Causes for Retraction in the Biomedical Literature: A Systematic Review of Studies of Retraction Notices

Background@#Many studies have evaluated the prevalence of different reasons for retraction in samples of retraction notices. We aimed to perform a systematic review of such empirical studies of retraction causes. @*Methods@#The PubMed/MEDLINE database and the Embase database were searched in June 2023. Eligible studies were those containing sufficient data on the reasons for retraction across samples of examined retracted notices. @*Results@#A 11,181 potentially eligible items were identified, and 43 studies of retractions were included in this systematic review. Studies limited to retraction notices of a specific subspecialty or country, journal/publication type are emerging since 2015. We noticed that the reasons for retraction are becoming more specific and more diverse. In a meta-analysis of 17 studies focused on different subspecialties, misconduct was responsible for 60% (95% confidence interval [CI], 53–67%) of all retractions while error and publication issues contributed to 17% (95% CI, 12–22%) and 9% (95% CI, 6–13%), respectively. The end year of the retraction period in all included studies and the proportion of misconduct presented a weak positive association (coefficient = 1.3% per year, P = 0.002). @*Conclusion@#Misconduct seems to be the most frequently recorded reason for retraction across empirical analyses of retraction notices, but other reasons are not negligible. Greater specificity of causes and standardization is needed in retraction notices.

Non-alcoholic Fatty Liver Disease and COVID-19 Susceptibility and Outcomes: a Korean Nationwide Cohort

Background@#Evidence for the association between underlying non-alcoholic fatty liver disease (NAFLD), the risk of testing severe acute respiratory syndrome coronavirus 2 (SARSCoV-2) positive, and the clinical consequences of coronavirus disease 2019 (COVID-19) is controversial and scarce. We aimed to investigate the association between the presence of NAFLD and the risk of SARS-CoV-2 infectivity and COVID-19-related outcomes. @*Methods@#We used the population-based, nationwide cohort in South Korea linked with the general health examination records between January 1, 2018 and July 30, 2020. Data for 212,768 adults older than 20 years who underwent SARS-CoV-2 testing from January 1 to May 30, 2020, were obtained. The presence of NAFLDs was defined using three definitions, namely hepatic steatosis index (HSI), fatty liver index (FLI), and claims-based definition. The outcomes were SARS-CoV-2 test positive, COVID-19 severe illness, and related death. @*Results@#Among 74,244 adults who completed the general health examination, there were 2,251 (3.0%) who were SARS-CoV-2 positive, 438 (0.6%) with severe COVID-19 illness, and 45 (0.06%) COVID-19-related deaths. After exposure-driven propensity score matching, patients with pre-existing HSI-NAFLD, FLI-NAFLD, or claims-based NAFLD had an 11–23% increased risk of SARS-CoV-2 infection (HSI-NAFLD 95% confidence interval [CI], 1–28%; FLI-NAFLD 95% CI, 2–27%; and claims-based NAFLD 95% CI, 2–31%) and a 35–41% increased risk of severe COVID-19 illness (HSI-NAFLD 95% CI, 8–83%; FLI-NAFLD 95% CI, 5–71%; and claims-based NAFLD 95% CI, 1–92%). These associations are more evident as liver fibrosis advanced (based on the BARD scoring system). Similar patterns were observed in several sensitivity analyses including the full-unmatched cohort. @*Conclusion@#Patients with pre-existing NAFLDs have a higher likelihood of testing SARSCoV-2 positive and severe COVID-19 illness; this association was more evident in patients with NAFLD with advanced fibrosis. Our results suggest that extra attention should be given to the management of patients with NAFLD during the COVID-19 pandemic.

Treatment Response to Hydroxychloroquine and Antibiotics for mild to moderate COVID-19: a retrospective cohort study from South Korea

ObjectivesTo assess the efficacy of hydroxychloroquine on mild-moderate COVID-19 patients in South Korea. MethodsA retrospective cohort study of the 358 laboratory-confirmed SARS-CoV-2 (COVID-19) patients was conducted. 226 patients met inclusion criteria for analysis. Propensity score matching (PSM) and Cox regression method were utilized to control and adjust for confounding factors. Mild to moderate COVID-19 patients were managed with hydroxychloroquine (HQ) plus antibiotics (n = 31) or conservative treatment (n = 195). ResultsKaplan-Meier curves drawn using propensity score-matched data revealed no differences between the length of time to viral clearance and duration of hospital stay between the two treatment arms (p=0.18, p=0.088). Multivariable Cox regression analysis similarly showed that time to viral clearance(Hazard ratio (HR) 0.97, [95%-confidence interval (CI): 0.57-1.67]) and symptom duration(HR 1.05, [95%-CI: 0.62-1.78]) were not different between groups. No severe adverse event or death was observed in either group. ConclusionsHQ with antibiotics was not associated with better clinical outcomes in terms of time to viral clearance, length of hospital stay, and duration of symptoms compared to conservative treatment alone. Large prospective randomized trials are necessary for definitive conclusions.

Comparative efficacy and safety of pharmacological interventions for the treatment of COVID-19: A systematic review and network meta-analysis of confounder-adjusted 20212 hospitalized patients

ObjectiveTo evaluate the comparative efficacy and safety of pharmacological interventions used in treating COVID-19 and form a basis for an evidence-based guideline of COVID-19 management by evaluating the level of evidence behind each treatment regimen in different clinical settings. DesignSystematic review and network meta-analysis Data SourcesPubMed, Google Scholar, MEDLINE, the Cochrane Library, medRxiv, SSRN, WHO International Clinical Trials Registry Platform, and ClinicalTrials.gov up to June 9th, 2020. Study SelectionPublished and unpublished randomized controlled trials (RCTs) and baseline-adjusted observational studies which met our predefined eligibility criteria. Main Outcome MeasuresThe outcomes of interest were mortality, progression to severe disease (severe pneumonia or admission to intensive care unit (ICU)), time to viral clearance, QT prolongation, fatal cardiac complications, and non-cardiac serious adverse events. The level of evidence behind each outcome was also measured using the Grading of Recommendations Assessment, Development, and Evaluation (GRADE) framework. Results49 studies with a total of 20212 confounder-adjusted patients were included for analysis. The risk of progression to severe pneumonia or ICU admission was significantly reduced with tocilizumab (GRADE low), anakinra (GRADE very low), and remdesivir (GRADE high) compared to standard care. Tocilizumab was shown to reduce mortality rate for both moderate-severe patients in the non-ICU setting at admission (Odds ratio (OR) 0.31, 95% confidence interval (CI) 0.18 to 0.54, GRADE low) and critically ill patients in the ICU setting (OR 0.67, 95% CI 0.50 to 0.91, GRADE low). High dose IVIG reduced death rate (GRADE low) while corticosteroids increased mortality for critically ill patients (GRADE moderate). Convalescent plasma and hydroxychloroquine were shown to promote viral clearance (OR 11.39, 95% CI 3.91 to 33.18, GRADE low and OR 6.08, 95% CI 2.74 to 13.48, GRADE moderate, respectively) while not altering mortality or progression to the severe courses. The combination of hydroxychloroquine and azithromycin was shown to be associated with increased QT prolongation incidence (OR 1,85, 95% CI 1.05 to 3.26, GRADE low) and fatal cardiac complications in cardiac-impaired populations (OR 2.26, 95% CI 1.26 to 4.05, GRADE low). High-dose (>600mg/day) hydroxychloroquine monotherapy was significantly associated with increased non-cardiac serious adverse events (GRADE moderate). ConclusionAnti-inflammatory agents (tocilizumab, anakinra, and IVIG) and remdesivir may safely and effectively improve outcomes of hospitalized COVID-19 patients. Widely used hydroxychloroquine provides marginal clinical benefit in improving viral clearance rates whilst posing both cardiac and non-cardiac safety risks, especially in the vulnerable population. Only 20% of current evidence on pharmacological management of COVID-19 is on moderate and high evidence certainty and can be considered in practice and policy; remaining 80% are of low or very low certainty and warrant further studies to establish firm conclusions. Systematic Review RegistrationPROSPERO 2020: CRD42020186527. Summary BoxO_ST_ABSSection 1: What is already known on this topicC_ST_ABS- Numerous clinical trials and observational studies have investigated various pharmacological agents as potential treatment for COVID-19. - Results from numerous studies are heterogeneous and sometimes even contradictory to one another, making it difficult for clinicians to determine which treatments are truly effective. - Level of evidence behind each outcome from diverse studies remains unknown. Section 2: What this study adds- Anti-inflammatory agents (tocilizumab, anakinra, and IVIG) and remdesivir may safely and effectively improve clinical outcomes of COVID-19. - Widely used hydroxychloroquine provides marginal clinical benefit in improving viral clearance rates whilst posing both cardiac and non-cardiac safety risks. - Only 20% of current evidence on pharmacological management of COVID-19 is on moderate/high evidence certainty and can be considered in practice and policy; remaining 80% are of low or very low certainty and warrant further studies to establish firm conclusions.

Comparative Efficacy and Safety of Pharmacological Managements for Hospitalized COVID-19 Patients: Protocol for Systematic Review and Trade-Off Network Meta-Analysis.

Coronavirus-Disease 2019 (COVID-19) is the clinical disease caused by the SARS-CoV-2 virus, the infectious agent causing the ongoing pandemic that has impacted the lives of hundreds of millions of people in almost every nation worldwide. It is a potentially fatal disease to many vulnerable patients including the elderly and those with chronic illnesses; but because this virus is a novel one, there are no firmly established treatment protocols. Many treatment methods are being investigated worldwide, and scientific conclusions drawn from these endeavors are crucial for healthcare professionals in combating this disease. In this network meta-analysis, we focus specifically on the pharmacologic agents that have been investigated for the treatment of COVID-19 and aim to produce a comprehensive picture of the evidence from current data in order to produce relevant insights on the comparative efficacy and safety profiles of various pharmacologic agents against COVID-19.

Treatment Response to Hydroxychloroquine, Lopinavir/Ritonavir, and Antibiotics for Moderate COVID 19: A First Report on the Pharmacological Outcomes from South Korea

The authors have withdrawn this manuscript because of the controversy about hydroxychloroquine and potential changes in results after peer-review, the authors intend to share their results in formal publication. Therefore, the authors do not wish this work to be cited as reference for the project. If you have any questions, please contact the corresponding author.

Medical Students' Needs Assessment for Counseling Programs / 의료커뮤니케이션

BACKGROUND: This study attempted to develop a student counseling program to help students solve problems effectively by understanding what they want to be counseled by the medical students, what they want to be counseled according to their needs, and investigating their needs.METHODS: A survey was conducted to 278 medical students in a city using a questionnaire developed by three medical education experts.RESULTS: As a result of analyzing the preference for counseling contents, academic achievement counseling was the highest. A result of analyzing the preference of counseling contents by counselors are as follows; professor : selection of major (19.5%) and career and aptitude (16.0%), senior : learning method (22.9%) and major selection (14.1%), professional counseling agencies : selection of major (12.6%), emotion and personality (11.6%), non-anonymous online bulletin board : selection of major (19.5%) and career and aptitude (16.0%), anonymous online bulletin board : interpersonal relationships (15.9%) and selection of major (13.9%)CONCLUSIONS: Based on the analysis of medical student's preference of counseling contents and preference of counseling contents according to the counselor, The results of this study suggest that the counseling system can be used as a basic data for development.

Factors Influencing Smoking Behavior in Patients with Pulmonary Tuberculosis / 임상간호연구

PURPOSE: This study was to investigate the factors affecting smoking behavior in patients with pulmonary tuberculosis. METHODS: The participants were 130 pulmonary tuberculosis patients at a national tuberculosis hospital. Using a descriptive survey design, data were collected from January to March in 2016 and were analyzed using binominal logistic regression. RESULTS: As a result of a correlation analysis of the data, depression had a significant positive correlation with smoking (r=.19, p=.030), stress (r=.54, p < .001), respectively. And depression had a significant negative correlation with smoking-related self-efficacy (r=−.20, p=.023). Smokingrelated self-efficacy, smoking (r=−.79, p < .001), and stress (r=−.23, p=.008) had a significant negative correlation with each other, respectively. The factors affecting the smoking behavior were smoking-related self-efficacy (OR=1.46, p < .001), sex (OR=67.36, p=.001), occupation (OR=17.51, p=.014), and depression (OR=1.16, p=.024). Those factors explained 84.7% (Negelkerke's R2=.847) of pulmonary tuberculosis patients' smoking behavior. CONCLUSION: Developing and applying a prevention eduction for reducing depression and enhancing smoking-related self-efficacy may become a venue toward good prognosis of the patients with pulmonary tuberculosis.

Personality Types and Application to Medical Education in Medical Students / 계명의대학술지

Myers-Briggs Type Indicator (MBTI) is a personality type test book, which is widely used in the field of personal counseling, team organization, school education and research. This study carried out MBTI of 361 medical students in the second grade of premedical course of Keimyung University School of Medicine from 2014 to 2018, and analyzed the data to use them for the students' education. The personality type was mostly distributed to ISTJ, ISTP, ESTP and ESTJ in order among 16 types. According to preference tendency, it was found out that the introverted type was extroverted, the recognition type was intuition type, the thinking type was emotional type, and the recognition type was more distributed than the judgment type. The psychological functions were ST, SF, NF, NT. MBTI type analysis of medical students shows that it is possible to organize members in group activities to improve their ability to understand themselves and understand others in class scenes. In addition, we expect to be able to design for improvement of stress management, conflict management, and communication ability. In the career counseling scene, in addition to the MBTI data analysis, it is expected that it will be possible to recommend a major suitable for the student personality type in parallel with other psychological tests. In addition, we expect to study the preferred field of study, satisfaction with the major in the future research by continuous data accumulation and analysis.

Guidelines for Improvement of Integrated Courses in a Medical School / 계명의대학술지

To systematically develop the courses or programs of medical education, guidelines were developed for the improvement of integrated courses, modifying the existing evaluation model of school curriculum to fit the curriculum of medical school. The guidelines were divided into three parts, prior-class, mid-class, and post-class, and 18 items were developed in the areas of situation analysis, developing process, goals, contents, organization, management, performance, and evaluation.

Differences of Perceptual Importance for Graduate Outcomes among Faculties, Students and Parents in a Medical School / 계명의대학술지

To find out the different cognition of the members of medical school about the importance of graduate outcomes such as 'clinical performance, communication, supporting patients, professionalism, problem solving and research, self-development', a survey applied with self-report method was conducted with 110 faculties, 132 students (71 premedical 2nd graders and 61 medical 2nd graders), and 30 parents about graduate outcomes and sub-outcome competences. Parents usually thought highly of the importance of graduate outcomes, while medical second graders comparatively regarded them as less important. Among graduate outcomes, 'clinical performance' was definitely considered the most important and was followed by 'communication'. As for 'self-development', parents and premedical 2nd graders regarded it as important, while faculty and medical 2nd graders had lower awareness about its importance. As to the suboutcome competences, faculty generally had lower awareness about their importance compared to students and parents.

Awareness of Students for Implementation of a Peer Mentoring Program in a Medical School / 계명의대학술지

To investigate the awareness of medical students about an implementation of peer mentoring program between senior and junior, this research survey was carried out on 341 students of a medical school including 62 students of 1(st) premedical graders, 72 of 2(nd) premdical grade, 74 of 3(rd) medical grade, 73 of 4(th) medical grade, and 60 of 5(th) medical grade. The questionnaire for the survey was composed of items, freely responding styled, about such as ‘conflicts experiencing during school living’, i‘nstances requesting senior's assistance’, ‘needs for a senior-junior mentoring’, ‘intention participating as mentor or mentee in prospective mentoring program’, ‘contents willing to get mentoring’, ‘formality of mentoring program’. As a result, there is strong needs to introduce the peer mentoring programs for graduating the doctors fitting to the outcomes based on institutional framework, and to cultivate the seniors as mentors through proper educations because the senior's advice or assistance may exert considerable reflections and influences on junior's lives.

The Changes of Corneal and Ocular High-Order Aberrations before and after Playing Computer Games

PURPOSE: To evaluate changes in corneal and ocular high-order aberration, ocular fatigue, and tear break-up time (TBUT) before and after playing computer games and the correlations among the variables. METHODS: Thirty-nine normal healthy subjects played computer games for 1 hour. Ocular fatigue was evaluated with a questionnaire, TBUT was measured with slit-lamp biomicroscopy, and high-order aberrations were measured with a KR-1W aberrometer (Topcon Medical System, Inc., Tokyo, Japan) in each subject before and after playing computer games. The right eye was used for statistical analyses. RESULTS: Subjective ocular fatigue (expressed as the interview score) increased from 4.23 +/- 5.35 to 12.05 +/- 8.68 after playing games (p < 0.001) and TBUT decreased from 8.03 +/- 6.43 sec to 4.90 +/- 3.31 sec (p < 0.001). Ocular high-order aberrations in the 4 mm and 6 mm zones were not significantly changed before and after playing games (p = 0.150, p = 0.202, respectively). However, corneal high-order aberrations in the 4 mm and 6 mm zones were significantly increased after playing computer games (p = 0.002, p = 0.002, respectively). Changes in TBUT, interview score, and corneal high-order aberration were not correlated with each other. CONCLUSIONS: Playing computer games increased corneal high-order aberrations as well as subjective ocular fatigue and TBUT.