Worldwide research productivity in fracture surgery: A 10-year survey of publication activity

Anterior approach for pediatric supracondylar humerus fractures: A systematic review

BACKGROUND AND PURPOSE

Open reduction is rarely performed in pediatric supracondylar humerus fractures. However, clear evidence is lacking regarding the optimal open approach to achieve satisfactory results. The anterior approach provides direct visualization of the fracture and excellent exposure to neurovascular structures, although its utilization is less common. The objective of this study was to review the indications, outcomes, and complications associated with the anterior approach for open reduction of these fractures.

METHODS

Our protocol was registered at PROSPERO: CRD42023446923. MEDLINE/PubMed, Embase, Web of Science, Clinicaltrials.gov, and Cochrane Library were searched from database inception to search date (December 2023) and screened in duplicate for relevant studies. Data were collected regarding patient demographics, indications for open reduction, Flynn's functional and cosmetic outcomes, and complications. Study quality was assessed using the Methodological Index for Non-Randomized Studies Criteria.

RESULTS

A total of 19 studies involving 483 patients were included. One study was classified as Level 2 evidence, ten as Level 3, and eight as Level 4. The mean MINORS score was 13.05±3.47. The primary indication for open reduction was failed closed reduction, observed in 46% of patients. 97.7% and 98.6% of patients achieved Flynn's functional and cosmetic satisfactory results, respectively. The postsurgical neurovascular injury rate was 1.4%. One patient required reintervention.

CONCLUSION

The anterior approach is safe and effective for managing pediatric supracondylar humerus fractures requiring open reduction.

LEVEL OF EVIDENCE

Systematic review of Level 2-4 evidence studies.

Analyzing the composition of the editorial boards in high-impact medical ethics journals: a survey study

BACKGROUND

The underrepresentation of scholarly works from low- and middle-income countries (LMICs) in academic literature is a documented concern, attributed partly to editorial biases. This trend, prevalent across various disciplines, has been less explored in the context of medical ethics journals. This study aimed to examine the composition of editorial board members (EBM) in high-impact medical ethics journals and to evaluate the extent of international diversity within these editorial teams.

METHODS

This study incorporated an analysis of 16 high-impact medical ethics journals. Information regarding the EBM of these journals was systematically gathered and categorized based on the World Bank's country income classifications. An in-depth examination of the editorial board compositions was then conducted.

RESULTS

The study identified 669 EBM across the selected journals. A predominant 89.84% (601) of these members were from high-income countries (HICs), with upper-middle-income countries contributing 7.47% (50) and lower-middle-income countries 2.69% (18). No EBM were associated with low-income countries. A regional breakdown indicated that North America was the most represented area, accounting for 48.88% (327), followed by Europe & Central Asia (27.50%, 184), East Asia & Pacific (13.45%, 90), Latin America & Caribbean (4.63%, 31), Sub-Saharan Africa (4.19%, 28), Middle East & North Africa (0.75%, 5), and South Asia (0.60%, 4). In total, these EBMs hailed from 46 different countries, with the United States representing the largest proportion (43.80%, 293), followed by the United Kingdom (13.15%, 88), Australia (7.92%, 53), Germany (6.73%, 45), and Canada (5.08%, 34).

CONCLUSIONS

There is a significant lack of international representation within the EBM of high-impact medical ethics journals. The majority of editors in this field are affiliated with HICs, leading to a severe underrepresentation of LMICs within the editorial boards.

How international are the editorial boards in the field of hand research? A cross-sectional study of leading subspecialty hand journals

BACKGROUND

Although low- and middle-income countries (LMIC) have great disease burden, but the lack of studies from LMIC have been shown in several fields. Multiple researchers from LMIC perceive editorial bias against their studies. Editorial board members (EBMs) from LMIC are under-represented across many medical journals. It is still unclear whether this phenomenon exists in the field of hand research. The purpose of this study was to investigate the composition of EBMs in leading subspecialty hand journals, and to reveal the international representation of EBMs in the field of hand research.

METHODS

This cross-sectional study included seven leading subspecialty hand journals. The EBMs were obtained from the journals' websites. The country affiliations of EBMs were categorized based on their locations and economy status. The composition of EBMs was investigated.

RESULTS

There were 211 EBMs in the seven journals. A total of 185 EBMs (87.7%) were affiliated with high-income countries (HIC), 18 (8.5%) with upper middle-income countries, and 8 (3.8%) with lower middle-income countries. None EBMs were affiliated with low income countries. The EBMs were affiliated with 30 countries. The biggest number of EBMs were affiliated with the USA 74 (35.07%), followed by the United Kingdom (45, 21.33%), and France (13, 6.16%). Most of EBMs were based in Europe and Central Asia (86, 40.8%) and North America (81, 38.4%).

CONCLUSIONS

The EBMs of leading subspecialty hand journals are dominated by HIC with a very low representation of LMIC. There is a need to make the editorial boards more international in the field of hand research.

An international analysis of stem cell research in intervertebral disc degeneration

Stem cell therapy has been increasingly investigated as a promising strategy for intervertebral disc degeneration (IDD). However, no international analysis of stem cell research has yet been conducted. This study aimed to analyze the major characteristics of published reports of stem cell use for IDD and to present a global insight into stem cell research. The study period spanned from the inception of the Web of Science database to 2021. A search strategy using specific keywords was implemented to retrieve relevant publications. The numbers of documents, citations, countries, journals, article types, and stem cell types were evaluated. A total of 1170 papers were retrieved. The analysis showed a significant increase in the number of papers over time (p < 0.001). High-income economies accounted for the majority of papers (758, 64.79 %). China produced the most articles (378, 32.31 %), followed by the United States (259, 22.14 %), Switzerland (69, 5.90 %), United Kingdom (54, 4.62 %), and Japan (47, 4.02 %). The United States ranked first in terms of the number of citations (10,346), followed by China (9177) and Japan (3522). Japan ranked first in terms of the number of citations per paper (74.94), followed by United Kingdom (58.54) and Canada (53.74). When standardized by population, Switzerland ranked first, followed by Ireland and Sweden. When gross domestic product was considered, Switzerland ranked first, followed by Portugal and Ireland. The number of papers was positively correlated with gross domestic product (p < 0.001, r = 0.673); however, there was no significant correlation with population (p = 0.062, r = 0.294). Mesenchymal stem cells were the most investigated stem cells, followed by nucleus pulposus-derived stem cells and adipose-derived stem cells. A sharp increase in stem cell research was observed in the field of IDD. China produced the most, although several European countries were more productive relative to their populations and economies.

Measuring socioeconomic outcomes in trauma patients up to one year post-discharge: A systematic review and meta-analysis

INTRODUCTION

Trauma accounts for nearly one-tenth of the global disability-adjusted life-years, a large proportion of which is seen in low- and middle-income countries (LMICs). Trauma can affect employment opportunities, reduce social participation, be influenced by social support, and significantly reduce the quality of life (QOL) among survivors. Research typically focuses on specific trauma sub-groups. This dispersed knowledge results in limited understanding of these outcomes in trauma patients as a whole across different populations and settings. We aimed to assess and provide a systematic overview of current knowledge about return-to-work (RTW), participation, social support, and QOL in trauma patients up to one year after discharge.

METHODS

We undertook a systematic review of the literature published since 2010 on RTW, participation, social support, and QOL in adult trauma populations, up to one year from discharge, utilizing the most commonly used measurement tools from three databases: MEDLINE, EMBASE, and the Cochrane Library. We performed a meta-analysis based on the type of outcome, tool for measurement, and the specific effect measure as well as assessed the methodological quality of the included studies.

RESULTS

A total of 43 articles were included. More than one-third (36%) of patients had not returned to work even a year after discharge. Those who did return to work took more than 3 months to do so. Trauma patients reported receiving moderate social support. There were no studies reporting social participation among trauma patients using the inclusion criteria. The QOL scores of the trauma patients did not reach the population norms or pre-injury levels even a year after discharge. Older adults and females tended to have poorer outcomes. Elderly individuals and females were under-represented in the studies. More than three-quarters of the included studies were from high-income countries (HICs) and had higher methodological quality.

CONCLUSION

RTW and QOL are affected by trauma even a year after discharge and the social support received was moderate, especially among elderly and female patients. Future studies should move towards building more high-quality evidence from LMICs on long-term socioeconomic outcomes including social support, participation and unpaid work.

Scientific Productivity in Rheumatoid Arthritis: A Global Survey of Research Activity

OBJECTIVES

Assessment of scientific productivity provides a macroscopic view of research activity in a specific field. However, no analyses of rheumatoid arthritis (RA) have been published to date. Thus, this study aimed to investigate the characteristics of studies published on RA worldwide.

METHODS

The Web of Science database was searched for articles on RA published between 2017 and 2019. Analysis parameters included the number of articles, number of times each publication was cited, country, journal, and research output adjusted by population and gross domestic product.

RESULTS

Overall, 16,936 publications were identified. The United States was the largest contributor (17.71%), followed by China (17.17%), Japan (6.37%), the United Kingdom (5.82%), and Italy (4.76%). High-income economies (69.98%) ranked first in productivity, followed by middle- (30%) and low-income economies (0.02%). Significant correlations were found between research productivity and population (r = 0.461, p = 0.000), as well as gross domestic product (r = 0.786, p = 0.000). Publications from the United States received the highest number of total citations (21,669), followed by China (10,952) and the United Kingdom (7846). Austria had the highest average citations (16.18), followed by Norway (8.19) and the United Kingdom (7.98). When normalized by population, the leading country was Denmark, followed by the Netherlands and Sweden. When adjusted by gross domestic product, Denmark ranked first in publications on RA, followed by the Netherlands and Greece.

CONCLUSION

The United States emerged as the largest contributor to the field of RA research. Countries with large populations and economies tended to have higher research productivity. Multiple countries in Europe performed better in research output when normalized by population and economy sizes.

Global production of nursing research: A 10-year survey of subspecialty nursing journals

AIM

This study aimed to investigate the characteristics of global productivity of nursing research in subspecialty nursing journals and to provide a general view of global nursing research.

METHODS

On 10 January 2020, Web of Science was used for research collection. Publications in subspecialty nursing journals from 2015 to 2019 were analysed.

RESULTS

A total of 34 275 publications were retrieved. The United States (15 155) ranked first, followed by Australia (2439), China (2076), Brazil (1803) and the United Kingdom (1602). High-income economies produced 82.26% of the total number of publications. Research production was not significantly correlated with the population (p = 0.113, r = 0.412), whereas it was positively correlated with gross domestic product (p = 0.030, r = 0.541). The United States had the highest number of total citations (46 297). The Netherlands ranked highest when analysing mean citations, followed by Finland and Australia. Sweden ranked highest after correcting for gross domestic product, followed by Australia and Finland. Australia was the most productive nation when adjusted by population, followed by Sweden and Norway.

CONCLUSION

The United States is the leader in nursing research productivity. Countries with large economies tend to make greater contributions to global nursing research. Some European countries and Australia were found to be more prolific when stratified by population size and economic activity.

Measuring post-discharge socioeconomic and quality of life outcomes in trauma patients: a scoping review

Purpose

Trauma is a global public health challenge. Measuring post-discharge socioeconomic and quality-of-life outcomes can help better understand and reduce the consequences of trauma.

Methods

We performed a scoping review to map the existing research on post-discharge outcomes for trauma patients, irrespective of the country or setting in which the study was performed. The scoping review was conducted by searching six databases – MEDLINE, EMBASE, the Cochrane Library, Global Index Medicus, BASE, and Web of Science – to identify all articles that report post-discharge socioeconomic or quality of life outcomes in trauma patients from 2009 to 2018.

Results

Seven hundred fifty-eight articles were included in this study, extracting 958 outcomes. Most studies (82%) were from high-income countries (HICs). More studies from low- and middle-income countries (LMICs) were cross-sectional (71%) compared with HIC settings (46%). There was a wide variety of different definitions, interpretations, and measurements used by various articles for similar outcomes. Quality of life, return to work, social support, cost, and participation were the main outcomes studied in post-discharge trauma patients.

Conclusions

The wide range of outcomes and outcome measures reported across different types of injuries and settings. This variability can be a barrier when comparing across different types of injuries and settings. Post-discharge trauma studies should move towards building evidence based on standardized measurement of outcomes.

Supplementary Information

The online version contains supplementary material available at 10.1186/s41687-021-00346-6.

Thematic research clusters in very old populations (≥ 80 years): a bibliometric approach

Background

Population aging will be one of humanity’s major challenges in the decades to come. In addition to focusing on the pathologies causing the greatest mortality and morbidity in this population, such as dementia, health research in elderly people must consider a myriad of other interlinked factors, such as geriatric syndromes, social aspects, and factors related to preserving quality of life and promoting healthy aging. This study aims to identify the main subject areas attracting research attention with regard to very old (≥ 80 years) populations.

Methods

Documents assigned with the medical subject heading “Aged, 80 and over” were retrieved from MEDLINE and the Web of Science. This dataset was used to determine publication output by disease, geographic region, country, and discipline. A co-word analysis was undertaken to identify thematic research clusters.

Results

Since the mid-2000s, there has been a boom in scientific output focusing specifically on very old populations, especially in Europe (43.7% of the documents) but also in North America (30.5%) and Asia (26%); other regions made only nominal contributions (0.5 to 4.4%). The USA produced the most research, while the most growth over the study period occurred in Japan, Spain, and China. Four broad thematic clusters were identified: a) geriatric diseases, health services for the aged, and social and psychological issues of aging; b) cardiovascular diseases; c) neoplasms, and d) bacterial infections & anti-bacterial agents.

Conclusions

Scientific research in very old populations covers a wide variety of interrelated topics. In quantitative terms, the top subject areas have to do with cardiovascular and cerebrovascular diseases (including aortic valve stenosis and stroke), dementia, and neoplasms. However, other degenerative pathologies, geriatric syndromes, and different social and psychosocial aspects also attract considerable interest. It is necessary to promote more equal participation in global research on pathologies and topics related to very elderly populations, as the highest rates of population aging and the largest numbers of elderly people in the next decades will be in low- and middle-income countries.

Supplementary Information

The online version contains supplementary material available at 10.1186/s12877-021-02209-7.

Bibliometric profile of global scientific research on digoxin toxicity (1849-2015)

Digoxin is a cardiac glycoside derived from the common foxglove digitalis purpurea and has been available for several centuries as a medicinal agent. Despite extensive patient experience over many years, there remains some controversy regarding the possibility that digoxin might have a deleterious effect on survival. This study was constructed to assess trends in digoxin toxicity research using well-established qualitative and quantitative bibliometric indicators. The current study is based on publications that have been indexed in Scopus. Articles referring to the subject of digoxin toxicity between 1849 and 2015 were assessed according to the document type, publication language, countries/territories, institutions, journal, impact factors, total number of citations, h-index, average number of citations per publication, and international collaborations. There were 2900 publications that included 2542 (87.7%) original research articles, while 5.3% were reviews and 4.6% letters. The country of origin was the USA in 849 publications, Germany in 241, the UK in 150, and France in 143. The USA and the UK had the highest number of international collaborations. The average number of citations per publications related to digoxin toxicity was 8.1, and the h-index was 59. The USA and Canada had the highest h-indices by country at 46 and 22, respectively. This study presents the first bibliometric analysis on digoxin toxicity publications. The USA was the most important contributors to digoxin toxicity literature with the greatest international collaboration, largest number of articles and highest h-index, followed by Germany and the UK. There has been a trend towards reduced publication numbers related to digoxin toxicity at global level, although it is still an important issue and we present the current research themes related to digoxin toxicity that were identified.

The Proportion of Abstracts Presented at the 2010 American Academy of Orthopaedic Surgeons Annual Meeting Ultimately Published

As attendees of orthopedic meetings consider how to integrate presented information into their practice, it is helpful to consider the quality of the data presented. One surrogate metric is the proportion of and changes to presented abstracts that become journal publications. With this study, using the 2010 American Academy of Orthopaedic Surgeons (AAOS) Annual Meeting abstracts, the authors sought to answer the following questions: Did the publications following abstract presentations differ in terms of the conclusions, study subjects, or coauthors? What proportion of abstracts was published? What are the most common subtopics and journals, and what is the most common author country? Keywords and authors from the 2010 AAOS Annual Meeting proceedings program (698 podium and 548 poster abstracts) were searched in PubMed, Embase, and Google Scholar. If a publication resulted, differences in the conclusion, number of study subjects, and authorship between the abstract and the journal publication were tabulated. The proportion of abstracts published, specialty subtopics, authorship country, and journals of publication were collected. At journal publication, 1.7% of podium and 1.7% of poster conclusions changed. Mean number of authors for podium and poster increased significantly (P<.001), and 30% of podium and 44% of poster had a change in the number of study subjects. The overall journal publication percentage was 61% (68% podium and 53% poster). The majority of the authors were from the United States. The most common journal was The Journal of Bone & Joint Surgery. It is important to evaluate the usefulness and clinical applicability of meetings, especially the final disposition of conference abstracts, from various angles to ensure that they are as worthwhile and educational as possible. [Orthopedics. 2020;xx(x):xx-xx.].

Bibliometric evaluation of orthopaedics and traumatology publications from France: 20-year trends (1998-2017) and international positioning

BACKGROUND

Little is known about the scientific publication output for individual countries and medical specialties. The contribution of French authors to the currently expanding volume of publications on orthopaedics and traumatology (OT) is unclear. Orthopaedics & Traumatology: Surgery & Research (OTSR) is an English-language version of a preexisting French journal that was launched in 2009 to increase the dissemination of research done in France. The objective of this study was to use Web of Science (WoS) data from 1998 to 2017 to determine (i) the contribution of OT publications to the total worldwide volume of scientific publications, (ii) the contribution of OT publications from France to the total worldwide volume of OT publications, and (iii) changes over time in the proportion of OT publications from France with special attention to potential effects of the creation of OTSR.

HYPOTHESIS

The proportion of OT publications from France increased after 2010-2012, indicating a positive effect of OTSR.

MATERIAL AND METHODS

WoS data were used to identify original studies and review articles written by at least one French author, published between 1998 and 2017, and dealing with OT (defined as orthopaedics and/or traumatology in adult and/or paediatric patients). The worldwide volumes of publications in OT and other specialties were compared. Within worldwide OT publications, the proportion from France was determined. Indicators of impact were evaluated during successive 5-year periods. Finally, the position of OT in worldwide research was assessed and OT journals were analysed.

RESULTS

Among worldwide scientific medical publications, the proportion dealing with OT increased year on year from 1.93% in 1998 to 2.65% in 2017. Among annual publications from France, the proportion dealing with OT rose similarly, from 1.32% to 2.40%. Over the 20-year study period, France moved from the sixth to the ninth position, chiefly due to a large increase in publications from Asia. However, France remained in third position among European countries and increased its OT production 3-fold between 1998 and 2017. The proportion of OT articles from France that ranked among the top 1% most cited articles increased by 65% from 2008-2012 (20 articles) to 2013-2017 (33 articles), and the proportion in the top 10% increased by 31.8% (211 in 2008-2012 and 278 in 2013-2017). This rate of progression was faster than in any of the other western countries. Between 1998-2011 and 2012-2017, the contribution of French OT to publication output showed a 1.56-fold greater increase than did the contribution of OT to the worldwide volume of scientific medical publications.

DISCUSSION

OT publications from France have kept pace with the steady increase seen worldwide over the last 20years. Although the US and UK remain in the lead, and despite the considerable growth in the output of Asian countries, France occupies a prominent position on the international OT scene. The creation of OTSR has elevated the international profile of French OT centres.

LEVEL OF EVIDENCE

IV, retrospective study with no control group.

Orthopaedic research in low-income countries: A bibliometric analysis of the current literature

BACKGROUND

To perform a bibliometric analysis and quantify the amount of orthopaedic and trauma literature published from low-income countries (LICs).

METHODS AND METHODS

The Web of Science database was utilised to identify all indexed orthopaedic journals. All articles published in the 76 orthopaedics journals over the last 10 years were reviewed, to determine their geographic origin.

RESULTS

A total of 131 454 articles were published across 76 orthopaedic journals over the last 10 years. Of these, 132 (0.1%) were published from LICs and 3515 (2.7%) were published from lower middle-income countries (LMICs); 85.7% (n = 112 716) of published orthopaedic research was undertaken in a high-income setting. The majority of the studies (n = 90, 74.4%) presented level IV evidence. Only 7.4% (n = 9) were high-quality evidence (level I or II). Additionally, the majority of research (74 articles, 56%) was published in partnership with high-income countries (HICs).

CONCLUSIONS

There is a stark mismatch between the publication of scientific reports on orthopaedic research and the geographical areas of greatest clinical need. We believe there is an urgent need for orthopaedic research to be carried out in low-income settings to guide treatment and improve outcomes, rather than assuming that evidence from high-income settings will translate into this environment.

LEVEL OF EVIDENCE

IV.