Political Landmines in Healthcare Research: An Obstacle to Progress.

The quest for groundbreaking discoveries in healthcare research faces significant challenges, not just technical but also political. Political landmines, such as controversies, regulations, and policies influenced by political agendas, affect healthcare research. These landmines can derail studies, stifle innovation, and impede the advancement of medical knowledge and public health. Political agendas often impose narratives that contradict scientific evidence, influencing research areas like reproductive health, climate change, and vaccinations. Funding volatility due to political shifts creates uncertainty, discouraging long-term projects and slowing healthcare innovation. Ethical and regulatory barriers shaped by political considerations further limit research scope and delay breakthroughs. Political influences also result in censorship and misinformation, undermining informed decision-making and public trust. Geopolitical tensions hinder international collaboration, reducing the capacity to address global health challenges. To mitigate these effects, the scientific community must advocate for evidence-based policies, communicate transparently with policymakers, and build robust alliances to support research independence. Fostering resilience within the research community is crucial for adapting to changing political climates and ensuring the continuity of essential projects. Healthcare research can continue to advance and improve global health outcomes by addressing these political challenges.

Highlights of the 18th International Conference on Pediatric Mechanical Circulatory Support Systems and Pediatric Cardiopulmonary Perfusion.

The 18th International Conference on Pediatric Mechanical Circulatory Support Systems and Pediatric Cardiopulmonary Perfusion was held in Milwaukee, WI, USA, on May 9 and 10, 2024. The conference was hosted by the Herma Heart Institute of Children's Wisconsin at the Pfister Hotel in downtown Milwaukee. This communication provides the highlights of the proceedings.

Coffee arabica research (1932-2023): Performance, thematic evolution and mapping, global landscape, and emerging trends.

Background: Research on Coffea arabica focuses on various aspects, including genetics, breeding, climate change resilience, pest and disease management, agronomy, sensory analysis, and sustainability. This study aims to analyze the hotspots, conceptual map and dynamicity, global landscape, and emerging trends in Coffea arabica research (CA-R). Methods: A comprehensive dataset comprising data-driven articles (N = 3967) from 1932 to 2023 was extracted from Scopus using predefined search terms. VOSviewer and Bibliometrix applications were utilized to analyze the data. Thematic evolution was examined by identifying shifts in research focus over time. The global landscape was assessed by examining comparative productivity and collaborative dynamics. Highly-cited CA-R was identified to highlight key findings in specific research areas. Results: The analysis revealed a steady growth of CA-R (annual growth rate = 6.53 %), with strong international collaboration (international co-authorships = 29.35 %) and significant contributions from various countries. Brazil leads the way with 1601 publications, accounting for 28.55 % of the total. Recognizable CA-R focused on important areas such as pollination, shade management, nanotechnology applications, roasting effects, disease management, and environmental impacts. Thematic analysis identified five distinct clusters representing different CA-R themes: "coffee", "coffea," "fermentation," "Coffea arabica," and "climate change." Emerging themes such as "in vitro culture," "sustainable agriculture," "climate change," and "coffee berry borer" were also identified. Conclusion: The current findings enhance our understanding of CA-R and lay the groundwork for future studies in the coffee industry.

A philosophical exploration of rural health and nursing based on an undergraduate United States-Australian collaboration through the lens of 'positionality'.

Growing nursing workforce maldistributions impede rural healthcare access globally. In-depth exploration of underlying philosophical ideas about rural health in nursing curricular could support recruitment and retention of nurses who are well positioned to support and advocated for health care and services relevant to their communities. Through a lens of positionality, the purpose of this paper is to explore rural health and nursing within the United States and Australia from the perspective of undergraduate students. Recognizing that both countries have 'first world' health services, issues of access to services associated with systemic and structural biases were significant features identified by participants. Their perceptions were supported by discussion with attendees of the 26th International Nursing Philosophy Conference from several countries, during a presentation titled 'What is different about rural health nursing: A philosophical exploration.' This international consistency suggests that systemic and structural biases are global phenomena. While exposure to rural health and rural nursing may be beneficial for recruitment, preparing nurses for rural practice requires more than educating students to complete clinical tasks. Uncovering collaboration, advocacy and policy development opportunities for nurses in rural communities could move the dial from recruiting rural nurses to fulfill immediate needs to retention of well-educated and highly skilled nurses. Building a stronger philosophical base for rural healthcare inclusive of all people, honouring their distinguishing characteristics such as age, gender, ethnicity, is long overdue. Positionality can inform how nurses across the globe relate to other countries' governments, cultures, norms, values, expectations, etc., which can influence the advancement of the profession and address social inequities among rural populations.

Factors influencing the research impact in cancer research: a collaboration and knowledge network analysis.

BACKGROUND: Cancer is a major public health challenge globally. However, little is known about the evolution patterns of cancer research communities and the influencing factors of their research capacity and impact, which is affected not only by the social networks established through research collaboration but also by the knowledge networks in which the research projects are embedded. METHODS: The focus of this study was narrowed to a specific topic - 'synthetic lethality' - in cancer research. This field has seen vibrant growth and multidisciplinary collaboration in the past decade. Multi-level collaboration and knowledge networks were established and analysed on the basis of bibliometric data from 'synthetic lethality'-related cancer research papers. Negative binomial regression analysis was further applied to explore how node attributes within these networks, along with other potential factors, affected paper citations, which are widely accepted as proxies for assessing research capacity and impact. RESULTS: Our study revealed that the synthetic lethality-based cancer research field is characterized by a knowledge network with high integration, alongside a collaboration network exhibiting some clustering. We found significant correlations between certain factors and citation counts. Specifically, a leading status within the nation-level international collaboration network and industry involvement were both found to be significantly related to higher citations. In the individual-level collaboration networks, lead authors' degree centrality has an inverted U-shaped relationship with citations, while their structural holes exhibit a positive and significant effect. Within the knowledge network, however, only measures of structural holes have a positive and significant effect on the number of citations. CONCLUSIONS: To enhance cancer research capacity and impact, non-leading countries should take measures to enhance their international collaboration status. For early career researchers, increasing the number of collaborators seems to be more effective. University-industry cooperation should also be encouraged, enhancing the integration of human resources, technology, funding, research platforms and medical resources. Insights gained through this study also provide recommendations to researchers or administrators in designing future research directions from a knowledge network perspective. Focusing on unique issues especially interdisciplinary fields will improve output and influence their research work.

Uncovering the hidden socioeconomic impact of juvenile idiopathic arthritis and paving the way for other rare childhood diseases: an international, cross-disciplinary, patient-centered approach (PAVE Consortium).

BACKGROUND: Juvenile idiopathic arthritis (JIA) refers to a heterogeneous group of rheumatic conditions in children. Novel drugs have greatly improved disease outcomes; however, outcomes are impacted by limited awareness of the importance of early diagnosis and adequate treatment, and by differences in access across health systems. As a result, patients with JIA continue to be at risk for short- and long-term morbidity, as well as impacts on virtually all aspects of life of the child and family. MAIN BODY: Literature on the socioeconomic burden of JIA is largely focused on healthcare costs, and the impact of JIA on patients, families, and communities is not well understood. High quality evidence on the impact of JIA is needed to ensure that patients are receiving necessary support, timely diagnostics, and adequate treatment, and to inform decision making and resource allocation. This commentary introduces the European Joint Programme on Rare Diseases: Producing an Arthritis Value Framework with Economic Evidence: Paving the Way for Rare Childhood Diseases (PAVE) project, which will co-develop a patient-informed value framework to measure the impact of JIA on individuals and on society. With a patient-centered approach, fundamental to PAVE is the involvement of three patient advocacy organizations from Canada, Israel, and Europe, as active research partners co-designing all project phases and ensuring robust patient and family engagement. The framework will build on the findings of projects from six countries: Canada, Germany, Switzerland, Spain, Israel, and Belgium, exploring costs, outcomes (health, well-being), and unmet needs (uveitis, mental health, equity). CONCLUSION: This unique international collaboration will combine evidence on costs (from family to societal), outcomes (clinical, patient and family outcomes), and unmet needs, to co-design and build a framework with patients and families to capture the full impact of JIA. The framework will support the development of high-quality evidence, encompassing economic and clinical considerations, unmet needs, and patient perspectives, to inform equitable resource allocation, health system planning, and quality of care better aligned with the needs of children with JIA, their families, and communities. Knowledge gained from this novel approach may pave the way forward to be applied more broadly to other rare childhood diseases.

International collaboration in health professions education.

This article explores the essential elements for achieving excellence in international collaborations within health professions education (HPE), drawing on the Association for Medical Education in Europe (AMEE) ASPIRE Award criteria for International Collaboration. The International Collaboration award transcends recognition of excellence through the award; it aims to foster excellence in international HPE collaborations more broadly, by establishing a framework for evaluation and development that functions cross-culturally. This framework is based on five key elements that contribute to successful collaborations: mutually agreed goals; shared responsibilities and leadership structures; processes that support collaboration; demonstrated long-term impact and sustainability, and evaluation and practice sharing. Recognizing the historical context of unequal power dynamics in international partnerships, this article promotes the development of ethical and equitable collaborations. We advocate for integrating cultural competence, epistemic plurality, and leadership skills into HPE curricula to prepare future healthcare professionals for effective international collaboration.

Motivators and mechanisms for an international rural health collaboration.

Collaborations are critical to address rural health challenges. We evaluated a new international collaboration between institutions in Georgia, the United States (US), and Scotland, United Kingdom (UK), to address rural health issues and to understand the barriers and facilitators to effective international collaboration efforts. A qualitative approach was used through in-depth interviews and focus groups with educators, researchers, and healthcare providers in the US and Scotland who were involved in the CONVERGE international rural health collaboration. Transcriptions were imported into the NVivo qualitative software program. A reflexive thematic analysis was employed to identify key themes from the collected data. Twelve interviews and two focus groups were conducted virtually with 17 participants. Two primary domains were identified from the thematic analysis: (1) motivators that increase engagement in international collaboration, and (2) mechanisms for, and barriers to, the continuity needed to create meaningful change. Six themes emerged related to commonality of issues, prospect of sharing knowledge, need of sustained funding and institutional support, and selection of human resources. Participants of CONVERGE were more likely to engage when they had a space to share ways to address challenging issues and integrate knowledge and practice. They were motivated by their desire for growth and the institutions they serve and emphasized that infrastructure support is vital for sustainable collaborations.

Experiences establishing a new speech-language pathology training program in Ethiopia, a resource-limited setting: Lessons learned.

PURPOSE: Ethiopia is the second most populous country in sub-Saharan Africa. While Ethiopia's health care system includes primary health centres, general, and specialised hospitals, allied health care like speech-language pathology was not available until 2003. This article was written with the aim of sharing the experience of establishing speech-language pathology as a profession and the first speech-language pathology training program in Ethiopia. METHOD: In this paper, we retrospectively examine how the leadership of local stakeholders, a multidisciplinary team, and the development of a professional infrastructure led to the success of the program. The authorship group, who were involved in the program from inception to implementation, share their experiences. RESULT: The speech-language pathology undergraduate program at Addis Ababa University graduated its first class in 2019. Plans to grow the training program at the graduate level are ongoing. CONCLUSION: This novel program, grown from several international partnerships, is an example of how low- and middle-income countries can improve access to the service providers necessary to treat their populations.

Transatlantic Educational Network: An Innovation Born of Necessity.

The coronavirus disease 2019 pandemic brought about many changes in the delivery of healthcare, graduate medical education, and collaborative efforts across academic medicine. While there was a temporary disruption in the fluid delivery of services, longer-term benefits emerged with the leveraging of innovative technology and multicenter collaborations. These new opportunities led 14 centers in the United States and Europe to develop a novel, remote, and collaborative educational effort in cardiovascular and thoracic anesthesiology, known as the Transatlantic Educational Network. This paper describes the initial pilot structure and preimplementation data and provides a rationale for the development and expansion of the pilot program in other areas of anesthesiology.

The importance of international collaborations in science and structural biology.

The Acta Cryst. F - Structural Biology Communications Editors explain how important international collaborations are in science and structural biology.

The needed link between open science and science diplomacy-A Latin American perspective.

The relevance of science diplomacy and open science in today's world is undeniable. Science diplomacy enables countries to jointly address pressing global challenges, such as climate change, pandemics, and food security. Open science, promoting accessible and transparent research, plays a pivotal role in this context. Nevertheless, the degree of openness is subject to specific circumstances, contingent upon varying factors, including local knowledge and resources. Latin America has not only been at the forefront of pioneering open access strategies, making it an interesting case to study, but it has also shown a tangible interest in using science diplomacy. Our research employs a mixed-methods approach, incorporating a quantitative survey involving 50 organizations and initiatives dedicated to promoting open science in Latin America, along with two qualitative focus group studies. Our primary objective is to assess if and how these entities use science diplomacy to achieve their objectives. Non-policy entities were prioritized due to their institutional stability in the region. We highlight successful strategies and delve into the existing barriers hindering the full implementation of open science principles. Our research aims to enhance collaboration between these organizations and policy and decision-makers by providing a set of recommendations in that direction. By shedding light on the current landscape and dynamics of open science in Latin America, we aspire to focus on science diplomacy, facilitate informed decision-making, and formulate policies that further propel the region along the path of openness, collaboration, and innovation in scientific research.

International Collaboration and Commercial Involvement in Randomized Controlled Trials From 10 Leading Countries, 1997 Through 2019.

Randomized controlled trials (RCTs) affect clinical decisions and their number is increasing. However, trends in international collaboration on RCTs and involvement of healthcare-related industries, the latter of which may contribute to bias, are not known. The objectives were to identify concerns surrounding RCTs, and to quantify changes in (1) the numbers of RCT articles in journals of high clinical importance, (2) international collaboration, and (3) commercial involvement in RCTs by authors in countries that contribute the most to the scientific literature. This was not a systematic review of the medical literature. It is a descriptive study of trends during the past two decades. We extracted RCT articles from MEDLINE data (1997-2019). When grouped by authors' country, the analyses were limited to the 10 leading countries in the natural sciences, as defined by the Nature Index 2019 Annual Tables. The Core Clinical Journals (CCJ) filter in PubMed was used to identify journals that were likely to be highly relevant to clinical practice. RCT articles that included authors from multiple countries were used as examples of international collaboration, and RCTs in which at least one author's affiliation was corporate were considered to have commercial involvement. The annual number of RCT articles more than doubled (from 10,360 to 22,384), but the number published in the CCJ was essentially unchanged (from 2,245 to 2,346). The vast majority of RCT articles had US-based authors. International collaboration increased in nine of the 10 countries studied, and it was particularly common among researchers in Europe, Canada, and Australia. In contrast, international collaboration decreased in China. Regarding commercial involvement, between 1997 and 2019 the proportion of single-country RCTs with commercial involvement decreased (from 12.4% to 3.8% for the United States, and from 2.5% to 0.0% for Europe-Canada-Australia). In contrast, the proportion of international-collaborative RCTs with commercial involvement increased (from 9.2% to 17.6% for the United States, and from 17.9% to 21.3% for Europe-Canada-Australia). The largest change in commercial involvement was the 12-fold increase in Japan: from 3% to 36% (1997-2019). Japan was also noteworthy for its 28-percentage-point decrease in first-authorship of RCT articles from 2012 to 2019. In conclusion, recent increases in the number of RCT articles have occurred almost exclusively outside the CCJ. Thus, many newer RCT articles might have relatively low clinical relevance or impact. International collaboration has generally increased, along with commercial involvement. The latter has become particularly common in Japan, increasing the potential for sponsorship bias. The effects of ongoing attempts to reverse that trend should be evaluated.

How to harness the power of web scraping for medical and surgical research: An application in estimating international collaboration.

The transformative potential of web scraping in surgical research through a comprehensive analysis of its revolutionary applications and profound impact is now within reach. This manuscript unveils the pivotal role of web scraping in driving innovation, enabling more effective management of human capital dynamics, and enhancing patient outcomes in the surgical field. As an example, we demonstrate how web scraping can uncover insights into international collaboration in surgery research revealing limited collaboration between surgeons in developed and developing countries.