Knowledge and Perceptions of Reactive Arthritis Diagnosis and Management Among Healthcare Workers During the COVID-19 Pandemic: Online Survey

Background@#Reactive arthritis (ReA) is an often neglected disease that received some attention during the coronavirus disease 2019 (COVID-19) pandemic. There is some evidence that infection with severe acute respiratory syndrome coronavirus 2 can lead to “reactive” arthritis. However, this does not follow the classical definition of ReA that limits the organisms leading to this condition. Also, there is no recommendation by any international society on the management of ReA during the current pandemic. Thus, a survey was conducted to gather information about how modern clinicians across the world approach ReA. @*Methods@#An e-survey was carried out based on convenient sampling via social media platforms. Twenty questions were validated on the pathogenesis, clinical presentation, and management of ReA. These also included information on post-COVID-19 arthritis. Duplicate entries were prevented and standard guidelines were followed for reporting internet-based surveys. @*Results@#There were 193 respondents from 24 countries. Around one-fifth knew the classical definition of ReA. Nearly half considered the triad of conjunctivitis, urethritis and asymmetric oligoarthritis a “must” for diagnosis of ReA. Other common manifestations reported include enthesitis, dermatitis, dactylitis, uveitis, and oral or genital ulcers. Threefourths opined that no test was specific for ReA. Drugs for ReA were non-steroidal antiinflammatory drugs, intra-articular injections, and conventional disease-modifying agents with less than 10% supporting biological use. @*Conclusion@#The survey brought out the gap in existing concepts of ReA. The current definition needs to be updated. There is an unmet need for consensus recommendations for the management of ReA, including the use of biologicals.

Global Health Strategies in the Face of the COVID-19 Pandemic and Other Unprecedented Threats

Global health is evolving as a discipline aiming at exploring needs and offering equitable health services for all people. Over the past four decades, several global initiatives have been introduced to improve the accessibility of primary health care (PHC) and solve most health issues at this level. Historically, the 1978 Alma-Ata and 2018 Astana Declarations were perhaps the most important documents for a comprehensive approach to PHC services across the world. With the introduction of the United Nations Sustainable Development Goals in 2015, developments in all spheres of human life and multi-sectoral cooperation became the essential action targets that could contribute to improved health, well-being, and safety of all people. Other global initiatives such as the Riyadh Declaration on Digital Health and São Paulo Declaration on Planetary Health called to urgent action to employ advanced digital technologies, improve health data processing, and invest more in research management. All these initiatives are put to the test in the face of the coronavirus disease 2019 (COVID-19) pandemic and other unprecedented threats to humanity.

Formulating Hypotheses for Different Study Designs

Generating a testable working hypothesis is the first step towards conducting original research. Such research may prove or disprove the proposed hypothesis. Case reports, case series, online surveys and other observational studies, clinical trials, and narrative reviews help to generate hypotheses. Observational and interventional studies help to test hypotheses. A good hypothesis is usually based on previous evidence-based reports.Hypotheses without evidence-based justification and a priori ideas are not received favourably by the scientific community. Original research to test a hypothesis should be carefully planned to ensure appropriate methodology and adequate statistical power. While hypotheses can challenge conventional thinking and may be controversial, they should not be destructive. A hypothesis should be tested by ethically sound experiments with meaningful ethical and clinical implications. The coronavirus disease 2019 pandemic has brought into sharp focus numerous hypotheses, some of which were proven (e.g. effectiveness of corticosteroids in those with hypoxia) while others were disproven (e.g. ineffectiveness of hydroxychloroquine and ivermectin).

Article-Level Metrics

In the era of digitization and Open Access, article-level metrics are increasingly employed to distinguish influential research works and adjust research management strategies. Tagging individual articles with digital object identifiers allows exposing them to numerous channels of scholarly communication and quantifying related activities. The aim of this article was to overview currently available article-level metrics and highlight their advantages and limitations. Article views and downloads, citations, and social media metrics are increasingly employed by publishers to move away from the dominance and inappropriate use of journal metrics. Quantitative article metrics are complementary to one another and often require qualitative expert evaluations. Expert evaluations may help to avoid manipulations with indiscriminate social media activities that artificially boost altmetrics. Values of article metrics should be interpreted in view of confounders such as patterns of citation and social media activities across countries and academic disciplines.

Article-Level Metrics

In the era of digitization and Open Access, article-level metrics are increasingly employed to distinguish influential research works and adjust research management strategies. Tagging individual articles with digital object identifiers allows exposing them to numerous channels of scholarly communication and quantifying related activities. The aim of this article was to overview currently available article-level metrics and highlight their advantages and limitations. Article views and downloads, citations, and social media metrics are increasingly employed by publishers to move away from the dominance and inappropriate use of journal metrics. Quantitative article metrics are complementary to one another and often require qualitative expert evaluations. Expert evaluations may help to avoid manipulations with indiscriminate social media activities that artificially boost altmetrics. Values of article metrics should be interpreted in view of confounders such as patterns of citation and social media activities across countries and academic disciplines.

Scientific Hypotheses: Writing, Promoting, and Predicting Implications

Scientific hypotheses are essential for progress in rapidly developing academic disciplines. Proposing new ideas and hypotheses require thorough analyses of evidence-based data and predictions of the implications. One of the main concerns relates to the ethical implications of the generated hypotheses. The authors may need to outline potential benefits and limitations of their suggestions and target widely visible publication outlets to ignite discussion by experts and start testing the hypotheses. Not many publication outlets are currently welcoming hypotheses and unconventional ideas that may open gates to criticism and conservative remarks. A few scholarly journals guide the authors on how to structure hypotheses. Reflecting on general and specific issues around the subject matter is often recommended for drafting a well-structured hypothesis article. An analysis of influential hypotheses, presented in this article, particularly Strachan's hygiene hypothesis with global implications in the field of immunology and allergy, points to the need for properly interpreting and testing new suggestions. Envisaging the ethical implications of the hypotheses should be considered both by authors and journal editors during the writing and publishing process.

Comprehensive Approach to Open Access Publishing: Platforms and Tools

The Open Access Initiative is gaining momentum due to the worldwide availability of advanced digital tools, online publishing platforms, and systems for tracking academic contributions. Several declarations and initiatives, including Plan S, have already laid a foundation for moving away from subscription to full and immediate open-access publishing. The global initiatives imply targeting journals satisfying the upgraded quality and visibility criteria. To meet these criteria, a comprehensive approach to Open Access is recommended. This article overviews the essential components of the comprehensive approach, increasing transparency, adherence to ethical standards, and diversification of evaluation metrics. With the increasing volume of quality open-access journals, their indexing with free databases and search engines is becoming increasingly important. The Directory of Open Access Journals and PubMed Central currently free searches of open-access sources. These services, however, cannot fully satisfy the increasing demands of the users, and attempts are underway to upgrade the indexing and archiving of open-access sources in China, Japan, Korea, Russia, and elsewhere. The wide use of identifiers is essential for transparency of scholarly communications. Peer reviewers are now offered credits from Publons. These credits are transferrable to their Open Researcher and Contributor iDs. Various social media channels are increasingly used by scholars to comment on articles. All these comments are tracked by related metric systems, such as Altmetrics. Combined with traditional citation evaluations, the alternative metrics can help timely identify and promote publications influencing education, research, and practice.

Updated Editorial Guidance for Quality and Reliability of Research Output

Over the past few years, updated editorial policy statements of several associations have provided a platform for improving the quality of scientific research and publishing. The updates have particularly pointed to the need for following research reporting standards, authorship and contributorship regulations, implementing digital tools for the identification and crediting academic contributors, and moving towards optimal ethical open-access models. This article overviews some of the recent editorial policy statements of global editorial associations and reflects on the role of the regional counterparts in advancing scholarly publishing. One of the globally promoted documents is the Recommendations of the International Committee of Medical Journal Editors (ICMJE). Its latest versions contain statements on proper research reporting, reviewing, editing, and publishing. Points on ethical target journals and ‘predatory’ sources are also available. This year, in a move to update its editorial policy, the Committee on Publication Ethics (COPE) released the Core Practices, comprehensively reflecting on the major issues in publication ethics. Updated joint statements of medical writers associations are also available to implement transparent policy on contributorship in sponsor-supported research projects and related reports. Several suggestions are put forward to improve global editorial statements on online profiling, crediting, and referencing. It is also highlighted that knowledge and implementation of updated editorial guidance is essential for editors' good standing.

Researcher and Author Impact Metrics: Variety, Value, and Context

Numerous quantitative indicators are currently available for evaluating research productivity. No single metric is suitable for comprehensive evaluation of the author-level impact. The choice of particular metrics depends on the purpose and context of the evaluation. The aim of this article is to overview some of the widely employed author impact metrics and highlight perspectives of their optimal use. The h-index is one of the most popular metrics for research evaluation, which is easy to calculate and understandable for non-experts. It is automatically displayed on researcher and author profiles on citation databases such as Scopus and Web of Science. Its main advantage relates to the combined approach to the quantification of publication and citation counts. This index is increasingly cited globally. Being an appropriate indicator of publication and citation activity of highly productive and successfully promoted authors, the h-index has been criticized primarily for disadvantaging early career researchers and authors with a few indexed publications. Numerous variants of the index have been proposed to overcome its limitations. Alternative metrics have also emerged to highlight ‘societal impact.’ However, each of these traditional and alternative metrics has its own drawbacks, necessitating careful analyses of the context of social attention and value of publication and citation sets. Perspectives of the optimal use of researcher and author metrics is dependent on evaluation purposes and compounded by information sourced from various global, national, and specialist bibliographic databases.

Researcher and Author Profiles: Opportunities, Advantages, and Limitations

Currently available online profiling platforms offer various services for researchers and authors. Opening an individual account and filling it with scholarly contents increase visibility of research output and boost its impact. This article overviews some of the widely used and emerging profiling platforms, highlighting their tools for sharing scholarly items, crediting individuals, and facilitating networking. Global bibliographic databases and search platforms, such as Scopus, Web of Science, PubMed, and Google Scholar, are widely used for profiling authors with indexed publications. Scholarly networking websites, such as ResearchGate and Academia.edu, provide indispensable services for researchers poorly visible elsewhere on the Internet. Several specialized platforms are designed to offer profiling along with their main functionalities, such as reference management and archiving. The Open Researcher and Contributor Identification (ORCID) project has offered a solution to the author name disambiguation. It has been integrated with numerous bibliographic databases, platforms, and manuscript submission systems to help research managers and journal editors select and credit the best reviewers, and other scholarly contributors. Individuals with verifiable reviewer and editorial accomplishments are also covered by Publons, which is an increasingly recognized service for publicizing and awarding reviewer comments. Currently available profiling formats have numerous advantages and some limitations. The advantages are related to their openness and chances of boosting the researcher impact. Some of the profiling websites are complementary to each other. The underutilization of various profiling websites and their inappropriate uses for promotion of ‘predatory’ journals are among reported limitations. A combined approach to the profiling systems is advocated in this article.

Plagiarism in the Context of Education and Evolving Detection Strategies

Plagiarism may take place in any scientific journals despite currently employed anti-plagiarism tools. The absence of widely acceptable definitions of research misconduct and reliance solely on similarity checks do not allow journal editors to prevent most complex cases of recycling of scientific information and wasteful, or ‘predatory,’ publishing. This article analyses Scopus-based publication activity and evidence on poor writing, lack of related training, emerging anti-plagiarism strategies, and new forms of massive wasting of resources by publishing largely recycled items, which evade the ‘red flags’ of similarity checks. In some non-Anglophone countries ‘copy-and-paste’ writing still plagues pre- and postgraduate education. Poor research management, absence of courses on publication ethics, and limited access to quality sources confound plagiarism as a cross-cultural and multidisciplinary phenomenon. Over the past decade, the advent of anti-plagiarism software checks has helped uncover elementary forms of textual recycling across journals. But such a tool alone proves inefficient for preventing complex forms of plagiarism. Recent mass retractions of plagiarized articles by reputable open-access journals point to critical deficiencies of current anti-plagiarism software that do not recognize manipulative paraphrasing and editing. Manipulative editing also finds its way to predatory journals, ignoring the adherence to publication ethics and accommodating nonsense plagiarized items. The evolving preventive strategies are increasingly relying on intelligent (semantic) digital technologies, comprehensively evaluating texts, keywords, graphics, and reference lists. It is the right time to enforce adherence to global editorial guidance and implement a comprehensive anti-plagiarism strategy by helping all stakeholders of scholarly communication.

Predatory Publishing Is a Threat to Non-Mainstream Science

This article highlights the issue of wasteful publishing practices that primarily affect non-mainstream science countries and rapidly growing academic disciplines. Numerous start-up open access publishers with soft or nonexistent quality checks and huge commercial interests have created a global crisis in the publishing market. Their publishing practices have been thoroughly examined, leading to the blacklisting of many journals by Jeffrey Beall. However, it appears that some subscription journals are also falling short of adhering to the international recommendations of global editorial associations. Unethical editing agencies that promote their services in non-mainstream science countries create more problems for inexperienced authors. It is suggested to regularly monitor the quality of already indexed journals and upgrade criteria of covering new sources by the Emerging Sources Citation Index (Web of Science), Scopus, and specialist bibliographic databases. Regional awareness campaigns to inform stakeholders of science communication about the importance of ethical writing, transparency of editing services, and permanent archiving can be also helpful for eradicating unethical publishing practices.

The Journal Impact Factor: Moving Toward an Alternative and Combined Scientometric Approach

The Journal Impact Factor (JIF) is a single citation metric, which is widely employed for ranking journals and choosing target journals, but is also misused as the proxy of the quality of individual articles and academic achievements of authors. This article analyzes Scopus-based publication activity on the JIF and overviews some of the numerous misuses of the JIF, global initiatives to overcome the ‘obsession’ with impact factors, and emerging strategies to revise the concept of the scholarly impact. The growing number of articles on the JIF, most of which are in English, reflects interest of experts in journal editing and scientometrics toward its uses, misuses, and options to overcome related problems. Solely displaying values of the JIFs on the journal websites is criticized by experts as these average metrics do not reflect skewness of citation distribution of individual articles. Emerging strategies suggest to complement the JIFs with citation plots and alternative metrics, reflecting uses of individual articles in terms of downloads and distribution of related information through social media and networking platforms. It is also proposed to revise the original formula of the JIF calculation and embrace the concept of the impact and importance of individual articles. The latter is largely dependent on ethical soundness of the journal instructions, proper editing and structuring of articles, efforts to promote related information through social media, and endorsements of professional societies.

Statement on Publication Ethics for Editors and Publishers

The digitization and related developments in journal editing and publishing necessitate increasing the awareness of all stakeholders of science communication in the emerging global problems and possible solutions. Journal editors and publishers are frequently encountered with the fast-growing problems of authorship, conflicts of interest, peer review, research misconduct, unethical citations, and inappropriate journal impact metrics. While the number of erroneous and unethical research papers and wasteful, or 'predatory', journals is increasing exponentially, responsible editors are urged to 'clean' the literature by correcting or retracting related articles. Indexers are advised to implement measures for accepting truly influential and ethical journals and delisting sources with predatory publishing practices. Updating knowledge and skills of authors, editors and publishers, developing and endorsing recommendations of global editorial associations, and (re)drafting journal instructions can be viewed as potential tools for improving ethics of academic journals. The aim of this Statement is to increase awareness of all stakeholders of science communication of the emerging ethical issues in journal editing and publishing and initiate a campaign of upgrading and enforcing related journal instructions.

The Pressure to Publish More and the Scope of Predatory Publishing Activities

This article overviews unethical publishing practices in connection with the pressure to publish more. Both open-access and subscription publishing models can be abused by 'predatory' authors, editors, and publishing outlets. Relevant examples of ‘prolific’ scholars are viewed through the prism of the violation of ethical authorship in established journals and indiscriminately boosting publication records elsewhere. The instances of ethical transgressions by brokering editorial agencies and agents, operating predominantly in non-Anglophone countries, are presented to raise awareness of predatory activities. The scheme of predatory publishing activities is presented, and several measures are proposed to tackle the issue of predatory publishing. The awareness campaigns by professional societies, consultations with information facilitators, implementation of the criteria of best target journals, and crediting of scholars with use of integrative citation metrics, such as the h-index, are believed to make a difference.

Specialist Bibliographic Databases

Specialist bibliographic databases offer essential online tools for researchers and authors who work on specific subjects and perform comprehensive and systematic syntheses of evidence. This article presents examples of the established specialist databases, which may be of interest to those engaged in multidisciplinary science communication. Access to most specialist databases is through subscription schemes and membership in professional associations. Several aggregators of information and database vendors, such as EBSCOhost and ProQuest, facilitate advanced searches supported by specialist keyword thesauri. Searches of items through specialist databases are complementary to those through multidisciplinary research platforms, such as PubMed, Web of Science, and Google Scholar. Familiarizing with the functional characteristics of biomedical and nonbiomedical bibliographic search tools is mandatory for researchers, authors, editors, and publishers. The database users are offered updates of the indexed journal lists, abstracts, author profiles, and links to other metadata. Editors and publishers may find particularly useful source selection criteria and apply for coverage of their peer-reviewed journals and grey literature sources. These criteria are aimed at accepting relevant sources with established editorial policies and quality controls.

Rewarding Peer Reviewers: Maintaining the Integrity of Science Communication

This article overviews currently available options for rewarding peer reviewers. Rewards and incentives may help maintain the quality and integrity of scholarly publications. Publishers around the world implemented a variety of financial and nonfinancial mechanisms for incentivizing their best reviewers. None of these is proved effective on its own. A strategy of combined rewards and credits for the reviewers1 creative contributions seems a workable solution. Opening access to reviews and assigning publication credits to the best reviews is one of the latest achievements of digitization. Reviews, posted on academic networking platforms, such as Publons, add to the transparency of the whole system of peer review. Reviewer credits, properly counted and displayed on individual digital profiles, help distinguish the best contributors, invite them to review and offer responsible editorial posts.

Publishing Ethics and Predatory Practices: A Dilemma for All Stakeholders of Science Communication

Publishing scholarly articles in traditional and newly-launched journals is a responsible task, requiring diligence from authors, reviewers, editors, and publishers. The current generation of scientific authors has ample opportunities for publicizing their research. However, they have to selectively target journals and publish in compliance with the established norms of publishing ethics. Over the past few years, numerous illegitimate or predatory journals have emerged in most fields of science. By exploiting gold Open Access publishing, these journals paved the way for low-quality articles that threatened to change the landscape of evidence-based science. Authors, reviewers, editors, established publishers, and learned associations should be informed about predatory publishing practices and contribute to the trustworthiness of scholarly publications. In line with this, there have been several attempts to distinguish legitimate and illegitimate journals by blacklisting unethical journals (the Jeffrey Beall's list), issuing a statement on transparency and best publishing practices (the Open Access Scholarly Publishers Association's and other global organizations' draft document), and tightening the indexing criteria by the Directory of Open Access Journals. None of these measures alone turned to be sufficient. All stakeholders of science communication should be aware of multiple facets of unethical practices and publish well-checked and evidence-based articles.

Preserving the Integrity of Citations and References by All Stakeholders of Science Communication

Citations to scholarly items are building bricks for multidisciplinary science communication. Citation analyses are currently influencing individual career advancement and ranking of academic and research institutions worldwide. This article overviews the involvement of scientific authors, reviewers, editors, publishers, indexers, and learned associations in the citing and referencing to preserve the integrity of science communication. Authors are responsible for thorough bibliographic searches to select relevant references for their articles, comprehend main points, and cite them in an ethical way. Reviewers and editors may perform additional searches and recommend missing essential references. Publishers, in turn, are in a position to instruct their authors over the citations and references, provide tools for validation of references, and open access to bibliographies. Publicly available reference lists bear important information about the novelty and relatedness of the scholarly items with the published literature. Few editorial associations have dealt with the issue of citations and properly managed references. As a prime example, the International Committee of Medical Journal Editors (ICMJE) issued in December 2014 an updated set of recommendations on the need for citing primary literature and avoiding unethical references, which are applicable to the global scientific community. With the exponential growth of literature and related references, it is critically important to define functions of all stakeholders of science communication in curbing the issue of irrational and unethical citations and thereby improve the quality and indexability of scholarly journals.

Systematic and Open Identification of Researchers and Authors: Focus on Open Researcher and Contributor ID

Unique identifiers of researchers and authors can help all stakeholders of scientific communications improve their workflows. There have been several attempts to establish professional networks of scholars and list their scholarly achievements on digital platforms. Some of these platforms such as Google Scholar, Web of Knowledge and PubMed are searched to pick relevant peer reviewers, assess authors' publication history or choose suitable candidates for research and academic projects. However, each of these hubs has its specific applications, limiting the universal use for permanent tagging of researcher profiles. The Open Researcher and Contributor ID (ORCID) initiative, launched in 2012, is aimed at registering scholarly contributors and averting the persistent ambiguity of recorded author names. The ORCID registry is growing fast and integrating with other ID-generating platforms, thereby increasing the functionality of the integrated systems. ORCID identifiers are increasingly used for selecting peer reviewers and acknowledging various scholarly contributions (e.g., published articles, reviewer comments, conference presentations). The initiative offers unique opportunities for transparent disclosures of author contributions and competing interests and improving ethical standards of research, editing, and publishing.