China’s Scientific Journals in a Transforming Period: Present Situation and Developing Strategies

Based on a detailed analysis of the global academic impact of China’s scientific journals, as well as of the publishing strategies and communication media used by their publishers, we conclude that the Science, Technology, and Medicine (STM) journal publishing industry in China is going through very rapid transformation. Journals are attempting to become more broadly international, and doing so by adopting new digital production methods and commercial models. In light of these efforts, we discuss the current challenges to the development of China’s scientific journal industry and suggest strategies that may be useful for reaching key goals

Short-term risk prediction after major lower limb amputation: PERCEIVE study

This multicentre cohort study of 537 patients evaluated the accuracy of preoperative predictions of outcomes by healthcare professionals and several relevant risk prediction tools. Surgeons and anaesthetists predicted 30-day outcomes after major lower limb amputation more accurately than most risk prediction tools. The best performing method of predicting mortality was a tool that incorporated healthcare professional estimation of risk.Background The accuracy with which healthcare professionals (HCPs) and risk prediction tools predict outcomes after major lower limb amputation (MLLA) is uncertain. The aim of this study was to evaluate the accuracy of predicting short-term (30 days after MLLA) mortality, morbidity, and revisional surgery. Methods The PERCEIVE (PrEdiction of Risk and Communication of outcomE following major lower limb amputation: a collaboratIVE) study was launched on 1 October 2020. It was an international multicentre study, including adults undergoing MLLA for complications of peripheral arterial disease and/or diabetes. Preoperative predictions of 30-day mortality, morbidity, and MLLA revision by surgeons and anaesthetists were recorded. Probabilities from relevant risk prediction tools were calculated. Evaluation of accuracy included measures of discrimination, calibration, and overall performance. Results Some 537 patients were included. HCPs had acceptable discrimination in predicting mortality (931 predictions; C-statistic 0.758) and MLLA revision (565 predictions; C-statistic 0.756), but were poor at predicting morbidity (980 predictions; C-statistic 0.616). They overpredicted the risk of all outcomes. All except three risk prediction tools had worse discrimination than HCPs for predicting mortality (C-statistics 0.789, 0.774, and 0.773); two of these significantly overestimated the risk compared with HCPs. SORT version 2 (the only tool incorporating HCP predictions) demonstrated better calibration and overall performance (Brier score 0.082) than HCPs. Tools predicting morbidity and MLLA revision had poor discrimination (C-statistics 0.520 and 0.679). Conclusion Clinicians predicted mortality and MLLA revision well, but predicted morbidity poorly. They overestimated the risk of mortality, morbidity, and MLLA revision. Most short-term risk prediction tools had poorer discrimination or calibration than HCPs. The best method of predicting mortality was a statistical tool that incorporated HCP estimation