Needlestick injuries: a density-equalizing mapping and socioeconomic analysis of the global research.

BACKGROUND: Needlestick injuries have caused a deleterious effect on the physical and mental health of millions of health-care workers over the past decades, being responsible for occupational infections with viruses such as HIV or hepatis C. Despite this heavy burden of disease, no concise studies have been published on the global research landscape so far. METHODS: We used the New Quality and Quantity Indices in Science platform to analyze global NSI research (n = 2987 articles) over the past 115 years using the Web of Science and parameters such as global versus country-specific research activities, semi-qualitative issues, and socioeconomic figures. RESULTS: Density-equalizing mapping showed that although a total of n = 106 countries participated in NSI research, large parts of Africa and South America were almost invisible regarding global participation in NSI research. Average citation rate (cr) analysis indicated a high rate for Switzerland (cr = 25.1), Italy (cr = 23.5), and Japan (cr = 19.2). Socioeconomic analysis revealed that the UK had the highest quotient QGDP of 0.13 NSI-specific publications per bill. US-$ gross domestic product (GDP), followed by South Africa (QGDP = 0.12). Temporal analysis of HIV versus hepatitis research indicated that NSI-HIV research culminated in the early 1990s, whereas NSI-hepatitis research increased over the observed period from the 1980s until the last decade. CONCLUSION: Albeit NSI research activity is generally increasing, the growth is asymmetrical from a global viewpoint. International strategies should be followed that put a focus on NSI in non-industrialized areas of the world.

The uterine fibroid/myoma tumour: analysis of the global research architecture using density-equalizing mapping.

Uterine fibroids can severely impact a woman's quality of life, result in significant morbidity and are a leading indication for hysterectomy. Many aspects of the disease remain largely obscure. Despite these knowledge gaps, no detailed maps of the global fibroid research architecture have yet been generated. This study used the NewQIS approach to assess worldwide research productivity, encompassing numerous aspects of the scientific output, quality and socioeconomic features. Regression analysis indicated an increase in fibroid research activity in the investigated time periods. Global research output was dominated by leading Western countries, with the USA at the forefront, but also by East Asian countries. Socioeconomic benchmarking revealed that Taiwan had the highest fibroid research activity per GDP, with a calculated average of 279.46 fibroid-related publications per 1000 billion USD GDP. Finland was the most active country with respect to research activity per population size. Subject area analyses revealed major differences in research focuses, for example 'Radiology, Nuclear Medicine and Medical Imaging' was assigned to 29.92% of South Korean and to only 10.38% of US-American publications. In conclusion, this analysis of global fibroid research activity illustrates a multitude of important features ranging from quantitative and semi-qualitative fibroid research aspects to socioeconomic benchmarking.

Correction to: World-wide research architecture of vitamin D research: density-equalizing mapping studies and socio-economic analysis.

After publication of the original article [1], the authors reported two errors which needed to be corrected.

World-wide research architecture of vitamin D research: density-equalizing mapping studies and socio-economic analysis.

BACKGROUND: Despite the numerous associations of vitamin D with health and disease, vitamin D deficiency is still common from a global perspective. While basic research, clinical and preventive activities grow constantly in vitamin D research, there is no in-depth analysis of the related global scientific productivity available so far. METHODS: Density equalizing mapping procedures (DEMP) were combined with socioeconomic benchmarks using the NewQIS platform. RESULTS: A total of 25,992 vitamin D-related research articles were identified between 1900 to 2014 with a significant increase (r2 = .6541) from 1900 to 2014. Authors located in Northern America - especially in the USA - distributed the majority of global vitamin D research, followed by their Western European counterparts. DEMP-analysis illustrates that Africa and South America exhibit only minor scientific productivity. Among high-income group countries, Scandinavian nations such as Denmark or Finland (2147.9 and 1607.7 vitamin D articles per GDP in 1000 billion USD) were highly active with regard to socioeconomic figures. CONCLUSION: Networks dedicated to vitamin D research are present around the world. Overall, the Northern American and Western European nations occupy prominent positions. However, South American, African and Asian countries apart from Japan only play a minor role in the global research production related to vitamin D. Since vitamin D deficiency is currently increasing in the Americas, Europe and parts of the Middle East, research in these regions may need to be encouraged.

Gender equality in academic research on epilepsy-a study on scientific authorships.

OBJECTIVE: The study aims to elucidate the state of gender equality in epilepsy research, analyzing the representation of female authorships from 2008 to 2016. METHODS: Gendermetrics aided in analyzing 106,282 authorships from 22,180 epilepsy-related original research articles. The key methodology was the combined analysis of the relative frequency and the odds ratio of female authorships. The Prestige Index measures the distribution of prestigious authorships between the two genders. RESULTS: The following were held by women: 39.6% of all authorships and 44.1% of the first, 41.0% of the co-, and 29.0% of the last authorships. Female authors have an odds ratio of 1.25 (95% CI 1.21-1.29) for first, 1.17 (CI 1.14-1.20) for co-, and 0.57 (CI 0.55-0.59) for last authorships. The female authorship ratios showed substantial growth in recent years, with an annual growth rate of 1.7% overall, with 2.4% for first, 1.4% for co-, and 1.9% for last authorships. Women publish fewer articles compared to men (43.8% female authors hold 39.6% of the authorships). Women are also less likely to secure prestigious authorships in articles with many authors that attract the highest citation rates. Multi-author articles with male key authors are cited slightly more frequently than articles with female key authors. Distinct differences at the country level were revealed. The prognosis for the next decade forecasts significantly increasing female odds for first authorships and only slightly higher female odds for last authorships. A female authorship ratio of 49.2% is predicted for the year 2026. SIGNIFICANCE: The integration of women in the scientific field of epilepsy is advanced. However, a dichotomy is present: Although the current system promotes early career steps, there is an apparent lack of female research leaders. This structural imbalance is expected to grow in the next decade due to the consistently high increase of female early career researchers.

Endometriosis and its global research architecture: an in-depth density-equalizing mapping analysis.

BACKGROUND: Endometriosis is one of the most common gynecological diseases. It is still a chameleon in many aspects and urges intense research activities in the fields of diagnosis, therapy and prevention. Despite the need to foster research in this area, no in-depth analysis of the global architecture of endometriosis research exists yet. METHODS: We here used the NewQIS platform to conduct a density equalizing mapping study, using the Web of Science as database with endometriosis related entries between 1900 and 2009. Density equalizing maps of global endometriosis research encompassing country-specific publication activities, and semi-qualitative indices such as country specific citations, citation rates, h-Indices were created. RESULTS: In total, 11,056 entries related to endometriosis were found. The USA was leading the field with 3705 publications followed by the United Kingdom (952) and Japan (846). Concerning overall citations and country-specific h-Indices, the USA again was the leading nation with 74,592 citations and a modified h-Index of 103, followed by the UK with 15,175 citations (h-Index 57). Regarding the citation rate, Sweden and Belgium were at top positions with rates of 22.46 and 22.26, respectively. Concerning collaborative studies, there was a steep increase in numbers present; analysis of the chronological evolution indicated a strong increase in international collaborations in the past 10 years. CONCLUSIONS: This study is the first analysis that illustrates the global endometriosis research architecture. It shows that endometriosis research is constantly gaining importance but also underlines the need for further efforts and investments to foster research and ultimately improve endometriosis management on a global scale.

Development of an animal model to evaluate the allergenicity of food allergens.

SCOPE: Considering the increasing numbers of patients suffering from food allergy (FA) as well as the great variety of novel foods and food compositions, an unmet need exists for the development of preclinical approaches to characterize the allergenic potential of proteins. The aim of our study was to evaluate the allergenicity of different food allergens in a rat model. METHODS: Brown Norway rats were sensitized to protein extracts (RuBisCO, apple, soy, peanut, garden pea) or ovalbumin (OVA) combined with Bordetella pertussis and aluminium hydroxide, followed by oral allergen challenges. RESULTS: Allergen-specific serum immunoglobulin production and the proliferation of mononuclear cells from spleen confirmed sensitization. To assess functional alterations in the gut, intestinal permeability was measured, which increased in sensitized and challenged animals compared to non-sensitized controls. Allergens with high allergenic potential (peanut, OVA, soy) caused a stronger immunological response than allergens with low allergenic potential, such as RuBisCO and apple. Moreover, the immunological responses were reduced when using boiled instead of raw soy and pea proteins. CONCLUSION: This model mimics key features of FA and facilitates investigating the allergenicity of allergens in novel food or food compositions in vivo.

Eating behavior and nutrition knowledge among musical theatre students.

Eating is a central part in human (social) life. Athletic performance and physical attractiveness are linked to appropriate nutritional behavior, especially for performing artists. Eating behavior and nutrition knowledge have not been examined in musical theatre students so far, which this study aims to analyze. We administered a cross-sectional questionnaire study to 37 musical theatre students. Results for the Eating Disorder Examination-Questionnaire (EDE-Q) showed non-pathological values for 92% of all participants, but 81% of participants answered correctly on only 30-59% of questions on the General Nutrition Knowledge Questionnaire (GNKQ). Our study results reveal the need for specific nutritional knowledge transfer programs for this target group.

Global cervical cancer research: A scientometric density equalizing mapping and socioeconomic analysis.

Cervical cancer has caused substantial morbidity and mortality for millions of women over the past decades. While enormous progress has been made in diagnosis, prevention and therapy, the disease is still fatal for many women-especially in low-income countries. Since no detailed studies are available on the worldwide research landscape, we here investigated the global scientific output related to this cancer type by an established protocol. The "New Quality and Quantity Indices in Science" platform assessed all relevant cervical cancer research published in the Web of Science since 1900. A detailed analysis was conducted including country-specific research productivity, indicators for scientific quality, and relation of research activity to socioeconomic and epidemiologic figures. Visualization of data was generated by the use of density equalizing map projections. Our approach identified 22,185 articles specifically related to cervical cancer. From a global viewpoint, the United States of America was the dominating country in absolute numbers, being followed by China and Japan. By contrast, the European countries Sweden, Austria, and Norway were positioned first when the research activity was related to the population number. When the scientific productivity was related to annual cervical cancer cases, Scandinavian countries (Finland #1, Sweden #4, Norway #5, Denmark #7), the Alpine countries Austria (#2) and Switzerland (#6), and the Netherlands (#3) were leading the field. Density equalizing mapping visualized that large parts of Africa and South America were almost invisible regarding the global participation in cervical cancer research. Our data documented that worldwide cervical cancer research activity is continuously increasing but is imbalanced from a global viewpoint. Also, the study indicated that global and public health aspects should be strengthened in cervical carcinoma research in order to empower more countries to take part in international research activities.

Oral administration of bacterial lysates attenuates experimental food allergy.

BACKGROUND: Modulating early immune response by application of bacteria and their by-products has been suggested as a preventive strategy against the development of allergic diseases. In light of this, the aim of the study was to test the effects of oral administration of bacterial lysates (BL) in a rat model of food allergy. METHODS: BL or PBS were administered orally to neonatal Brown Norway rats up to an age of 42 days. Additionally, animals were sensitized 3 times (days 35, 40 and 45) intraperitoneally with ovalbumin (OVA). On days 60 and 61, rats were locally challenged with OVA by gavage feeding. RESULTS: Detection of increased allergen-specific Ig serum levels and proliferative responses of spleen mononuclear cells confirmed systemic sensitization. In serum of animals that received BL in addition to OVA sensitization, the levels of allergen-specific IgE and IgG were significantly reduced compared to animals which were not exposed to BL. Allergen-stimulated lymphocytes from spleen and mesenteric lymph nodes of BL-treated animals showed a significantly elevated cytokine production of IL-10. To assess local functional changes of the intestinal barrier we measured the intestinal permeability, which was increased in OVA-sensitized and challenged animals compared to nonsensitized controls, yet significantly reduced in sensitized animals which received BL. CONCLUSION: These data suggest that local administration of BL (pathogen-associated molecular patterns) in the intestine exhibits immuno-modulating effects. Furthermore, pathophysiological features of food allergy, such as the loss of gut mucosal integrity, might be reduced by the treatment with BL.

[Shift- and Nightwork - a scientometric analysis]. / Schicht- und Nachtarbeit - eine szientometrische Analyse.

Economic restructuring processes in Germany require changes within all social and health care systems regarding night shiftwork. The aim of this paper was to analyse research results referring to shift- and nightwork using scientometric methods. A total of 3092 items could be detected. A constant increase in the number of publications per year since 1977, especially since 1990' was obvious. One third of the research results, a total of 884 articles could be assigned to the USA. Great Britain could be identified with 365 articles and France with 244 published articles. Sleep, Ergonomics and Chronobiology International are the most prolific journals. The Swedish scientist Torbjörn Akerstedt is to this date the most acclaimed researcher referring to his issue. He has written 105 articles about shift- and nightwork. He is not only a most efficient author, but also has the highest h-index [30]. Self-citations and multiple co-authorships distort parameters like impact factor and h-index enormously and should be regarded from a critical point of view.

Epidemiological Influences and Requirements of Global Childhood Obesity Research.

INTRODUCTION: Obesity is classified as a global epidemic and judged to be the greatest public health threat in Western countries. The tremendously increasing prevalence rates in children lead to morbidity and mortality in adults. In many countries, prevalence has doubled since the 1980s. Other countries show a continuous increase or stagnate at a very high level. Given these regional differences, this study aims to draw a global world map of childhood obesity research, including regional epidemiological characteristics, to comprehensively assess research influences and needs. METHODS: In addition to established bibliometric parameters, this study uses epidemiological data to interpret metadata on childhood obesity research from the Web of Science in combination with state-of-the-art visualization methods, such as density equalizing map projections. RESULTS: It was not until the 1990s that belated recognition of the dangerous effects of childhood obesity led to an increase in the number of publications worldwide. In addition, our findings show that countries' study output does not correlate with epidemiologic rates of childhood obesity. In contrast, the primary driver of the research efforts on childhood obesity appears to be largely driven government funding structures. DISCUSSION/CONCLUSION: The geographical differences in the epidemiological background of childhood obesity complicate the implementation of transnational research projects and cross-border prevention programs. Effective realization requires a sound scientific basis, which is facilitated by globally valid approaches. Hence, there is a need for information exchange between researchers, policy makers, and private initiatives worldwide.

Rheumatoid arthritis: scientific development from a critical point of view.

Rheumatoid arthritis (RA) is classified as a chronic, progressive, systemic autoimmune disorder leading to inflammation, stiffness, defective position and destruction of joints. Finally a complete loss of mobility and functioning can be the result. The fraction of disability varies strongly, for example, a systematic review shows a 50% disability in a period from first occurrence to disability from 4.5 to 22 years. Scientific efforts focused strongly on therapeutic and diagnostic methods during recent years. So far, there is no scientometric approach of the topic rheumatoid arthritis available although there is an increased need to evaluate quality and quantity of scientific research. Density-equalizing algorithms, scientometric methods and large scale data analysis were applied to evaluate the quality and quantity of scientific efforts in the field of rheumatoid arthritis. Data were gained from Pubmed and ISI-Web. During the period 1901-2007, 78,128 items were published by 129 countries including the USA, UK and Germany being the most productive suppliers, representing 45.7% of all publications. Another 23 countries published more than 100 items. In terms of international cooperation the USA proved to be the most successful partner. "Arthritis and Rheumatism", "Annals of the Rheumatic Diseases" and the "Journal of Rheumatology" are the most prolific journals. The current study is the first analysis of "rheumatoid arthritis" research activities and output. Our analysis revealed single areas of interest, the most prolific journals, authors and institutions dealing with the topic. Nevertheless, statements concerning the scientific quality should be considered critical due to a bias according to self-citation and co-authorship.

Influence of Second-Hand Smoke and Prenatal Tobacco Smoke Exposure on Biomarkers, Genetics and Physiological Processes in Children-An Overview in Research Insights of the Last Few Years.

Children are commonly exposed to second-hand smoke (SHS) in the domestic environment or inside vehicles of smokers. Unfortunately, prenatal tobacco smoke (PTS) exposure is still common, too. SHS is hazardous to the health of smokers and non-smokers, but especially to that of children. SHS and PTS increase the risk for children to develop cancers and can trigger or worsen asthma and allergies, modulate the immune status, and is harmful to lung, heart and blood vessels. Smoking during pregnancy can cause pregnancy complications and poor birth outcomes as well as changes in the development of the foetus. Lately, some of the molecular and genetic mechanisms that cause adverse health effects in children have been identified. In this review, some of the current insights are discussed. In this regard, it has been found in children that SHS and PTS exposure is associated with changes in levels of enzymes, hormones, and expression of genes, micro RNAs, and proteins. PTS and SHS exposure are major elicitors of mechanisms of oxidative stress. Genetic predisposition can compound the health effects of PTS and SHS exposure. Epigenetic effects might influence in utero gene expression and disease susceptibility. Hence, the limitation of domestic and public exposure to SHS as well as PTS exposure has to be in the focus of policymakers and the public in order to save the health of children at an early age. Global substantial smoke-free policies, health communication campaigns, and behavioural interventions are useful and should be mandatory.

Research landscape of a global environmental challenge: Microplastics.

Microplastics can be found all over the world, in the remotest regions and even in the Arctic snow. Primary microplastic is either produced as microparticles or enters the natural environment already as microparticles. Whereas secondary microplastic is generated by fragmentation or abrasion of other products in the natural environment. Both pollute the global ecospheres and even enter the human food chain. This study aims at the evaluation of the global publication output on both types of microplastic referring to absolute and contextual numbers. Only since 2006, the focus on the environmental burden led to an enormous increase of publications on MP. While China, USA and Germany are leading players regarding the absolute numbers, Portugal, Chile and Ireland are among the top countries when including socio-economic features and research expenditures. The responsibility for the big plastic waste producers can be shown by significantly correlating numbers of articles and the plastic waste generation, albeit here China and USA fall behind. However, the biggest producers are not the most affected countries. Despite the strong international interest, our study shows that many countries play no role at all in the publication landscape of MP. For future planning, it is necessary to extend the international collaborations to reach sustainable solutions for the whole planet earth.

Global research on Fabry's disease: Demands for a rare disease.

BACKGROUND: Fabry disease (FD), the second most prevalent lysosomal storage disorder, is classified as a rare disease. It often leads to significant quality of life impairments and premature death. Many cases remain undiagnosed due to the rarity and heterogeneity. Further, costs related to treatment often constitute a substantial financial burden for patients and health systems. While its epidemiology is still unclear, newborn screenings suggest that its actual prevalence rate is significantly higher than previously suspected. METHODS: Based on well-established methodologies, this study gives an overview about the background of the development of FD-related research and provides a critical view of future needs. RESULTS: On the grounds of benchmarking findings, an increasing research activity on FD can be observed. Most publishing countries are the USA, some European countries, Japan, Taiwan, and South Korea. In general, high-income countries publish comparably more on FD than low- or middle-income economies. The countries' financial and infrastructural background are unveiled as crucial factors for the FD research activity. CONCLUSIONS: Overall, there is a need to foster FD research infrastructure in developing and emerging countries with focus on cost-intensive genetic research that is independent from economic interests of big pharmaceutical companies.

Gender and workforce in urology - use of the BG Index to Assess Female Career Promotion in Academic Urology.

PURPOSE: Today, the majority of medical graduates in countries such as the UK, the US or Germany are female. This poses a major problem for workforce planning especially in urology. We here use first the first time the previously established Brüggmann Groneberg (BG) index to assess if female academic career options advance in urology. METHODS: Different operating parameters (student population, urology specialist population, urology chair female:male (f:m) ratio) were collected from the Federal Office of Statistics, the Federal Chamber of Physicians and the medical faculties of 36 German universities. Four time points were monitored (2000, 2005, 2010 and 2015). From these data, female to male (f:m) ratios and the recently established career advancement (BG) index have been calculated. RESULTS: The German hospital urology specialists' f:m ratios were 0.257 (499 female vs. 1944 male) for 2015, 0.195 for 2010, 0.133 for 2005 and 0.12 for 2000. The career advancement (BG) index was 0.0007 for 2000, 0,0005 for 2005, 0.094 for 2010 and 0.073 for 2015. The decrease from 2010 to 2015 was due to an increase in the f:m ratio of hospital urologists and female medical students. CONCLUSION: The BG index clearly illustrated that there is an urgent need for special academic career funding programs to counteract gender problems in urology. The BG index has been shown to be an excellent tool to assess female academic career options and will be very helpful to assess and document positive or negative changes in the next decades.

Stress and airway reactivity in a murine model of allergic airway inflammation.

Airway reactivity is a phenomenon with vast clinical implications in children. The regulation of airway reactivity is influenced by local and central mechanisms. In airway diseases like bronchial asthma, the pathological regulation of the airway caliber causes symptoms like cough and dyspnea. Stress has long been considered a powerful manipulator in the physiological regulation of the airways. To explore potential mechanisms linking stress to the exacerbation of asthma, we developed an animal model that combines allergic airway inflammation and exposure to stress. This review summarizes the experimental data obtained in our and similar mouse models. First, we describe the innervation and neuromediators in the airways, next we analyze the occurrence of airway hyperresponsiveness, and then we explore the phenomenon of stress to finally connect all of the topics in a synopsis.

Differential affection of intestinal immune cell populations after cerebral ischemia in mice.

BACKGROUND/AIMS: Infections cause a major clinical problem within the first days after cerebral stroke. In a mouse model we have recently demonstrated that stroke leads to immunodepression facilitating spontaneous bacterial pneumonia and bacteremia. So far, it has been unknown whether poststroke immunomodulation impairs local intestinal immune populations which may promote gut barrier dysfunction leading to translocation of intestinal microorganisms and microbial products. In this study, we investigated changes in intestinal intraepithelial, lamina propria and Peyer's patch immune cell populations after experimental stroke. METHODS: 129SV mice were subjected to experimental stroke by filament occlusion of the middle cerebral artery or sham operation. After 24 h, animals were sacrificed, and intraepithelial lymphocytes, lamina propria lymphocytes and Peyer's patches were isolated and leukocyte subpopulations analyzed by flow cytometry. RESULTS: Peyer's patches revealed a significant reduction of T and B cell counts after cerebral ischemia, while no differences in natural killer cells and macrophages were observed. In contrast, no significant changes in intraepithelial and lamina propria lymphocyte subsets were observed in middle cerebral artery animals compared to controls. CONCLUSION: Cerebral ischemia has differential effects on cellularity of gut-associated lymphoid tissue. Further studies on the mechanisms involved in quantitative changes of gut immune cells as well as on the function of these cells are needed to better understand the consequences of stroke-induced alterations of the local intestinal immune compartment for the enhanced susceptibility to infections after stroke.

Lipopolysaccharide stimulation of dendritic cells induces interleukin-10 producing allergen-specific T cells in vitro but fails to prevent allergic airway disease.

Dendritic cells (DCs) play an important role in directing naive T cells towards a Th1/Th2 or regulatory T cells (Treg) cell phenotype. In this context, interleukin (IL)-10 has been shown to exhibit immune regulatory capacities. The aim of this study was to delineate the influence of high-IL-10-producing DCs on DC-T-cell interactions in inhibiting allergen-induced airway inflammation and hyperreactivity in a murine model of allergic airway disease. Bone marrow-derived dendritic cells (BMDCs) were generated from hemopoietic progenitors by culture with granulocyte-macrophage colony-stimulating factor (GM-CSF), and stimulated with ovalbumin (OVA) +/- lipopolysaccharide (LPS). The effects of ovalbumin-pulsed BMDCs on cytokine production by allergen-specific naive T cells were studied in vitro. The development of airway inflammation in Balb/c mice was determined after intranasal administration of BMDCs in vivo. LPS stimulation of BMDCs strongly enhanced IL-10 production. Coculture of LPS-modulated DCs exhibiting increased IL-10 production with allergen-specific naive T cells reduced the production of interferon (IFN)-gamma and IL-5, but enhanced the production of IL-10. After blockade with anti-IL-10 plus anti-IL-10-receptor antibodies, the level of IFN-gamma and IL-5 production by cocultured T cells was restored, underlining the regulatory function of IL-10. Intranasal administration of high-IL-10-producing LPS-stimulated, OVA-primed BMDCs prior to repetitive airway allergen challenges resulted in an even enhanced airway inflammation. These data demonstrate that increased IL-10 production by DCs may be a critical element for T-cell activation and differentiation in the context of allergen-induced immune responses in vitro. However, this DC modulation did not translate into suppression of allergic airway disease in vivo.