Ulcerative Colitis: A Critical Approach to the Global Research Output Employing Density-equalizing Mapping and Scientometric Methods.

BACKGROUND AND AIMS: Despite decades of effort, numerous aspects on ulcerative colitis (UC) remain unknown and require further investigation. Scientists experience numerous challenges to survey >40,000 items that have been published on UC since 1900, to evaluate their scientific impact or to identify collaborative networks publishing the most relevant work. Hence, no current, detailed and comprehensive knowledge regarding the worldwide research architecture of UC has been established until now. METHODS: We conducted a scientometric study employing the previously validated NewQIS (New Quality and Quantity Indices in Science) platform to quantify the global research activity in the field of UC. Hereby, the total research productivity, scientific output of countries, individual institutions, authors, journals, their collaborative networks as well as semiqualitative aspects were assessed. Results were visualized via state-of-the-art density-equalizing mapping projections. RESULTS: The United States, Germany, and the United Kingdom play leading roles regarding scientific activity, multilateral and bilateral cooperations. Within the past decades, research on UC diversified into a field covering numerous subject areas. Recently published studies predict that the scientific progress will be mainly depending on international cooperations; we can confirm that development by now. CONCLUSIONS: Scientometrics proofed to be a useful methodical approach to evaluate quantitative and semiqualitative aspects regarding UC. Also, we conclude that the influence of international cooperations on the scientific progress in the field of UC is constantly progressing.

A world map of esophagus cancer research: a critical accounting.

BACKGROUND: Esophageal cancer (EC) is one of the deadliest cancers worldwide. The contemporary strong increase of the adenocarcinomas in Western countries and the high mortality rates require the intensification of prospective multinational studies. METHODS: Therefore, this global health issue has been chosen for the bibliometric review of the global publication output. As source for meta and citation data, the Web of Science has been used and Density Equalizing Maps were applied for visualization. RESULTS: 17,387 articles on EC could be identified. The years with publication and citation maxima correspond to the appearance of the most prolific articles. China is the most publishing country, followed by Japan and the USA. Germany and the UK ranked 4th and 5th. The analysis of the ratios articles and socio-economic parameters emphasizes the leading position of the Scandinavian countries and Japan. Here, the high-income countries come out on top. The high incidence regions are mainly represented by Chinese and Japanese research. The association of the publication output and the overall research funding could be shown. CONCLUSIONS: A strengthened international network increasingly consisting of the scientifically best positioned countries as well as more of the high incidence countries worldwide is mandatory for future research. The findings deliver scientists, clinicians and decision makers backgrounds for future decisions all over the world.

Crohn's Disease: A Critical Approach to Publication Procedures and Citation Behavior of the Global Research Network.

BACKGROUND AND GOALS: Crohn's disease (CD) is an inflammatory bowel disease, which can lead to abdominal pain, weight loss, fatigue, severe diarrhea, and malnutrition. Despite enormous efforts and progress in diagnosis and therapy, there are still many aspects of uncertainty leading to an increasing scientific interest in this topic. As it is challenging to survey all articles regarding CD and to measure their scientific importance, this study uses reliable scientometric tools to evaluate the global research output on CD related to quantitative and qualitative aspects and in chronological and geographical context. STUDY: We conducted a scientometric analysis to assess all global research activity on CD from 1900 until 2013. We analyzed the research output of countries, individual institutions, journals, authors and their collaborative networks and depicted our findings by density-equalizing map projections. RESULTS: The worldwide research architecture indicated that the United States, the United Kingdom, Germany, and France play leading role regarding scientific activity, h-indices, multilateral and bilateral cooperations. There is a dramatic increase of collaborative publications since the 1990s, which underlines recent studies pronouncing that the scientific progress will be mainly depending on international cooperations. CONCLUSIONS: We conclude that the field of CD is constantly progressing, in which the influence of international cooperations on the scientific productivity is of major and growing importance. North American and Western European nations constitute the scientific leaders in the field of CD whereas developing or underdeveloped countries did not exhibit considerable research productivity.

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.

Maternal depression research: socioeconomic analysis and density-equalizing mapping of the global research architecture.

Maternal depression can be accounted for one of the most common complications during pregnancy and the postpartum period affecting women all over the world. So far, no detailed map of the worldwide maternal depression research architecture has been constructed, which encompasses aspects of research activity, quality, and also socioeconomic features. Using the NewQIS platform, density-equalizing mapping projections, scientometric techniques, and economic benchmarking procedures were applied to evaluate global maternal depression research for the period between 1900 and 2012. In total, 7330 related publications and 3335 international collaborations were identified. The USA was the most active country concerning collaborations and total research activity. In the socioeconomic analysis of research activity in high-income countries, Australia was ranked first with an average of 412.05 maternal depression-related publications per 1000 billion US$ GDP (Q1), followed by the UK (Q1 = 373.51) and Canada (Q1 = 306.32). The group of upper-middle-income countries was led by South Africa (Q1 = 145.67), followed by Turkey (Q1 = 91.8). China authored 11.95 maternal depression-related publications per 1000 billion US$ GDP. The USA had the highest activity of maternal depression research per GDP in billion US$ per capita (Q2 = 60.86). When research activity was related to population size (Q3 = publications per Mio. inhabitants), Australia (Q3 = 26.44) was leading the field, followed by Norway (Q3 = 18.48). Gender analysis revealed a relatively high degree of female scientists involved in this field of research with pronounced differences between single subject areas. In summary, we here present the first picture of the global scientific development in maternal depression research over a period of more than 100 years. The research landscape is clearly dominated by North American and Western European countries, with only minor contribution of Asian or South American countries.

Cancer care and residents' working hours in oncology and hematology departments: an observational real-time study in German hospitals.

BACKGROUND: Physicians currently working in hematology and oncology wards are often frustrated with their working conditions. They express dissatisfaction with the working hours, poor organization of work and a low salary compared with the burdens of cancer care. However, to date, there have been no real-time observational studies to verify these subjective reports. Therefore, this study is the first to provide objective data about residents' workload. METHODS: A real-time task analysis was conducted by individually observing 21 hematology and oncology residents at German hospitals. A total of 626 h of observation were performed using an Ultra Mobile PC. RESULTS: The residents observed in this study worked an average of 9 h 56 min per day, during which time was divided among the following activities: 31.20% for internal communication, 22.06% for indirect patient care and 10.99% for ward rounds. Per workday residents spent an average 6.20% of their shift time talking to patients. CONCLUSIONS: This study provides the basis for future analyses on physicians' workflow. Some key results may be used to recommend measures to improve physicians' work performance and the quality of cancer care.

Gastric Cancer: Bibliometric Analysis of Epidemiological, Geographical and Socio-Economic Parameters of the Global Research Landscape.

BACKGROUND: Although the incidence and mortality of gastric cancer (GC) decreased in the last years, some countries remain highly affected. Especially in high-income economies the cases of cardia types are steadily increasing. Currently, GC is ranked third as cause for cancer death worldwide, whereby two-thirds of deaths still occur in low-income countries. But the global numbers are changing, and new regional challenges must be addressed. METHODS: Therefore, this disease has been chosen for in-depth bibliometric analyses that combines the evaluation of publication meta-data with density equalizing visualization techniques. This study focuses on the chronological and geographical characteristics of GC research worldwide. Epidemiological and socio-economic parameters were analyzed and the influence of political framework conditions was examined. In addition, international collaborations and research priorities were evaluated. RESULTS: In the last years, the publication numbers are rising more extensively in comparison to other cancer types. Albeit the usual leading positions, the United States is not the most publishing country on GC. It occupies the third position. Instead, China and Japan are the most publishing countries and together with South Korea also the key players as well as the most affected countries. These countries' governments are also the main donors for GC-research. The number of articles and the expenditures for research and development (R??D) as well as the incidence rate are correlated. Despite the scarce contribution of low-economic countries to the publication output, international collaborations lead to a modest output in those regions. CONCLUSION: This study pools background information for scientists, practitioners, funders and decision-makers by providing information on the development and priorities of GC research. Adaptive international approaches and partnerships are crucial to meet future changing epidemiological features 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.

Does type of hospital ownership influence physicians' daily work schedules? An observational real-time study in German hospital departments.

BACKGROUND: During the last two decades the German hospital sector has been engaged in a constant process of transformation. One obvious sign of this is the growing amount of hospital privatization. To date, most research studies have focused on the effects of privatization regarding financial outcomes and quality of care, leaving important organizational issues unexplored. Yet little attention has been devoted to the effects of privatization on physicians' working routines. The aim of this observational real-time study is to deliver exact data about physicians' work at hospitals of different ownership. By analysing working hours, further impacts of hospital privatization can be assessed and areas of improvement identified. METHODS: Observations were made by shadowing 100 physicians working in private, for-profit or non-profit as well as public hospital departments individually during whole weekday shifts in urban German settings. A total of 300 days of observations were conducted. All working activities were recorded, accurate to the second, by using a mobile personal computer. RESULTS: Results have shown significant differences in physicians' working activities, depending on hospital ownership, concerning working hours and time spent on direct and indirect patient care. CONCLUSION: This is the first real-time analysis on differences in work activities depending on hospital ownership. The study provides an objective insight into physicians' daily work routines at hospitals of different ownership, with additional information on effects of hospital privatization.

A world map of evidence-based medicine: Density equalizing mapping of the Cochrane database of systematic reviews.

Systematic reviews represent the core and backbone of evidence-based medicine (EBM) strategies in all fields of medicine. In order to depict a first global sketch of the international efforts in the Cochrane database systematic reviews (CDSR), we analyzed the systematic reviews of the Cochrane database. Our global maps of systematic reviewing offer intriguing structural insights into the world of EBM strategies. They demonstrate that for the CDSR, the UK and Commonwealth countries take the lead position. Since patients, care providers and health systems all over the world benefit from systematic reviewing, institutions in other countries should increase their commitment.

Descriptive review of junior OB/GYN physicians' work task financial compensation in German hospitals.

Beginning in the first decade of the 21st centruy, there was a growing disregard for the benefits of the German medical system concerning the junior obstetricians/gynecologists (OB/GYN) job situation. As in other fields of medicine, numerous colleagues left Germany to work in other countries such as the United Kingdom, Noway, Sweden, or Switzerland. According to studies, financial factors represent one of the reasons for the discontent. We here present a practical descriptive approach to assess/review the actual compensation of single work tasks of OB/GYNs on the basis of previously published, existing data. Using the workflow data from the Medical work Assessment in German hospitals (MAGRO) platform of twenty junior OB/GYNs with an average workday of 9:24:35 h (SD = 01:05:07 h), a large scale data analysis of 2,325,556 different time points was performed to calculate the financial valuation of single work tasks. In order to assess the evolution over the past years, different modern and historic (e.g. AiP) pay scales were used and analysed in relation to the actual work on a weekly, monthly and per annum basis. Our review shows that there has been a dramatic increase in the financial reward of the practical work tasks of junior OB/GYN physicians in German hospitals in comparison to the situation of the early 2000s years. In this respect, it can not be further argued that the German system has large disadvantages concerning the payment of junior doctors in comparison to other European countries.