Worldwide inequality in access to full text scientific articles: the example of ophthalmology

Research practice, satisfaction, motivation, and challenges among university academics in Kurdistan Region of Iraq

BACKGROUND

Researchers in universities and academic institutions must be in a leading position in generating research evidence to inform and direct national policies and strategies, improve service delivery, and achieve the main objectives. This study aimed to determine the factors that promote or hinder research productivity and quality among university academics in Kurdistan Region of Iraq.

METHODS

A cross-sectional study was conducted on 949 university academics from all public universities in the Kurdistan Region of Iraq. The authors developed a questionnaire that included sociodemographic data, challenges, satisfaction, and motivation for conducting research. Data were collected using a Google form. Frequencies, percentages, and the Chi-square test were used to analyze the data.

RESULTS

Most university academics (94.6%) believed that research was part of their job, but only 51.6% were satisfied with their role as academic researchers. The lack of financial motivation was the main reason for dissatisfaction, while the main incentive to conduct research was the passion for science. Around 21% of the university academics had not published any research, while 53.1% published 1-5 articles. Half of the participants (49.7%) lacked training in writing research proposals, and the majority (86.1%) have not applied for international grants. Approximately half of university academics (46.9%) shared their research findings with stakeholders, and the primary method was by sharing their published papers (59.4%), followed by seminars (42.2%). One of the important challenges in conducting research was the lack of funding (62.8%).

CONCLUSIONS

The academics at universities in the Kurdistan Region of Iraq are passionate about their role as researchers, but face many challenges in conducting effective research. A strategic plan is needed to provide an encouraging environment for university academics regarding infrastructure, financial, and technical support. More studies are needed to identify the root factors of academic staff needs and challenges.

Determinants of obesity in Latin America

Obesity rates are increasing almost everywhere in the world, although the pace and timing for this increase differ when populations from developed and developing countries are compared. The sharp and more recent increase in obesity rates in many Latin American countries is an example of that and results from regional characteristics that emerge from interactions between multiple factors. Aware of the complexity of enumerating these factors, we highlight eight main determinants (the physical environment, food exposure, economic and political interest, social inequity, limited access to scientific knowledge, culture, contextual behaviour and genetics) and discuss how they impact obesity rates in Latin American countries. We propose that initiatives aimed at understanding obesity and hampering obesity growth in Latin America should involve multidisciplinary, global approaches that consider these determinants to build more effective public policy and strategies, accounting for regional differences and disease complexity at the individual and systemic levels.

Can we use ChatGPT for Mental Health and Substance Use Education? Examining Its Quality and Potential Harms

BACKGROUND

The use of generative artificial intelligence, more specifically large language models (LLMs), is proliferating, and as such, it is vital to consider both the value and potential harms of its use in medical education. Their efficiency in a variety of writing styles makes LLMs, such as ChatGPT, attractive for tailoring educational materials. However, this technology can feature biases and misinformation, which can be particularly harmful in medical education settings, such as mental health and substance use education. This viewpoint investigates if ChatGPT is sufficient for 2 common health education functions in the field of mental health and substance use: (1) answering users' direct queries and (2) aiding in the development of quality consumer educational health materials.

OBJECTIVE

This viewpoint includes a case study to provide insight into the accessibility, biases, and quality of ChatGPT's query responses and educational health materials. We aim to provide guidance for the general public and health educators wishing to utilize LLMs.

METHODS

We collected real world queries from 2 large-scale mental health and substance use portals and engineered a variety of prompts to use on GPT-4 Pro with the Bing BETA internet browsing plug-in. The outputs were evaluated with tools from the Sydney Health Literacy Lab to determine the accessibility, the adherence to Mindframe communication guidelines to identify biases, and author assessments on quality, including tailoring to audiences, duty of care disclaimers, and evidence-based internet references.

RESULTS

GPT-4's outputs had good face validity, but upon detailed analysis were substandard in comparison to expert-developed materials. Without engineered prompting, the reading level, adherence to communication guidelines, and use of evidence-based websites were poor. Therefore, all outputs still required cautious human editing and oversight.

CONCLUSIONS

GPT-4 is currently not reliable enough for direct-consumer queries, but educators and researchers can use it for creating educational materials with caution. Materials created with LLMs should disclose the use of generative artificial intelligence and be evaluated on their efficacy with the target audience.

Development and pilot testing of PROACTIVE: A pediatric onco-critical care capacity and quality assessment tool for resource-limited settings

BACKGROUND

Nearly 90% children with cancer reside in low- and middle-income countries, which face multiple challenges delivering high-quality pediatric onco-critical care (POCC). We recently identified POCC quality and capacity indicators for PROACTIVE (PediatRic Oncology cApaCity assessment Tool for IntensiVe carE), a tool that evaluates strengths and limitations in POCC services. This study describes pilot testing of PROACTIVE, development of center-specific reports, and identification of common POCC challenges.

METHODS

The original 119 consensus-derived PROACTIVE indicators were converted into 182 questions divided between 2 electronic surveys for intensivists and oncologists managing critically ill pediatric cancer patients. Alpha-testing was conducted to confirm face-validity with four pediatric intensivists. Eleven centers representing diverse geographic regions, income levels, and POCC services conducted beta-testing to evaluate usability, feasibility, and applicability of PROACTIVE. Centers' responses were scored and indicators with mean scores ≤75% in availability/performance were classified as common POCC challenges.

RESULTS

Alpha-testing ensured face-validity and beta-testing demonstrated feasibility and usability of PROACTIVE (October 2020-June 2021). Twenty-two surveys (response rate 99.4%) were used to develop center-specific reports. Adjustments to PROACTIVE were made based on focus group feedback and surveys, resulting in 200 questions. Aggregated data across centers identified common POCC challenges: (1) lack of pediatric intensivists, (2) absence of abstinence and withdrawal symptoms monitoring, (3) shortage of supportive care resources, and (4) limited POCC training for physicians and nurses.

CONCLUSIONS

PROACTIVE is a feasible and contextually appropriate tool to help clinicians and organizations identify challenges in POCC services across a wide range of resource-levels. Widespread use of PROACTIVE can help prioritize and develop tailored interventions to strengthen POCC services and outcomes globally.

Toward equitable open research: stakeholder co-created recommendations for research institutions, funders and researchers

Open Research aims to make research more accessible, transparent, reproducible, shared and collaborative. Doing so is meant to democratize and diversify access to knowledge and knowledge production, and ensure that research is useful outside of academic contexts. Increasing equity is therefore a key aim of the Open Research movement, yet mounting evidence demonstrates that the practices of Open Research are implemented in ways that undermine this. In response, we convened a diverse community of researchers, research managers and funders to co-create actionable recommendations for supporting the equitable implementation of Open Research. Using a co-creative modified Delphi method, we generated consensus-driven recommendations that address three key problem areas: the resource-intensive nature of Open Research, the high cost of article processing charges, and obstructive reward and recognition practices at funders and research institutions that undermine the implementation of Open Research. In this paper, we provide an overview of these issues, a detailed description of the co-creative process, and present the recommendations and the debates that surrounded them. We discuss these recommendations in relation to other recently published ones and conclude that implementing ours requires 'global thinking' to ensure that a systemic and inclusive approach to change is taken.

Jumping over the paywall: Strategies and motivations for scholarly piracy and other alternatives

Despite the advance of the Open Access (OA) movement, most scholarly production can only be accessed through a paywall. We conduct an international survey among researchers (N  =  3304) to measure the willingness and motivations to use (or not use) scholarly piracy sites, and other alternatives to overcome a paywall such as paying with their own money, institutional loans, just reading the abstract, asking the corresponding author for a copy of the document, asking a colleague to get the document for them, or searching for an OA version of the paper. We also explore differences in terms of age, professional position, country income level, discipline, and commitment to OA. The results show that researchers most frequently look for OA versions of the documents. However, more than 50% of the participants have used a scholarly piracy site at least once. This is less common in high-income countries, and among older and better-established scholars. Regarding disciplines, such services were less used in Life & Health Sciences and Social Sciences. Those who have never used a pirate library highlighted ethical and legal objections or pointed out that they were not aware of the existence of such libraries.

Dynamics of cumulative advantage and threats to equity in open science: a scoping review

Open Science holds the promise to make scientific endeavours more inclusive, participatory, understandable, accessible and re-usable for large audiences. However, making processes open will not per se drive wide reuse or participation unless also accompanied by the capacity (in terms of knowledge, skills, financial resources, technological readiness and motivation) to do so. These capacities vary considerably across regions, institutions and demographics. Those advantaged by such factors will remain potentially privileged, putting Open Science's agenda of inclusivity at risk of propagating conditions of 'cumulative advantage'. With this paper, we systematically scope existing research addressing the question: 'What evidence and discourse exists in the literature about the ways in which dynamics and structures of inequality could persist or be exacerbated in the transition to Open Science, across disciplines, regions and demographics?' Aiming to synthesize findings, identify gaps in the literature and inform future research and policy, our results identify threats to equity associated with all aspects of Open Science, including Open Access, Open and FAIR Data, Open Methods, Open Evaluation, Citizen Science, as well as its interfaces with society, industry and policy. Key threats include: stratifications of publishing due to the exclusionary nature of the author-pays model of Open Access; potential widening of the digital divide due to the infrastructure-dependent, highly situated nature of open data practices; risks of diminishing qualitative methodologies as 'reproducibility' becomes synonymous with quality; new risks of bias and exclusion in means of transparent evaluation; and crucial asymmetries in the Open Science relationships with industry and the public, which privileges the former and fails to fully include the latter.

Publication Trends of Nonobstetric Brachial Plexus Injury Research: A Bibliometric Analysis

OBJECTIVE

To evaluate publication trends in nonobstetric brachial plexus injury research.

METHODS

In September 2020, Scopus was searched for articles on nonobstretric brachial plexus injury. Citation count, year of publication, country of corresponding author and its income category, destiny journal and its 5-year impact factor (IF), and research type were retrieved.

RESULTS

The analysis comprised 1245 articles. Mean number of citations per article was 18.01 (95% confidence interval 16.46-19.55). Mean IF was 3.60 (95% confidence interval 3.25-3.95). The 5 most prolific journals had an IF <5. The journal with the highest number of articles was the Journal of Hand Surgery (American Volume) (n = 70, 5.6%). The most prolific country was the United States (n = 313, 25.1%). There were 913 articles (73.3%) from high-income countries, 246 (19.8%) from upper middle-income countries, and 68 (5.5%) from lower middle-income countries. No articles were from low-income countries. The representation of middle-income countries increased from 2.1% of published articles in 1980-1989 to 40.0% in 2010-2019. Primary research represented 64.0% (n = 797) of articles, while secondary research and case reports represented 13.0% (n = 162) and 23.0% (n = 286) of articles, respectively. Narrative reviews (n = 142, 11.4%;) and systematic reviews (n = 20, 1.6%) comprised articles from the secondary research group.

CONCLUSIONS

While high-income countries still represent the majority of publications, the contribution of researchers from middle-income countries is increasing. The most common destiny journals are field specific, with a relatively low IF. Although most articles are primary research, a representative portion have a shallow level of evidence (case reports and narrative reviews).

Open science as a path to education of new psychophysiologists

There is a pressing need for resources to train the next generation of psychophysiologists. Psychophysiology, and especially the subfield of cognitive electrophysiology, poses challenges for educators because it requires an understanding of complex concepts and experimental design, advanced analysis and programming skills, and access to specialized software and equipment. These challenges are common to other STEM fields as well. We present PURSUE (Preparing Undergraduates for Research in STEM Using Electrophysiology - www.PursueERP.com) as an example initiative that engages open educational practices to create and share freely available electrophysiology training materials. This model uses evidence-based pedagogy to create accessible and flexible materials, an open database with supporting lab-based training resources, and also provides instructor support during implementation. This model can be used for other areas within STEM. We review benefits and challenges of using open science research and publishing practices for training. Open science resources have benefits for both course-based undergraduate research experiences and other types of training by increasing access to publications, software, and code for conducting experiments and analyses, as well as access to data for those who do not have access to research equipment. Further, we argue that coordinated open educational practices are necessary to take full advantage of open science resources for training students. Open educational practices such as open educational resources, collaborative course building, and implementation support greatly enhance the ability to incorporate these open science resources into a curriculum.

Access to scientific literature by the conservation community

Access to the scientific literature is perceived to be a challenge to the biodiversity conservation community, but actual level of literature access relative to needs has never been assessed globally. We examined this question by surveying the constituency of the International Union for Conservation of Nature (IUCN) as a proxy for the conservation community, generating 2,285 responses. Of these respondents, ∼97% need to use the scientific literature in order to support their IUCN-related conservation work, with ∼50% needing to do so at least once per week. The crux of the survey revolved around the question, “How easy is it for you currently to obtain the scientific literature you need to carry out your IUCN-related work?” and revealed that roughly half (49%) of the respondents find it not easy or not at all easy to access scientific literature. We fitted a binary logistic regression model to explore factors predicting ease of literature access. Whether the respondent had institutional literature access (55% do) is the strongest predictor, with region (Western Europe, the United States, Canada, Australia and New Zealand) and sex (male) also significant predictors. Approximately 60% of respondents from Western Europe, the United States, Canada, Australia and New Zealand have institutional access compared to ∼50% in Asia and Latin America, and ∼40% in Eastern Europe and in Africa. Nevertheless, accessing free online material is a popular means of accessing literature for both those with and without institutional access. The four journals most frequently mentioned when asked which journal access would deliver the greatest improvements to the respondent’s IUCN-related work were Conservation Biology, Biological Conservation, Nature, and Science. The majority prefer to read journal articles on screen but books in hard copy. Overall, it is apparent that access to the literature is a challenge facing roughly half of the conservation community worldwide.