cigarettes (p<0.01). Of toxicants identified and measurable in smoke; 1,3-butadiene accounted for 45% of cancer potency; hydrogen cyanide for 89% of cardiovascular; and acrolein for 97% of respiratory potency--these three toxicants accounting for 65% of identified brand potency. Individual toxicant emissions varied across brands by a factor of 1.5 for carbon monoxide, to 32 for lead. Compared with HEM, one Canadian brand, 'Export A full flavor', carried a 37% lower cancer risk. This lower risk was largely due to differences in nicotine yield, lowering the toxicant/nicotine ratio. CONCLUSIONS: Cigarettes, unregulated, are unduly dangerous. Though many smoke toxicants cannot yet be quantified, risk assessment based on current data suggests that regulation could partly reduce identifiable cancer risk, and possibly eliminate the excess cardiovascular and respiratory toxicity of HEM, when compared with regular Canadian brands. The first goal should be to reduce emissions of the leading three toxicants, in addition to more effective charcoal filters. Tobacco smoke, unlike unburnt or non-smoking tobacco, contains toxic gases and trillions of reactive oxygen species molecules per puff, and will remain inherently harmful. Regulation could usefully part-reduce smoke toxicity exposure for continuing smokers, while not relenting on efforts to assist smokers and society to be quit of smoking.

Carcinogens↗

[Citation analysis of published articles in the Chinese Journal of Internal Medicine in the period of 2000-2004].

OBJECTIVE: To identify and analyze the scientific level and quality of the articles published in Chinese Journal of Internal Medicine. METHOD: Using the database of the Chinese Medical Citation Index (CMCI), the numbers and distribution of the cited original articles in Chinese Journal of Internal Medicine from 2000 to 2004 were analyzed according to the method of citation analysis. RESULT: The percentage of cited papers in all the published articles was 47.10% during the period, the average times of citation of an original article by other researchers is 4.30 and the top cited frequency was 133. There were 250 articles being cited 5 or more (25.43% of the total papers), and the times of citation from them were 2834 (67.01% of the total). 983 cited articles were written by 845 authors from different countries. The author of the most frequently cited articles wrote 6 papers and the authors with one cited paper were 751 (88.88% of all the authors). The cited authors were from 31 municipalities and provinces as well as from other countries. Beijing, Guangdong and Shanghai were in the front of the list of places with authors being frequently cited. Beijing was the top of the rank (44.74% of total authors). There were 266 institutes cited and the most frequently cited institute was Peking Union Medical College Hospital of Peking Union Medical College and Chinese Academy of Medical Sciences. There were 685 citing journals and the self-citing rate is 3.52%. CONCLUSIONS: The Chinese Journal of Internal Medicine has published high quality articles. As a core medical journal, it is the one of the most important information resources for the medical researchers.

Bibliometrics↗

[An analysis of articles published from 1996-2005 in the Chinese Journal of Hepatology (Zhonghua Ganzangbing Zazhi].

OBJECTIVE: To study the academic level, subject location, influence, readership, degree of usage and recognition by the readers of the Chinese Journal of Hepatology. METHODS: By referring to the "Chinese & T Journal Citation Reports" edited by the Institute of Scientific and Technical Information of China, the numbers, types, pertinent diseases, funding statues, citing, and the intervals between receiving and the publication of all the articles published in the 72 issues of the Chinese Journal of Hepatology were statistically analyzed. The work units and the geographic locations of the authors were also analyzed. RESULTS: During the past ten years, 2,437 articles were published, 27.4 percent of the total received. Of the published articles 892 were on viral hepatitis (36.6%), 428 on liver fibrosis or cirrhosis (17.6%), 421 on liver cancer (17.3%), and 696 on other subjects (28.6%). The impact factor and the total cited numbers of the articles of the journal were among the top five in the profession. Some other reference indexes used to evaluate the periodicals of the journal were better than average level of other periodicals in China. The number of references of each original article in this journal averaged 4.6, most of which were English ones. The average number of the authors of each articles were 4.5, and 89.7 percent of all the articles were written by two authors. Only one article was from an American author (first author), and the others first authors were all from 31 provinces, main cities and PLA institutions in China. Of the total 2,437 articles, 71.7% (1,744) were from the following: Chongqing (387), Shanghai (381), Beijing (315), Guangdong (227), PLA institutions (212), Zhejiang (115), and Hubei (107). CONCLUSION: The Chinese Journal of Hepatology is a periodical which has been highly regarded by professionals and has a great influence in academic fields.

Bibliometrics↗

Comparison of the three primary structures of deoxyribonuclease isolated from bovine, ovine, and porcine pancreas. Derivation of the amino acid sequence of ovine DNase and revision of the previously published amino acid sequence of bovine DNase.

Based on the published bovine DNase sequence (Liao, T.-H., Salnikow, J., Moore, S., and Stein, W. H. (1973) J. Biol. Chem. 248, 1489-1495), the ovine DNase sequence is derived from the amino acid compositions of isolated short peptides covering all regions of the intact polypeptide. The sequence is substantiated by results of automated Edman degradation of the intact polypeptide and of the two middle CNBr fragments, and by elucidation of the complete sequence of the COOH-terminal CNBr peptide. The 12 changes from bovine to ovine DNase are at residues 22 (Ala to Ser), 29 (Val to Leu), 35 (Val to Ala), 54 (Tyr to Asp), 62 (Thr to Ser), 83 (Leu to Val), 121 (His to Pro), 127 (Glu to Ala), 132 (Ala to Pro), 159 (His to Asp), 163 (Val to Ile), and 231 (Ala to Val). A minor genetic variant form of ovine DNase has Val at residue 163. The data from automated Edman degradation of the largest CNBr peptide of bovine DNase show that the published bovine DNase sequence is in error and that an Ile-Val-Arg tripeptide must be inserted between Arg-27 and Arg-28. The corrected sequence is substantiated by two peptides covering this region each with three amino acids more than the published sequence. Comparison of the bovine, ovine, and porcine DNase sequences reveals the following: with the revised bovine sequence, all three DNase sequences can be aligned without a gap; all three DNases have a carbohydrate side chain at Asn-18, but only porcine DNase has carbohydrate at Asn-106; there are 12 changes between bovine and ovine DNases, 56 between bovine and porcine, and 50 between ovine and porcine; there are six highly variable regions and four invariable ones; bovine and ovine DNases have the same length while porcine DNase is longer by 2 amino acid residues at the COOH terminus; the residues around the nucleotide-binding site, the four pairs of salt bridges, and the essential His-134 groups are not changed.

Amino Acid Sequence↗

[Primary care research in the Valencia community. Original articles published over a 4-year period (1990-1993)].

OBJECTIVE: To evaluate the quality of Primary Care (PC) research in the Community of Valencia through research articles. DESIGN: Descriptive study. SETTING: Primary Care in the community of Valencia. PATIENTS AND OTHER PARTICIPANTS: Research articles on PC published 1990-1993 by professionals from the Community of Valencia in: Atención Primaria, Medicina Clínica, Revista Clínica Española and Gaceta Sanitaria. MEASUREMENTS AND MAIN RESULTS: 43 articles published between 1990 and 1993 (6, 6, 9 and 22, respectively) were obtained from the Medline and Indice Médico Español (Spanish Medical Index) bases. Characteristics of the study, authors and bibliographic references were analysed. The greatest number of studies were published in Atención Primaria (81%), making up consistently about 10% of the annual total of articles in this journal. A descriptive design and inferential statistical analysis (comparison of proportions) were mainly used. Average number of authors was 5.14 (C.I. 95%, 4.7 - 5.6). The participation of residents (39%) was greater than that of family doctors and below that of other specialists, suggesting a certain disenchantment with research. The collaboration of different centres (49%) was high, fundamentally Health Centres among themselves and with universities. CONCLUSIONS: PC research in the Community of Valencia appears to be experiencing similar growth to that in the rest of Spain.

Analysis of Variance↗

[Evaluation of the use of statistical techniques in original articles published in the Medicina Clínica during 3 decades (1962-1992)].

BACKGROUND: The incorrect use of statistical techniques in medical articles may seriously compromise the validity of conclusions. This finding otherwise is relatively common. METHODS: A total of 84 original articles published in Medicina Clínica between 1962 and 1992 were reviewed with the aim of assessing the use and appropriateness of statistical techniques. The use of statistics, the quality of the analyses performed, and the inaccuracy of the statistical techniques used were evaluated. We also classified the statistical techniques most commonly used throughout the study period. RESULTS: There was a marked increase in the use of statistical analyses, from 8.3% in 1962 to 83.3% in 1992. It should be noted that a substantial part of this increase has been due to the use of inferential tests, which accounted up to 70% in the sample of articles published in 1992. This finding, however, was associated with an increase in the number of incorrect analyses. The most common statistical errors included assumption of normal distribution of data (with no mention of the test used to confirm this fact), mistake between standard deviation and standard error of the mean, inadequate inferences on the basis of the sample size, inappropriate use of the Student's t test, chi-square test, nonparametric tests or multivariate analyses as well as misunderstanding of linear regression and correlation. CONCLUSIONS: High standards in scientific research have been accompanied by a significant increase in the number of clinical studies with statistical analysis of data. However, this apparently favorable situation has been associated with an increase in the number of inaccurate analyses. It has been found that sophisticated statistical tests are rarely used in articles published in Medicina Clínica.

Chi-Square Distribution↗

An analysis of randomized controlled trials published in the US family medicine literature, 1987-1991.

BACKGROUND: Randomized controlled trials (RCTs) are frequently used to evaluate the effectiveness of health care interventions in family medicine. The value of the information obtained from RCTs depends largely on the quality of design and the way in which they are conducted and reported. Despite the increasing number of RCTs being conducted in family medicine, there is a scarcity of descriptive data on the methodological characteristics, including design features and quality of RCTs in this setting. METHODS: All 55 RCTs published in four peer-reviewed US family medicine journals between 1987 and 1991 were identified and their methodological characteristics reviewed. Three potential sources of bias were assessed in each of the trial reports: (1) control of selection bias at entry, (2) control of selection bias after entry, and (3) control of bias in assessing outcome(s). RESULTS: Fifty-five RCTs published between January 1987 and December 1991 were identified in the four journals. The absolute number of RCTs published over the 5 years increased steadily, and there was a 49% increase in the proportion of RCT articles. Measures used to control for selection bias before entry into the study were reported in 14 (25%) of the RCTs, the statistical power of the trial in 5 (9%), and whether the study had been reviewed by an institutional review board in 6 (11%). CONCLUSIONS: The RCTs analyzed offered some imaginative solutions to the logistic difficulties of conducting RCTs in general practice. Nevertheless, the methodology and reporting of RCTs in the future should be improved.

Bias↗

[Primary care research: the content of articles published in scientific journals].

OBJECTIVE: The quantifying, by subject area, of research published in scientific journals on primary health care, in five different cultural/geographic areas. DESIGN: Descriptive study. SETTING: Scientific journals on primary health care. PARTICIPANTS: Original articles published in 1991 in the following journals on primary health care (general practice): Atención Primaria, Canadian Family Physician, Family Practice, Journal of Family Practice and Scandinavian Journal of Primary Health Care. INTERVENTIONS AND MAIN RESULTS: The classification adopted here was that used in the research into primary health care by the Canadian Association of Family Physicians. The five journals between them published 263 original articles. Articles on organisation and provision of health services constituted 42% of the total; next in frequency were articles on epidemiology (18%) and on psychosocial concerns. Methodological studies and research into training and professional kills represent a scarce 6% and 8% respectively. CONCLUSIONS: The most commonly occurring subject in primary health care research is research on services. In the future it would be desirable to develop other areas (the clinical and psycho-social areas, methodology, and training).

Canada↗

An assessment of the statistical procedures used in original papers published in the SAMJ during 1992.

OBJECTIVE: To assess the statistical procedures used in original papers published in the SAMJ. DESIGN: Descriptive study based on a random sample of 100 papers from the 153 papers with methodological content that were published in the SAMJ during 1992. RESULTS: This review showed that 34% (95% CI (25%; 43%)) of papers used no statistical procedure at all or used simple descriptive statistics only. In sampling methods, there was a predominance of the use of the period sampling method as opposed to probability sampling methods. Inappropriate statistical methods were used in 15% (6%; 24%) of papers, while in 16% (9%; 23%) statistical procedures and in 13% (6%; 20%) the sampling methods used could not be identified. Inaccurate graphical methods were used in 17% (6%; 28%) of papers. Confidence intervals and power calculations are used far too infrequently, in 33% (19%; 47%) and 11% (3%; 19%) of appropriate papers respectively. If the Journal's readers are at least familiar with simple descriptive statistics, contingency table analysis, simple epidemiological statistics, t-test procedure and confidence interval calculation and interpretation, they will have a complete understanding of the statistical content of 60% of original articles published in the Journal. CONCLUSION: Guidelines for the statistical treatment of reported data and the statistical review of articles before publication will assist substantially in improving the quality of statistical analysis. More intensive use of available biostatistical and epidemiological expertise at the study design and analysis stages is needed to shift the emphasis from descriptive research to analytical investigation.

Evaluation Studies as Topic↗

A study of some international medical journals aiming to elicit stylistic guidelines for writing publishable papers.

OBJECTIVE: To provide some indications and guidelines on style and presentation for those aiming to publish in selected international journals. SETTING: University library in the Istituto di Clinica Chirurgica, Bari University Hospital. METHODS: A single topic, portal hypertension, was chosen to ensure a certain homogenity for the purposes of comparison, and the three most recent articles on this topic were identified in six international journals (three published in England and three in the USA; three in the medical and three in the surgical field) and studied from the points of view of style and presentation. RESULTS: Strong similarities were found among the 18 selected articles. In the interests of brevity, all were characterized by compact statements, qualified by lists of examples, and strings of adjectival nouns. In all, the Introduction and Conclusions sections were relatively short, the main body of the article being reserved to the Patients and Methods, Results and Discussion/Comments sections. Apart from very slight spelling or grammar differences characterizing English or American usage, all the articles could, with slight alterations in format in some cases, equally well have been published in any other of the journals studied. CONCLUSIONS: Brevity, even at the expense of elegance, and a straightforward, unambiguous, to some extent standardized, approach to the presentation of a scientific study, are essentials for the acceptance of an article for publication in the selected temational journals.

England↗

Review of published clinical trials conducted in Singapore from 1959 to 1994.

Trials are increasingly being used to evaluate the effectiveness of health care interventions. As has been recognised by those active in these activities, there is a need, not only to search for all published materials, but also to evaluate their quality and usefulness. This paper is an attempt to provide information and to examine the areas of focus and quality of information on all published clinical trials conducted in Singapore from 1959 to 1994. The searches were conducted using the MEDLINE CD-ROM for the period from 1966 to 1994 and manual search for the period before 1966. All published studies involving drugs or procedures (surgical techniques or instrumentation) on human subjects performed in Singapore were included in the study. Out of a total of 136 papers obtained, 90 fulfilled our criteria. There is an increase in the number of publications over the years especially in the last 10 years; with the biggest surge in the last 5 years. Most of the clinical trials were pharmacological intervention studies (57.8%) although there is a steady rise in non-pharmacological studies recently. As the number of clinical trials increases, coupled with the rising cost, it would be useful for the relevant authorities to consider setting up a registry to co-ordinate the trials that are being conducted.

Clinical Trials as Topic↗

Ethical and quasi-ethical issues in medical editing and publishing.

The peer review system is a complex, delicately balanced, and dynamic system by which most new medical information is made known. The participants in the process - authors, reviewers, and editors - all have responsibilities to shoulder and rights that need to be protected. An ethical structure has evolved over time to accomplish these two goals. This paper discusses six of these ethical or quasi-ethical issues. Authorship is currently a contentious matter, in part because authors see it as a credit, whereas editors view it as responsibility. Conflict of interest, usually financial, which seems to be increasing with the growing commercialization of medicine, can undermine the credibility and integrity of publication. Confidentiality is an essential component of peer review to protect an author's creative work from exploitation or misappropriation and to protect reviewers from retribution. Redundant publication, publishing or attempting to publish essentially the same work more than once, is regarded seriously because it wastes a journal's resources, confuses later literature reviews, and depreciates the value of authorship. Advertising is a necessary fact of life for most medical journals, but safeguards must be in place to prevent its influencing editorial decisions. When fraud or plagiarism is alleged about something a journal has published, the journal is not equipped to undertake the kind of investigation needed, and should refer the matter to the institution that sponsored the research.

Advertising↗

Perish, then publish: Thomas Harriot and the sine law of refraction.

A talented young scientist, Thomas Harriot, wrote the first English account of the New World, "A Briefe and True Report of the New Found Land of Virginia," distinguished by its serious effort to describe and understand the American Indian. Harriot went on to make innovations in mathematics and was one of the first astronomers to use the telescope. His largely unappreciated contribution to the history of ophthalmology was the first formulation of the sine law of refraction of light, found in his unpublished papers long after his death in 1621. Willebrord Snell discovered the sine law in Holland in 1621 but also died without formally publishing it. Rene Descartes first published the sine law in 1637. The sine law of refraction became not only the prime law of all lens systems but ushered in a new world of physical laws.

Astronomy↗

Going digital: image preparation for biomedical publishing.

Authors are more often being held responsible for readying their own data figures for digital publication by scanning them at the proper resolution and preparing them for presentation in both print and on-line journals. In this manner, the visuals can be printed at the highest quality the publisher can provide and be ready for rapid electronic distribution on the Internet. Therefore, authors must become knowledgeable in the visual preparation process in order to generate electronic images that will be as true a representation of the original image as possible. Perfecting this procedure can be a learning experience and often requires some experimentation. When accomplished, the author will have more control of exactly how the images will look before they are published. In addition to the scan resolution, the type of digital scanner and software applications used are very important, and instruction manuals should be followed closely so as to understand the full potential of the digitizing equipment. Anat Rec (New Anat): 257:128-136, 1999.

Anatomy↗

Secular changes in the quality of published randomized clinical trials in rheumatology.

OBJECTIVE: To assess the quality of published randomized clinical trials (RCTs) in rheumatology and to determine whether there has been improvement in quality between 2 time periods, 1987-1988 and 1997-1998. METHODS: Using MEDLINE and a hand search of selected rheumatology journals, we identified RCTs of adult rheumatic diseases published in English in 1987-1988 or 1997-1998. We examined trial quality with an expanded version of the Jadad scale, which assesses the adequacy of reported random sequence generation, allocation concealment, blinding, and analysis. All trials were read by 1 reviewer, with prior standardization using a random sample read by 2 reviewers. We also evaluated "high"- versus "low"-impact journals based on citation index. RESULTS: Two hundred forty RCTs (1987-1988 119 RCTs, 1997-1998 121 RCTs) were assessed. Results showed improvement in the quality of the trials, but the rates of reported random sequence generation, allocation concealment, power, and intent-to-treat analyses were persistently low. Low rates of reports of random sequence generation, allocation concealment, and intent-to-treat analyses were present even in the high-impact journals. CONCLUSION: There has been improvement in the quality of reporting of RCTs in rheumatology between 1987-1988 and 1997-1998. However, methodologic problems such as lack of allocation concealment, inadequate random sequence generation, lack of reporting of power, and lack of intent-to-treat analyses remain common. Many of these problems are established sources of bias in RCTs and are easily rectifiable.

Humans↗

Scope and strategies of genetic epidemiology: analysis of articles published in Genetic Epidemiology, 1984-1991.

Genetic epidemiology is a relatively new discipline that seeks to unravel the role of genetic factors and their interactions with environmental factors in the etiology of diseases, using population and family study approaches. To characterize the overall direction and emphasis of research strategies used in this field, we reviewed original research articles published in the journal Genetic Epidemiology since its inception in 1984 until the end of 1991. Of 259 published original articles, 92 (35%) focused primarily on methodologic/statistical developments, most commonly in the area of linkage analysis/gene mapping, and 167 (65%) articles were applied or data-derived. Only 42 articles (16%) were population studies, and 217 (84%) were family studies. Most family studies dealt with genetic analysis of pedigree data using segregation and linkage analyses. Of the 137 applied family studies, 73 (53%) were drawn from well-defined populations, and only 40 (29%) considered specific environmental factors in their analyses. These findings clearly indicate a rapid growth in the methodologic and statistical aspects of genetic epidemiology, and in the emphasis on family-based studies and genetic analysis methods. Further developments in genetic epidemiology will require greater integration of epidemiologic approaches of study design and analyses into population and family studies of disease etiology.

Epidemiology↗

Sensitivity analysis in economic evaluation: a review of published studies.

A structured methodological review of journal articles published in 1992 was undertaken to determine whether recently published economic evaluation studies deal systematically and comprehensively with uncertainty. Ninety three journal articles were identified from a range of searches including a computerised search of the MEDLINE CD-Rom database. Articles were reviewed to determine how they had handled uncertainty in: a) data sources; b) generalisability; c) extrapolation; and d) analytic method. Articles were subsequently assessed to determine how they had represented this uncertainty in terms of the overall results of their analysis. Finally, studies were rated on the basis of their overall performance with respect to dealing systematically and comprehensively with uncertainty. Despite the numerous books and articles devoted to the appropriate methods to be employed by analysts conducting economic evaluation, 22 (24%) studies failed to consider uncertainty at all and 35 (38%) studies employed sensitivity analysis in a manner judged as inadequate. In all, 36 (39%) studies were judged to have given at least an adequate account of uncertainty with 13 (14%) of those judged to have provided a good account of uncertainty. Such disappointing results may reflect a general lack of detail in much of the methods literature concerning how sensitivity analysis should be applied and how results should be presented. Journal editors and readers of economic evaluation articles should acquaint themselves with the methods for handling uncertainty in order that they can critically evaluate the extent to which authors have allowed for uncertainties inherent in their analysis.

Cost-Benefit Analysis↗