Surgical Research Research Articles

Involvement of the University of Rwanda in Medical and Surgical Research: A Bibliometric Analysis of Achievements and Gaps

Background: In the past few decades, global health research has grown incredibly quickly. The interest of scientists and medical professionals in evidence-based medicine (EBM), new drug and vaccine discovery are among the main reasons for the rapid increase of the scholarly literature in health research. The aim of this research is to analyse the scholarly literature published by UR - affiliated researchers, and discover the achievements and gaps in medical and surgical research at the University of Rwanda. Methods: The University of Rwanda was searched in Lens Scholarly Works, and all articles connected to the university were discovered. We filtered the initial results by field of study to locate materials that were published in medical and surgical fields. Except for co-authorship and keyword co-occurrence analysis which were done using VOSviewer software, all bibliometric analyses were carried out using Lens database. Results: For the initial search, University of Rwanda was associated with 2,821 articles. After careful assessment of publications based on their field of study, a total of 1, 220 and 106 publications were found to be in the medical and surgical fields respectively. The analysis was based on the category of scholarly work, the chemicals of focus of the study, the authors, the funders, and the journal that published the study. Journal articles constitute a sizable fraction of these publications, whereas conference articles, book chapters, reprints, and reports make up a far smaller portion. By comparing the numbers of publications, authors, and funding in the surgical and medical field, many gaps are apparent in surgical than medical research field. Conclusion: Although there is an increase in number of publications in the University of Rwanda, the number of medical and surgical literature in UR is still low. Improving mentorship to students and involving them in ongoing research projects; not restricting them to only data collection but allow them to participate in peer-reviewed publications are key measures to increase number of medical and surgical scholarly publications in University of Rwanda.

Choosing the Best Design in Surgical Research.

Choosing the Best Design in Surgical Research.

Collaboration is key: the role of social media in advancing surgical research

Social media has revolutionized how we design, deliver, and disseminate surgical research for the better. The rise of collaborative research groups has been a major contributor to and beneficiary of social media, leading to increased involvement from clinicians, medical students, healthcare professionals, patients, and industry.Everyone benefits from collaborative research by widening access and participation and delivering more impactful research with increasing validity of results applicable to global populations. Now more than ever, the international surgical community is engaged in the process of surgical research, including the role of interdisciplinary collaboration. Patient groups are also central to the process of collaboration. By delivering increasingly relevant research, and by asking pertinent research questions that patients value, higher-impact research is more likely to directly lead to clinical change. From an academic perspective, hierarchies have flattened, facilitating the inclusion of anyone who is interested in contributing to surgical research to be able to do so.Social media has led to a paradigm shift in how surgical research may be conducted. Diversity of thought in research is improving, and engagement in surgical research is at an all-time high. Collaboration of all stakeholders is key to #SoMe4Surgery success and is the new ‘gold standard’ of surgical research.

Association for Academic Surgery/Society of University Surgeons research awards are highly successful in fostering future surgeon–scientists

BackgroundThe surgeon–scientist brings a unique perspective to surgical research. The Association of Academic Surgeons and Society of University Surgeons foster the development of surgeon–scientists through foundation awards to residents and junior faculty. We sought to evaluate the academic success of surgeons who received an Association for Academic Surgery/Society of University Surgeons award. MethodsInformation was collected for individuals who received a resident or junior faculty research award from the Association for Academic Surgery or Society of University Surgeons. Google Scholar, Scopus, and the National Institutes of Health Research Portfolio Online Reporting Tools: Expenditures and Results were used to assess scholarly achievements. ResultsEighty-two resident awardees were included, 31 (38%) of whom were female. Thirteen (24%) are now professors, 12 (22%) are division chiefs, and 4 (7%) are department chairs. Resident awardees have a median of 886 citations (interquartile range 237–2,111) and an H-index of 14 (interquartile range 7–23). Seven (13%) went on to receive K08/K23 awards, and 7 (13%) received R01s, with a total of about $200 million in National Institutes of Health funding (79-fold return on investment). Thirty-four junior faculty awardees were included, 10 (29%) of whom were female. Thirteen (38%) are now professors, 12 (35%) are division chiefs, and 7 (21%) are department chairs. Faculty awardees have a median of 2,617 citations (interquartile range 1,343–7,857) and an H-index of 25 (interquartile range 18–49). Four (12%) received K08 or K23 awards, and 10 (29%) received R01s, with about $139 million in National Institutes of Health funding (98-fold return on investment). ConclusionAssociation for Academic Surgery/Society of University Surgeons research awardees experience high degrees of success in academic surgery. Most resident awardees pursue fellowship training and remain in academic surgery. A high percentage of both faculty and resident awardees hold leadership positions and successfully achieve National Institutes of Health funding.

Social media and academic surgical research dissemination

Academic research dissemination has evolved tremendously throughout the 20th and early 21st centuries. With the advent of new technology and remote communication, the fast and efficient sharing of ideas has spread worldwide and has been appropriately embraced by academic surgical researchers. The use of social media by surgeons has expanded our ability to share hypotheses and published works that lead to higher degrees of collaboration than previously possible. The strengths of social media use for research dissemination in surgery include immediate collaboration on a global scale, faster dissemination of results previously hindered by the publishing process, open peer review from a wider audience, and enhancing the experience of academic meetings. However, social media use for research dissemination is not perfect and is hindered by lack of author verification, public misinterpretation, and lack of standardized enforceable professional guidelines. To combat these potential pitfalls, surgical societies should prioritize specific and intervenable guidelines for surgeons regarding the appropriate use of social media for research dissemination.

Citation versus disruption in the military: Analysis of the top disruptive military trauma research publications.

Bibliometric analysis of surgical research has become increasingly prevalent. Citation count (CC) is a commonly used marker of research quality, but may overlook impactful military research. The disruption score (DS) evaluates manuscripts on a spectrum from most innovative with more positive scores (disruptive [DR]) to most entrenched with more negative scores (developmental; DV). We sought to analyze the most DR and DV versus most cited research in military trauma. Top trauma articles by DS and by CC were identified via professional literature search. All publications in military journals were included. Military trauma-related keywords were used to query additional top surgical journals for military-focused publications. Publications were linked to the iCite NIH tool for CC and related metrics. The top 100 DR and DV publications by DS were analyzed and compared with the top 100 articles by CC. Overall, 32,040 articles published between 1954 and 2014 were identified. The average DS and CC were 0.01 and 22, respectively. Most articles were published in Mil Med ( 68%). The top 100 DR articles were frequently published in Mil Med (51%) with a mean DS of 0.148. Of these, the most cited article was only the 40th most disruptive. The top 100 CC articles averaged a DS of 0.009 and were commonly found in J Trauma (53%). Only five publications were on both the top 100 DR and top 100 CC lists; 19 were on both the top DV and CC lists. Citation count was not correlated with DR ( r = -0.134; p = 0.07) and only weakly correlated with DV ( r = 0.215; p = 0.003). DS identifies publications that changed military paradigms and future research directions previously overlooked by citation count alone. The DR and DV articles are distinct with little overlap between highly cited military articles. Multiple bibliometric measures should be employed to avoid overlooking impactful military trauma research. Diagnostic Test or Criteria; Level IV.

Surgical research—comic opera no more

Surgical research—comic opera no more

P-057 EFFECTS ON SURGICAL QUALITY, TRAINING, AND RESEARCH ON INGUINAL HERNIA AFTER CENTRALIZATION OF PLANNED INGUINAL HERNIA SURGERY IN A REGION

Abstract Aims Evaluate the effects of centralization of inguinal hernia surgery in Region Halland in Sweden on surgical quality, training and research on inguinal hernia. Methods Comparison of outcomes for Region Halland in relation to the national average in the Swedish Hernia Register before and after centralization. Review of how training and research on inguinal hernia changed after centralization. Results The percentage of patients operated on by “inguinal hernia specialists” increased from nearly 40% in 2008 to 90% in 2019. 20% of the surgeons operating > 90 hernias/year in Sweden are active in Region Halland, even though Region Halland only performs 4% of all inguinal hernia operations in Sweden. The risk of reoperation 3 years after inguinal hernia decreased from nearly 100% greater to 30% less than the national average (4% to 1.7%). The percentage of women that underwent the recommended posterior mesh surgeries increased from 5% (2007) to 90% (2019). The percentage of patients with bilateral hernias operated with TEP-TAPP increased from 5% (2007) to 98% (2020). After centralization residents’ training was formalized including at least 30 operation/resident. Halland runs one of the two national courses on TEP/TAPP. Peer-review publications on inguinal hernias increased from 2 to 6 articles. Conclusion The quality of inguinal hernia surgery and training of residents became better after centralization. The number of region-conducted research projects on inguinal hernia increased after centralization.

OC-106 #SOME4SURGERY

Abstract Aim Digital transformation of society is now a reality, as is the incessant increase in the use of social networks. The aim is to present digital platforms for surgeons, how they are used, what impact they have and their roles in research and communication. Material and methods We carried out a narrative review based on bibliographic searches on the use of social networks in health professionals, as well as studies of impact and repercussion in the field of surgical communication and research. Results There are different social networks that can be used by surgeons, Twitter being preferred for its easy use and speed of diffusion, with the ability to group specific topics and amplify them through the use of hashtags such as #SoMe4Surgery (Social Media for Surgery). It is possible to spread knowledge in specific areas, facilitate conversation, collaboration and support between professionals with common interests anywhere in the world. Conclusions Social networks have been described as a necessary component in the usual practice of surgery and as an obligation for surgeons to know how to recognize their power and potential and to be used in the preparation of guides or expert panels, as well as the dissemination of information and interaction between professionals in the face of the growing difficulty in the resources available to access continuing education programs or attendance at face-to-face events. All this through responsible use (even requiring the publication of a guide for the ethical use of social networks by the American College of Surgeons).

Surgical research in Colombia part 3: Authorship and publications of Colombian medical students in surgery in Colombian medical journals-cross-sectional study.

A bibliometric cross-sectional study was carried out, in which the Colombian medical journals were reviewed from 2010 to 2020. The articles with topics in general surgery and subspecialties where the authorship of medical students could be identified, were selected. Data on the sociodemographic and scientific characteristics of the authors and their publications were extracted and analyzed. A total of 14383 articles from 34 Colombian medical journals were reviewed. From 2010 to 2020, 807 articles related to surgery were published in Colombia. The most frequent typology of these articles was original articles (n=298; 37%), followed by case reports (n=222; 28.2%) and reviews (n=137; 17.3%). A total of 132 medical students and 141 authorships and were found, specifically in 9.9% (n=80/807) of these publications, with a higher frequency in original articles (n=32; 40%) and case reports (n=29; 36.2%). Collaboration of students with professors or surgeons was evidenced in 97.5% of the publications. The authorship of Colombian medical students in scientific publications in surgery in Colombian medical journals was low. From 2010 to 2020, student authors were found in 1 out of every 10 publications, mainly in original articles and clinical cases.

Legacy gifts 72 years in the making: a surgical research fellowship funded jointly by a father and daughter

How you can still leave a legacy gift to RCS England whilst ensuring your loved ones are protected.

A Road Map to Creating a High-Quality Clinical Database in Plastic Surgery.

Detailed in-house databases are a staple of surgical research and a crucial source of data for many studies from which clinical guidelines are built. Despite the importance of generating a clear and thorough developmental design, the literature on database creation and management is limited. In this article, the authors present their stepwise single-institution process of developing a clinical facial fracture database. The authors outline the process of development of a large single-institution clinical pediatric facial fracture database. The authors highlight critical steps from conception, regulatory approval, data safety/integrity, human resource allocation, data collection, quality assurance, and error remediation. The authors recorded patient characteristics, comorbidities, details of the sustained fracture, associated injuries, hospitalization information, treatments, outcomes, and follow-up information on Research Electronic Data Capture. Protocols were created to ensure data quality assurance and control. Error identification analysis was subsequently performed on the database to evaluate the completeness and accuracy of the data. A total of 4451 records from 3334 patients between 2006 and 2021 were identified and evaluated to generate a clinical database. Overall, there were 259 incorrect entries of 120,177 total entries, yielding a 99.8% completion rate and a 0.216% error rate. The quality of clinical research is intrinsically linked to the quality and accuracy of the data collection. Close attention must be paid to quality control at every stage of a database setup. More studies outlining the process of database design are needed to promote transparent, accurate, and replicable research practices.

A Meta-analysis Investigating the Gender Distribution and Rank of Authorship in Surgical Literature: Towards Improving Representation & Leadership of Women in Surgical Research

Journal of the American College of Surgeons 236(5):p S100, May 2023. | DOI: 10.1097/01.XCS.0000933172.02802.1a

A Retrospective Observational Study on the Integration of Social Media into Surgical Research

Journal of the American College of Surgeons 236(5):p S100, May 2023. | DOI: 10.1097/01.XCS.0000933176.43981.55

Registry randomized controlled trials: the future of surgical trials?

Registry randomized controlled trials: the future of surgical trials?

A 10-Year Analysis of Representation of Women in Patent Applications and NIH Funding in Vascular Surgery

There has been an increasing focus on gender disparities in the medical field and in the field of vascular surgery specifically. We aimed to characterize gender representation in vascular surgery innovation over the past 10years, using metrics of patents and National Institutes of Health (NIH) support. We performed a retrospective review of all vascular-related patent filings (Google Scholar) and NIH-funded grants (NIH RePORTER) over a 10-year period (January 1st, 2012, to December 31st, 2021). Gender-API (Application Programming Interface) was used to identify the gender of the inventors, with manual confirmation of a 10% random sample. Gender representation for patent inventors and grant principal investigators (PIs) were compared using Chi-squared and Student's t-tests as appropriate. Yearly temporal changes in representation were analyzed using Wilcoxon signed-rank tests and linear regression analyses. We identified 2,992 unique vascular device patents with 6,093 associated inventors over 10years. Women were underrepresented in patent authorship overall (11.5%), and were least likely to be listed as first inventor (8.9%) and most commonly fourth and fifth inventors (15.5% and 14.1%, respectively) compared to men. There was no significant change in representation of women inventors over time (-0.2% females per year, 95% confidence interval (CI) -0.54 to 0.10). We identified 1736 total unique NIH grants, with 23.8% of funded projects having women PIs. There was an increase in the proportion of women PIs over time (+1.31% per year, 95% CI 0.784 to 1.855; P<0.001). Projects with women PIs received mean total awards that were significantly lower than projects with men PIs ($350,485±$220,072 vs. $451,493±$411,040; P<0.001), but the overall ratio of funding:women investigators improved over time (+$11,531 per year, 95% CI $6,167 to $16,895; P=0.0011). While we have made strides in increasing the number of women in the surgical research space, there is still room for improvement in funding parity. In addition, we found substantial and persistent room for improvement in representation of women in surgical innovation. As we enter a new frontier of surgery hallmarked by equalizing gender representation, these data should serve as a call-to-action for initiative aimed at rebuilding the foundation of surgical innovations upon equal gender representation.

Global research status and trends in orthopaedic surgical robotics: a bibliometric and visualisation analysis study.

This study aimed to investigate and summarise the current state of research and trends in orthopaedic surgical robots. Data on publicly available publications related to orthopaedic surgical robots were extracted by abstract searches of the Web of Science Core Collection database. A bibliometric analysis and detailed reading of the publications were then carried out and the information was visualised using co-authorship analysis, coupling analysis, co-citation analysis and co-occurrence analysis in VOSviewer. With 436 publications included in the study from 1993 to 2022, the overall contribution of publications to the world showed an increasing trend year by year, with a particularly pronounced after 2017, and a geographical trend of predominantly East Asia, North America, and Western Europe. Of these, China was the largest contributor (n = 128). Overall, the UK affiliates and their scholars were leaders in the field, with a high number of publications, total citations, average citations per article and H-index. The most published institutions and authors were Imperial College London (n = 21) and Professor Fares Sahi Haddad of University College London (n = 12), respectively. Journals with a high overall impact on robotic orthopaedic surgery were the Journal of Arthroplasty, Bone Joint Journal, International Journal of Medical Robotics and Computer Assisted Surgery. Keyword co-occurrence network analysis revealed four main clusters: robot-assisted knee, hip arthroplasty, spine surgery, and robotic technology research and development. The top three most common sites for robot-assisted surgery use were the knee, hip and spine. The most used robot types were the knee and spine, with Mako and Arobot being the most used robots for the knee and TiRobot for the spine. This study comprehensively reveals the current status and trends of global research on orthopaedic surgical robots, covering countries, institutions, authors, journals, research hotspots, robot types and surgical sites, providing directional guidance and research ideas for further research on the technological development and clinical evaluation of orthopaedic surgical robots.

Patient and procedural risk factors for decline in lower-extremity motor scores following adult spinal deformity surgery.

The purpose of this study was to discern factors that differentiate patients who experience postoperative lower-extremity motor function decline in the early postoperative period. Adult spinal deformity (ASD) patients who were enrolled in a multicenter, observational, and prospectively collected study from 2018 to 2021 at 18 spinal deformity centers in North America were queried. Eligible participants met at least one of the following radiographic and/or procedural inclusion criteria: pelvic incidence minus lumbar lordosis (PI-LL) ≥ 25°, T1 pelvic angle (T1PA) ≥ 30°, sagittal vertical axis (SVA) ≥ 15 cm, thoracic scoliosis ≥ 70°, thoracolumbar scoliosis ≥ 50°, global coronal malalignment ≥ 7 cm, 3-column osteotomy, spinal fusion ≥ 12 levels, and/or age ≥ 65 years with ≥ 7 levels of instrumentation. Patients with an inflammatory or autoimmune disease and those who were incarcerated or pregnant were excluded, as were non-English speakers. Only patients with baseline and 6-week postoperative lower-extremity motor score (LEMS) were analyzed. Patient information, including demographic data, operative data, patient-reported outcomes, and radiographic parameters, were collected. Univariate and multivariable logistic regression models were built to quantify the degree to which a patient's postoperative LEMS decline was related to demographic and clinical characteristics. In total, 205 patients (mean age 61.5 years, mean total instrumented levels 12.6, 67.3% female, 54.2% primary cases, 79.5% with pelvic fixation) were evaluated. Of these 205 patients, 32 (15.5%) experienced LEMS decline in the perioperative period. These patients were older (p = 0.0014) and had greater BMI (p = 0.0176), higher frailty scores (p = 0.047), longer operating room times (p = 0.033), and greater estimated blood loss (p < 0.0001), and they were more frequently observed to have intraoperative neurophysiological monitoring (IONM) changes (p = 0.018). The deteriorated cohort had greater C7SVA at baseline (p = 0.0028) but were comparable in terms of all other radiographic parameters. No radiographic differences were seen between the groups at the 6-week visit; however, the deteriorated cohort experienced greater change in PI-LL (p < 0.0001), lumbar lordosis (p = 0.0461), C7SVA (p = 0.0004), and T1PA (p < 0.0001). Multivariate logistic regression demonstrated that the presence of IONM changes and each degree of negative change in T1PA conferred 3.71 (95% CI 1.01-13.42) and 1.09 (1.01-1.19) greater odds of postoperative LEMS deterioration, respectively. In this study, 15.6% of ASD patients incurred LEMS decline in the perioperative period. The magnitude of change in global sagittal alignment, specifically T1PA, was the strongest independent predictor of LEMS decline, which has implications for surgical planning, patient counseling, and clinical research.

Rise of pediatric surgery collaboratives to facilitate quality improvement

Broad changes in pediatric surgical care delivery are limited by the rarity of pediatric surgical diseases and the geographic dispersion of pediatric surgical care across different hospital types. Pediatric surgical collaboratives and consortiums can provide the patient sample size, research resources, and infrastructure to advance clinical care for children with who require surgery. Additionally, collaboratives can bring together experts and exemplar institutions to overcome barriers to pediatric surgical research to advance quality surgical care. Despite challenges to collaboration, many successful pediatric surgical collaboratives emerged in the last decade and continue to push the field forward towards high-quality, evidence-based care and improved outcomes. This review will discuss the need for continued research and quality improvement collaboratives in pediatric surgery, identify challenges faced when building collaboratives, and introduce future directions to expand impact.

PD45-08 THULIUM FIBER LASER VS HOLMIUM:YAG LASER: A PROSPECTIVE CASE-CONTROL STUDY IN LARGE URETERIC STONES

You have accessJournal of UrologyCME1 Apr 2023PD45-08 THULIUM FIBER LASER VS HOLMIUM:YAG LASER: A PROSPECTIVE CASE-CONTROL STUDY IN LARGE URETERIC STONES Mohamed Hatem, Abdullah Aljarod, Hatem Kamkoum, Tawiz Gul, Mohamed Ebrahim, Mohamad Rejeb, Kalpana Singh, Abdulla AL-Ansari, Omar Aboumarzouk, and Morshed Salah Mohamed HatemMohamed Hatem More articles by this author , Abdullah AljarodAbdullah Aljarod More articles by this author , Hatem KamkoumHatem Kamkoum More articles by this author , Tawiz GulTawiz Gul More articles by this author , Mohamed EbrahimMohamed Ebrahim More articles by this author , Mohamad RejebMohamad Rejeb More articles by this author , Kalpana SinghKalpana Singh More articles by this author , Abdulla AL-AnsariAbdulla AL-Ansari More articles by this author , Omar AboumarzoukOmar Aboumarzouk More articles by this author , and Morshed SalahMorshed Salah More articles by this author View All Author Informationhttps://doi.org/10.1097/JU.0000000000003358.08AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookLinked InTwitterEmail Abstract INTRODUCTION AND OBJECTIVE: The new Thulium Fiber Laser (TFL) has been recently introduced as an alternative lithotripsy technology. TFL is a promising alternative to Holmium:YAG (Ho:YAG) owing to its use of a more suitable TFL wavelength, smaller fibers, and potential for using a smaller and less expensive laser system. TFL has already showed its efficacy and safety in lithotripsy. We aimed to compare between TFL and Ho:YAG ureteroscopic lithotripsy for large stones >1cm. METHODS: We prospectively case controlled studied patients with ureteral calculi in the period between June 2020-July 2022. All adult patients with ureteric stones that required to undergo ureterolithotripsy were included. TFL or HO:YAG were used alternatively between the two modalities. The age, co-morbidities, body mass index (BMI), stone size, and volume were recorded. The evaluated parameters were stone-free rate (SFR), operative time, and complication rate. The surgical research section review board approved the study. Chi-Square tests with standardized residuals were calculated to see association with categorical variables and the groups. RESULTS: A total of 172 adult patients with ureteric stones >1cm were included in this study. 87 patients in the TFL group with a mean age of 37.9+-8.8 and 85 in the Ho:YAG group with a mean age of 39.4+-10.5 (p=0.34). There was no difference regarding BMI (26+-3.6 vs 26+-3.7)(p=0.96), Co-morbidity (16% vs 24% with multiple comorbidities)(p=0.49), anaesthesia type using general or spinal (57% vs 55%) (p=0.77), stone volume (1.6+-0.5 vs 1.5+-0.5)(p=0.41), or basket use (15% vs 15%)(p=0.95). Interestingly, the TFL group took longer to perform, with higher operative time than the Ho:YAG group (81.7+-42.2 vs 67+-35.1 (p=0.016)). This was likely due to the fact the TFL group did have more multiple stones requiring lithotripsy than the Ho:YAG group, however this was not statistically significant, but clearly, clinically significant whereby there was a 27% vs 19% multiple stones rate (p=0.23). There was no difference in the SFR (95% vs 96% (p=0.72)), second look ureteroscopy (14% vs 8%) (p=0.25)) or early or late complication rates, 1% vs 4% (p=0.3) and 0% vs. 1% (p=0.31), respectively. All patients were stone and complication free on follow up. CONCLUSIONS: TFL has proven its efficacy and safety with high SFR and low early and late complication rates. TFL ureteroscopic lithotripsy took longer to perform than Ho:YAG, probably due to having a higher stone burden, however statistically not significant. Source of Funding: No funding for this review was received. © 2023 by American Urological Association Education and Research, Inc.FiguresReferencesRelatedDetails Volume 209Issue Supplement 4April 2023Page: e1165 Advertisement Copyright & Permissions© 2023 by American Urological Association Education and Research, Inc.MetricsAuthor Information Mohamed Hatem More articles by this author Abdullah Aljarod More articles by this author Hatem Kamkoum More articles by this author Tawiz Gul More articles by this author Mohamed Ebrahim More articles by this author Mohamad Rejeb More articles by this author Kalpana Singh More articles by this author Abdulla AL-Ansari More articles by this author Omar Aboumarzouk More articles by this author Morshed Salah More articles by this author Expand All Advertisement PDF downloadLoading ...