Sport and exercise medicine research activity in the Arab world: a 15-year bibliometric analysis

Factors Influencing Sports Medicine as a Career Choice Among Orthopaedic Trainees in Saudi Arabia

Background:

Sports medicine is one of the most popular orthopaedic specialties, with more fellowship applicants than in any other subspecialty of orthopaedics.

Purpose:

To investigate the factors influencing orthopaedic trainees to complete their fellowships and subsequently subspecialize in sports medicine in Saudi Arabia, as well as to compare the motivational factors of trainees planning to pursue sports medicine versus other orthopaedic specialties.

Study Design:

Cross-sectional study.

Methods:

An online anonymous questionnaire was distributed to 400 orthopaedic surgical trainees from 44 training centers (residency and fellowship training programs) across Saudi Arabia. The questionnaire identified trainees planning to select sports medicine as their career and the most influential factors affecting their choice; items exploring the influential factors were answered on a 5-point Likert-type scale. A comparison of responses was performed with candidates aiming to pursue other orthopaedic specialties. The chi-square or Fisher exact test was used to compare demographic parameters and the percentage of “agree” and “strongly agree” responses between trainees opting for sports medicine fellowships and those choosing other fellowships.

Results:

Of the 400 potential participants, 250 orthopaedic trainees (response rate, 63%) completed the survey (201 [80%] male and 49 [20%] female). Sports medicine was the most coveted specialty among trainees, with 70 (28%) participants opting for it as their career choice. The most prominent factors for the decision included disease prognosis and surgical outcomes (90%), personal interest (87%), experience during residency training (83%), type of surgical skills (81%), disease pathology and patient population (77%), expected workload and lifestyle (73%), role model or mentor (70%), and patient volume and variety of cases (67%). Significant differences compared with trainees who preferred other orthopaedic specialties included role model/mentor impact (70% vs 54%), expected rate of income (60% vs 47%), and private sector job opportunities (64% vs 45%) (P = .025, .034, and .020, respectively).

Conclusion:

Study findings indicated that a significant percentage of orthopaedic trainees in Saudi Arabia choose to specialize in sports medicine. Role model/mentorship, private sector job opportunities, and expected rate of income were the most influential when compared with the motivations of trainees not choosing sports medicine.

Exercise for Stroke Rehabilitation: A Bibliometric Analysis of Global Research From 2001 to 2021

Objective

To make a bibliometric analysis of global trends in research into exercise interventions for stroke between 2001 and 2021.

Method

This study did the systematic literature from 2001 to 2021 in Web of Science Core Collection. CiteSpace software was used to analyze the relationship of publications with countries, journals, authors, references, and keywords.

Results

A total of 3,484 publications were obtained in the bibliometric analysis. The number of publications increased gradually over the period. The United States have the most number of publications. The journal stroke had the most citations per paper (106.95) and the highest impact factor (IF 2020, 7.194). The most high frequency keywords are “stroke,” “rehabilitation,” and “recovery,” the top of burst key words are “health,” “speed,” and “aerobic exercise”.

Conclusion

These findings provide the trends of exercise for stroke s and provided the potential research frontiers in the past 20 years. It will be a useful basis for further research into focus issues, cooperators, development trends.

Library and information science research in the Arab World: a bibliometric analysis 1951–2021

Purpose

This study aims to investigate the research productivity of library and information science (LIS) authors affiliated with the 22 countries of the Arab League. It also identifies the top countries, organizations, authors, journals, natures of collaboration, and frequently used keywords in LIS research in the Arab world.

Design/methodology/approach

Bibliometric methods were used to evaluate the research performance of the authors affiliated with library organizations in the Arab region. The Elsevier Scopus database was selected for data retrieval. A comprehensive search strategy was adopted to retrieve 863 publications contributed by LIS authors affiliated with the Arab countries. VOS viewer, Biblioshiny, BiblioAnalyitics, Microsoft Access and Microsoft Excel were used for data visualization and analysis.

Findings

This paper presents the dynamics and the state of the LIS research in the Arab region published between 1951 and 2021. The results of the study have highlighted an upward trend in the growth of the publications, especially in the past four years. The largest number of studies were published in the year 2020. The country-wise analysis ranked Kuwait and Saudi Arabia as the top LIS research producing countries with five and four researchers, respectively. The Kuwait University, the King Fahd University of Petroleum and Minerals and the Imam Abdulrahman Bin Faisal University were the three most productive organizations. Academic libraries, social media, bibliometrics, information-seeking behavior, information literacy and knowledge management were identified as the major areas of interest for the researchers. Internet and open access were topics that had gained recent popularity, while the digital library, research data management, green librarianship, link data, cloud computing, library leadership, library automation and artificial intelligence were identified as areas requiring further attention. Furthermore, the single-author pattern was found to be the most preferred pattern.

Practical implications

The findings of this study would help prospective researchers in choosing the neglected areas of research that require further investigation. They would also help policymakers in identifying factors that need more attention and allocation of research funds.

Originality/value

To the best of the authors’ knowledge, this is the first comprehensive bibliometric study that presents a holistic picture of the LIS research in the Arab region.

Probing the Colorectal Cancer Incidence in Lebanon: an 11-Year Epidemiological Study

BACKGROUND AND OBJECTIVES

Lebanon has witnessed an increase in the rates of several cancer sub-types over the past couple of years. The aim of our study is to investigate the incidence rates of colorectal cancer over 11 years in Lebanon and compare them with other countries.

MATERIALS AND METHODS

Data was collected from the National Cancer Registry (NCR) of Lebanon from the years of 2005 till 2015 inclusive. Data of other countries was retrieved from the online database "Cancer Incidence in Five Continents". The age-specific and age-standardized incidence rates (ASR(w)) were calculated and analyzed using Joinpoint regression.

RESULTS

Colorectal cancer ranked as the 5th most common cancer in Lebanon. The average ASR(w) was 12.6 per 100,00 for males and 10.7 per 100,00 for females. Colorectal cancer ASR (w) showed a significantly increasing trend in both males and females. Lebanon had the second highest incidence of colorectal cancer in the MENA region.

CONCLUSION

Incidence of colorectal cancer has been increasing significantly over the course of our study. It is important to study the risk factors associated with colorectal cancer and develop proper preventive and screening policies in order to decrease exposure and therefore decrease incidence rates in the future.

Back injuries in Major League Baseball

BACKGROUND

There is a scarcity of epidemiological studies on back injuries in Major League Baseball (MLB). In our study, we explore all back related injuries in the MLB from 2010 to 2016 (inclusive) in an aim to help better understand these injuries, assess their risks, and improve their prevention policies.

METHODS

The transaction lists from the MLB website were screened for back injuries from 2010 THROUGH 2016. Only players who were placed on the disabled list (DL) for one or more days due to back-related injury were included in our study. Our database included the player's position, team, injury location, injury type, days spent on the DL and month of injury occurrence.

RESULTS

254 back injuries, an equivalent of 7% of all injuries, were recorded between 2010 and 2016 (inclusive). These injuries increased from 2010 to 2016. Back related injuries were found to place players on the disabled list for around 54 days. Injuries were recorded mostly during April, and strain was significantly greater than any other type of injury (P value <0.001).

CONCLUSIONS

Back injuries are prevalent in the MLB. Better understanding of the trends and patterns of these injuries will help in establishing better prevention policies.

Effect of Leishmaniasis on the Performance of Elementary School Students: A Case Study among Syrian Refugees in Some Bekaa (Lebanon) Area Schools

Since the Syrian conflict started, Lebanon became a common destination receiving a huge number of Syrian refugees that are living in camps spread all over the country, with the largest concentration in the Bekaa Valley. Generous steps are being taken to increase the access to formal education, such as offering free public education and opening second shifts in the public schools in the afternoon. Yet barriers, such as child labor and health-related factors like the spreading of some communicable diseases, like Leishmania, are keeping children out of classroom. The present study was done with the aim of investigating the effect of leishmaniasis on the performance and the academic achievement of Syrian refugee children. The results showed varying degrees of knowledge and dealing with the case of leishmaniasis. The disease clearly had an effect on the students’ attendance in schools, and by proxy on their academic performance.

Health communication in low-income countries: A 60-year bibliometric and thematic analysis

BACKGROUND

Health communication is a field that uses social and behavioral models to improve health outcomes and raise awareness on major health risks that threaten human well-being. Low-income countries (LICs) suffer from the effects of communicable and noncommunicable diseases that are exacerbated by weak health-care systems, lack of awareness campaigns, and ineffective communication tactics. This work aims to explore health communication research in LICs to find strategies that help improve health outcomes in the future.

MATERIALS AND METHODS

The PubMed database was explored systematically for publications related to health communication from LICs between January 1, 1960, and January 1, 2020. Publications were categorized according to country of origin and were analyzed with respect to population size, gross domestic product (GDP), and primary school enrollment of each state as obtained from the World Bank Open Data.

RESULTS

Collectively, LICs published 796 contributions, comprising 1.08% of the total biomedical research published by LICs and 0.27% of the world's health communication research. Malawi had the highest number of publications per GDP, with 32.811 publications per billion US$. Uganda had the most contributions per population, with 9.579 publications per million persons. Ethiopia had the highest amount of contributions per primary school enrollment with a ratio of 2.461 publications per %gross. The role of health communication in promoting HIV awareness and prevention was the most common theme explored. Other infectious diseases, such as malaria, tuberculosis, and Ebola, were also highlighted. Improving communication in health education was also explored.

CONCLUSION

Health communication is a rising field in LICs, with research focusing on disease prevention. Efforts to amplify research are key to effectively utilize the health communication models and improve health outcomes in LICs.

Psychological Climacteric Symptoms and Attitudes toward Menopause among Emirati Women

Menopause is an inevitable developmental event that women encounter at an age of 42–54 years. The drop of estrogen levels that accompanies cessation of menstruation is associated with multiple vasomotor, physical, neuropsychological, and sexual symptoms, which may hamper quality of life. This study aimed to examine the severity of psychological symptoms and their correlates among peri- and postmenopausal Emirati women (N = 60, mean age = 54.88 ± 6 years). Participants were interviewed using the Menopause-Specific Quality of Life (MENQOL) and attitudes toward menopause scale (ATMS). In four path analysis models, vasomotor symptoms, weight gain, and fatigue had significant direct effects on symptoms of anxiety, depression (only weight gain and fatigue), and psychological distress. Fatigue significantly mediated the effects of vasomotor symptoms and weight gain on symptoms of anxiety, depression (only vasomotor symptoms), psychological distress, and memory problems. These models explained 47.6%, 44.5%, 56.6%, and 29.1% of the variances in anxiety, depression, psychological distress, and memory problems, respectively. Participants with more severe menopausal symptoms expressed more negative attitudes toward menopause though regression analysis revealed that only vasomotor symptoms could significantly contribute to ATMS scores. In conclusion, psychological distress is widespread among menopausal women, and it is associated with vasomotor symptoms, fatigue, and change of body composition (obesity). Psychological symptoms, along with vasomotor symptoms, express a key link to negative attitudes toward menopause. Therefore, interventional strategies that target psychological distress may promote coping with midlife transition and improve mental health among menopausal women.

Health communication research in the Arab world: A bibliometric analysis

Objective

Health communication is a novel field in the Arab world. This study aimed to describe and characterise health communication research activity in the region.

Methods and analysis

The PubMed database was used to search for publications related to health communication from Arab states. Publications were classified according to country of origin, without limiting for date. Research activity and output were examined with respect to population and the gross domestic product (GDP) of each Arab state.

Results

A total of 66 contributions related to health communication came from the Arab countries, with the first paper published from Lebanon in 2004. Health communication-related publications constituted 0.03% of the total biomedical research contributions published by the Arab world since 2004 and 1% of the world’s health communication literature. Number of health communication contributions ranged between 0 and 12, with Lebanon producing the most output. Qatar ranked first with respect to contributions per population, whereas Lebanon ranked first with respect to contributions per GDP. Algeria, Comoros, Djibouti, Iraq, Kuwait, Libya, Mauritania, Somalia, Sudan and Yemen had nil health communication publications.

Conclusion

Recognising the barriers facing the health communication field and addressing them carefully are vital in the plan to better the Arab world’s output and contribution in the field.

Prevalence and patterns of shoulder injuries in Major League Baseball

Background: This study aims to explore the epidemiological patterns of shoulder injuries in professional baseball.Methods: The transaction lists of the 'Major League Baseball' website were screened for injuries from 2011 to 2016, inclusive. Only players that were placed on the 'Disabled List' were included in the study. Our database included the player's position, injury location, injury cause, and time spent on the Disabled List.Results: A total of 3090 injuries were recorded; 511 (17%) were shoulder injuries, making it the most vulnerable anatomic location in baseball (N = 511). Of the 511 shoulder injuries, 132 (25.8%) were due to inflammation, making it the most common cited cause of shoulder injury. Most shoulder injuries occurred in April with 125 (24%) injuries, while June and May came in second and third with 89 (17%) and 81 (16%) injuries, respectively. The pitcher was the player most prone to injury, as it constituted 78% of the injuries. The average time spent off by a shoulder injury was 69 days, which implicated substantial economic losses for the injured athlete's club.Conclusion: Shoulder injuries are prevalent in professional baseball. The overhead pitching motion puts the shoulder at risk and accounts for the high incidence of its injuries.

Gorham-Stout Disease of the Shoulder: Clinical, Pathologic and Therapeutic Considerations

BACKGROUND

Gorham-Stout disease (GSD) is a rare skeletal disorder characterized by massive osteolysis of a bony area in the body. When it hits the shoulder, the patient is faced with a debilitating limitation in terms of motion, stability and quality of life. GSD etiology and pathology are unknown and, as a result, therapeutic modalities remain unclear. The aim of this paper is to explore and offer medical insight into the possible etiologies, pathologies and therapeutic modalities of GSD in the shoulder.

METHODS

We explored PubMed/Medline for GSD cases in the shoulder. The search involved all articles published from database inception until February 1, 2019. Only articles published in English were included. Demographics and clinical information extrapolated from the reported cases were analyzed to deduce patterns and infer conclusions.

RESULTS

Only 32 studies met our criteria, with a total of 37 cases (n=37). Males predominated in 21 cases (57%). Twelve cases (32%) were younger than 18 years, and 18 cases (49%) were aged between 18 and 65 years. Shoulder pain was the predominant reporting symptom. The humerus was the most common shoulder site affected (54%), followed by the scapula (35%) and the clavicle (30%). Almost half of the cases affected the right shoulder (51%), the left shoulder was affected in 16 cases (43%). Conservative treatment was opted in 17 cases (46%), while surgery was performed in 13 cases (35%). Good outcomes were reported in 28 cases (76%), while death occurred twice (5%).

CONCLUSION

Understanding the demographics and clinical characteristics of GSD in the shoulder region will help in formulating better therapeutic interventions and preventive health policies.

Maternal mortality and health in the Arab World: A 25-year epidemiological study

AIM

In this work, we aim to assess the maternal health in terms of maternal mortality ratios and lifetime risk of maternal death in of women in the Arab World.

METHODS

Data on maternal mortality rates (MMR) and lifetime risk of maternal death (LTR) were extracted from the official databases of the United Nations Children's Fund. Annual Percentage Change was calculated using Joinpoint regression model. Statistical significance among countries was determined using one-way analysis of variance (anova) on spss version 25.0 (IBM SPSS, 2017).

RESULTS

The MMR and LTR significantly decreased in almost all Arab countries. Somalia was found to be the country with the highest burden of MMR, while Gulf countries had the lowest burden.

CONCLUSION

Our study shows a decrease in the MMR and LTR of maternal death in the Arab world. Although there is a decrease in these rates, but continuous research and efforts must be undergone to better develop the health care system in a great number of Arab countries to decrease the burden of maternal deaths.

Top-Cited Articles from Dental Education Journals, 2009 to 2018: A Bibliometric Analysis

The number of citations an article receives is an important indicator to quantify its influence in its field. The aim of this study was to identify and analyze the characteristics of the 50 top-cited articles addressing dental education published in two journals dedicated to dental education (European Journal of Dental Education and Journal of Dental Education). The Web of Science database was searched to retrieve the 50 most-cited articles from the two journals in December 2018. The top-cited articles were analyzed for journal of publication, number of citations, institution and country of origin, year of publication, study type, keywords, theme and subtheme, and international collaborations. The results showed the 50 top-cited articles were cited between 24 and 146 times each. The majority of these top-cited articles (n=34) were published in the Journal of Dental Education Half (n=25) of the articles were by authors in the U.S. The most common study types were surveys (n=26) and reviews (n=10). The main themes of these top-cited articles were curriculum and learner characteristics. This bibliometric analysis can serve as a reference for recognizing studies with the most impact in the scholarship of dental education.

Breast Cancer Epidemiology among Lebanese Women: An 11-Year Analysis

Background and Objectives: Breast cancer is the most prevalent cancer in women worldwide. Lebanon is a developing country in the Middle East with a prominent breast cancer incidence. The aim of our study was to explore the incidence rates of breast cancer in Lebanon from 2005 to 2015, and compare them to the rates of other countries. Materials and Methods: Breast cancer data for the years 2005-2015 was collected from the National Cancer Registry of Lebanon and stratified by gender and age group. Age-specific and age-standardized incidence rates were calculated and analyzed using joinpoint regression. Age-standardized incidence rates in the world population (ASR(w)) were obtained for other countries, from two online databases. Results: Breast cancer was found to be the most prevalent cancer in Lebanon, accounting for 20% of all cancer cases. The average ASR(w) was 96.5 per 100,000. Over the studied period, breast cancer ASR(w) in Lebanon showed a significantly increasing trend with an annual percent change (APC) of +4.6. Moreover, the APC of breast cancer age-specific rates significantly increased for the age groups 45-49 (p = 0.013), 50-54 (p < 0.001), 55-59 (p = 0.001), 60-64 (p = 0.002), 65-69 (p = 0.003), 70-74 (p < 0.001), and 75+ years (p < 0.001). Lebanon had the highest breast cancer ASR(w), when compared to other regional countries, and trailed only behind Denmark, when compared to selected countries from different parts of the world. Conclusions: Breast cancer incidence in Lebanon is among the highest in the world. Future studies should focus on exploring the genetic profile of the Lebanese population in an aim to extrapolate proper prevention guidelines.

Epidemiological Study of Lung Cancer Incidence in Lebanon

Background and Objectives: Lung cancer (LC) is the most common cancer in the world. Developing countries in the Middle East and North Africa (MENA) region, including Lebanon, have witnessed a great increase in the incidence rates of this disease. The aim of our study is to investigate the incidence rates of lung cancer in Lebanon from 2005 to 2015 and to compare these rates to other countries from the MENA region and other regions of the world. Material and Methods: Lung cancer data for the years 2005-2015 were collected from the National Cancer Registry of Lebanon and stratified by gender and age group. Age-specific and age-standardized incidence rates were calculated and analyzed using joinpoint regression. Age-standardized incidence rates to the world population (ASR(w)) for other countries were obtained from two online databases. Results: Lung cancer ranked as the second most common cancer in Lebanon and accounted for 9.2% of all newly diagnosed cancers. Lung cancer ASR(w) showed a significantly increasing trend over the period studied for males and females. Lung cancer ASR(w) among males in Lebanon came second after Malta when compared to other MENA countries, but it was among the lowest when compared to non-MENA countries. For females, Lebanon ranked first when compared to other MENA countries but was among the lowest when compared to countries in other regions of the world. The lung cancer incidence rate increased with age in both sexes and 89.2% of patients were 50 years of age or older. Conclusion: Lebanon has the highest incidence of LC in females and the second highest for males in the MENA region. The lung cancer incidence rate is on the rise and older age groups are much more burdened by this disease than the young ones. Several risk factors, particularly smoking, play a role in increased LC incidence among the Lebanese population.

Musculoskeletal and head injuries in the Ultimate Fighting Championship (UFC)

OBJECTIVES

Mixed martial arts (MMA) has witnessed a surge in popularity worldwide. This study explores the musculoskeletal and head injuries sustained in the professional fights of the Ultimate Fighting Championship (UFC), and establishes associations between injury profiles and impactful contributory factors.

METHODS

The Nevada State Athletic Commission database was screened for ringside physician reports of UFC fights between January 2016 and July 2018. Information on the fighter's gender, weight, injury, way of finish, and match result were collected. Injury rates were calculated and statistical analyses were conducted to determine significant associations among variables. P-values <0.05 were considered significant (95% CI).

RESULTS

A total of 291 injuries were recorded in 285 fights from nine weight divisions. The overall injury rate was 51 per 100 athletic exposures (AE). Males predominantly partook in 249 matches (87%) and had higher injury rates (54 injuries per 100 AE) than females (30 injuries per 100 AE). Decision was the most common way a match ended. Knockouts (KOs) were significantly higher in males (36%) than in females (14%, P = 0.0007). Submissions were significantly higher in females (36%) than in males (16%, P = 0.001). Head injuries (67%) were the most common injuries reported with a rate of 34 per 100 AE. Upper limb injuries were significantly higher in females (40%) than in males (14%, P = 0.0003). Lower limb injuries were significantly higher in males (19%) than in females (5%, P = 0.01). Head injuries were significantly associated with KOs (P < 0.0001). Upper limb injuries (P = 0.032) and lower limb injuries (P = 0.034) were significantly associated with matches that ended with Decision. Trend-line analyses showed that as weight division increases, overall injury rates, head injuries, lower limb injuries, and KOs' frequency increase, whereas upper limb injuries, Submission frequency, and Decision frequency decrease.

CONCLUSION

MMA has a high injury rate. Gender, way of finish, and weight play an important role in predicting fight outcomes and injury profiles. Injury prevention policies must be entertained to limit injury risk in MMA.

Stroke in the Arab World: A bibliometric analysis of research activity (2002-2016)

Background

The Arab world has an increasing prevalence of strokes, a leading cause of death in this part of the world.

Aims

The aim of this article is to quantify the stroke research activity in the Arab countries over the past 15 years taking into consideration the population, GDP, and DALY of each country.

Methods

A PubMed search was conducted to find stroke research articles published from the Arab countries between 2002 and 2016 (inclusive). Medical subject headings related to strokes and author origin/affiliation were used for this purpose.

Results

The Arab world only produced 0.51% of all the stroke-related publications on PubMed even though the stroke-related DALY percentage in this region was greater than 2.88% during the period we studied. In general, the number of publications increased in the last few years. Somalia came first regarding the percentage of stroke to non-stroke publications released. Lebanon had the highest number of publications per GDP (in US Billion Dollars), Qatar had the highest number of publications per million persons (PPMP), while Saudi Arabia had the highest number of publications per 1% of stroke DALY. In addition, a strong positive correlation was found between the number of stroke publications and GDP; however, the correlation between the number of stroke publication and either population size or DALY was a weak positive one.

Conclusions

A general increase in publications is noticed, but stroke research activity in the Arab world is still poor compared to other parts of the world.

•

The Arab world only contributed to 0.51% of all the stroke-related publications on PubMed even though the stroke-related DALY percentage in this region was greater than 2.88% between 2002 and 2016.

•

The number of stroke-related publications produced by the Arab world increased in the last few years.

•

Lebanon had the highest number of publications per GDP (in US Billion Dollars), Qatar had the highest number of publications per million persons (PPMP).

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A strong positive correlation was found between the number of stroke publications and GDP.

Physician leadership and hospital ranking: Expanding the role of neurosurgeons

Background

Empirical studies that explore whether hospitals with physician leadership perform better than hospitals led by nonphysician managers are scarce. This study looks at the leaders currently being hired by hospitals in the Arab World and explores whether chief executive officers (CEOs) in hospitals ranked higher are typically physician leaders or nonphysician managers. Furthermore, we discuss whether physicians, especially neurosurgeons, are equipped to lead hospitals and healthcare institutions worldwide.

Methods

The "Ranking Web of World Hospitals" by Cybermetrics Lab, 2017, was used. A dataset on CEOs in the top 50 hospitals and the bottom 50 hospitals in the Arab World was constructed. Independent samples t-test and regression equations were conducted, and P values <0.05 were considered statistically significant.

Results

A total of 283 hospitals were ranked. Among the top 50 hospitals, 54% of the CEOs were physicians, whereas the remaining were nonphysician managers. Among the bottom 50 hospitals, 74% of the CEOs were physicians, whereas 26% of the CEOs were nonphysicians. Interestingly, physician leadership was significantly associated with lower hospital ranking (bottom 50 hospitals) in the Arab World (P = 0.0031).

Conclusion

This article does not establish that nonphysician managers make more effective leaders when compared with physicians, but it starts an empirical course. For better evaluation of hospital leadership qualities, a new hospital ranking system must be created that focuses on patient satisfaction and perception of quality. Physician leaders, especially academic neurosurgeons, are an extraordinary leadership source, combining sound management with high medical standards. With the right academic training, neurosurgeons can play an increasingly significant role in addressing the challenges facing healthcare today.