Determining the Relationship Between Altmetric Score and Literature Citations in the Oral and Maxillofacial Surgery Literature.

PURPOSE: We explored whether Altmetric scores (London, UK) correlate with traditional bibliometrics in the oral and maxillofacial surgery (OMS) literature. MATERIALS AND METHODS: This study analyzed the 7 OMS journals with the highest impact factors (IFs) and the 20 most-cited articles within those journals from 2013 and 2016. Citations, Altmetric scores, and media "mentions" were studied. Correlations between Altmetric scores, citations, and IF were examined using Pearson correlation coefficients and descriptive statistics. Twitter account data (San Francisco, CA) also were compared with other metrics. RESULTS: There was no correlation between citations and Altmetric scores (r = 0.146, P = .087) or between IF and Altmetric scores (r = 0.139, P = .100) in 2013. Altmetric scores also were not significantly correlated with citations (r = 0.116, P = .176) or IF (r = 0.104, P = .225) in 2016. Total Altmetric scores were 2.5 times higher in 2016 than in 2013, with news outlets, Facebook (Menlo Park, CA), and Twitter showing 257%, 243%, and 307% increases in mentions, respectively. CONCLUSIONS: Compared with articles in other fields, OMS articles accrued lower Altmetric scores, representing a paucity of attention garnered on social media outlets. Altmetric scores are currently insufficient to replace traditional bibliometrics but can provide valuable information on public acquisition of knowledge, especially in the immediate post-publication interval.

Factors Associated With Low and High Article Citations in the Oral and Maxillofacial Surgery Literature.

PURPOSE: We assessed the factors in reported oral and maxillofacial surgery (OMS) studies associated with the number of citations. MATERIALS AND METHODS: We identified all primary research studies reported from 1998 to 2008 in the International Journal of Oral and Maxillofacial Surgery, Journal of Oral Maxillofacial Surgery (JOMS), British Journal of Oral Maxillofacial Surgery (BJOMS), and Journal of Craniomaxillofacial Surgery. Of the identified studies, 66 had obtained only 0 to 3 citations in the 10 years after publication. We compared these lowest cited reports with the 66 highest cited reports. The characteristics of the lowest and highest cited studies were compared using bivariate analysis. Logistic regression analysis using generalized estimating equations was conducted to examine the association between the selected article-, author-, and journal-level characteristics and high citations. RESULTS: On the initial bivariate analysis, highly cited studies were associated with greater abstract and manuscript word counts (P < .0001), manuscript pages (P < .0001), figures (P = .0482), sample sizes (P = .0149), and references (P < .0001). They were also more likely to have reported a significant result (P = .0202), been published in JOMS (P = .0405), and covered topics such as dentoalveolar/implantology and trauma/reconstruction (P = .0002). Lowly cited articles were more likely to have been published in BJOMS (P = .0405) and addressed topics unrelated to core OMS procedures (P = .0002). The H-indexes of the first and corresponding authors were greater in the high-citation group (P < .0001). After multivariate analysis, a greater number of manuscript pages (P = .0015) and classification as dentoalveolar/implantology (P = .0017) or trauma/reconstruction (P = .0368) had greater odds of high citations. In addition, a higher H-index for the first author made it more likely to be in the high-citation group (P = .0397). CONCLUSIONS: Relatively few studies in the OMS literature failed to produce citations in the 10 years after publication, indicating that most studies accepted for publication provide meaningful contributions. Significant differences were found between the highest and lowest cited publications, suggesting that study design and article structure might influence the articles' audience and effect.

Buffered 1% Lidocaine With Epinephrine Is as Effective as Non-Buffered 2% Lidocaine With Epinephrine for Mandibular Nerve Block.

PURPOSE: To assess outcomes for pulpal anesthesia and pain on injection for buffered 1% lidocaine with 1:100,000 epinephrine (EPI) versus non-buffered 2% lidocaine with 1:100,000 EPI. PATIENTS AND METHODS: In a randomized cross-over trial approved by the institutional review board, buffered 1% lidocaine with 1:100,000 EPI was compared with non-buffered 2% lidocaine with 1:100,000 EPI. After mandibular nerve block with buffered lidocaine 40 mg or non-buffered lidocaine 80 mg, patients reported responses at the mandibular first molar and canine after cold and electrical pulp testing (EPT). Patients also reported pain on injection with a 10-point Likert-type scale. Teeth were tested before nerve block and at 30-minute intervals until a positive response returned. Two weeks later, patients were tested with the alternate drug combinations. The same outcomes were assessed. Predictor variables were alternate drug formulations. Outcome variables were patients' responses to cold and EPT stimulation of the mandibular first molar and canine and pain on injection. An assessment of treatment difference was performed using Wilcoxon rank-sum tests with Proc NPAR1WAY (SAS 9.3, SAS Institute, Cary, NC). Significance was set at a P value less than .05. RESULTS: Fifty-seven percent of patients were women and 43% were men. Seventy percent were Caucasian, 17% were African American, and 13% had another ethnicity. Median age was 25 years (interquartile range [IQR], 21-26 yr) and median body weight was 140 lbs (IQR, 120-155 lbs). After the cold test and EPT, the time to sensation return for the molar or canine was not statistically different between the 2 drug formulations. Patients reported significantly lower pain scores with the buffered versus non-buffered drug (P < .01). CONCLUSIONS: After mandibular nerve block, buffered 1% lidocaine with EPI can produce similar clinical outcomes for duration of pulpal anesthesia as non-buffered 2% lidocaine with EPI and lower pain on injections, which are a potential benefit to patients.

Buffered 1% Lidocaine With Epinephrine Can Be as Effective as Nonbuffered 2% Lidocaine With Epinephrine for Maxillary Field Block.

PURPOSE: Buffering local anesthetics with epinephrine (Epi) offers clinicians options not often considered. This study assessed outcomes for pulpal anesthesia, pain on injection, and time to midface numbness for buffered 1% lidocaine with 1:100,000 Epi versus nonbuffered 2% lidocaine with 1:100,000 Epi. MATERIALS AND METHODS: In this trial with a randomized, crossover design, buffered 1% lidocaine was compared with nonbuffered 2% lidocaine. Subjects were adult volunteers who served as their own controls. The predictor variables were alternate drug formulations. The outcome variables were subjects' responses to cold and electric pulp testing (EPT) stimulation of the maxillary first molar and canine, pain levels during the injection, and time to midface numbness. After maxillary field blocks with 40 mg of buffered lidocaine or 80 mg of nonbuffered lidocaine, subjects reported pain on injection and responses of the maxillary first molar and canine after cold and EPT stimulation. Teeth were tested before field block and at 30-minute intervals until a positive response was detected. Two weeks later, subjects were tested with the alternate drug combinations. For all outcome variables, assessment of treatment difference, calculated as 1% buffered minus 2% nonbuffered, was performed with the Wilcoxon rank sum test with significance at P < .05. RESULTS: More of the 24 subjects were women and Caucasian. The median age was 23.5 years (interquartile range, 21, 25 years), and the median body weight was 155 lb (interquartile range, 128.5, 176.5 lb). Pain levels during the injection were significantly lower for 1% buffered lidocaine, with P = .04. Times to response after injection were not significantly different between the 2 drug formulations for the cold test on a molar, with P = .08, or the cold test on a canine, with P = .22. However, times to response were significantly longer for nonbuffered drugs for EPT on the molar and canine, both with P = .01. CONCLUSIONS: Buffering 1% lidocaine with 1:100,000 Epi reduces the pain on injection with a maxillary field block and results in similar lengths of pulpal anesthesia tested with a cold stimulus as compared with nonbuffered 2% lidocaine with 1:100,000 Epi.

Analyzing the relationship between Altmetric score and literature citations in the Implantology literature.

BACKGROUND: The influence of research has long been studied using citations and impact factors (IFs). Electronic media is changing how people interact with the scientific literature. There are few investigations into these trends. PURPOSE: To explore whether Altmetrics correlate with traditional bibliometrics in the Implantology literature. MATERIALS AND METHODS: Five Implantology journals with the highest IF and the 10 most highly-cited articles within those journals from 2013 to 2016 were reviewed. Altmetric score, citation count, and media "mentions" were recorded. Comparisons were conducted between Altmetric score, citations, and IF by performing Pearson correlation coefficients and descriptive statistics. Twitter accounts were studied and compared to other metrics. RESULTS: Analysis revealed no correlation between citations and Altmetrics (r = .096,P = .506) or IF and Altmetrics (r = .111,P = .443) in 2013. Altmetrics were also not significantly correlated with citations (r = 0.148,P = .305) or IF (r = .145,P = .315) in 2016. Total Altmetric scores were nine times higher in 2016 compared to 2013, with news outlets and Twitter seeing large increases in mentions. Twitter was the top medium receiving mentions across the two cohorts. CONCLUSIONS: Compared to other fields, Implantology articles received lower Altmetric scores, noting an area of improvement. Altmetrics at this time are insufficient to replace traditional bibliometrics, but may provide helpful real-time information concerning article dissemination.

Generalization of fear-potentiated startle in the presence of auditory cues: a parametric analysis.

Intense fear responses observed in trauma-, stressor-, and anxiety-related disorders can be elicited by a wide range of stimuli similar to those that were present during the traumatic event. The present study investigated the experimental utility of fear-potentiated startle paradigms to study this phenomenon, known as stimulus generalization, in healthy volunteers. Fear-potentiated startle refers to a relative increase in the acoustic startle response to a previously neutral stimulus that has been paired with an aversive stimulus. Specifically, in Experiment 1 an auditory pure tone (500 Hz) was used as the conditioned stimulus (CS+) and was reinforced with an unconditioned stimulus (US), an airblast to the larynx. A distinct tone (4000 Hz) was used as the nonreinforced stimulus (CS-) and was never paired with an airblast. Twenty-four hours later subjects underwent Re-training followed by a Generalization test, during which subjects were exposed to a range of generalization stimuli (GS) (250, 1000, 2000, 4000, 8000 Hz). In order to further examine the point at which fear no longer generalizes, a follow-up experiment (Experiment 2) was performed where a 4000 Hz pure tone was used as the CS+, and during the Generalization test, 2000 and 8000 Hz were used as GS. In both Experiment 1 and 2 there was significant discrimination in US expectancy responses on all stimuli during the Generalization Test, indicating the stimuli were perceptually distinct. In Experiment 1, participants showed similar levels of fear-potentiated startle to the GS that were adjacent to the CS+, and discriminated between stimuli that were 2 or more degrees from the CS+. Experiment 2 demonstrated no fear-potentiated startle generalization. The current study is the first to use auditory cues to test generalization of conditioned fear responses; such cues may be especially relevant to combat posttraumatic stress disorder (PTSD) where much of the traumatic exposure may involve sounds.

Versatility of fear-potentiated startle paradigms for assessing human conditioned fear extinction and return of fear.

Fear conditioning methodologies have often been employed as testable models for assessing learned fear responses in individuals with anxiety disorders such as post-traumatic stress disorder (PTSD) and specific phobia. One frequently used paradigm is measurement of the acoustic startle reflex under conditions that mimic anxiogenic and fear-related conditions. For example, fear-potentiated startle is the relative increase in the frequency or magnitude of the acoustic startle reflex in the presence of a previously neutral cue (e.g., colored shape; termed the conditioned stimulus or CS+) that has been repeatedly paired with an aversive unconditioned stimulus (e.g., airblast to the larynx). Our group has recently used fear-potentiated startle paradigms to demonstrate impaired fear extinction in civilian and combat populations with PTSD. In the current study, we examined the use of either auditory or visual CSs in a fear extinction protocol that we have validated and applied to human clinical conditions. This represents an important translational bridge in that numerous animal studies of fear extinction, upon which much of the human work is based, have employed the use of auditory CSs as opposed to visual CSs. Participants in both the auditory and visual groups displayed robust fear-potentiated startle to the CS+, clear discrimination between the reinforced CS+ and non-reinforced CS-, significant extinction to the previously reinforced CS+, and marked spontaneous recovery. We discuss the current results as they relate to future investigations of PTSD-related impairments in fear processing in populations with diverse medical and psychiatric histories.