key: cord-0881954-2s04ary7
authors: Gustot, Thierry
title: Editorial for JHEP Reports
date: 2020-07-03
journal: JHEP Rep
DOI: 10.1016/j.jhepr.2020.100141
sha: 61ca4ed2a40e63ae5fac8ab25c6d1699f8aa62d2
doc_id: 881954
cord_uid: 2s04ary7

nan

A situation that is well known to the scientific community has recently come back to the forefront, helped by the COVID-19 pandemic we are going through. Indeed, for many reasons (source of funding, academic promotion, competition between research teams, financial interest from the private sector, search for personal recognition), authors tend to publish their results more and more quickly, sometimes at the price of quality and reproducibility. Scientific journals are participating in this frenetic race by offering fast track peer review trajectories that guarantee rapid evaluation by reviewers but limit the ability to evaluate the submitted work in detail. Second to this, we observe a steady increase in the number of articles that have been retracted over time, with a clear acceleration since the 2000s [1] . Publication misconduct in various forms (e.g.

compromised peer review, plagiarism, data manipulation, etc.) has been reported as the most frequent reason for retraction of published articles, accounting for 28-76% of cases [2] . Some authors refer to the strategy "publish first, retract later". The problem is that often the retraction process is slow (up to 46 months according to some reports) and problematic articles remain accessible and continue to do damage in the scientific community.

We are facing a torrent of publications about COVID-19 in prestigious journals such as the New England Journal of Medicine, The Lancet, JAMA, etc. Currently, the health emergency is being used as an argument to speed up the publication of data. As of June 10, 2020, 21,172 items (original articles, journals, editorials and letters) concerning COVID-19 are referenced in PubMed for the year 2020. Many leading journals make a call for manuscripts related to COVID-19. The requirement level of some of these journals is also being reduced for all data related to COVID-19. In addition, the visibility of these publications is greatly increased through social media for the scientific community but also for the general public. One of the positive points is that contradictory debates are emerging. Nevertheless, a thorough reading of the articles and profound assessment of the methodology are sometimes missing. We are already facing expressions of concern and retractions on some very recent publications [3] . Retraction watch reports 15 retracted and 2 temporarily articles concerning COVID-19

(https://retractionwatch.com/retracted-coronavirus-covid-19-papers/). This specific situation is only the exacerbation of a constant and very real challenge, of which the misconducted publication is a not insignificant part.

The scientific community must be aware of this threat and must continue to de-passionate the debates by objectively analyzing the data with the time necessary for peer review to preserve the integrity and credibility of scientific research. The time for scientific investigation and the replicability of results is not the time of social media and fasttracks. Nevertheless, the publishers and editorial teams have a duty of transparency and wide dissemination of knowledge. They cannot neglect recent dissemination tools, bearing in mind the need to continue to follow high quality scientific standards.

It is my privilege to synthesize the fourth issue of JHEP Reports in 2020. The current issue is composed of six original articles, one case-report, one letter and four outstanding up-to-date reviews by key opinion leaders on different subjects in Hepatology. I propose to divide my editorial in the different topics of hepatology.

Currently, it is well established that achieving sustained virological response (SVR) by antiviral treatments in chronic HCV infection is associated with an improvement of long-term outcomes (decreases in incidence of hepatocarcinoma, decompensation, listing for liver transplantation and liver-related death) [4] .These data come mainly from Western countries. Few data on . Apart from a difference in severity at baseline, these data suggested that the rates of progression were similar between the two cohorts. The most predicting factor of liver outcomes was the severity of liver diseases at enrollment with a 5-fold increase of risk for patients with cirrhosis compared to those without. In this study, SVR was only associated with a significant decrease of the occurrence of liver outcomes in patients with decompensated cirrhosis due to the fact that the follow-up was too short for the other subgroups.

The safety of interferon-free regimen has led to the treatment of patients with decompensated cirrhosis. Several studies demonstrated that patients with decompensated achieved SVR in more than 80% with an improvement of their MELD score [5] . This major clinical progress has led to a decline of HCV as an indication of liver transplantation (LT) [6] . For all these reasons, we must try to treat chronic HCV infection in a patient at early stage but also if decompensation of cirrhosis has already occurred to avoid further liver events and potential indication for LT.

Currently subjects. This decrease was correlated to the severity of cirrhosis. This study confirms that INR and aPTT are inadequate marker of bleeding risk and is in the line of the paradigm shift from a bleeding profile to a prothrombotic state in cirrhosis. In addition, there is some evidence that anticoagulant treatment in cirrhotic patients may prevent decompensation episodes [7] .

One of major challenges in liver transplantation is the organ shortage leading to the mortality of the waiting list.

To increase the availability of grafts, some teams use marginal grafts to reduce the mortality of When a liver graft is refused consecutively at least five times, this graft is supplied to a transplant center which can choose the recipient on the waiting list (center-allocation). The authors report an increase of 13% of graft loss/death risk in recipients of CA grafts compared to those with PA grafts. Using sophisticated statistical analysis to reduce bias, they observed that when a transplant team performed significant transplantations with CA grafts (at least 7% of their total activity) the results of CA grafts were not statistically different from those with PA grafts. This publication suggests that we can enlarge our selection criteria of liver grafts but this must be made in a learning process with accumulation of experience.

Another strategy is to improve the quality of the grafts and/or to limit the liver damage during preservation. Currently, flushing and static cold storage (SCS) within adequate solution is the gold-standard method but there is a lot of interest for hypothermic oxygenated machine perfusion (HOPE). The results of this 'new' technology become to be published with encouraging results [8] . The use of this device is limited to several reasons: cost, required medical staff, etc.

A simpler solution might be to add an oxygen carrier to SCS. In this issue, Alix et al. compared the addition of an oxygen carrier (M101) which is natural giant hemoglobin coming from an invertebrate, to SCS with SCS alone and the HOPE device in a pig model of LT (JHEP Reports).

They observed that SCS + M101 and HOPE were better than SCS alone in different preservation parameters (oxidative stress, inflammatory mediators). After 1 hour of preservation, HOPE seemed to be better than SCS + M101. When the LT was performed in pigs, the peak of transaminases was similar in SCS + M101 and HOPE and better than SCS alone. The hepatocyte necrosis and inflammatory process were lower in SCS + M101 and HOPE than in SCS alone. In the future, this strategy could represent an alternative to the use of HOPE.

Autoimmune hepatitis (AIH) is classically treated by the association of corticosteroids and azathioprine with remission rates around 60%. represents a promising tool in differential diagnosis [9] . In this issue, two independent studies do not confirm these results. The first article from de Vries, Tielbeke et al. observed that, in a prospective observational single center study of 213 consecutive patients with a suspicion of pancreatobiliary malignancy, the blood IgG4/IgG mRNA ratio was positive (defined as ≥5%) in all patient with IgG4-RD (n=3) and in 41% of patients with other benign or malignant disease (JHEP Reports). In this study, the specificity was only 58.6%. The second study from Schulte et al. tested the accuracy of the blood IgG4/IgG mRNA ratio for the diagnosis of IgG4-RD in a retrospective cohort of 98 patients with different diagnosis (IgG4-RD, pancreatobiliary malignancy, chronic pancreatitis, PSC) (JHEP Reports). They used a cut-off range from 3.5 to 6% for positivity. The false positive results were found in 48 to 72% in cholangiocarcinoma and in 43 to 48% in pancreatic carcinoma. These two studies suggest that the accuracy of this IgG4/IgG mRNA ratio is insufficient to implement it in the clinical practice. It remains essential to publish negative results or data not confirming previous results to ensure progression of investigations.

Enjoy the issue and submit your interesting investigations to JHEP Reports.

Why Has the Number of Scientific Retractions Increased?

Publish First, Retract Later. Is It Time for Introspection?

Expression of Concern: Hydroxychloroquine or Chloroquine With or Without a Macrolide for Treatment of COVID-19: A Multinational Registry Analysis

Association Between Sustained Virological Response and All-Cause Mortality Among Patients With Chronic Hepatitis C and Advanced Hepatic Fibrosis

Sofosbuvir and Velpatasvir for HCV in Patients With Decompensated Cirrhosis

Reduction in Liver Transplant Wait-Listing in the Era of Direct-Acting Antiviral Therapy. Hepatol Baltim Md

Enoxaparin prevents portal vein thrombosis and liver decompensation in patients with advanced cirrhosis

Transplanting Marginal Organs in the Era of Modern Machine Perfusion and Advanced Organ Monitoring

Immunoglobulin G4(+) B-cell Receptor Clones Distinguish Immunoglobulin G 4-related Disease From Primary Sclerosing Cholangitis and biliary/pancreatic Malignancies