Science ethics education: effects of a short lecture on plagiarism on the knowledge of young medical researchers.

PURPOSE: Plagiarism is the most common form of scientific fraud. It is agreed that the best preventive measure is education of young scientists on basic principles of responsible conduct of research and writing. The purpose of this article was to contribute to the students' knowledge and adoption of the rules of scientific writing. METHODS: A 45 min lecture was delivered to 98 attendees during 3 courses on science ethics. Before and after the course the attendees fulfilled an especially designed questionnaire with 13 questions, specifically related to the definition and various types of plagiarism and self-plagiarism. RESULTS: Although considering themselves as insufficiently educated in science ethics, the majority of the attendees responded correctly to almost all questions even before the course, with percentages of correct responses to the specific question varying from 45.9-85.7%. After completion of the course, these percentages were significantly (p<0.01) higher, ranging from 66.3-98.8%. The percentage of improvement of the knowledge about plagiarism ranged from 9.18- 42.86%. The percentage of impairment ranged from 1.02- 16.33%, the latter being related to the question on correct citing unpublished materials of other people; only for this question the percentage of impairment (16.33%) was greater than the percentage of improvement (11.22%). CONCLUSION: Even a short lecture focused on plagiarism contributed to the students' awareness that there are many forms of plagiarism, and that plagiarism is a serious violation of science ethics. This result confirms the largely accepted opinion that education is the best means in preventing plagiarism.

Science ethics education part II: changes in attitude toward scientific fraud among medical researchers after a short course in science ethics.

PURPOSE: To determine the impact of the short science ethics courses on the knowledge of basic principles of responsible conduct of research (RCR), and on the attitude toward scientific fraud among young biomedical researchers. METHODS: A total of 361 attendees of the course on science ethics answered a specially designed anonymous multiple- choice questionnaire before and after a one-day course in science ethics. The educational course consisted of 10 lectures: 1) Good scientific practice - basic principles; 2) Publication ethics; 3) Scientific fraud - fabrication, falsification, plagiarism; 4) Conflict of interests; 5) Underpublishing; 6) Mentorship; 7) Authorship; 8) Coauthorship; 9) False authorship; 10) Good scientific practice - ethical codex of science. RESULTS: In comparison to their answers before the course, a significantly higher (p<0.001) number of students qualified their knowledge of science ethics as sufficient after the course was completed. That the wrongdoers deserve severe punishment for all types of scientific fraud, including false authorship, thought significantly (p<0.001) more attendees than before the course, while notably fewer attendees (p<0.001) would give or accept undeserved authorship CONCLUSION: Even a short course in science ethics had a great impact on the attendees, enlarging their knowledge of responsible conduct of research and changing their previous, somewhat opportunistic, behavior regarding the reluctance to react publicly and punish the wrongdoers.

Science ethics education part I. Perception and attitude toward scientific fraud among medical researchers.

PURPOSE: To assess the knowledge of basic principles of responsible conduct of research and attitude toward the violations of good scientific practice among graduate biomedical students. METHODS: A total of 361 subjects entered the study. The study group consisted mainly of graduate students of Medicine (85%), and other biomedical sciences (15%). Most participants were on PhD training or on postdoctoral training. A specially designed anonymous voluntary multiple-choice questionnaire was distributed to them. The questionnaire consisted of 43 questions divided in 7 parts, each aimed to assess the participants' previous knowledge and attitudes toward ethical principles of science and the main types of scientific fraud, falsification, fabrication of data, plagiarism, and false authorship. RESULTS: Although they considered themselves as insufficiently educated on science ethics, almost all participants recognized all types of scientific fraud, qualified these issues as highly unethical, and expressed strong negative attitude toward them. Despite that, only about half of the participants thought that superiors-violators of high ethical standards of science deserve severe punishment, and even fewer declared that they would whistle blow. These percentages were much greater in cases when the students had personally been plagiarized. CONCLUSION: Our participants recognized all types of scientific fraud as violation of ethical standards of science, expressed strong negative attitude against fraud, and believed that they would never commit fraud, thus indicating their own high moral sense. However, the unwillingness to whistle blow and to punish adequately the violators might be characterized as opportunistic behavior.

Do the time to chemotherapy response and the dose intensity have an impact on patient outcome in advanced non-small cell lung cancer?

PURPOSE: To better define the importance of early response rate (RR) as well as dose intensity (DI) in advanced non small cell lung cancer (NSCLC) patients treated with platinum-based combination chemotherapy. PATIENTS AND METHODS: Analysed were stage IIIB and IV NSCLC patients included in 4 prospective clinical trials. All of them were treated with cisplatin 120 mg/m2 (the majority of patients) or carboplatin 500 mg/m2, and since 2000 with AUC 5 (the minority of patients) with second-generation platinum-based regimens. Responding patients (complete response/CR and partial response/PR) were divided into 4 different categories, depending on the time when response was first registered. DI and total dose (TD) of cisplatin was calculated for 93 patients with response or stable disease (SD). RESULTS: Among 362 patients analysed, 117 (32%) were responders. Although "early" responders (54 patients after the 2nd cycle, median survival 10 months; 42 patients after the 3rd cycle, median survival 11 months) lived shorter than "late" responders (11 patients after the 4th cycle median survival 12 months; 10 patients after the 5th cycle, median survival 19 months), these differences were not statistically significant, neither in terms of overall survival (OS) nor in time to progression (TTP). DI in patients with CR+PR+SD was 30 mg/m2/week (median). TD of cisplatin in CR+PR patients was 577 mg, whereas it was 475 mg in patients with SD (p=0.004). These differences followed significant differences in the number of the cycles received and median survival between CR+PR vs. SD patients. CONCLUSION: Early response was not associated with better survival, DI in SD patients did not differ from responding patients, but responding patients received more cisplatin and lived longer.

Biweekly oxaliplatin, fluorouracil and leucovorin versus cisplatin, fluorouracil and leucovorin in patients with advanced gastric cancer.

PURPOSE: To compare a bi-weekly infusion of leucovorin (LV) 5-fluorouracil (5-FU) for 2 days, plus oxaliplatin (LV5- FU2-oxaliplatin) and LV5-FU2-cisplatin (CDDP) regimens with respect to toxicity, objective response rates, time to progression (TTP) and overall survival (OS) in patients with advanced gastric cancer. PATIENTS AND METHODS: Patients received LV5-FU2- oxaliplatin (oxaliplatin 85 mg/m(2), day 1; folinic acid 200 mg/m(2), days 1-2; 5-FU 400 mg/m(2), i.v. bolus, days 1-2; 5-FU 600 mg/m(2), 22-hour continuous infusion, days 1-2) or LV5- FU2-CDDP (CDDP 50 mg/m(2), day 1; plus LV5-FU2). A total of 72 patients were enrolled into this study (36 vs. 36). RESULTS: A total of 305 cycles were administered in the LV5-FU2-oxaliplatin arm (median 8) and 272 cycles in the LV5-FU2-CDDP arm (median 8). Grades 3-4 toxicity were as follows (LV5-FU2-oxaliplatin %/LV5-FU2-CDDP %; p<0.05): neutropenia 5/49, thrombocytopenia 2/6, anemia 6/16 nausea/vomiting 2/15, and mucositis 0/3. Response rate of LV5-FU2-oxaliplatin was 41% (partial response/PR 41%, stable disease/SD 31%, progressive disease/PD 28%; 95% confidence internal/95% CI 27-58) and of LV5-FU2-CDDP was 25% (PR 25%, SD 36%, PD 39%; 95% CI 14-41; p =0.013). The median TTP of the patients in the LV5-FU2-oxaliplatin arm was 8 months and 6 months for those in the LV5- FU2-CDDP arm (p=0.073). The median survival time of the patients in the LV5-FU2-oxaliplatin arm was 10 months and 7 months for those in the LV5-FU2-CDDP arm (p=0.003). CONCLUSION: Our study showed that oxaliplatin may be substituted for cisplatin with LV5-FU2 with favorable safety and efficacy profile. The encouraging results from our study support the effectiveness of oxaliplatin-fluoropyrimidine- containing chemotherapy in gastric cancer and could provide a new core on which to add other agents in future investigations.

Incomplete operative removal of colorectal liver metastases followed by chemotherapy decreases survival in comparison to chemotherapy alone.

Metastatic colorectal carcinoma (CRC) has an inevitable fatal outcome except in a small percentage of selected patients, approximately 10-20%, with good prognosis after successful complete operative removal of the liver metastases. In patients not eligible for surgical resection of the liver metastases, chemotherapy is currently the only widely available treatment option. Controversy still exists about the criteria for operability of CRC liver metastases, and some patients, still undergo ineffective, i.e. unnecessary surgery. The aim of this paper is to analyse and compare the overall survival (OS) and time to progression (TTP) in patients who underwent incomplete removal of liver CRC metastases followed by chemotherapy, and patients treated with chemotherapy alone. Seventy-three patients with CRC liver metastases underwent incomplete operative removal of the metastases followed by FOLFIRI (Cohort A - 27 patients) or with FOLFIRI alone (Cohort B - 46 patients). Patients received FOLFIRI until progression. FOLFOX4 was used as second line chemotherapy. The median OS in Cohort A was 8 months, the median TTP was 5 months, and the response rate was 44%; the median OS in Cohort B was 19 months, the median TTP was 8m, and the response rate was 39%. There was a significant difference in OS and in TTP (p < 0.01) in favour of the chemotherapy alone group (B). Patients undergoing incomplete removal of the liver metastases had shorter survival and TTP in comparison with patients treated with chemotherapy alone.

The influence of steroid receptors status on disease outcome in early breast cancer patients treated with adjuvant cyclophosphamide, methotrexate and fluorouracil chemotherapy.

PURPOSE: To assess the influence of steroid receptors (SR) status on disease outcome of early breast cancer patients treated with adjuvant cyclophosphamide, methotrexate and 5-fluorouracil (CMF) chemotherapy. PATIENTS AND METHODS: Sixty-six node-negative patients with grade 3 invasive breast carcinoma and 95 patients with 1-3 involved axillary lymph nodes regardless of tumor grade received adjuvant CMF chemotherapy. The endpoints of this analysis were disease-free survival (DFS) and overall survival (OS). Statistical analysis included log rank test and Cox regression models. RESULTS: The median follow-up period was 81 months (range 6-208). Patients with progesterone receptor (PR) - negative tumors had better DFS compared to women with PR-positive tumors (log rank test, p=0.033). Estrogen receptor (ER) - negative and PR-negative patients in the node-negative subgroup had better DFS than ER-positive and PR-positive patients (for ER: log rank test, p=0.009, and for PR: log rank test, p=0.004). However, positive lymph nodes were the only significant predictor of disease progression among patients receiving CMF therapy (Likelihood Ratio test, p <0.001). Women under 40 bearing SR-positive breast cancer had a trend toward worse DFS (log rank test, p=0.054) compared to older SR-positive premenopausal women. CONCLUSION: We can not unequivocally reveal the influence of SR status on disease outcome in early breast cancer patients treated with adjuvant CMF, although SR-positive patients in the node-negative group were shown to have worse DFS in comparison to SR-negative ones. However, nodal status remained the only independent predictor of disease progression in these patients.