Search

Objectives Transcatheter procedures are increasingly being recognized as a priority for cardiac surgeons and cardiac surgery trainees. The optimal method of teaching these procedures during residency training has not been established. We used an evidence-based approach to systematically review the literature and identify competencies to inform future paradigms of transcatheter training in cardiac surgery. Methods A scoping review was conducted to retrieve relevant literature on the performance of transcatheter cardiovascular procedures, identify competencies required by surgical residents learning to perform these procedures, and develop a preliminary list of competencies for consideration during transcatheter training. MEDLINE, Scopus, and ERIC were queried until April 1, 2020, using a systematic search strategy. No limitations were placed on publication date or type. Results A total of 1456 sources of evidence were retrieved. After deduplication and screening, there remained 33 that were included in the scoping review, published between 2006 and 2020. The distribution of publication types included 10 comparative studies (30.3% of total), 8 societal statements (24.2% of total), 5 surveys and 5 opinion articles (each 15.2% of total), 2 editorials and 2 descriptions of a simulator (each 6.1% of total), and 1 narrative review (3.0% of total). From these, a total of 400 items were identified and organized into 97 competencies. Conclusions Evidence on the competencies required to perform transcatheter cardiovascular procedures is available from a variety of sources. The identified competencies may be a useful resource for developing curricula and teaching transcatheter procedures to cardiac surgery residents.

OBJECTIVES End-stage kidney disease has dramatic health effects and life consequences in children. Presently, kidney transplant has been globally accepted as a treatment of choice for end-stage kidney disease in both children and adults, leading to better quality of life and longer patient survival. Because of lack of comprehensive information on the outcome of kidney transplant among children in Iran, we aimed to present a proper vision of pediatric kidney transplant in Iran by systematically reviewing the current literature. MATERIALS AND METHODS Major databases were searched, including Medline, Web of Knowledge, Google Scholar, Scopus, Cochrane, and the Iranian Scientific Information Database for all eligible studies in accordance with specific keywords. The inclusion criteria for the retrieved studies were determination of graft survival, patient survival, and reasons for graft failure. The exclusion criteria were as follows: (1) a lack of clear results; (2) non-English or non-Persian language format; (3) lack of access to the full-text manuscripts; and (4) case reports, case series, and review papers. A total of 115 studies were initially assessed based on the keywords; of these, 8 met inclusion criteria and were considered for final analysis; these were published between 2005 and 2017. RESULTS According to our results, 1-year graft survival rates were overall 89.7%, and 5-year graft survival rates were 65.4%. The 1-year patient survival rates were estimated to be 97.1%, and 5-year patient survival rates were estimated to be 89.8%. Acute rejection, dialysis status before transplant, and inappropriate immunosuppression were the main risk factors. CONCLUSIONS Our systematic review and meta-analysis indicated a high success rate of childhood kidney transplant in Iran according to long-term graft and patient survival rates.

The Covid-19 pandemic has greatly impacted physical therapy services. In the context of the physical distancing strategy, physical therapy services at health care centers are very limited. Telemedicine or telerehabilitation offers a solution that is expected to be realized by physical therapy services so that it can be accessed by patients with impaired function and movement from home and can reduce the risk of the getting Covid-19 virus infection during this pandemic. This study aims to systematically review the effectiveness of physical therapy services through telemedicine or telerehabilitation during Covid-19 pandemic. The method used is a systematic review done by searching for articles from Science Direct, Scopus, and Proquest with the keywords "Effective AND Physical Therapy AND Telemedicine OR Telerehabilitation AND Coronavirus". The inclusion criteria are articles published from April 2020 to April 2021, full-text articles, and in English. Research subjects are physical therapy patients who use telemedicine or telerehabilitation. The exclusion criteria were articles that had topics outside of physical therapy services through telemedicine or telerehabilitation during the Covid-19 pandemic. The literature search yielded 30 potential articles and 8 of them met the eligibility criteria. All selected studies show that physical therapy services through telemedicine or telerehabilitation have a good result on the recovery process of movement and body function of patients with cardiorespiratory, musculoskeletal, and neuromuscular disorders during the Covid-19 pandemic. This method of remote health care delivery allows patients to carry out an exercise program at home and reduces their risk of getting Covid-19 virus infection.

The purpose of this study is to understand the concepts and evolution of big data analytics applied to health services, considering activities that involve the diagnosis, treatment, and management of the patient. The literature review, consulting the databases Scopus and Web of Science and employing the keywords health analytics and big data analytics with no time restrictions, found papers that approach, specifically, the use of big data analytics in the context of healthcare, represented by examples and related analyses. Clarifying its concepts and the evolution of its performance foments the development of new research. Thus, time and decision-making appear as actions developed by both the information technology team and the clinical team, which, based on the interpretations of big data analytics involving patients, may consider variables such as cost, time, decision, and functional structure performance as the main determining factors aligned with corporate strategy. This work expects to foster research on aspects of public health, in addition to considering the concern with the survival of affected people

Introduction While evaluations of indoor smoke-free legislation have demonstrated major public health benefits among adults, their impact on the smoking behavior of young people remains unclear. Therefore, we performed a systematic review of the association between smoke-free legislation in hospitality venues and smoking behavior of young people. Aims and Methods A systematic search was conducted in PubMed, Scopus, and Embase in June 2020. We searched for studies that assessed the association of any form of smoke-free legislation in any hospitality venue (eg, bar and restaurant) with a smoking behavior outcome (eg, initiation and current smoking) among young people (aged 10–24 years). . Results Our search yielded 572 articles of which 31 were screened based on full-text and 9 were included in the analysis. All studies were published between 2005 and 2016. The majority of studies used a quasi-experimental design. Four studies evaluated smoke-free legislation in hospitality venues specifically. Two studies reported that comprehensive, but not weaker, smoke-free legislation decreases progression to established smoking. Two other studies provided mixed results on which level of comprehensiveness of legislation would be effective, and which smoking outcomes would be affected. Five studies evaluated legislation that also included other workplaces. Out of these five studies, three studies found significant decreases in current smoking, smoking frequency, and/or smoking quantity, whereas two other studies did not. Conclusions Most of the studies found that smoke-free legislation in hospitality venues is associated with a decrease in smoking behavior among young people. Their results indicate the need for comprehensive smoke-free legislation without exemptions. Implications This is the first systematic review to provide insight into the relationship between smoke-free legislation in hospitality venues and smoking behavior of young people. Our findings show that there is a need for comprehensive smoke-free legislation without exemptions (such as designated smoking areas).

The authors aimed to provide an overview of the evidence on the effects of exercise in people with Alzheimer’s disease through a comprehensive review of the existing systematic reviews and meta-analyses. A literature search was performed in CINAHL, Cochrane Library, EMBASE, PubMed, SPORTDiscus, Scopus, and Web of Science databases according to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines. The AMSTAR-2-Tool was used for the quality assessment. Twenty-three reviews fulfilled the criteria. Most of the reviews investigated the effects of aerobic exercise on Alzheimer’s disease symptoms. The largest effects of exercise were seen in terms of improved cognition by multiple exercises. The majority of the reviews were rated as being of moderate quality and none were classified as having high quality. Exercise is an effective way to treat Alzheimer’s disease symptoms and has a low incidence of related adverse events. As most reviews were evaluated as low-moderate quality, caution is needed in the interpretation of the results.

Effective patient-provider communication is crucial to promote shared decision-making. However, it is unclear how to explain treatment changes to ensure patient acceptance, such as when transitioning from a bio-originator to a biosimilar. This review investigates communication strategies used to educate patients on transitioning to biosimilars and explores whether the willingness to transition and treatment persistence differs for the delivery (verbal or written) and the amount of information provided. MEDLINE, Embase, Scopus, and relevant conference databases were systematically searched. Communication strategies from 33 studies (88% observational cohort studies) published from 2012 to 2020 were synthesized and willingness to transition, persistence, and subjective adverse events explored. Patients only received information verbally in 11 studies. The remaining 22 studies also provided written information. Cost-saving was the main reason provided for the transition. Patients were most willing to transition when receiving written and verbal information (χ(2) = 5.83, p = .02) or written information that only addressed a few (3-5) concerns (χ(2) = 16.08, p .05). Few randomized controlled trials have been conducted. Available data shows more willingness to transition when patients received written and verbal information. Initial documents should contain basic information and consultations or telephone calls used to address concerns.

Objective Otolaryngologists are at increased occupational risk of Coronavirus Disease 2019 (COVID-19) infection due to exposure from respiratory droplets and aerosols generated during otologic, nasal, and oropharyngeal examinations and procedures. There have been a variety of guidelines and precautions developed to help mitigate this risk. While many reviews have focused on the personal protective equipment (PPE) and preparation guidelines for surgery in the COVID-19 era, none have focused on the more creative and unusual solutions designed to limit viral transmission. This review aims to fill that need. Data sources PubMed, Ovid/Medline, and Scopus. Methods A comprehensive review of literature was performed on September 28, 2020 using PubMed, Ovid/Medline, and Scopus databases. All English-language studies were included if they proposed or assessed novel interventions developed for Otolaryngology practice during the COVID-19 pandemic. The Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines were followed. Results A total of 41 papers met inclusion criteria and were organized into 5 categories (‘General Recommendations for Otolaryngologic Surgery’, ‘Equipment Shortage Solutions’, ‘Airway Procedures’, ‘Nasal Endoscopy and Skull Base Procedures’, and ‘Otologic Procedures’). Articles were summarized, highlighting the innovations created and evaluated during the COVID-19 pandemic. Creative solutions such as application of topical viricidal agents, make-shift mask filters, three-dimensional (3-D) printable adapters for headlights, aerosol containing separation boxes, and a variety of new draping techniques have been developed to limit the risk of COVID-19 transmission. Conclusions Persistent risk of COVID-19 exposure remains high. Thus, there is an increased need for solutions that mitigate the risk of viral transmission during office procedures and surgeries, especially given that most COVID-19 positive patients present asymptomatically. This review examines and organizes creative solutions that have been proposed and utilized in the otolaryngology. These solutions have a potential to minimize the risk of viral transmission in the current clinical environment and to create safer outpatient and operating room conditions for patients and healthcare staff.

Rationale and Objective Radiology has traditionally remained one of the most male-dominated specialties, although a higher proportion of women are now beginning to occupy roles as academic radiologists than their male counterparts. The present study investigated trends in National Institutes of Health (NIH) funding within Diagnostic Radiology stratified by gender, and correlated with measures of academic output, including h-index. Materials and Methods Data on funding was obtained from the online NIH Research Portfolio Online Reporting Tools Expenditure and Results for fiscal years 2016–2019, and information regarding each Principal Investigator (PI) was obtained from the Scopus database and departmental websites. Mann-Whitney U tests were performed on collected data for statistical comparison of continuous variables. Results Of the 2929 grants included in this analysis, 1789 (61.07%) were awarded to male PIs and 1140 (38.9%) to female PIs. Among PIs holding a PhD degree, male PIs had a higher mean grant amount ($619,807.00) compared to female PIs ($158,486.00). Conclusion Although female representation within academic radiology has been increasing, the mean NIH grants awarded to women is less than that awarded to men. Reasons for this are numerous and may include differential prioritization of career objectives among men and women, although such rationalization is inevitably speculative in nature. Significant gender differences in NIH funding were seen at the PhD level, and the strongest correlation between NIH funding and academic output was observed for the h-index of female PIs. These results underscore the fact that women are ostensibly being held to a higher academic standard than men in terms of funding decisions.

Female physicians in academic medicine have faced barriers that potentially affect representation in different fields and delay promotion. Little is known about gender representation differences in United States academic radiology departments, particularly within the most pursued subspecialties.To determine whether gender differences exist in United States academic radiology departments across seven subspecialties with respect to academic ranks, departmental leadership positions, experience, and scholarly metrics.In this cross-sectional study from November 2018 to June 2020, a database of United States academic radiologists at 129 academic departments in seven subspecialties was created. Each radiologist's academic rank, departmental leadership position (executive-level - Chair, Director, Chief, and Department or Division Head vs vice-level - vice, assistant, or associate positions of executive level), self-identified gender, years in practice, and measures of scholarly productivity (number of publications, citations, and h-index) were compiled from institutional websites, Doximity, LinkedIn, Scopus, and official NPI profiles. The primary outcome, gender composition differences in these cohorts, was analyzed using ChiOverall, 5086 academic radiologists (34.7% women) with a median 14 years of practice (YOP) were identified and indexed. There were 919 full professors (26.1% women, p0.01) and 1055 executive-level leadership faculty (30.6% women, p0.01). Within all subspecialties except breast imaging, women were in the minority (35.4% abdominal, 79.1% breast, 12.1% interventional, 27.5% musculoskeletal, 22.8% neuroradiology, 45.1% pediatric, and 19.5% nuclear; p0.01). Relative to subspecialty gender composition, women full professors were underrepresented in abdominal, pediatric, and nuclear radiology (p0.05) and women in any executive-level leadership were underrepresented in abdominal and nuclear radiology (p0.05). However, after adjusting for h-index and YOP, gender did not influence rates of professorship or executive leadership. The strongest single predictors for professorship or executive leadership were h-index and YOP.Women academic radiologists in the United States are underrepresented among senior faculty members despite having similar levels of experience as men. Gender disparities regarding the expected number of women senior faculty members relative to individual subspecialty gender composition were more pronounced in abdominal and nuclear radiology, and less pronounced in breast and neuroradiology. Overall, h-index and YOP were the strongest predictors for full-professorship and executive leadership among faculty.● Though women comprise 34.7% of all academic radiologists, women are underrepresented among senior faculty members (26.1% of full professors and 30.6% of executive leadership) ● Women in junior faculty positions had higher median years of practice than their male counterparts (10 vs 8 for assistant professors, 21 vs 13 for vice leadership) ● Years of practice and h-index were the strongest predictors for full professorship and executive leadership.

The Center for Drug Evaluation and Research (CDER) performs an essential role in public health by ensuring, evaluating, and monitoring the safety and efficacy of drugs before they are sold in the US. Before approving new drug applications, CDER ensures that therapeutic benefits of both prescription and over-the-counter drugs (brand name and generic) provide more health benefits than the potential risks. First passed by Congress in 1992, the Prescription Drug User Fee Act (PDUFA) allowed the Food and Drug Administration (FDA) to collect fees from drug manufacturers to fund new drug approvals. The law allowed the FDA to expedite drug approvals, but possibly lowered standards for safety and brought potential conflicts of interest within the FDA and pharmaceutical industry. To examine the conflicts of interest, we conducted a review using the Excerpta Medica database, US National Library of Medicine National Institutes of Health Database (PubMed), Scopus, and Google. Our search yielded Vioxx (rofecoxib) and Exondus-51 (eteplirsen) as examples of consequence when the FDA and pharmaceutical industry are too closely aligned. We further examine how the pharmaceutical industry may indirectly influence the FDA by lobbying to Congress or directly by hiring ex-FDA commissioners.

OBJECTIVES: Although previous studies have examined the effects of exercise training on other International Classification of Functioning, Disability and Health (ICF) component levels in persons with multiple sclerosis (MS), the effects of exercise training on participation remain unclear. The objectives of this review were to: (1) characterize systematically the use of outcome measures that capture participation in exercise training studies; (2) quantify the effect of exercise training on participation in persons with MS.METHODS: A search of 6 electronic databases (CINAHL, Sport Discuss, EMBASE, MEDLINE, Cochrane Central, Scopus) was conducted to identify controlled and noncontrolled trials involving exercise training and participation in persons with MS. Search strings were built from Medical Subject Headings and CINAHL headings. ICF linking rules were used to identify participation chapters and categories captured. Meta-analysis was used to quantify the effect of exercise training on participation in randomized controlled trials comparing exercise effects to no intervention/usual care.RESULTS: We included 49 articles involving controlled and noncontrolled exercise trials in the systematic review of outcome measures. We captured 16 different outcome measures that captured all 9 participation chapters and identified 89 unique participation categories. Across these 16 outcome measures, mobility was the most commonly represented participation chapter, with 108 items. A subsample of 23 randomized controlled trials was included in the meta-analysis. An overall effect of 0.60 (standard error = 0.12, 95% confidence interval: 0.37-0.84, z = 4.9, p < 0.001) was calculated, indicating a moderate, positive effect of exercise training on participation.CONCLUSION: The current review provides information that can be used to guide the selection of outcome measures that capture participation in studies of exercise training in persons with MS. Exercise training has a positive effect on outcomes that capture participation, providing further evidence for the role of exercise training in promoting and maintaining engagement in everyday life.

Purpose The aims of the current study were 1) to compare the total number and dollar amount of industry funding and National Institutes of Health (NIH) funding to academic orthopedic sports medicine surgeons and 2) to examine the impact of academic influence on industry funding and NIH funding to academic orthopedic sports medicine surgeons. Methods Academic orthopedic sports medicine surgeons were identified using faculty webpages. Academic influence was approximated by a physician's h-index and number of publications and obtained from the Scopus database. Total industry payments were acquired through the Open Payments Database and NIH funding was determined from the NIH website. Statistical analysis was performed using Mann-Whitney U testing and Spearman correlations with significance set at p Results Physicians who received industry research payments and NIH funding had a significantly higher mean h-index and mean total publications than physicians that did not receive industry research payments and NIH funding. There were no significant differences in h-index (p= 0.374) or number of publications (p=0.126) between surgeons receiving industry non-research funding and those who did not. H-index and number of publications were both weakly correlated with the amount of industry research and non-research funding. Conclusion While academic influence is associated with industry research funding and NIH funding, there is no association between measures of academic influence and total industry and industry non-research payments. Combined with the weak associations between academic influence and the amount of industry payments, academic influence does not appear to be a major determinant of industry funding to academic orthopedic sports medicine surgeons. Clinical relevance While surgeons should be cognizant of potential conflicts with industry, the relationship between academic sports medicine surgeons and industry may be less subject to bias than previously believed.

Objetivo: Realizar uma overview relacionada ao assunto traumatismo em dentes decíduos e permanentes, bem como analisar a qualidade metodológica e o risco de viés dos trabalhos incluídos (PROSPERO CRD42018107840). Métodos: Este trabalho foi conduzido de acordo com o Preferred Reporting Items for Overviews (PRIO). A estratégia de busca foi aplicada nas bases de dados eletrônicas PubMed, WebScience, Embase, Cochrane e Scopus; que incluiu publicações até outubro de 2020, sem restrição de ano e idioma. Foram avaliados os critérios de elegibilidade: trabalhos com enfoque em lesões traumáticas dentárias; apresentar termo “revisão sistemática” (RS) e/ou “meta-análise” no título ou resumo, critérios de elegibilidade, técnicas sistematizadas para coleta e análise de dados, e instrumentos para avaliação da qualidade dos estudos incluídos; identificar as bases de dados utilizadas na pesquisa; abranger o assunto: traumatismo de dentes permanentes e/ou decíduos ou tecidos de suporte. Foi realizada a avaliação da qualidade das RSs utilizando o Assessment of Multiple Systematic Reviews (AMSTAR2) e averiguada a aderência do artigo ao Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA). Os resultados foram analisados pelo Grading of Recommendations, Assessment, Development and Evaluation (GRADE) a fim de classificar a certeza da evidência científica e avaliado o risco de viés pelo ROBIS. Resultados: Foram identificados 2.561 trabalhos, sendo 2.469 excluídos, totalizando 92 artigos incluídos. Nota-se que a partir do ano de 2018 os trabalhos apresentaram melhor qualidade metodológica. E a maioria dos trabalhos apresentaram certeza da evidência científica alta pelo sistema GRADE modificado, e risco de viés baixo pela ferramenta ROBIS. Conclusão: As revisões sistemáticas e meta-análises incluídas apresentaram dificuldade no processo de estruturação metodológica atribuindo, em média, certeza da evidência científica alta para o GRADE, como também risco de viés baixo pelo ROBIS.

Aim : to analyze and summarize the available data of studies aimed at deepening knowledge in the field of the influence of alcohol on the course of pregnancy, possible consequences; to study the prevalence of alcohol consumption by Russian women, as well as possible preventive measures. Materials and Methods . The results of Russian and foreign studies on the effect of alcohol on the fetus and pregnancy outcome, published in the international databases Scopus, Web of Science, PubMed/MEDLINE, Cochrane Library, have been analyzed. The search for scientific publications was limited to the period from 2012 to 2021. We used search queries in Russian ("alcohol", "pregnancy", "prevention", "fetus", "fetal alcohol syndrome") and English ("alcohol", "pregnancy", "prophylaxis", "fetus", "fetal alcohol syndrome"). Results . The presented data analysis indicates an extremely negative effect of alcohol on the body of pregnant women, as well as on the health of our future generation. This article proves the importance of the problem, the need for further research on the mechanisms of fetal alcohol syndrome (FAS) and the development of effective prevention measures, possible methods of treatment, and assistance for alcoholic fetal syndrome. Today in Russia there is an acute lack of information on the real extent of the problem with maternal alcohol consumption during pregnancy. There is still no exact data on the prevalence of FAS in Russia. Conclusion . From the analysis of domestic and foreign literature, it can be concluded that the problem of preventing fetal alcohol syndrome is an urgent and unexplored problem in Russia. There is a need for doctors to conduct pregravid preparation of a married couple when they plan to conceive a healthy child. It is necessary to raise awareness and improve the quality of training for obstetricians and gynecologists in order to identify women with high risk factors for alcohol abuse and childbirth with FAS in the early stages of pregnancy management. It is also necessary to identify new or use already known biomarkers of maternal blood to verify excessive alcohol consumption during pregnancy.

Background: Migrants are vulnerable to communicable diseases and face barriers in access to immunization programs. Individual studies suggest that they suffer immunization inequity, but the gap in vaccination compared to non-migrants has not been quantified. This systematic review quantitatively determined the level of vaccination coverage among migrants compared to non-migrants, collating the published literature. Methods: A search without language restrictions was conducted in PubMed, Scopus and Web of Science, from database inception to February 2021. Observational studies that provided the vaccination rates among migrant and non-migrant groups were included. Study quality was assessed using Newcastle-Ottawa scale. Data were synthesized pooling data from individual studies to generate summary odds ratio (OR) with 95% confidence interval (CI) using random effects model, assessing heterogeneity with I2 statistic and publication bias with funnel asymmetry analysis. Findings: There were 44 relevant studies (7,937,996 participants). Overall risk of bias was low in 13 (30%), moderate in 22 (50%) and high in 9 (20%) studies. Point estimates of individual ORs showed lower vaccination coverage among migrants in 36 of 39 meta-analyzable studies. Overall, the odds of vaccination coverage among migrants were lower compared to non-migrants (7,375,184 participants, summary OR 0.50, 95% CI 0.37-0.66, I2 99.9%). There was no funnel asymmetry. Interpretation: Migrants are half as often vaccinated compared to non-migrants. Public health prevention programs need to prioritize vaccination equity, not just to protect migrants but also to protect the host communities. Registration Details: Review protocol was prospectively registered (PROSPERO CRD42021228061). Funding Information: No source of funding. Declaration of Interests: KSK is Distinguished Investigator at University of Granada funded by the Beatriz Galindo (senior modality) program of the Spanish Ministry of Education. All other authors declare no competing interests.

Background Combining clinical and research excellence has become an increasingly difficult endeavor for thoracic surgeons, with typical success rates for the National Heart, Lung and Blood Institute and the National Cancer Institute being 25.1% and 11.3%, respectively. The Thoracic Surgery Foundation (TSF), which is an arm of The Society of Thoracic Surgeons, provides research awards and grants aimed at early career faculty to assist in securing federal peer-reviewed funding. The aim of this study was to assess the impact of these awards. Methods Faculty awardees of the TSF research awards from 1995 to 2019 were included in the study. The scholarly work of awardees was assessed by using Scopus , MEDLINE, and Google Scholar for publications, citations, and h-index. The National Institutes of Health (NIH) RePorter and the Federal RePorter were used to search for any grants awarded to these individuals. For publications and citations associated with a TSF grant, a 4-year window from the time of the research award was used. Results Fifty-two research awards were given to early career faculty during this study period, and 8 (15%) were awarded to MD PhDs. Six (12%) of awardees were female. Cardiac faculty members were awarded 27 (52%) awards, and general thoracic faculty members were awarded 25 (48%); of the cardiac faculty, 4 (17.4%) were congenital cardiac faculty. In the 4-year period after the TSF grant award, the mean number of published articles per awardee was 23 (interquartile range [IQR], 12 to 36), with a median citation count of 147 (IQR, 32 to 327). The current median h-index was 26 (IQR, 15 to 36), with 2323 (IQR, 1173 to 4568) median citations. Forty-eight percent of all awardees received at least 1 subsequent grant; 40.4% of these awardees received grants from the NIH, and 25% had 2 or more NIH grants. Comparing academic position at the time of the award with current position, 54% of awardees had an advancement in their professional rank. On analyzing leadership positions, 42% of awardees were division chiefs, 21% were associate clinical directors, and 28% were clinical directors. Conclusions Being a recipient of the TSF award may position an individual to excel in academic medicine, with a large portion of awardees improving their academic standing with time. The rate of successful NIH grant funding after being a TSF awardee is higher than typical institutional success rates.

OBJECTIVE Gender discrepancies exist in academia for leadership positions, advancement opportunities, and research. As of 2019, the ratio of total male-to-female attending plastic and reconstructive surgeons was 4.8:1. However, the ratio of male-to-female residents in integrated plastic surgery programs fell to 1.3:1, indicating rising female representation. With more balanced gender distributions of residents, the authors sought to determine whether this translates to greater equality of opportunities and achievements. Specifically, this study compares the academic productivity of male and female integrated plastic surgery residents. METHODS A list of integrated plastic surgery residency programs was obtained from the Accreditation Council for Graduate Medical Education website and ranked by reputation using the Doximity Residency Navigator. Integrated plastic surgery residents from 2019 to 2020 were identified via program websites and social media accounts. Works published during residency were identified through PubMed and Scopus from July 1 of each resident's intern year through August 10, 2020. Demographic variables for residents, including training class and medical school, as well as for programs, including geographic region, Doximity ranking, and medical school affiliation, were collected. Medical schools were ranked according to US News by research. Research productivity was assessed through the number of total research articles with authorship position (first, second, or last), the number of articles published in plastic surgery journals with the highest impact factors (Plastic and Reconstructive Surgery and Aesthetic Surgery Journal), and H-indices. Chi-Squared tests and Mann-Whitney U-tests were used to make comparisons between male and female residents (α = 0.05). RESULTS In total, 931 residents in 81 integrated plastic surgery programs were identified, including 534 (57.4%) male and 397 (42.6%) female residents. There were no differences between male and female residents in terms of training year or program geography. Female residents were more likely to come from a top-50 medical school than males (54.7% vs. 48.1%, p = 0.049). There were no significant differences in gender distribution of residents from top-20 programs or programs affiliated with a top-20 medical school. The median (IQR) number of publications in total, and for each gender, was 3 (1-6). There was no difference in the number of total publications by training year by gender, besides the second-year resident class where male residents had a median (IQR) of 2 (1-4) compared to 1 (0-3) (p = 0.028). Male and female residents did not differ with regards to authorship position or proportion of times publishing in top journals. The distribution of H-indices for male residents was slightly higher than female residents (p = 0.003), but the median (IQR) was the same at 3 (1-5). CONCLUSIONS Currently, male and female integrated plastic surgery residents have similar levels of academic productivity. This suggests that female representation is slowly increasing along the pipeline in academia, representing a paradigm shift from previous trends of gender inequality in plastic surgery.

Objective To provide a systematic review of self-administered decision aids (DAs) for citizens invited to participate in colorectal cancer screening synthesizing the effectiveness of self-administered DAs on informed choice or the components hereof; knowledge, attitudes, and participation. Methods The literature search was undertaken in PubMed, CINAHL, PsycINFO, Embase and Scopus and last updated 19 March 2021. Results were presented by narrative synthesis, meta-analyses and vote counting based on direction of effect. Results Fourteen studies of fair methodological quality were included. One study reported on informed choice and 13 studies reported on the components. Self-administered DAs increased participation and knowledge whereas it was inconclusive with regard to attitudes towards screening. The studies were very heterogeneous with different comparators, outcomes and means of measurement. Conclusion This systematic review showed a potential for self-administered DAs to support informed choice in colorectal cancer screening, especially by increasing knowledge. Practice Implications It seems reasonable to consider informed choice to be one of the main outcomes of self-administered DAs. Yet there is a need for consensus on how to measure informed choice in cancer screening, especially a validated measurement of knowledge defining what constitutes 'adequate knowledge'.

Summary Background & aims Nutrition following liberation of mechanical ventilation and throughout acute hospitalisation may be important in aiding recovery. While oral nutrition is the most common mode of nutrition provision in this time period, it is unclear what factors influence oral nutrition intake due to limited research in the area to date. This article outlines the methods for a scoping review to explore and collate reported barriers and facilitators to oral nutrition intake in patients following liberation of mechanical ventilation. Methods A scoping review will be conducted, and the following databases searched: MEDLINE, Embase, Emcare, and CINAHL. Grey literature, including but not limited to conference abstracts and theses will be searched for via ProQuest, Scopus, Web of Science and PsychInfo. Study selection, data extraction and data charting will be conducted by two reviewers. Data will be synthesised into figures and tables, with the COM-B framework providing a structure for grouping themes and findings. Included literature will comprise of primary research studies, reviews and grey literature from 2000 onward, that include critically ill adult patients who have been recruited in an ICU, received a therapy usually delivered in ICU, or had an average length of ICU stay greater than or equal to two days. Studies that report the presence of oral nutrition-related barriers or facilitators following liberation of mechanical ventilation will be considered for inclusion.

Objective To examine and identify the scope of research addressing health information requirements for gout patients using value chain analysis. Methods Five electronic databases (PubMed, CINAHL, ERIC, PsycINFO, Embase, and Scopus) and grey literature (WorldCat) were searched in accordance with a published protocol. Only English language articles were included, with no limitations for date of publication. The findings of the 33 studies included for final analysis were subsequently divided into 6 groups according to the stages of the care delivery value chain their research most closely pertained to: screening/preventing (n = 2), diagnosing (n = 1), preparing (n = 7), intervening (n = 11), recovering/rehabilitating (n = 5), and monitoring/managing (n = 13). Results The 33 studies focused on one or more of the following information phenotypes: 1) pathophysiology; 2) medical treatment; and 3) nonpharmaceutical interventions. Long term treatment adherence was a popular topic amongst studies that focused on gout patient education. Conclusion Based on the identified studies, gout patients are being told what to do, but are not being adequately educated regarding why recommended interventions are important or how to accomplish them. Practice implications This review provides a foundation to develop and evaluate personalized education materials using value chain analysis.

Objective With the exponential growth of coronavirus 2019 (COVID-19) related literature, we aimed to identify and characterize the 100 most cited COVID-related articles in the field of neurology and neurosurgery. Methods In March 2021, we performed a title-specific search of the Scopus database using the terms (“neurology” or “neurologic” or “neurosurgery” or “neurosurgical”) and “COVID” as our search query term without date restrictions. The top 100 most cited English-language articles were obtained and reviewed. Results Our search yielded 9,648 articles published from December 2019 to March 2021. Bibliometric analysis of the top 100 articles found that (1) the most cited article had a citation count of 1741 and was the first to report on the detailed neurologic manifestations of the disease; (2) Neurology had the most number of publications; (3) the majority of the primary authors were neurologists, but 35% came from non-neuroscience specialties; (4) the United States of America, Italy, United Kingdom, China, and Germany were the top contributors, with a combined total of 77%; (5) most of the publications were correspondence or editorial articles; and (6) most articles discussed the neurologic manifestations and complications of patients with COVID-19. Conclusions This study has identified the top 100 most cited neurologic or neurosurgical COVID-19-related articles published to date. This list can be used to identify high impact studies that will help healthcare practitioners in clinical decision making and researchers in navigating key areas of study and guiding future research.

Purpose To identify 100 articles with significant impact on the clinical care of patients with glaucoma. Design Cross-sectional study. Participants A total of 108 members of the American Glaucoma Society (AGS) in the original survey and 63 in the follow-up survey. Methods The 100 most frequently cited English-language original articles relevant to glaucoma were identified via a Scopus search. The American Academy of Ophthalmology (AAO) Preferred Practice Pattern Glaucoma Panel selected an additional 100 articles including newer and “classic” papers. An anonymous survey including the list of 200 articles was distributed to the AGS membership. Survey participants were asked to rate the impact of each article on the clinical care of glaucoma patients using a 4-point Likert scale. Survey respondents were able to provide “write-in” suggestions for the AGS 100. A subsequent anonymous follow-up survey was distributed asking participants to use the same Likert scale to rate 31 “write-in” articles suggested in the original survey. The AGS 100 was created by ranking the top 100 articles based on mean Likert scores from the original and follow-up surveys. Main Outcome Measures Original English-language articles that have influenced the clinical care of patients with glaucoma. Results The mean ± standard deviation Likert score of articles included in the AGS 100 was 2.9 ± 0.3 (range, 2.47–3.69). The median citation number was 345 (range, 11–2426). Publication year ranged from 1965 to 2020. Articles were published in 14 journals, the most common of which were Ophthalmology (42%), American Journal of Ophthalmology (21%), and Archives of Ophthalmology (20%). Forty-eight articles were derived from randomized clinical trials. Conclusions The AGS 100 is a collection of articles judged to have significant clinical impact on glaucoma care. The list will serve as an online educational resource for ophthalmologists in training and in practice.

Objective: Carotid endarterectomy (CEA) is the gold standard surgical procedure for managing carotid stenosis due to atherosclerosis and reducing the risk of ischemic stroke. This bibliometric analysis summarizes the most-cited articles on CEA and highlights the contributing articles to today’s evidence-based practice.Methods: A title-specific search using the Scopus database was used to perform the search. Pertinent article-based, journal-based, and author-based parameters were obtained for review.Results: A total of 6,824 articles were published between 1970 and 2020. The top 100 most-cited articles accumulated a total of 54,153 citations with an average citation count (CC) of 541, with only a 4.53% self-citation rate for all authors. The publication trends peaked between 1997 and 2010, in which two-third of the highly cited works were published. The most prolific categories with top citations are the clinical, indications, and management, in a descending order. There were 41 published Randomized Controlled Trials (RCT) in the most-cited list.Conclusions: Citation analysis on carotid endarterectomy has witnessed a marked shift in the publication trends from studying the outcome and complications to comparing carotid stenting with endarterectomy. This analysis is a good introductory article to physicians interested in this topic, as it summarizes the highly impactful articles and enlists the most-cited RCT on CEA.

OBJECTIVES: Growing inequalities, austerity public funding, and the COVID-19 pandemic have contributed to heightened interest in mobilising the assets and resources within communities to support health and well-being. We aimed to identify the type of actions or initiatives by food retail stores intended to support local communities and contribute to well-being. STUDY DESIGN: A Scoping Review. METHOD: A scoping review was conducted in Scopus, Web of Science, and of grey literature to identify the extent of study of food retail stores in supporting community well-being, types and outcomes recorded from community-oriented actions. Data extraction included: population targeted, the content of initiative/action, outcomes recorded and key insights. Studies were grouped into broad categories relating to their actions and objectives. RESULTS: Actions were associated with either strengthening communities or public health prevention or promotion. Few studies reported clearly on impact, and most accounts of impact on well-being and broader community outcomes were narrative accounts rather than objectively measured. Although rigorous capture of outcomes was absent, there were consistent themes around partnership and community insights that are relevant to the development and implementation of future actions in communities. CONCLUSIONS: This is an under-researched area that may nevertheless hold potential to support the broader public health effort in communities. To provide clear recommendations for specific investments, there is merit in identifying a subset of health and well-being outcomes most likely to be associated with food retailer community actions in order to assess and capture impact in future. We propose that the theoretical underpinning associated with asset-based approaches, which take account of context and community conditions, would be a useful framework for future study.

Supplemental digital content is available in the text., Objectives Intravenous medication delivery is a complex process that poses systemic risks of errors. The objective of our study was to identify systemic defenses that can prevent in-hospital intravenous (IV) medication errors. Methods A systematic review adhering to Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines was conducted. We searched MEDLINE (Ovid), Scopus, CINAHL, and EMB reviews for articles published between January 2005 and June 2016. Peer-reviewed journal articles published in English were included. Two reviewers independently selected articles according to a predetermined PICO tool. The quality of studies was assessed using the Grading of Recommendations Assessment, Development and Evaluation system, and the evidence was analyzed using qualitative content analysis. Results Forty-six studies from 11 countries were included in the analysis. We identified systemic defenses related to administration (n = 24 studies), prescribing (n = 8), preparation (n = 6), treatment monitoring (n = 2), and dispensing (n = 1). In addition, 5 studies explored defenses related to multiple stages of the drug delivery process. Systemic defenses including features of closed-loop medication management systems appeared in 61% of the studies, with smart pumps being the defense most widely studied (24%). The evidence quality of the included articles was limited, as 83% were graded as low quality, 13% were of moderate quality, and only 4% were of high quality. Conclusions In-hospital IV medication processes are developing toward closed-loop medication management systems. Our study provides health care organizations with preliminary knowledge about systemic defenses that can prevent IV medication errors, but more rigorous evidence is needed. There is a need for further studies to explore combinations of different systemic defenses and their effectiveness in error prevention throughout the drug delivery process.

Background: Elderly people with dementia may exhibit behavioral and psychological symptoms throughout the course of disease. Non-pharmacological therapies, such as regular physical activity, are considered strategies for managing these symptoms. Objective: The aim of this study was to investigate whether participation in physical exercise programs is effective in reducing behavioral and neuropsychiatric symptoms in elderly people with Mild Cognitive Impairment (MCI) and dementia. Methods: A literature review was carried out in MEDLINE (PubMed), SciELO, Web of Science, Scopus and SPORTDiscus databases from 2010 to 2020. The eligible studies were randomized clinical trials involving elderly people with mild cognitive impairment or dementia and assessing changes in neuropsychiatric and psychological symptoms as primary or secondary outcomes. The studies had a group with only physical exercise as an intervention compared to a control group. Results: Of 175 publications identified in the initial survey, only 7 studies met the eligibility criteria. Four out of 7 studies demonstrated positive effects in reducing behavioral symptoms, while the others did not report differences between gains according to the type of protocol. Conclusions: Moderate to intense aerobic and muscle strengthening exercises may have a potential benefit in the management of behavioral and psychological symptoms in dementia, but studies varied in their conclusions. This review indicates the need for further intervention studies to investigate, as a primary outcome, the absolute effect of physical exercise and its impact on behavioral and psychological symptoms in elderly people with MCI dementia, especially in the early stages of the disease. RESUMO Antecedentes: Idosos com demência podem manifestar sintomas comportamentais e psicológicos durante o percurso da doença. Terapias não farmacológicas, como por exemplo a atividade física regular, são consideradas como uma das estratégias para manejar esses sintomas. Objetivo: O objetivo deste estudo é investigar se a participação em programas de exercício físico é efetiva na redução de sintomas comportamentais e neuropsiquiátricos de idosos com comprometimento cognitivo leve (CCL) e demência. Métodos: Foi realizada uma revisão da literatura nas bases de dados Medical Literature Analysis and Retrieval System Online — MEDLINE (PubMed), Scientific Electronic Library Online (SciELO), Web of Science, Scopus e SPORTDiscus de 2010 a 2020. Os estudos elegíveis foram: ensaios clínicos randomizados envolvendo idosos com CCL ou demência, que medissem como desfecho primário ou secundário a mudança nos sintomas neuropsiquiátricos e psicológicos. Os estudos tiveram grupo com apenas o exercício físico como intervenção em comparação a um grupo controle. Resultados: De 175 publicações identificadas na pesquisa inicial, apenas sete estudos atenderam aos critérios de elegibilidade. Quatro em sete estudos demonstraram efeitos positivos na redução dos sintomas comportamentais, enquanto os demais não fizeram diferenciação entre os ganhos conforme o tipo de protocolo. Conclusões: Exercícios aeróbicos e de fortalecimento muscular de intensidade moderada a vigorosa podem ter um benefício potencial no manejo dos sintomas psicológicos e comportamentais da demência. Esta revisão mostrou a necessidade de mais estudos de intervenção, buscando investigar como desfecho primário o efeito absoluto do exercício físico e seu impacto nos sintomas comportamentais e psicológicos de idosos com CCL e demência, principalmente nas fases iniciais da doença.

Digital recording is a method that has the potential to help chronic disease (CKD) patients undergoing hemodialysis manage problems related to fluid intake. This literature review examines the mobile application intervention for hemodialysis patients, application characteristics, application, effectiveness in changing user behavior, and user satisfaction. The method used is a literature review using articles sourced from electronically based data such as EBSCO, Google Scholar, Pubmed and Scopus with the keywords diet management, fluid status, hemodialysis in the period 2010-2021. The results are five studies describing the evaluation of changes in dietary behavior related to with self-management has a positive change impact. Conclusion: According to the current study, digital recording using an application can hold promise in hemodialysis patients' self-management of fluid intake dietary behavior.

Objective Infections are among the most common complications in recipients of durable left ventricular assist devices (LVAD). However, existing studies examining infections in LVAD recipients are limited is size and design. Comprehensive, systematic reviews of all types of infections occurring among recipients of contemporary LVADs have not been conducted. The goal of this scoping review was to synthesize all available evidence related to rates of infections (including location and types) in LVAD recipients. Methods In February 2019, 4,581 published studies were identified through searching five bibliographic databases: PubMed, Scopus, EMBASE, CINAHL and Web of Science Core Collection. Inclusion criteria required reporting of infectious complications among LVAD recipients receiving contemporary (HeartMate II, HeartMate 3 and HeartWare HVAD) LVADs. Study key characteristics were extracted by 2 independent reviewers and current literature described narratively. All analyses took place between Feb 2019 and Jan 2021. Results A total of 132 studies met inclusion criteria. Most studies were observational (n=118; 89.4%), single-center (n=93, 70.4%) and from the U.S. (n=88; 66.7%). Only 48 (36.3%) studies used the standardized International Society for Heart and Lung Transplantation (ISHLT) definition for reporting infections. Only 35 (26.5%) studies reported age, gender and racial distribution of their study population. Driveline infections were the most commonly reported infection type. Conclusions Most studies did not utilize standardized infection definitions or provide complete information on infection locations and types. In order to further advance the scientific rigor, published studies should (i) use standardized definitions for reporting infections and (ii) stratify rates by infection location and type.

Background and objectives High-deductible health plans (HDHPs) as a type of consumer-directed health insurance plan aim to control unnecessary service utilization and share the responsibility in payments and care with the patient. Our objective was to systematically pool the medical and non-medical impacts of HDHPs on patients with diabetes. Methods We searched databases, including PubMed, Scopus, Embase, and Wiley, to identify relevant published studies. We outlined the eligibility criteria based on the study population, intervention, comparison, outcome, and types of studies (PICOT). We included peer-reviewed quantitative studies published in English, including quasi-experimental, observational, and cross-sectional studies in this review. We used the narrative data synthesis method to categorize and interpret the results. Results Initial search yielded 149 results. After removing duplicates and screening for relevant titles and abstracts, and reviewing full texts, 11 studies met eligibility criteria. Overall, diabetic patients with HDHP were less likely to adhere to treatment and prescription refills, utilize fewer healthcare services and medications, and more likely to have acute emergency visits than their counterparts enrolled in low-deductible plans. However, the results on overall healthcare costs and the final health outcome were unclear. Conclusions It appears that HDHPs negatively impact low-income diabetic patients by leading them to forgo preventive and primary care services and experience excessive preventable emergency department visits. The socioeconomic characteristics of patients must be considered when developing HDHP policies, and adjustments should be made to HDHPs accordingly.

Background Physical fitness status is a key aspect of health and, consequently, it is important to create and adopt appropriate interventions to maintain or improve it, and assess it using valid measures. While in other testing contexts, standard operating procedures (SOPs) are commonly and widely adopted, in physical fitness testing, a variety of unstandardized testing protocols are proposed. Aims The topic of this review was to evaluate the existing literature on SOPs in physical fitness assessment and to provide guidelines on how SOPs could be created and adopted. Method The electronic databases PubMed, Web of Science and Scopus were screened and original, peer-reviewed studies that included SOPs, related to physical fitness, were recorded. Results After the inclusion and exclusion criteria screening, a total of six studies were included and these were critically and narratively analyzed. Conclusions Standard operating procedures are rarely adopted in the field of physical fitness and a step by step guide has been provided in this manuscript. In the future, it is suggested to follow protocols as a routine, because this is the only way to generalize and contextualize findings.

The COVID-19 pandemic has highlighted issues due to mental health disorders, in particular the serious consequences derived from lockdown measures. This paper aims to analyse the literature on the potential direct impact of the natural environment on mental health disorders. We have systematically reviewed the studies analysing green spaces and mental health included in this review using PubMed, Web of Science, Scopus and Cochrane Library. A retrospective time-frame is considered, covering the COVID-19 pandemic. We have found that exposure to, use and proximity to green spaces have a beneficial impact on mental health among elderly, students and patients with underlying pathologies. However, it has negative effects on the mental health of women and young adults. Exposure to and interaction with the natural environment can improve certain mental health disorders and should be taken into account for strategies and policies related to future threats to public health.

(1) Background: to reveal the prevalence of non-motor disorders in Parkinson’s disease (PD), we analyzed both Russian and international studies on the issue of PD-associated non-motor disorders in Caucasian patients; (2) Methods: We have carried out a search for full-text Englishand Russian-language articles published during the last ten years (from 2010 to 2020) in PubMed, Scopus, Web of Science, Springer, Clinical case, and E-library databases using multiple versions of keywords and their combinations. (3) Results: General prevalence of PD-associated non-motor disorders proved to be high. At the same time, we did not find significant differences between the prevalence of cognitive, affective, or behavioral disorders in PD patients. However, depression was found to be more common in PD patients in the Russian Federation; (4) Conclusions: According to the results of our review, cognitive and affective disorders in PD represent the issues of major concern.

Objectives: To assess the causes and risk factors of post-traumatic stress disorder (PTSD) in adult asylum seekers and refugees. To explore whether the causes and risk factors of PTSD between male and female adult refugees/asylum seekers are different. Study design: Systematic review of current literature. Data Sources: PubMed, Web of Science, Scopus and Google Scholar up until February 2019. Method: A structured, systematic search was conducted of the relevant databases. Papers were excluded if they failed to meet the inclusion and exclusion criteria. Afterwards, a qualitative assessment was performed on the selected papers. Results: 12 Studies were included for the final analysis. All papers were either case studies/reports or cross-sectional studies. Traumatic events experienced by refugees/asylum seekers are the most frequently reported pre-migration causes of PTSD development, while acculturative stress is the most common post-migration stressor. There were mixed reports regarding the causes of PTSD between both genders of refugees/asylum seekers. Conclusions: This review’s findings have potential clinical application in terms of helping clinicians to risk stratify refugees/asylum seekers for PTSD development and thus aid in embarking on earlier intervention measures. However, more rigorous research similar to this study is needed for it to be implemented into clinical practice.

Objective In this systematic scoping review, it was aimed to assess the epidemiology of methanol poisoning, clinical findings and patients' management, causes, and recommendations regarding prevention or reduction of methanol poisoning during COVID-19 pandemic. Methods Three Electronic databases [Medline (accessed from PubMed), Scopus, and Science Direct] were searched systematically from December 01, 2019 to September 10, 2020, using MESH terms and the related keywords in English language. Considering the titles and abstracts, unrelated studies were excluded. The full texts of the remained studies were evaluated by authors, independently. Then, the studies' findings were assessed and reported. Results Total of 86 articles were obtained within the first step of searching, and 64 ones remained after removing the duplications. Through the title and abstract screening, 35 were removed. Finally, after reading the full text of the remained articles, 15 ones included in data extraction. Most of the previous reported evidence (13/15) were letter to editor, commentary and short reports. None of them were interventional, and none of them followed the patients. Findings were summarized in four categories: 1) epidemiology; 2) clinical findings and patients' management; 3) causes; and 4) recommendation regarding prevention or reduction of methanol poisoning during COVID-19 pandemic. Conclusion The recent outbreak is the largest methanol mass poisoning outbreak throughout Iran and the world in recent decades. The causes of methanol poisoning during the COVID-19 pandemic are intertwined, and most of them are modifiable by health policy makers. Building trust, educating and warning, as well as controlling and monitoring are three main recommendation for prevention or reduction of methanol poisoning.

Introduction We aimed to search the literature for global surgical curricula, assess if published resources align with existing competency frameworks in global health and surgical education, and determine if there is consensus around a fundamental set of competencies for the developing field of academic global surgery. Methods We reviewed SciVerse SCOPUS, PubMed, African Medicus Index, African Journals Online (AJOL), SciELO, Latin American and Caribbean Health Sciences Literature (LILACS) and Bioline for manuscripts on global surgery curricula and evaluated the results using existing competency frameworks in global health and surgical education from Consortium of the Universities for Global Health (CUGH) and Accreditation Council for Graduate Medical Education (ACGME) professional competencies. Results Our search generated 250 publications, of which 18 were eligible: (1) a total of 10 reported existing competency-based curricula that were concurrent with international experiences, (2) two reported existing pre-departure competency-based curricula, (3) six proposed theoretical competency-based curricula for future global surgery education. All, but one, were based in high-income countries (HICs) and focused on the needs of HIC trainees. None met all 17 competencies, none cited the CUGH competency on “Health Equity and Social Justice” and only two mentioned “Social and Environmental Determinants of Health.” Only 22% (n = 4) were available as open-access. Conclusion Currently, there is no universally accepted set of competencies on the fundamentals of academic global surgery. Existing literature are predominantly by and for HIC institutions and trainees. Current frameworks are inadequate for this emerging academic field. The field needs competencies with explicit input from LMIC experts to ensure creation of educational resources that are accessible and relevant to trainees from around the world.

BACKGROUND One of the most popular bariatric procedures is sleeve gastrectomy, and it has become significantly more common in recent years. AIM To evaluate the research activity in sleeve gastrectomy over the last two decades, and to visualize the hot spots and emerging trends in this type of bariatric surgery using bibliometric methods. METHODS The Scopus database was used to search for publications related to sleeve gastrectomy. The retrieved publications were reviewed in terms of year of publication, type of study, country of origin, institutions, journals, and citation patterns by using descriptive analysis. Collaboration network and term co-occurrence analysis were visualized by using VOSviewer software. RESULTS The search strategy yielded a total of 6508 publications on sleeve gastrectomy from 2001 to 2020. As regards the document type, the majority were articles (n = 5230; 80.36%), followed by reviews (n = 544; 8.36%). The top three countries are the United States, with 1983 publications (30.47%), followed by France (600; 9.22%) and Italy (417; 6.71%). The most cited publication was published in 2012 by Schauer et al in the New England Journal of Medicine (n = 1435 citations). This publication found that weight loss was greater in the sleeve gastrectomy group than in the medical therapy group. Furthermore, this study demonstrated that 12 mo of medical therapy plus bariatric surgery greatly improved glycemic regulation in obese patients with uncontrolled type 2 diabetes compared with medical therapy alone. The focus of the current literature on sleeve gastrectomy was directed toward several themes such as morbidity and potential complications, the complexity of the procedure and different surgical approaches, and diabetes and body mass index in correlation to sleeve gastrectomy. CONCLUSION The number of sleeve gastrectomy publications has gradually grown over the last 20 years. This bibliometric analysis could help researchers better understand the knowledge base and research frontiers surrounding sleeve gastrectomy. In addition, future studies may focus on emerging research hotspots.

Background and aim The growing globalization has changed the goals and methods of diplomacy. Due to the challenges and complexities of dealing with noncommunicable diseases (NCDs) at the national and international levels, policy makers require global health diplomacy (GHD) to achieve the goals of prevention and control of NCDs. The purpose of this systematic review was to identify the challenges and opportunities in GHD for NCDs. Methods A systematic review of articles was conducted by searching MEDLINE via PubMed, Web of Science, Scopus, and Embase and by using Google and Google Scholar search engines. Additional articles were identified by reviewing reference lists and a number of special journals. The inclusion criteria include literature published in English from 2007 to 2020, and the exclusion criteria are literature published in any language other than English, absence of full text, dissertations, and duplicates. Overall, 32 articles met the requirements for inclusion in this review and were analyzed using content analysis in MAXQDA 10. Findings There are 32 published articles on GHD for NCDs. Identified challenges were classified into three levels: global (global health governance), national (Governance at the state level, health sector, and civil society), and industry. The progress on global health issues has created opportunities for the development of GHD for the prevention and control of NCDs. These opportunities were divided into three levels: international, national, and individual level. Conclusion Various challenges at the global level, national level, and industry led to less engagement of policymakers in GHD for prevention and control of NCDs and, as a consequence, a less coordinated approach to address prevention and control of NCDs worldwide. So, there is a need for more efforts of collective action and negotiation for tackling NCDs. Policymakers and managers of the health system should increase the advocacy, building a coalition with civil society, use negotiation and diplomacy to engage with other sectors and organizations, manage industry conflicts, and leverage foreign policy to promote health and welfare.

Background While midwives are positioned as critical providers for improving sexual, reproductive, maternal and newborn health outcomes in the Middle East and North African (MENA) countries, the standards of midwifery have not been explored systematically in this region. Aim The purpose of this scoping review was to provide an overview of existing literature on midwifery practice, education, and regulation in MENA countries in the context of ICM standards. Methods A search was conducted inclusive of English and Persian written studies published between 2000 and 2019 in CINAHL plus; Ovid MEDLINE; PubMed; Scopus; and grey literature. Title and abstract and full-text review were performed in Covidence, and data extraction and synthesis performed using NVivo 12. Results The initial search identified 7,994 articles. Overall, 139 studies were included in the review. Although, the primary concept of most included studies was “midwifery practice”, “midwifery regulation” was addressed in limited way. Approximately 90% were from Middle Eastern countries. Forty-two per cent of studies used cross-sectional designs, and most originated from Iran, Jordan, and Palestine. Diversity was found in midwifery education, practice and regulation across the MENA countries. Midwives from different nations had uneven levels of proficiency, scope of practice, and education. Midwifery curricula were aligned with ICM competencies in some countries. Most countries had midwifery associations and were members of ICM. Some countries had regulations recognising midwifery as an autonomous profession. Conclusion Midwifery practice, education and regulation in MENA countries were not always comparable with ICM standards, although some progress was evident.

Objective To explore the practice of antenatal milk expression (AME) and related outcomes for mother–infant dyads during the first 2 weeks after birth. Data Sources We searched the electronic databases MEDLINE, Embase, CINAHL, Emcare, Maternity & Infant Care Database, Scopus, and Web of Science for relevant literature. We also conducted backward reference searches on relevant publications and nondatabase searches after review of the full texts. Study Selection Articles were eligible for inclusion if they reported primary studies focused on AME, included samples of mother–infant dyads, and were published in English. We did not impose time or design limitations given the sparse availability of literature on AME. We identified 766 articles. After the removal of duplicates, we screened 588 articles, and of these, we included 15 articles in our review. Data Extraction We used the Preferred Reporting Items for Systematic Review and Meta-analyses (PRISMA) guidelines to guide data extraction and reporting. We evaluated the quality of evidence using the Melnyk and Fineout-Overholt rating system and the Joanna Briggs Institute critical appraisal tools. Data Synthesis We synthesized data from the included articles into four themes: Breastfeeding Self-Efficacy, Milk Supply, Infant Well-Being, and Infant Feeding Methods. Conclusion AME may support breastfeeding by improving breastfeeding self-efficacy and milk supply and by decreasing early formula use. Synthesized literature on AME shows the safety of the practice and that infants of women who practice AME have a greater likelihood of breastfeeding exclusivity during the short term.

Aim Vaccines are vital to ending the COVID‐19 pandemic and we reviewed the data on vaccinating children, and including them in clinical trials, as most of the activity has focused on adults. Methods English and Chinese databases, including PubMed, Elsevier Scopus, Web of Science, CNKI and CQVIP were searched, along with websites such as the World Health Organization and the University of Oxford. Results We identified 44 papers and 16 news items about vaccinating children against the virus, published from 10 February 2020 to 14 July 2021. Child vaccination has been slow and only a few countries have included children in Phase II or III clinical trials. The data on children were much more limited than on adults, but most children were asymptomatic or had mild symptoms and some deaths had been recorded. More clinical trials are needed to assess the safety and efficacy of vaccinating children, as higher vaccination levels can help to build up herd immunity. The percentage of parents willing to vaccinate their children against the virus ranged from 48.2% to 72.6%, with much lower rates for letting them participate in clinical trials. Conclusion Vaccines should be offered to children as soon as their safety and efficacy are established.

BACKGROUND Despite the existence of numerous published models predicting the risk of caesarean delivery in women undergoing induction of labour (IOL), validated models are scarce. OBJECTIVES To systematically review and externally assess the predictive capacity of caesarean delivery risk models in women undergoing IOL. SEARCH STRATEGY Studies published up to 15 January 2021 were identified through PubMed, CINAHL, Scopus and ClinicalTrials.gov, without temporal or language restrictions. SELECTION CRITERIA Studies describing the derivation of new models for predicting the risk of caesarean delivery in labour induction. DATA COLLECTION AND ANALYSIS Three authors independently screened the articles and assessed the risk of bias (ROB) according to the prediction model risk of bias assessment tool (PROBAST). External validation was performed in a prospective cohort of 468 pregnancies undergoing IOL from February 2019 to August 2020. The predictive capacity of the models was assessed by creating areas under the receiver operating characteristic curve (AUCs), calibration plots and decision curve analysis (DCA). MAIN RESULTS Fifteen studies met the eligibility criteria; 12 predictive models were validated. The quality of most of the included studies was not adequate. The AUC of the models varied from 0.520 to 0.773. The three models with the best discriminative capacity were those of Levine et al. (AUC 0.773, 95% CI 0.720-0.827), Hernandez et al. (AUC 0.762, 95% CI 0.715-0.809) and Rossi et al. (AUC 0.752, 95% CI 0.707-0.797). CONCLUSIONS Predictive capacity and methodological quality were limited; therefore, we cannot currently recommend the use of any of the models for decision making in clinical practice. TWEETABLE ABSTRACT Predictive models that predict the risk of cesarean section in labor inductions are currently not applicable.

Globally, prevalence of Helicobacter pylori is around 50%, and it has a directly proportional relationship with gastric cancer. Screening and treatment of Helicobacter pylori could reduce gastric cancer by 35%. Drawing on the scarce resources, it is reasonable to use the most cost-effectiveness Helicobacter pylori screening procedure. The purpose of this study was to evaluate Helicobacter pylori screening techniques and to specify the efficient technique from a cost-effectiveness perspective. This systematic review was conducted via searching electronic databases including Scopus, Embase, PubMed, Web of Science, and Cochrane Reviews. Our search retrieved 904 articles, of which, 606 full-text studies have been selected after duplicate removal. Next, the 25 articles were sorted based on eligibility criteria and quality appraisal; eventually, only eight studies have been included for analysis. We reported the incremental cost-effectiveness ratio (ICER) screening compared to non-screening and different screening strategies. Eight studies were identified and retained for the final analysis. In this study, when screening techniques were compared to no-screening, serology screening techniques showed to be cost-effective. The lowest ICER calculated was US$$1230 cost per life-year gained (LYG) and US$1500 cost per quality-adjusted life-year (QALY). However, determining the optimal strategy compared to other strategies was depended on parameters such as context-specific, type of cost, threshold, and perspective, and also, it influenced by the framework of the cost-effectiveness analysis.

The Canadian Network for Observational Drug Effect Studies (CNODES) studies the benefits and risks of post-market drugs and evaluates its research mobilization efforts for accountability, demonstrating value, and learning. As part of these evaluation efforts, and acknowledging gender disparity in authorship across many academic disciplines, CNODES examined the relationship between gender and authorship in its own journal articles and the literature citing them.CNODES articles (published 2012-2017) and all citing articles were identified and extracted using Scopus. Scopus author IDs were used to extract full names and a web service (www.genderapi.com) was used to estimate gender, converting all probabilities80% to "indeterminate." T-tests and visualizations were used to compare the proportion of females between CNODES and the citing literature.Twenty-eight CNODES articles and 463 citing articles were identified. The mean number of authors per article was 9.5 in CNODES articles and 5.7 in the citing literature. CNODES articles had a female authorship rate of 36%, compared to 29% in the citing literature (7% difference, 95% CI: [1%, 13%]). There were no female authors in 14% of CNODES articles versus 36% of the citing literature. Women were first authors in 25% and corresponding authors in 14% of CNODES articles.This analysis provides a benchmark and method to monitor progress in female parity in pharmacoepidemiology authorship. Further work is needed to determine and address barriers and facilitators to women's recruitment and advancement in the field of pharmacoepidemiology.

Purpose Blindness and vision loss are still frequent disabilities associated with a relevant impact on health care and quality of life, and a high economic burden. Supranational programs established by the World Health Organization (WHO), International Agency for the Prevention of Blindness (IAPB), and World Health Assembly (WHA) aim at reducing avoidable visual impairment. Age-related macular degeneration (AMD), diabetic retinopathy (DR), and other retinal diseases are well known causes of visual disability. Since more than a decade, intravitreal agents are available for the treatment of these diseases. The aim of this study is to review whether pharmacotherapy with anti-vascular endothelial growth factor (VEGF) drugs has led to a decrease in the prevalence of blindness with emphasis on AMD and different countries. A brief analysis of other factors correlated to changes in the rate of blindness is also presented. Methods PubMed and Scopus web platforms were used to identify relevant studies on epidemiology of blindness and vision impairment, the influence of intravitreal therapies, and the existence of different vision care models. Additional data and material was searched in web internet accessed by the web browser Firefox. Results Age-standardized prevalence of blindness secondary to AMD has started to decline as testified by a number of studies in different countries. This is due to the adoption of anti-VEGF therapy and its adequate management. The frequency of treatment and regimens applied are indirect signs of successful treatment. Local rules and regulations may represent an obstacle. Conclusions This review shows that by implementing existing health care systems and dispensing adequate therapies in the field of retinal diseases, the prevalence of blindness due to these conditions can decline.

INTRODUCTION. Depression, anxiety, and stress are common problems among nurses. OBJECTIVE. This meta-analysis was conducted to investigate the prevalence of depression, anxiety, and stress among nurses working in Iranian hospitals. MATERIALS AND METHODS. Published studies on nurses working in Iranian hospitals were investigated in this meta-analysis. All national and international online databases, including Web of Science, PubMed, Scopus, Embase, Cochrane Library, Scientific Information Database (SID), MagIran, and IranMedex, as well as Google Scholar, were searched using related keywords without any time limits until September 2017. The heterogeneity of studies was assessed using the I2 index. Data were analyzed in STATA version 11.1. RESULTS. In 28 studies with a sample size of 6581 people, the prevalence of depression was 31% (n=2040) among Iranian nurses (31% in females and 28% in males) according to Beck’s Depression Inventory (BDI); 30% (n=1974) (54% in females and 40% in males) according to the 21-Item Depression, Anxiety and Stress Scale (DASS-21); and 9% according to the General Health Questionnaire (GHQ-28). The prevalence of mild, moderate, and severe depression in nurses was 39%, 16%, and 20% according to the BDI; 8%, 24%, and 4% according to DASS-21; and 48%, 36%, and 16% according to GHQ-28, respectively. The prevalence of anxiety and stress was 85% and 67% in Beck’s inventory, 28% and 38% in DASS-21, and 46% and 49% in GHQ-28, respectively. CONCLUSION. According to the BDI and DASS-21, about one-third of Iranian nurses have depression with a female predilection. Nurses play an essential role in improving the quality of treatment; therefore, health policymakers must pay attention to reducing depression among nurses.

Introduction and Objectives:Massive hemorrhage (MH) is a growing pathology in military settings and increasingly in civilian settings; it is now considered a public health problem in the United States with large-scale programs. Tourniquets are the fastest and most effective intervention in MH if direct pressure is not effective.The Liaison Committee on Resuscitation (ILCOR) recognizes a knowledge gap in optimal education techniques for first aid providers. This review aims to describe training and evaluation methods for teaching tourniquet use to both health care and military professionals.Methods:The MEDLINE, CINAHL, WEB of Science, and Scopus databases were reviewed (from 2010 through April 2020). The quality of the selected studies was assessed using the Consolidated Standards of Reporting Trials (CONSORT) scale. Studies that met at least 65% of the included items were included. Data were extracted independently by two reviewers.Results:Ten of the 172 articles found were selected, of which three were randomized clinical trials. Heterogeneity was observed in the design of the studies and in the training and evaluative methods that limit the comparison between studies.Conclusions:The results suggest that the training strategies studied are effective in improving knowledge, attitudes, and practical skills. There is no universal method, learning is meaningful but research should be directed to find out which ones work best.

Dhat syndrome is a culture-bound syndrome, mostly prevailed in South East Asia that has been systematically defined approximately six decades ago. Assessment of the published literature would help to identify the research density as well as the gaps. We aim to do a bibliometric analysis of published global scientific literature on dhat syndrome. The Scopus database was systematically searched by using the keywords “Dhat syndrome”, “Semen loss syndrome”, “Semen loss anxiety” from inception to 11th August 2021. A total of 89 articles on dhat syndrome were found in the Scopus database. Most of the articles were from India and were published in the Indian Journal of Psychiatry and Asian Journal of Psychiatry. The majority (>58%) of research on dhat syndrome was published in the last decade. The PGIMER (Chandigarh), AIIMS (New Delhi) & KGMU (Lucknow) are the leading institutes in dhat syndrome research. The year 2004 had the highest number of total citations (n = 135), while the year 1975 had the highest number of citations per article (60 citations per article). This bibliometric review identified that despite dhat syndrome is a common condition in the South East Asian countries, research on the condition is limited.

Measuring, analyzing, and evaluating social, environmental, and economic impact is crucial to aligning the sustainable development strategies of international organizations, governments, and businesses. In this sense, society has been a determining factor exerting pressure for urgent solutions. The main objective of this paper is to provide an exhaustive analysis of the literature about the tools for measuring social impact and their evolution over the last 50 years. The search was conducted in the main academic databases (Scopus and Web of Science), where 924 articles were found from 1969 to 2020 related to the topic. The results of the quantitative analysis show that 71% of the publications were in the last ten years and the most productive countries were the USA and the United Kingdom. The relational analysis identifies 4 large clusters that fragment the literature into different subfields. The most used keywords are linked to the term "Social" in measurement methods, new concepts, and participants. This article contributes to the literature by giving the researcher an insight into the current state of art, trends, categories within the field, and future lines of research.

Access to dental services are particularly important among Indigenous populations at a global level. This scoping review aimed to investigate challenges in the provision and utilization of oral health services among Indigenous Australians. This scoping review was conducted up to June 10, 2020. Five main databases were searched, including PUBMED, SCOPUS, ISI Web of Science, EMBASE and PROQUEST. Thematic analysis was used to analyse the data applying MAX QDA10 software. For a better understanding of the themes and subthemes, a thematic network was presented. Results show that there are six main themes and 14 sub-themes affecting Indigenous Australians’ utilization and provision of oral health services. Personal characteristics, socio-economic status and challenges regarding access were the main factors influencing utilization of oral health services. The findings suggest that challenges relating to public health, policymaking and service provision can affect Indigenous Australians’ provision to oral health services. Benefits in Indigenous Australian access and utilization of oral health services may improve if policy makers at both national and local levels increase resourcing in this important public health sector. A deeper understanding of the social and cultural nuances driving Indigenous Australians’ reluctance to attend for dental care is crucial.