Journal Of Surgery Research Articles

A Bibliometric Analysis of the Articles Published in the Aesthetic Plastic Surgery Journal (1976-2023).

Despite the important role of the Aesthetic Plastic Surgery (APS) journal in the field of aesthetic plastic surgery, there is a notable absence of literature that focuses exclusively on the bibliometric analysis of this journal. In recognition of APS's 48 years of publishing, this study aims to perform a bibliometric analysis of the articles published in the APS (1976-2023). Articles published in the APS were extracted from the Web of Science Core Collection database. VOSviewer was employed to perform bibliometric analyses. Microsoft Excel was utilized to analyse the publication and citation trends. From 1976 to 2023, 5134 articles were published in the APS. These articles were contributed by 12,963 researchers from 3354 institutions across 91 countries. The USA and China were the leading contributors. The most prolific author is Luan Jie from China. The co-citation networks highlighted the influence of the journal Plastic and Reconstructive Surgery. We categorized the articles into four groups, and the results show that articles with the highest publications and citations in the APS are related to facial cosmetic surgery. In terms of specific surgical procedures, breast augmentation surgery has garnered consistent attention from researchers over the past 48 years, ranking first in both the number of publications and citations. The findings of this study indicate that the APS is a significant scientific journal, is widely utilized by global researchers in the field of aesthetic plastic surgery, and spans diverse knowledge domains. This journal requires that authors assign a level of evidence to each article. For a full description of these Evidence-Based Medicine ratings, please refer to the Table of Contents or the online Instructions to Authors www.springer.com/00266 .

Editorial diversity correlates with journal impact factor and author diversity in cardiothoracic surgery.

While there are no widely accepted diversity, equity, and inclusion (DEI) metrics for journals, geographic and sex diversity across a journal's editorial board may provide a surrogate measure of its commitment to DEI. We explored the association between journal quality and DEI metrics for cardiothoracic surgery (CTS) journals and investigated whether editorial diversity correlates with diversity across published articles. We collected the following data for 30 CTS journals: country of publication (categorized by income level), journal quality metrics (citation-based metrics, e.g., impact factor (IF) or H-index), and sex and geographic representation across editorial boards and published articles. Bivariate correlations between numeric variables were assessed using Spearman's correlation. Female representation across editorial boards was 12.1%. Most editorial board members belonged to the United States (35.2%), with only 7.4% from the lower-middle-income countries and 0% from low-income countries. IF showed a strong positive correlation with female editorial representation (r=0.70) but an inverse correlation with low- and middle-income countries (LMICs) editorial representation (r=-0.45). Female editorial representation demonstrated a significant positive correlation with female first authorship (r=0.45), whereas LMIC editorial representation correlated strongly with LMIC corresponding authorship (r=0.85). Women and researchers from LMICs are in the minority across editorial boards of CTS journals. However, a strong correlation between journal H-index and female editorial representation indicates that top-ranked journals are spearheading efforts to improve equitable sex-based and gender representations. Similar efforts are required to ensure more global geographic representation across editorial boards and top-ranked CTS journals are the best placed to lead by example.

European Journal of Vascular and Endovascular Surgery Publication Standards for Reporting Vascular Surgical Research

Manuscripts submitted to the European Journal of Vascular and Endovascular Surgery (EJVES) often contain shortcomings in baseline scientific principles and incorrectly applied methodology. Consequently, the editorial team is forced to offer post hoc repair in an attempt to support the authors to improve their manuscripts. This repair could theoretically have been prevented by providing more clear definitions and reporting standards to serve researchers when planning studies and eventually writing their manuscripts. Therefore, here we summarise the general principles for EJVES reporting standards. These reporting standards did not follow a systematic approach but reflect the common opinion of the current senior and section editors team. This team decided to only include recommendations regarding the most common pathologies in vascular surgery in this first edition of reporting standards, namely carotid artery disease, abdominal aortic aneurysm (AAA), peripheral arterial occlusive disease (PAOD), and chronic venous disease. In future editions, we plan to expand the areas of research. We present (1) a common set of minimum but required reporting standards applicable to every report, e.g., patient characteristics, study design, treatment environment, selection criteria, core outcomes of interventions such as 30 day death and morbidity, and measures for completeness of data including outcome information, and (2) a common set of minimum reporting standards for four vascular areas. The editors of the EJVES propose universally accepted definitions and reporting standards for carotid artery disease, AAA, PAOD, and chronic venous disease. This will enable the development of a convincing body of evidence to aid future clinical practice guidelines and drive clinical practice in the right direction. These first ever publication and reporting standards for EJVES aim to improve future research in our journal.

“A New Era in Surgical Excellence: Launching the Karnataka State Chapter’s Surgical Journal”–Karnataka Journal of Surgery

“A New Era in Surgical Excellence: Launching the Karnataka State Chapter’s Surgical Journal”–Karnataka Journal of Surgery

Mapping the scientific landscape and evolution of the international journal of surgery: A scientometric analysis (2004-2024)

Aim: The purpose of this study was to analyze the publication characteristics and development of the International Journal of Surgery over its 20-year history. Methods: This study included articles published in IJS during the 20 years from 2004 to 2024. The data were analyzed using the Citespace, VOS viewer, and the ‘Bibliometrix’ package in R software. We studied the dynamics and trend patterns of IJS literature production through descriptive bibliometrics and identified the most prolific authors, publications, institutions, and countries. Bibliometric maps were utilized to visualize published articles’ content and identify the most prolific research terms and topics in IJS, as well as their evolution over time. Results: A total of 5964 publications in the IJS from 2004 to 2023 and 356 publications in 2024 were included in the analysis. The study revealed a positive trend in literature production, although the number of articles published in IJS has slightly decreased recently. The most productive country was China (n=1,211), the most productive institution was Sichuan University (n=151), and the most prolific author was Wang Yang (n=87). The top 15 most cited articles focus primarily on research reporting standard guidelines for surgical studies. Research published in IJS mainly targeted middle-aged and older adults, emphasizing postoperative complications and treatment outcomes. The future research focus in IJS might center on integrating artificial intelligence and deep learning technologies to revolutionize surgical research and practice. Conclusions: The International Journal of Surgery significantly contributes to advances in surgical research. IJS prioritized enhancing patient outcomes and advancing surgical techniques, focusing on middle-aged and older adults, postoperative complications, and treatment outcomes. The journal emphasized robust evidence through retrospective, controlled, and cohort surgical studies. Integrating artificial intelligence and deep learning represented a significant frontier poised to revolutionize surgical care, shaping the future landscape of research and practice.

7046 Thyroid Storm After Thyroidectomy Without Underlying Hyperthyroidism

Abstract Disclosure: A.J. White-Cotsmire: None. B. Kodali: None. C. McHenry: None. M. Rahhal: None. Background: Thyroid storm is a feared complication of total thyroidectomy; however, this is a rare phenomenon seen primarily in patients with undiagnosed or poorly controlled thyrotoxicosis from Graves’ disease. Preoperative treatment of patients with hyperthyroidism with beta-adrenergic blockers and anti-thyroid medication to ensure that patients are euthyroid prior to thyroidectomy have largely eliminated this risk of thyroid storm. (1) We report a case of thyroid storm caused by release of preformed thyroid hormone, following extensive manipulation and resection of a large retrosternal nontoxic multinodular goiter. To our knowledge, this has not yet been previously described. Clinical Case: A 57yo female underwent a total thyroidectomy with resection of a large benign multinodular goiter with retrosternal extension, which was causing compressive symptoms. She had a nodular goiter for 7 years that was increasing in size. Fine needle aspiration 2 years prior to surgery demonstrated colloid and adenomatoid nodules with Hurthle cell changes. She had no history of hypo- or hyperthyroidism. TSH prior to surgery was 0.576µIU/ml (normal = 0.450-5.330µIU/ml). Extensive manipulation was required to deliver the goiter from beneath the manubrium. Pathology from her thyroid revealed a multinodular goiter without evidence of malignancy. Post-operative course was uncomplicated, and after an overnight stay, the patient was discharged home with 150mcg (1.5mcg/kg) levothyroxine daily. She presented to the emergency department 4 days later and was admitted to the intensive care unit with diffuse abdominal pain, nausea, vomiting, and myalgias, and she was diagnosed with atrial fibrillation with rapid ventricular response. TSH on admission was 0.020 µIU/ml, thyroglobulin levels were >2,250.0ng/mL (n=0.8 – 48.0 ng/mL), thyroglobulin antibodies were negative. Her levothyroxine was stopped, her heart rate was controlled with metoprolol, and she was started on oral anticoagulation with rivaroxaban. She was discharged after a 7-day hospital stay. At 3 weeks follow-up her TSH was 35.67µIU/ml and her thyroglobulin levels were 23.9ng/mL. Her symptoms had resolved, and levothyroxine was resumed at a lower dose of 137mcg daily. Six weeks later her TSH level was 7.785µIU/ml, and her thyroglobulin was 1.8ng/mL. Conclusion: To our knowledge, this is the first case of thyroid storm reported following thyroidectomy in a patient with nontoxic multinodular goiter in a clinically and biochemically euthyroid patient. Massive increase in thyroglobulin postoperatively and rapid resolution of symptoms suggest that the release of preformed thyroid hormone related to vigorous thyroid manipulation was likely the cause. Reference: (1) Christou N, Mathonnet M. Complications after total thyroidectomy. Journal of Visceral Surgery. 2013;150(4):249-256. doi:10.1016/j.jviscsurg.2013.04.003 Presentation: 6/1/2024

AI in Surgery: Navigating Trends and Managerial Implications Through Bibliometric and Text Mining Odyssey.

Background:This research employs bibliometric and text-mining analysis to explore artificial intelligence (AI) advancements within surgical procedures. The growing significance of AI in healthcare underscores the need for healthcare managers to prioritize investments in this technology. Purpose:To assess the increasing impact of AI on surgical practices through a comprehensive analysis of scientific literature, providing insights that can guide managerial decision-making in adopting AI solutions.Research Design:The study analyzes over 6000 scientific articles published since 1990 to evaluate trends and contributions in the field, informing managers about the current landscape of AI in surgery.Study Sample:The research focuses on publications from various influential publishers across North America, Northern Asia, and Eastern & Western Europe, highlighting key markets for AI implementation in surgical settings.Data Collection and Analysis:A bibliometric approach was utilized to identify key contributors and influential journals. At the same time, text-mining techniques highlighted significant keywords related to AI in surgery, aiding managers in recognizing essential areas for further exploration and investment.Results:The year 2022 marked a significant upsurge in publications, indicating widespread AI integration in healthcare. The U.S. emerged as the foremost contributor, followed by China, the UK, Germany, Italy, the Netherlands, and India. Key journals, such as Annals of Surgery and Spine Journal, play a crucial role in disseminating research findings, serving as valuable resources for managers seeking to stay informed.Conclusions:The findings underscore AI's pivotal role in enhancing diagnostic precision, predicting treatment outcomes, and improving operational efficiency in surgical practices. This progress represents a significant milestone in modern medical science, paving the way for intelligent healthcare solutions and further advancements in the field. Healthcare managers should leverage these insights to foster innovation and improve patient care standards.

Selected Abstracts from the October 2024 Issues of the Journal of Vascular Surgery and the Journal of Vascular Surgery: Venous and Lymphatic Disorders

Selected Abstracts from the October 2024 Issues of the Journal of Vascular Surgery and the Journal of Vascular Surgery: Venous and Lymphatic Disorders

The Most Influential Publications in Oral and Maxillofacial Surgery Over the Past Decade

Reliable metrics are needed to measure the impact of academic publications in order to fully understand and evaluate the contributions of articles published in the field of oral and maxillofacial surgery(OMFS). The aim was to identify and analyze the top 100 articles each year, with the highest Field-Weighted Citation Impact(FWCI) and citation counts, in the field of OMFS over the past decade, totaling 1,000 articles. The research was conducted on April 20, 2024, using the Scopus database. It identified the top 100 articles each year with the highest FWCI from the top six journals with the highest metric scores in OMFS, totaling 1,000 articles. The citation counts of these publications in Google Scholar were also recorded. The predictor variable was the articles. The primary outcome variable was the FWCI value, while the secondary outcome variable was the number of citations. The covariates were the journals in which the articles were published, the publication year, the type of document, the type of access policy, and the subject of the research. There was a weak positive correlation between FWCI and citation count(rho = 0.083, P = .009). All covariates significantly affected FWCI(P < .005), while all but access policy significantly affected citation count(P = .167). The highest average FWCI(6.31 ± 5.51) was observed in the Journal of Stomatology, Oral and Maxillofacial Surgery(JSOMS), and the highest citation count was found in the Journal of Oral and Maxillofacial Surgery(JOMS)(61.5 ± 126.4). Orthognathic Surgery and Dentofacial Deformities were the scientific fields with the most publications(14 %). COVID-19 and Artificial Intelligence had the highest FWCI(8.65 ± 10.98 and 7.68 ± 6.42, respectively). MRONJ had the highest average citation count(88.6 ± 254). This study demonstrates that using both FWCI and citation count metrics can more accurately assess the impact of academic publications in the field of OMFS. These findings can serve as a guide for future research and contribute to strategic decisions aimed at improving clinical practices and patient care.

Do prospective randomized controlled trials comply with filed protocols? Spin study of 206 trials from 2010 to 2023

IntroductionProspective randomized controlled trials (RCT) have a robust methodology, but some distortions may occur during the course of study. Some protocols may not be available at the time an article is reading. Some authors may change the methodology between the time the protocol was submitted and when the trial results are actually published. Others may distort results to favor more attractive findings and draw conclusions that support prior hypotheses. This has rarely been investigated and none explored the RCTs published in the Journal of Bone and Joint Surgery (JBJS). Therefore, we did a retrospective investigation aiming to determine: (1) the proportion of trials with a protocol deposited and accessible to the reader, (2) whether the trials scrupulously followed the filed protocols. HypothesisProtocols were available in over 80% of cases, and these protocols were followed in over 80% of trials for the primary endpoint. Patients and methodsThis was a retrospective study of articles published in the JBJS between January 2010 and November 2023. Differences in primary and secondary endpoints between protocols and articles were sought. ResultsOf the 206 RCT articles studied, 113 (54.9%) described clear and identifiable endpoints, and 93 (45.1%) were not identifiable and were inferred in the results; 184 (89.3%) articles identified a trial protocol. For the 184 articles (89.3%) declaring a trial protocol in the text, 23 (11.1%) protocols were not accessible. In all, 45 articles (21.8%) thus had no protocol available on the Internet (i.e., not available to the reader either because it was not cited in the text or because it was not accessible) so we analyzed 161 articles. The primary endpoint remained unchanged in 97 articles (60.2%) out of the 161 studied, was changed in 64 articles (39.8%), and was lacking (protocol not accessible) in 45 articles (21.8% of all articles). The secondary endpoints of the articles were unchanged in 61 articles (37.9%) out of the 161 studied. DiscussionLike other leading journals, JBJS publishes RCT articles containing a significant proportion of inconsistencies between preoperative trial protocols and the methods actually used in the research. Level of evidenceIII; retrospective comparative study non randomized

Podium to Publication: An Analysis of Papers Presented at the British Association of Paediatric Surgeons (BAPS) Congress (2009–19)

BackgroundThe British Association of Paediatric Surgeons (BAPS) annual congress is an opportunity to present clinical and scientific data that may influence future practice. The presentation of the Abstract is but the first step towards definitive publication in the medical literature. Our aim was to review what the success rate has been from previous congresses. MethodsAbstracts were reviewed for the 11-year-period 2009 to 2019. A MEDLINE search using keywords from title and authors’ names was used to identify subsequent publication. Comparison with a previous dataset [1] (1999-2008) was also carried out. Linear data were compared for trend using Mann-Whitney-U. P ≤ 0.05 was accepted as significant. Data were expressed as median (interquartile range). Results1061 abstracts were presented orally with 555 (52.3%) subsequently published. The number per year was 90 (81–106) compared to 81 (74–79) in 1999–2008 (P = 0.25), although with a higher number actually published thereafter [45 (32–54)% vs. 30 (27–35)%; P = 0.0003)]. Publication occurred in a wide range of journals (n = 99), with most being in the Journal of Pediatric Surgery (n = 251), albeit with a smaller proportion (49% vs. 69% formerly, P < 0.05). Overall, UK institutions contributed 52.6% (n = 558) of abstracts with 240 (43%) of them subsequently published at 19 (17–29)/year. The proportion of UK presentations had increased from 43% formerly (P = 0.016). Most UK presentations originated from institutions within London [41% vs. 45% formerly, P = 0.04]. There was a wide range of abstracts from institutions from outside of the UK (n = 49) with 38 (26–51) abstracts accepted each year and of these 62.4% were subsequently published at 20 (15–36)/year. ConclusionThere has been an increase in abstracts accepted for presentation over the period, together with a higher proportion actually reaching publication. A strong international contribution was noted which has also been maintained. London remains the primary source of abstracts and publications from within the UK, although there was a higher proportion from other UK centres noted over this period.Reference [1] Macdonald AL, Parsons C, Davenport M. Outcome of abstracts presented at the British Association of Paediatric Surgeons congresses (1999–2008). J Pediatr Surg. 2012; 47: 386-90. doi: 10.1016/j.jpedsurg.2011.09.043.

Rosalind Franklin Society Proudly Announces the 2023 Award Recipient for Journal of Gynecologic Surgery

Rosalind Franklin Society Proudly Announces the 2023 Award Recipient for <i>Journal of Gynecologic Surgery</i>

Evaluating Compliance of Randomized Controlled Trial Abstracts in Plastic Surgery Journals with CONSORT Guidelines Using GPT-4 AI

Background: The quality of reporting in randomized controlled trials (RCTs) is crucial for accurate interpretation and synthesis of evidence. The Consolidated Standards of Reporting Trials (CONSORT) guidelines provide a standardized framework for reporting RCT abstracts. This study aimed to evaluate the adherence of RCT abstracts published in three major plastic surgery journals to the CONSORT tool guideline for reporting abstracts, utilizing Generative Pre-trained Transformer 4 artificial intelligence (GPT-4 AI) technology. Methods: Abstracts of RCTs published between 2010 and 2023 were collected. The GPT-4 AI model was utilized to assess the abstracts based on the CONSORT criteria. Descriptive statistics were used to report the compliance scores and identify areas where abstracts lacked compliance. Results: Of the initially identified 500 abstracts, a total of 371 RCT abstracts met the inclusion criteria and were analyzed. The mean CONSORT score was 10.05 (±2.22), with a median score of 10.72. Specific areas where abstracts lacked compliance included trial design (39.6%), participant details (28.8%), intervention descriptions (15.6%), randomization process (25.3%), and the number of participants analyzed (33.4%). Trial registration (18.3%) and funding information (15.1%) were also frequently missing. Conclusions: Our study’s innovative use of the GPT-4 AI model for analysis demonstrated the potential of AI technology in streamlining and enhancing the evaluation of research compliance. We advocate for heightened awareness and more rigorous application of CONSORT guidelines among authors, reviewers, and journal editors. Emphasizing the role of AI technology in the evaluative process can further improve the reporting quality of future RCTs in plastic surgery, contributing to more reliable and transparent research in the field.

Global research trends in postoperative ileus from 2011 to 2023: A scientometric study.

Postoperative ileus (POI) is a common complication after abdominal surgery with high morbidity, which hinders patient recovery, prolongs hospitalization, and increases healthcare costs. Therefore, POI has become a global public health challenge. POI triggering is multifactorial. Autonomic and hormonal mechanisms are generally involved in POI pathogenesis. Recent studies have shown that beta adrenergic signaling of enteric glia is a POI trigger. Currently, the status quo, trends, and frontiers of global research on POI remain unclear. To explore the current status, trends, and frontiers of POI research from 2011 to the present based on bibliometric analysis. Publications published on POI research from 2011 to 2023 were retrieved on June 1, 2023, from the Web of Science Core Collection. CiteSpace 6.2.R2 and VOSviewer were used to conduct bibliometric visualization. In total, 778 POI records published from 2011 to 2023 were retrieved. Over the past few decades, the annual cumulative number of related articles has linearly increased, with China and the United States of America contributing prominently. All publications were from 59 countries and territories. China and the University of Bonn were the top contributing country and institution, respectively. Neurogastroenterology & Motility was the most prolific journal. The Journal of Gastrointestinal Surgery had the highest number of citations. Wehner Sven was the most productive author. Burst keywords (e.g., colon, prolonged ileus, acupuncture, paralytic ileus, pathophysiology, rectal cancer, gastrointestinal function, risk) and a series of reference citation bursts provided evidence for the research frontiers in recent years. This study demonstrates trends in the published literature on POI and provides new insights for researchers. It emphasizes the importance of multidisciplinary cooperation in the development of this field.

Knowledge mapping of frailty and surgery: a bibliometric and visualized analysis

PurposeFrailty is common in surgical patients and is closely associated with postoperative outcomes.AimsThis study employed bibliometric methods to summarize and analyze research related to frailty and surgery, comprehensively analyzing the research structure and providing visualized maps.MethodsThis study analyzed the volume of publications, countries, institutions, authors, journals, references, and keywords related to perioperative frailty in the Web of Science Core Collection from 1978 to 2024. Visual bibliometric analyses were conducted from multiple perspectives, including collaboration networks, citation analysis, and keyword clustering.ResultsFrom 1978 to 2024, 21,879 authors from 95 countries and regions published 4,119 papers on perioperative frailty in 973 journals worldwide. The United States has the most publications, while Italy has the highest degree of international collaboration. The University of California System has the highest number of publications. The University of Kansas Medical Center is the institution with the highest centrality. The top nine authors in terms of publication volume are all from the USA. Bowers Christian A. is the most prolific author. The Journal of Vascular Surgery is the journal with the most publications. Current research directions include preoperative risk assessment of frailty, the relationship between frailty and postoperative complications, elderly frailty, and the relationship between frailty and sarcopenia. Research hotspots include risk stratification, postoperative delirium, the elderly, and sarcopenia.ConclusionThis study has identified the research hotspots and trends in perioperative frailty. Our findings will enable researchers to understand this field’s knowledge structure better and identify future research directions.

The Comparative Performance of Large Language Models on the Hand Surgery Self-Assessment Examination.

Generative artificial intelligence (AI) models have emerged as capable of producing human-like responses and have showcased their potential in general medical specialties. This study explores the performance of AI systems on the American Society for Surgery of the Hand (ASSH) Self-Assessment Exams (SAE). ChatGPT 4.0 and Bing AI were evaluated on a set of multiple-choice questions drawn from the ASSH SAE online question bank spanning 5 years (2019-2023). Each system was evaluated with 999 questions. Images and video links were inserted into question prompts to allow for complete AI interpretation. The performance of both systems was standardized using the May 2023 version of ChatGPT 4.0 and Microsoft Bing AI, both of which had web browsing and image capabilities. ChatGPT 4.0 scored an average of 66.5% on the ASSH questions. Bing AI scored higher, with an average of 75.3%. Bing AI outperformed ChatGPT 4.0 by an average of 8.8%. As a benchmark, a minimum passing score of 50% was required for continuing medical education credit. Both ChatGPT 4.0 and Bing AI had poorer performance on video-type and image-type questions on analysis of variance testing. Responses from both models contained elements from sources such as PubMed, Journal of Hand Surgery, and American Academy of Orthopedic Surgeons. ChatGPT 4.0 with browsing and Bing AI can both be anticipated to achieve passing scores on the ASSH SAE. Generative AI, with its ability to provide logical responses and literature citations, presents a convincing argument for use as an interactive learning aid and educational tool.

Comment on the article “Multiple recurrences of adnexal torsion in a 9-year-old girl: a clinical observation”

Commentary on the article by N.S. Bakaeva, D.A. Baranov, V.A. Vecherkin, V.A. Ptitsyn, P.V. Koryashkin, V.M. Gagloeva “Multiple recurrences of adnexal detorsion in a 9-year-old girl: case report”, published in the journal Russian Journal of Pediatric Surgery, Anesthesia and Intensive Care. 2024;14(3):441–449. DOI: https://doi.org/psaic1781

"Academic Influence and Industry Funding in Nerve Allograft Research: A Co-Authorship Network Analysis".

Clinical use of acellular nerve allografts is rapidly increasing despite limited high-quality, comparative evidence of superiority. Simultaneously, non-research payments to clinicians by the nerve allograft industry exceeds $14,000,000 over the last decade. In this study, the authors hypothesized that nerve allograft-related academic influence would correlate with industry funding. PubMed studies on nerve allografts in plastic and reconstructive surgery journals were reviewed. Using author lists from extracted studies, a co-authorship network was generated and degree centralities - quantitative measurements of influence within a network - were calculated. Open Payments data from the nerve allograft industry was summated for each author. Finally, Pearson correlation and linear regression were used to analyze the relationship between centrality and payments received. 185 studies were included, with 581 unique authors (nodes) and 2,406 co-authorships (ties) between them. Among authors with exceptional network influence (centrality >10, 75th percentile; n=113), 56 were clinicians with valid NPIs and therefore eligible for inclusion in the Open Payments database. 44 (79%) of these authors received at least one payment from the industry. Pearson correlation revealed a moderate (0.4<r<0.6) positive correlation between centrality and payments received (r=0.51, p<0.001). Linear regression demonstrated an estimated 16% increase in total pay per additional unit of centrality (p<0.001; 95% CI [8%, 25%]). There is a significant connection between academic influence and financial support from the nerve allograft industry. Such results warrant discussion concerning conflicts of interest in clinical research and best practices for mitigating potential bias related to commercially backed treatments.

Letter from the Editor-in-Chief of The Pacific Northwest Journal of Surgery

This is an opening editorial letter from the Editor-in-Chief regarding the aims and objectives of The Pacific Northwest Journal of Surgery.

276 Use of triaxial accelerometers and a machine learning algorithm for behavioral identification to assess the effectiveness of a joint supplement in old domestic cats (Felis catus)

Abstract Degenerative joint disease (DJD) has a 90% prevalence in older cats and adversely affects quality of life1. Long-term administration of non-steroidal anti-inflammatory drugs is usually required but can have adverse effects2. Nutraceuticals have been shown to relieve joint pain in cats without such side effects; however, due to differences in dose rates and formulations there is no consensus as to their efficacy. Most studies have utilized subjective insensitive measures such as veterinary or owner-assessed changes in activity. Accelerometers can provide objective data on cat activity and can identify specific behaviors3.Triaxial accelerometers (ActiGraph, Pensacola, FL) were fitted to the collars of 16 cats (aged 11 to 16 yr; Massey University, Palmerston North, NZ) for 20 wk to assess their activity and behavior. The cats were fed the same diet (Chef: Kraft Heinz Wattie’s Ltd., Hastings, NZ) for 4 wk to collect baseline acceleration data, before being divided into two groups balanced for physical activity. After 4 wk, a blood sample were taken from all of the cats to establish their baseline levels of a range of inflammatory markers (e.g., IL-6, TNFα, INF- γ, SDF-1). The test group (n = 8) then received a joint supplement added to the baseline diet while the control group (n = 8) were fed the diet unsupplemented for 16 wk. The commercial joint supplement contained glucosamine, chondroitin sulphate, and green-lipped mussel (Tandem, Wellington, NZ), at daily doses shown previously to be effective in cats4,5,6. The aim of the work was to assess the efficacy of the joint supplement in maintaining or promoting activity and specific behaviors in the cats. At the end of the period of supplementation a second blood sample was taken and assessed for the same range of inflammatory markers. Overall physical activity was not different between groups at baseline but was greater over the study in the test group compared with the control (P &amp;lt; 0.03). Grooming, as identified by the algorithm, showed a tendency (P = 0.051) to be greater in the test group than the control. These results suggest that the supplement had a positive effect on both overall activity and more specifically on grooming behavior in old cats. However, no differences in the range of inflammatory markers were seen before or after supplementation. While the behavioral measures could indicate the supplement reduced the effects of DJD, further research is required to confirm this.1Cunningham et al (2022) Journal of Feline Medicine and Surgery 24, 962-974. 2Lemetayer and Taylor (2014) Journal of Feline Medicine and Surgery 16, 547-562; 3Smit et al., (2023) Sensors 23, 7165; 4Corbee (2022) Veterinary Medicine and Science 8, 1025–1035; 5Corbee et al. (2013) Journal of Animal Physiology and Animal Nutrition 97, 846–853; 6Lascelles et al. (2010) Journal of Veterinary Internal Medicine, 24, 487–495.