Pivotal Articles Research Articles

Mapping Ethical, Legal, and Social Implications (ELSI) of gamete donation.

This scoping review investigates the Ethical, Legal, and Social Implications (ELSI) of gamete donation, a critical facet of Assisted Reproductive Technologies, by analyzing the evolving research scope, methodological approaches, and the geographical skew in the literature. Despite the increased global uptake of donor gametes, current scholarship predominantly emanates from Western contexts and focuses on majoritized groups. This bias constrains the universality of research findings and limits their applicability across varied legal, cultural, and social contexts, underscoring a need for broader inclusivity. We addressed 867 pivotal articles published between 1999 and 2019. Our analysis reveals a discernible escalation in research volume, with 62% based on empirical research. The intellectual landscape unfolds into four dominant clusters: Regulatory Frameworks, Incentives, and Access; Family Dynamics and Genetic Linkages; Identity and Privacy in Donor Conception; and Cultural and Societal Attitudes towards GD. Each cluster highlights nuanced dimensions of gamete donation, from regulatory intricacies and psychological welfare to identity ethics and cultural perceptions. Our findings advocate for a shift towards more globally representative and methodologically inclusive research. By integrating diverse cultural narratives and expanding geographical breadth, future research can offer holistic understandings of gamete donation, fostering equitable and culturally resonant practices and policies worldwide.

Exploring the Evolution of Sustainability Paradigms: From Linear to Circular Economy Models

Abstract As a response to the urgent environmental degradation and depletion of resources, this article analyzes the historical evolution from linear to circular economy models as a response for achieving sustainability. Tracing back to sustainable forest use proposed in 17th-century and evolving towards modern circular economy principles, there is a paradigm shift of decoupling economic growth from resource consumption. Moving through the landscape of sustainability, the paper criticizes the linear economy model that originated during industrialization period and was incapable of addressing sustainability. Key milestones, such as sustainable development, closed-loop-systems, and biomimicry, demonstrate the journey to current business models. An extensive literature review proves the interdisciplinary importance of circular economy research, exploring domains such as Sustainability Science, Management, and Bioengineering. The present research combines bibliometric analysis and systematic review on articles published between 2000 and 2023. These methods were chosen to assess the main directions of research for development of circular economy models, and recent trends. Research is centered around dynamics and trajectory of scholarly outputs on the topic, mainly those published in the past five years. A sharp rise in the number of publications regarding circular economy models is found, characterized by three notable inflections in 2017, 2018 and 2021. Two pivotal articles emerge as influential contributions. The interdisciplinary landscape of circular economy research is observed, covering diverse research areas such as Supply Chain and Logistics, Bioengineering, or Social Psychology. The cooccurrence analysis reveals 6 thematic clusters for which we propose a conceptual framework. The clusters are: environmental impact, sustainable development, interdisciplinary connections (niche sciences), circular supply chain, climate change, and IT-centric approaches that have emerged in research in the past five years. Insights from recent trends provide valuable guidance to researchers, professionals, and policymakers by using an interdisciplinary lens in the transition to a circular economy.

The expanding role of gene-based prescribing for phase II drug-metabolizing enzymes

Clinical pharmacogenomics has expanded rapidly with the ability to translate evidence from basic science findings into actionable decisions guiding pharmacotherapy in – various disease states. Most findings with potential clinical relevance have been in drug-metabolizing enzymes where variation could cause interindividual differences in response and efficacy. Conventionally, these metabolizing enzymes are classified as Phase I and Phase II enzymes. Although Phase II enzymes are responsible for the metabolism of many drugs, research has focused more on variation in Phase I enzymes. Our aim in this review was to discuss from a historical to present context, the research on key variants in major Phase II enzymes and to summarize clinical pharmacogenetic association studies that could help guide future translation into practice. We evaluated pivotal articles in PubMed (1980–2022) on human pharmacogenomic studies (preclinical and clinical) of N-acetyltransferases (NATs), methyltransferases, glutathione transferases, sulfotransferases, and glucuronosyltransferases for the evidence of clinical applicability and utility. Of the 5 Phase II enzyme superfamilies reviewed, there is presently evidence to support clinical utility for gene-based prescribing for two of them. A third family (NATs) is evaluated as having strong likelihood for future utility in the pharmacological treatment of acquired immunodeficiency syndrome-associated opportunistic infections, tuberculosis, and endemic diseases.

Exploring the top-cited literature in telerehabilitation for joint replacement using the descriptive, diagnostic, predictive, and prescriptive analytics model: A thematic and bibliometric analysis.

Telerehabilitation offers a novel approach supplementing or replacing traditional physical rehabilitation. While research on telerehabilitation for joint replacement (TJR) has expanded, no study has investigated the top 100 cited articles (T100TJR) using the descriptive, diagnostic, predictive, and prescriptive analytics (DDPP) model. This study aims to examine the features of T100TJR in TJR through the DDPP approaches. A comprehensive search of the Web of Science Core Collection was conducted to locate all pertinent English-language documents from the database's inception until August 2, 2023. The T100TJR articles were then identified based on citation counts. The DDPP analytics model, along with 7 visualization techniques, was used to analyze metadata elements such as countries, institutions, journals, authors, references, and keywords. An impact timeline view was employed to highlight 2 particularly noteworthy articles. We analyzed 712 articles and observed a consistent upward trend in publications, culminating in a noticeable peak in 2022. The United States stood out as the primary contributor. A detailed examination of the top 100 articles (T100TJR) revealed the following leading contributors since 2010: the United States (by country), University of Sherbrooke, Canada (by institutions), 2017 (by publication year), and Dr Hawker from Canada (by authors). We delineated 4 major themes within these articles. The theme "replacement" dominated, featuring in 89% of them. There was a strong correlation between the citations an article garnered and its keyword prominence (F = 3030.37; P < .0001). Additionally, 2 particularly high-impact articles were underscored for recommendation. Telerehabilitation for TJR has seen rising interest, with the U.S. leading contributions. The study highlighted dominant themes, especially "replacement," in top-cited articles. The significant correlation between article citations and keyword importance indicates the criticality of keyword selection. The research underscores the importance of 2 pivotal articles, recommending them for deeper insights.

Trends in STEM Education Research in Europe in 2005-2019

Finnish STEM education research experts critically examined the focus of STEM education research, particularly in physics, chemistry, and biology, using the didactic triangle framework. Analyzing numerous research papers and master's theses from forums like NorDiNa and ESERA, three pivotal articles were highlighted. These articles revealed dominant research trends like the student-content relationship, underscored areas lacking attention, such as educators' insights into students' perceptions, and advocated for a broader, more holistic approach in future STEM education research endeavors.

Janis S. Bohan (1945-2021).

Memorializes Janis S. Bohan (1945-2021). Janis was a profound thinker, a prolific researcher, and an indefatigable activist, whose contributions influenced feminist and lesbian, gay, bisexual, trans, and other gender and sexual minorities (LGBTQ+) scholarship. During the 1990s, she published pivotal articles in Psychology of Women Quarterly which brought to psychologists' attention critical advances and trenchant debates in feminist theory. During her long retirement, Janis engaged in many volunteer activities and extensive political activism, both locally and nationally. (PsycInfo Database Record (c) 2022 APA, all rights reserved).

Paradigm-Shifting Research in Gastroenterology, Hepatology, and Nutrition: A Top 20 List of Articles Published in 2020

Paradigm-Shifting Research in Gastroenterology, Hepatology, and Nutrition: A Top 20 List of Articles Published in 2020

The role of diffusion tensor imaging in idiopathic normal pressure hydrocephalus: A literature review.

Idiopathic normal pressure hydrocephalus (iNPH) is a syndrome that comprises a triad of gait disturbance, dementia and urinary incontinence, associated with ventriculomegaly in the absence of elevated intraventricular cerebrospinal fluid (CSF) pressure. It is important to identify patients with iNPH because some of its clinical features may be reversed by the insertion of a CSF shunt. The diagnosis is based on clinical history, physical examination and brain imaging, especially magnetic resonance imaging (MRI). Recently, some papers have investigated the role of diffusion tensor imaging (DTI) in evaluating white matter alterations in patients with iNPH. DTI analysis in specific anatomical regions seems to be a promising MR biomarker of iNPH and could also be used in the differential diagnosis from other dementias. However, there is a substantial lack of structured reviews on this topic. Thus, we performed a literature search and analyzed the most recent and pivotal articles that investigated the role of DTI in iNPH in order to provide an up-to-date overview of the application of DTI in this setting. We reviewed studies published between January 2000 and June 2020. Thirty-eight studies and four reviews were included. Despite heterogeneity in analysis approaches, the majority of studies reported significant correlations between DTI and clinical symptoms in iNPH patients, as well as different DTI patterns in patients with iNPH compared to those with Alzheimer or Parkinson diseases. It remains to be determined whether DTI could predict the success after CSF shunting.

Measuring Plantar Tissue Stress in People With Diabetic Peripheral Neuropathy: A Critical Concept in Diabetic Foot Management.

Excessive stress on plantar tissue over time is one of the leading causes of diabetic foot ulcers among people with diabetic peripheral neuropathy. Plantar tissue stress (PTS) is a concept that attempts to integrate several well-known mechanical factors into one measure, including plantar pressure, shear stress, daily weight-bearing activity, and time spent in prescribed offloading interventions (adherence). Despite international diabetic foot guidelines recommending the measure of each of these individual mechanical factors in people with neuropathy, only recently has technology enabled their combined measurement to determine PTS. In this article we review the concept of PTS, the mechanical factors involved, and the findings of pivotal articles reporting measures of PTS in people with neuropathy. We also discuss key existing gaps in this field, including the lack of standards to measure and report PTS, a lack of practical solutions to measure shear stress, and the lack of PTS thresholds that may indicate benefit or detriment to people with neuropathy. To address some of these gaps, we propose recommended clinical and research standards for measuring and reporting PTS in people with neuropathy. Last, we forecast future clinical, research, and technological advancements that may use PTS to highlight the importance of this critical concept in the prevention and management of diabetic foot ulcers.

How structure shapes dynamics: knowledge development in Wikipedia--a network multilevel modeling approach.

Using a longitudinal network analysis approach, we investigate the structural development of the knowledge base of Wikipedia in order to explain the appearance of new knowledge. The data consists of the articles in two adjacent knowledge domains: psychology and education. We analyze the development of networks of knowledge consisting of interlinked articles at seven snapshots from 2006 to 2012 with an interval of one year between them. Longitudinal data on the topological position of each article in the networks is used to model the appearance of new knowledge over time. Thus, the structural dimension of knowledge is related to its dynamics. Using multilevel modeling as well as eigenvector and betweenness measures, we explain the significance of pivotal articles that are either central within one of the knowledge domains or boundary-crossing between the two domains at a given point in time for the future development of new knowledge in the knowledge base.

Explaining authors’ contribution to pivotal artifacts during mass collaboration in the Wikipedia’s knowledge base

This article discusses the relevance of large-scale mass collaboration for computer-supported collaborative learning (CSCL) research, adhering to a theoretical perspective that views collective knowledge both as substance and as participatory activity. In an empirical study using the German Wikipedia as a data source, we explored collective knowledge as manifested in the structure of artifacts that were created through the collaborative activity of authors with different levels of contribution experience. Wikipedia’s interconnected articles were considered at the macro level as a network and analyzed using a network analysis approach. The focus of this investigation was the relation between the authors’ experience and their contribution to two types of articles: central pivotal articles within the artifact network of a single knowledge domain and boundary-crossing pivotal articles within the artifact network of two adjacent knowledge domains. Both types of pivotal articles were identified by measuring the network position of artifacts based on network analysis indices of topological centrality. The results showed that authors with specialized contribution experience in one domain predominantly contributed to central pivotal articles within that domain. Authors with generalized contribution experience in two domains predominantly contributed to boundary-crossing pivotal articles between the knowledge domains. Moreover, article experience (i.e., the number of articles in both domains an author had contributed to) was positively related to the contribution to both types of pivotal articles, regardless of whether an author had specialized or generalized domain experience. We discuss the implications of our findings for future studies in the field of CSCL.

On the shoulders of giants

Who does not want to leave a legacy? It is a basic human desire, maybe even a need, to leave something on this earth that in some way marks that we were here, albeit for a blink in time. In life we do this by what we build and the children we create and nurture. In the medical world we can create a legacy in several ways: by teaching, by patient care and by research. Of these 3 categories, research lends itself to perhaps the most objective measure by the application of simple mathematics. In this issue of CUAJ, Hennessey and colleagues1 present their results in the search for “The top 100 cited articles in urology.” Within the limitations of the methodology, these cited articles provide a history of the important milestones of our specialty from 1965 to the present. The start point of 1965 reflects the limit of the databases, which therefore leaves out some pivotal articles that form the basis of many subsequent breakthroughs: Halifax-born Nobel laureate Charles Huggins and his description of the relationship between the hormonal milieu and the progression of prostate cancer is an example, since his seminal work was published before 1965 (he was awarded the Nobel Prize in Medicine in 1966). Another limitation of the methodology is the anglophone dominance of the journals that were searched: 92% of the 93 journals are published in the English language. Although, as a unilingual anglophone, this ratio does reflect my reading preference, I am not confident that it truly reflects the worldwide experience. For instance, is it possible that Chaussy and colleagues’ 1982 paper describing the use of extracorporeal shock wave lithotripsy (number 92) was also published in their native German language? It is also apparent that certain subspecialties of urology are underrepresented, possibly because of the decisions by the authors concerning which journals to include. The complete absence of articles related to pediatric urology can be explained by this bias. We also must not confuse popularity with importance. In a quick scan of the top 10 papers (anyone reminded of Letterman?) you will not find Walsh and Donker’s initial description of the nerve-sparing radical prostatectomy technique (number 51), Morales and coauthors’ report on the use of bacille Calmette-Guerin to treat superficial bladder tumours (number 52) or Lapides and colleagues’ experience with clean intermittent catheterization (number 87), 3 innovations which revolutionized their respective areas of urology. Nonetheless, the numbers do not lie: Feldman and colleagues’ 1994 paper reporting on impotence in the Massachusetts male aging study, with 1435 citations, was the most cited urology article in the English language. At the very least, this observation behooves every urologist and resident to be familiar with this work. Perhaps journal clubs across the country should plan to review every article on the top 100 list over a time frame of several years. This exercise would certainly be an interesting journey through the last 44 years of our specialty, and provide perspective to the current body of knowledge that we consider “facts.” The authors are to be congratulated for providing a road map for the journey of urology from 1965 to 2007. It should serve as a reminder that knowledge acquisition is a cumulative activity; in the words of Sir Isaac Newton, who wrote in a letter to Robert Hooke in 1676, “If I have seen further it is by standing on the shoulders of giants.”

Hemicrania Continua: Functional Imaging and Clinical Features With Diagnostic Implications.

This review focuses on summarizing 2 pivotal articles in the clinical and pathophysiologic understanding of hemicrania continua (HC). The first article, a functional imaging project, identifies both the dorsal rostral pons (a region associated with the generation of migraines) and the posterior hypothalamus (a region associated with the generation of cluster and short-lasting unilateral neuralgiform headache with conjunctival injection and tearing [SUNCT]) as active during HC. The second article is a summary of the clinical features seen in a prospective cohort of HC patients that carry significant diagnostic implications. In particular, they identify a wider range of autonomic signs than what is currently included in the International Headache Society criteria (including an absence of autonomic signs in a small percentage of patients), a high frequency of migrainous features, and the presence of aggravation and/or restlessness during attacks. Wide variations in exacerbation length, frequency, pain description, and pain location (including side-switching pain) are also noted. Thus, a case is made for widening and modifying the clinical diagnostic criteria used to identify patients with HC.

Abstracts and Citations

This review focuses on summarizing 2 pivotal articles in the clinical and pathophysiologic understanding of hemicrania continua (HC). The first article, a functional imaging project,identifies both the dorsal rostral pons (a region associated with the generation of migraines) and the posterior hypothalamus(a region associated with the generation of cluster and short-lasting unilateral neuralgiform headache with conjunctival injection and tearing [SUNCT]) as active during HC. The second article is a summary of the clinical features seen in a prospective cohort of HC patients that carry significant diagnostic implications. In particular, they identify a wider range of autonomic signs than what is currently included in the International Headache Society criteria (including an absence of autonomic signs in a small percentage of patients), a high frequency of migrainous features, and the presence of aggravation and/or restlessness during attacks. Wide variations in exacerbation length, frequency, pain description, and pain location (including side-switching pain) are also noted. Thus, a case is made for widening and modifying the clinical diagnostic criteria used to identify patients with HC.

EComment. Accuracy of all reference citations

I read with interest and a lot of attention the article by Birgand et al. regarding the results of their quasi-experimental single-centre prospective cohort study related to the efficacy of gentamicin-impregnated collagen sponges in preventing deep sternal wound infections in high-risk cardiac surgery patients [1]. I would greatly appreciate it, if the authors could explain the relation of their first reference by Barennes et al. to their very well presented data [2]. According to the International Committee of Medical Journal Editors, readers should be provided with direct references to original research work whenever possible. There is no need for large numbers of references. Small numbers of references to key or pivotal original articles often provide the appropriate volume of information [3]. In addition, citation errors sometimes appear in the published version of articles inadvertently [3]. Conflict of interest: none declared

Adolescent Literacy: Looking Back and Moving Forward in the Global Flow

AbstractAwaiting abstract

Preoperative Cardiac Evaluation of the Vascular Surgery Patient—An Anesthesia Perspective

The morbidity and mortality associated with vascular surgery procedures are largely the results of cardiac events. National guidelines have been regularly proposed and updated by the American College of Cardiology (ACC)/American Heart Association (AHA) to ensure optimal perioperative management and risk stratification. Controversy remains between experts and other cardiology societies regarding several patient care issues including revascularization before surgery, timing of β-blocker therapy, and the administration of antiplatelet therapy. Several landmark articles recently published have helped to modify the guidelines in the hope of improving vascular patient outcomes. In this review, we searched all recent available literature pertaining to perioperative cardiac evaluation before major vascular surgery. We propose an algorithm for preoperative cardiac evaluation, which is a modification to the AHA recommendations. Incorporated in this algorithm are recent published pivotal articles that can help in guiding physicians caring for the vascular patient requiring major operative or endovascular interventions.

The use of the internet for medical information and a needs assessment for a web based educational resource: A survey of Canadian medical oncology trainees and training program directors

17022 Background: Medical Oncology trainees develop their skills and knowledge through formal educational sessions, independent learning and clinical rotations. The internet serves as a source of up to date information and a potential educatinal resource. Despite the existence of many websites with oncology related information, there has not been a comprehensive assessment of how medical oncology trainees and program directors use the internet to meet educational objectivs. Method: In the first phase of developing a new educational website (OncologyEducation.com), we surveyed medical oncology trainees and program directors from training programs across Canada to assess how they accessed the internet to determine the elements they considered essential for a trainee-oriented site. Results: 12 out of 13 Canadian medical oncology training programs participated in our survey. A total of 12 program directors and 23 trainees responsed to our survey for a 74.5% response rate. 71.4% of respondents spend up to 10 hours per week on the internet for work related reasons. Pubmed and UptoDate were the most frequently visited sites. Respondents reported using the internet for email (97.1%), answering clinical questions (88.6%), accessing practice guidelines (80%), and literature updates (71.4%). Respondents expressed a need for an educational website stressing the following content: (1) Key updates by disease sites (2) Access to pivotal journal articles (3) Access to upcoming conferences/information (4) Links to other medical sites/medical oncology sites (5) Fellowship Opportunities. Conclusion: The internet is an important resource for supplementing the training of medical oncology trainees. The development of an educational website based on the needs assessed in this survey is warranted. Upon development of the website it will be evaluated for effectiveness and impact on oncology training and clinical practice. No significant financial relationships to disclose.

RE-VISIONS: Rethinking Hairston’s “Breaking Our Bonds”

Maxine Hairston’s 1985 Chair’s Address is the first in an occasional series prompting us to reread and “re-vision” pivotal articles that have appeared in CCC. The full texts of those pieces will be available at CCC Online (http://inventio.us/ccc), and I invite you to reread those important texts online along with these new commentaries in print.

Re-Visions: Déjà Vu All Over Again

Maxine Hairston’s 1985 Chair’s Address is the first in an occasional series prompting us to reread and “re-vision” pivotal articles that have appeared in CCC. The full texts of those pieces will be available at CCC Online (http://inventio.us/ccc), and I invite you to reread those important texts online along with these new commentaries in print. For this inaugural appearance of “Re-Visions,” Joseph Harris and Susan McLeod comment on “Breaking Our Bonds and Reaffirming Our Connections,” excerpts of which appear below (originally published in the October 1985 issue of CCC [Vol. 36, No. 3, pp. 272–282]).