Biomedical doctoral students' research practices when facing dilemmas: two vignette-based randomized control trials.

Our aim was to describe the research practices of doctoral students facing a dilemma to research integrity and to assess the impact of inappropriate research environments, i.e. exposure to (a) a post-doctoral researcher who committed a Detrimental Research Practice (DRP) in a similar situation and (b) a supervisor who did not oppose the DRP. We conducted two 2-arm, parallel-group randomized controlled trials. We created 10 vignettes describing a realistic dilemma with two alternative courses of action (good practice versus DRP). 630 PhD students were randomized through an online system to a vignette (a) with (n = 151) or without (n = 164) exposure to a post-doctoral researcher; (b) with (n = 155) or without (n = 160) exposure to a supervisor. The primary outcome was a score from - 5 to + 5, where positive scores indicated the choice of DRP and negative scores indicated good practice. Overall, 37% of unexposed participants chose to commit DRP with important variation across vignettes (minimum 10%; maximum 66%). The mean difference [95%CI] was 0.17 [- 0.65 to 0.99;], p = 0.65 when exposed to the post-doctoral researcher, and 0.79 [- 0.38; 1.94], p = 0.16, when exposed to the supervisor. In conclusion, we did not find evidence of an impact of postdoctoral researchers and supervisors on student research practices.Trial registration: NCT04263805, NCT04263506 (registration date 11 February 2020).

Biliary Complications After Liver Transplantation: Incidence, Risk Factors and Impact on Patient and Graft Survival.

INTRODUCTION: Biliary complications (BC) are one of the most frequent surgical complications after liver transplantation. They include biliary stenosis, leaks, choledocolitiasis and sphincter of Oddi dysfunction. These complications can cause graft dysfunction, retrasplantation, or even death. The purpose of this study was to identify factors related to BC. MATERIALS AND METHODS: The medical records of all adult patients who underwent their first liver transplantation in our institution from 2005 to 2013 were reviewed, and any BC that required management was recorded. Cumulative incidence of BC was estimated using Kaplan-Meier. Patient and graft survival was compared using the log-rank test. The Cox regression model was used to establish associated factors. RESULTS: Of the 236 patients who underwent liver transplantation, 41 patients (17.8%) developed BC. Cumulative incidence was 12.9%, 17.2%, and 20%, after 1, 3 and 5 years of the transplantation, respectively. Twenty-six cases of biliary stenosis, 11 of leaks, and 4 of choledocolitiasis were identified. Most patients were managed endoscopically (82.9%). There were no differences in patient or graft survival. DISCUSSION: Biliary stenosis is the most frequent BC. Patients with higher risk of BC were of blood type AB (P < .001), had viral hepatitis (P = .049), or had alcoholic cirrhosis (P = .036). The success with the endoscopic treatment reduced the need for surgical interventions. CONCLUSIONS: The incidence of BC in our institution is comparable with the incidence reported in other institutions. Further prospective studies with larger series of patients are warranted to identify other factors associated with development of BC.