Original Article introductionOpen access (OA) to science is a model for publishing scholarly peer-reviewed journals made possible by the Internet. [1] The full text of OA journals and articles can be freely read, as the publishing is funded through means other than subscriptions. [1,2] They seem to have been through three distinct periods: The Pioneering years, the innovation years, and the consolidation years. [2] Indeed, OA journals do represent a recent revolution in scientific communication. It is now required by an increasing number of major funders and institutions. [2] They attract authors who wish to give their work prompt and unfettered access. [3] The proliferation of online OA journals has included major journal "brands" targeting articles that could not make it to the conventional publishing.Unfortunately, OA movement also included journals and publishers that lack a legitimate foundation and use online publishing solely for financial gain, and hence, the name "predatory" was coined. [4][5][6] With the advancing information technology and website designing software, predatory journals (PJ) may present a seemingly legitimate face for an illegitimate publication process that lacks basic industry standards, sound peer-review practices, or any commitment to scholarly publication ethics. [4][5][6] Recent editorials in this journal sent wake-up calls to editors and authors in the Middle East and Africa on false academia, Objectives: There is a recent proliferation of predatory journals (PJ) targeting unwary authors and unsuspecting institutions. We evaluated the awareness, attitude, and practices related to predatory publishing among physicians from the Middle East and Africa. Subjects and Methods: An online survey of a convenience sample of physicians was conducted. One hundred and forty responses were received. Of these 76 were complete and they formed the basis of this study. Results: Respondents hold a specialty board or equivalent (46.1%), doctorate (26.3%) or Master (13.2%). Half of the respondents published between 1 and 10 articles and less than a fifth had no prior authorship experience. Respondents are reportedly fully aware (30.3%) or fairly familiar but were not confident with details (43.4%), whereas 26.3% have no clear idea about models of publishing (open access [OA] vs. subscription-only). Nearly one third have never heard about predatory publishing and one in six of the respondents may have heard about it, but they were not sure. 69.7% reported no knowledge of Jeffery Beall and his list. The majority thought it might be somewhat difficult (51.4%) or difficult (24.3%) to distinguish between predatory and legitimate OA journals and 40%-60% affirmed knowledge of features of predatory publishing practices. 50%-60% recognized that PJ target authors in the developing nations. Respondents reported a variable frequency of unsolicited E-mails inviting them to submit articles to suspected PJ or act as reviewers or editors. Only a minority would take further action to protest against such invitations....

BACKGROUNDFasting during Ramadan is a challenge for Muslim patients with diabetes and for their healthcare providers. However, data on the effects of Ramadan fasting on hospital admissions and outcomes in patients with diabetes are scarce.OBJECTIVESEvaluate the characteristics of patients with diabetes admitted during the fasting month of Ramadan compared with the non-fasting month of Dhu al-Qidah.DESIGNA retrospective cohort study medical record review.SETTINGA university teaching hospital.PATIENTS AND METHODSWe reviewed the records of all patients with diabetes admitted to the medical department at Benghazi Medical Center, including medical ward, intensive care unit and coronary care unit, during the months of Ramadan and Dhu al-Qidah, 2016. We compared differences in reasons for admission, length of stay and in-hospital mortality between patients admitted during Ramadan and Dhu al-Qidah and between patients who were fasting at time of admission during Ramadan and those who were not.MAIN OUTCOME MEASURESMain reason for admission, length of stay and in-hospital mortality rate.SAMPLE SIZE402 patients with diabetes.RESULTSDuring Ramadan, 186 patients were admitted compared with 216 during Dhul al-Qidah. There was no statistically significant difference in reasons for admission, length of hospital stay, or in-hospital mortality (borderline for mortality, P=.078), between patients with diabetes admitted during Ramadan and Dhu al-Qidah. Of those admitted in Ramadan, 59.1% were fasting on admission. Fasting patients admitted during Ramadan had a significantly higher proportion of the diseases of the circulatory system when compared with non-fasting patients (39.4% vs. 23.6%, P=.028) while in-hospital mortality was higher in non-fasting patients (29.2% vs. 8.7%, P<.001). There was no significant difference in length of stay between fasting and non-fasting patients.CONCLUSIONSThe frequency of admissions for most medical conditions were not changed during Ramadan but the frequency of acute coronary syndrome was higher in those who were fasting on admission. Patients with diabetes who were not fasting on admission had more high-risk features that prevented them from fasting and therefore are at increased risk of in-hospital mortality.LIMITATIONSSingle center and retrospective.

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In patients with diabetes and acute coronary syndrome, hyperglycemia during hospitalization predicted a worse outcome in terms of the rates of in-hospital complications and in-hospital mortality. Hyperglycemia at the time of admission was also associated with higher rate of complications particularly at the time of presentation.

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