Barriers to Meeting Community Needs in New York State during COVID-19: Results From a Pilot Survey of Nongovernmental Population and Community Health Professionals.

Capacity building and training help empower the community and population health organizations to partner with local health departments and collaboratively design multisectoral interventions that account for the complexity of public health and health promotion challenges in the era of COVID-19 and beyond. Ideally, training programs should be informed by an understanding of the needs and priorities of the professionals for whom they are intended. This brief report focuses on the results of a pilot online survey conducted as part of a larger pilot study by the New York State Association of County Health Officials and the Region 2 Public Health Training Center among population and community health professionals (n = 27) from four counties in New York State during the COVID-19 pandemic. Survey participants included a diverse group of staff members from various large and small nonprofit organizations, federally qualified health centers, academic institutions, hospitals, and insurers. Survey findings provide preliminary insights into the extent to which these organizations have been involved in the COVID-19 response in partnership with LHDs, barriers they faced in responding to the needs of the populations they serve and adjusting their work routines/operations to COVID-19 guidelines, and their top emerging organizational and training needs. Lessons learned from conducting an online survey during a public health emergency and implications for future training interventions for population and community health professionals are also discussed within the context of promoting multisectoral collaboration with local health departments, solving complex public health problems, and advancing health equity.

Disparities in Sports Medicine Health Care Access in Illinois High Schools: Access to Team Physicians, Athletic Trainers, and Automated External Defibrillators.

ABSTRACT: High school athletes have higher rates of injuries and sudden death than their college counterparts. Medical care for these athletes should include access to team physicians, athletic trainers, and automated external defibrillators. Disparities in medical care access provided by high schools for their athletes may be due to school characteristics or socioeconomic or racial factors. This study investigated relationships between these factors and access to team physicians, athletic trainers, and automated external defibrillators. Medical care access is negatively related to the percentage of low-income students and positively related to the number of sports offered. Relationships between race and access to a team physician became nonsignificant when the percentage of low-income students was considered. Physicians who treat high school athletes should consider the medical care access provided by their schools when they educate these patients about preventing and treating sports injuries.

A US State Index of Successful Aging: Differences Between States and Over Time.

Policy Points The focus of successful aging is on the social contexts that enable individuals to be productively engaged and secure, with an emphasis on equity. There is currently no index to measure progress towards this goal at the US state level. We developed an empirical index for the evaluation of US state adaptation to societal aging across five critical domains that support successful population aging: (1) productivity and engagement, (2) security, (3) equity, (4) cohesion, and (5) well-being. Our index shows substantial variability over time and is not overly influenced by the performance of an individual domain. This suggests that it can be used to monitor state progress over time toward the goal of supporting successful aging. Rather than a major national trend, there are large between-state differences and changes in our index over time. This suggests individual US state policies and programs, as well as local economic conditions, may have a substantial impact on adaptations to societal aging. CONTEXT: Although it is recognized that aspects of US state environments impact the likelihood that older adults age successfully, there is currently no reliable and comprehensive measure of contexts that best support successful aging at a state level. The current project adapts a multidimensional index previously used to assess adaptation to successful aging in developed countries and applies it to the 50 US states and the District of Columbia. METHODS: We obtained data from multiple sources for all 50 US states and the District of Columbia from 2003 to 2017 in order to measure five distinct domains that define successful population aging: (1) productivity and engagement, (2) security, (3) equity, (4) cohesion, and (5) well-being. We created a ranking of states for the year 2017 based on these domains, and also examined how individual US state rankings changed over time from 2003 to 2017. FINDINGS: The level of adaptation to successful aging varied substantially between states and over time. The highest-ranked states in 2017 were Vermont, Hawaii, Iowa, Colorado, and New Hampshire, and the lowest-ranked states were Louisiana, Arkansas, Kentucky, West Virginia, and Mississippi. Mississippi, South Carolina, Iowa, Arizona, and Delaware had the greatest improvement in their ranking over the period of 2003 to 2017. Our findings were generally robust to the weighting scheme used and were not overly influenced by any particular domain. CONCLUSIONS: The US State Index of Successful Aging can be used to monitor US state progress in promoting the well-being and health of aging populations. Factors driving the changes in the index remain to be elucidated.

Symptom management in Chinese adults with end stage renal disease (ESRD).

BACKGROUND: With over $50 billion spent annually in the United Sates (U.S.) on patients with chronic kidney diseases, and an incidence of end-stage renal disease (ESRD) in Asian Americans that is 1.5 times higher than in Caucasians, there is a compelling need to improve symptom management strategies for this population. AIMS: 1) To identify common, bothersome symptoms and both Eastern and Western symptom-management strategies in older Chinese-American ESRD patients. 2) To validate the effectiveness of these symptom-management strategies through literature review and an expert panel. METHODS: 1) Older Chinese-Americans were surveyed to assess common ESRD symptoms and management strategies. 2) An umbrella review of patients' symptom-management strategies was conducted, and findings were confirmed by experts. RESULTS: 1) Thirty Chinese-American ESRD patients with an average age of 80 (SD = 13.08) reported strategies to manage fatigue, pain, sleep disturbance, dyspnea, anxiety, nausea and vomiting, constipation, and pruritus. 2) A total of 55 studies were included in the umbrella review. Evidence of varying quality and confirmation by experts supported the effectiveness of 33 symptom-management strategies used by Chinese-American ESRD patients. CONCLUSION: Further study is needed to understand why Chinese-American patients, on average, reported fewer symptoms compared with the general population but scored lower on quality of life measures; to validate reported amelioration strategies; to explore strategy effectiveness; and to uncover additional symptoms and strategies among older Chinese-Americans living with ESRD.

Developing Complex, Cross-Cutting Skills in the Public Health Workforce: Using a Crosswalk Analysis to Map Public Health Competencies to Strategic Skills for the Governmental Public Health Workforce.

In recent years, many public health organizations have used 2 frameworks for workforce development planning and action: the Core Competencies for Public Health Professionals (Core Competencies) and the Strategic Skills for the Governmental Public Health Workforce (Strategic Skills). A third framework is also available for organizations emphasizing population health: the Competencies for Population Health Professionals (Population Health Competencies). This crosswalk analysis-conducted by the Public Health Foundation with input from the Region 2 Public Health Training Center and the de Beaumont Foundation-harmonizes these 3 schemas by systematically mapping the 2014 version of the Core Competencies and the 2019 Population Health Competencies with the 2017 version of the Strategic Skills to produce a comprehensive matrix depicting their relationships. When developing training and curricula, health department personnel and academic faculty can use the results to identify competencies public health professionals may wish to master to build the Strategic Skills. Organizations can also replicate the analytic methodology to align the Core Competencies with other sets of strategic priorities.

New York State Local Health Department Preparedness for and Response to the COVID-19 Pandemic: An In-Progress Review.

A mixed-methods approach was taken to describe lessons learned by local health department leaders during the early stages of the COVID-19 pandemic in New York State and to document leaders' assessments of their departments' emergency preparedness capabilities and capacities. Leaders participating in a survey rated the effectiveness of their department's capabilities and capacities in administrative and public health preparedness, epidemiology, and communications on a scale from 1 to 5; those partaking in focus groups answered open-ended questions about the same 4 topics. Subjects rated intragovernmental activities most effective ( = 4.41, SD = 0.83) and reported receiving assistance from other county agencies. They rated level of supplies least effective ( = 3.03, SD = 1.01), describing low supply levels and inequitable distribution of testing materials and personal protective equipment among regions. Local health departments in New York require more state and federal aid to maintain the public health workforce in preparation for future emergencies.

To improve nursing home care in the wake of COVID-19, AGS calls for US government to focus on three critical areas.

In response to the U.S. Senate Committee on Finance's hearing on COVID-19 in the nation's nursing homes, the American Geriatrics Society (AGS) submitted a written statement for the record, calling on committee members to focus on three critical areas where attention can help achieve the AGS' vision for a future in which we can all contribute to our communities and maintain our health, safety, and independence as we age; and where older people have access to high quality, person-centered care informed by geriatrics principles. These three areas are: (1) investing in the U.S. direct care workforce, the backbone of our health and long-term care system; (2) increasing funding for geriatrics health professions programs under Title VII and ensuring that these programs are included in public health planning efforts; and (3) preparing for public health emergencies with attention to the needs of older Americans.

A Phase 1 study of BAL101553, a novel tumor checkpoint controller targeting microtubules, administered as 48-h infusion in adult patients with advanced solid tumors.

Purpose BAL101553, the prodrug of the microtubule-destabilizer BAL27862, previously showed signs of antitumor activity when administered as a 2-h infusion, but its use was limited by vascular toxicity. We investigated an alternative dosing strategy aimed at improving the safety profile of BAL101553. Methods This multicenter, open-label, Phase 1 dose-escalation study used a 3 + 3 design to determine the maximum tolerated dose (MTD), dose-limiting toxicities (DLTs), pharmacokinetics, and antitumor activity of BAL101553 administered as a 48-h IV infusion on Days 1, 8, and 15 of a 28-day cycle. Patients received oral BAL101553 on Days 15-21 of cycle 2 to assess oral bioavailability. Results BAL101553 was well tolerated at doses up to ≤70 mg/m2. Three grade 3 DLTs occurred: hypotension (70 mg/m2), hyponatremia and neutropenia (both 90 mg/m2). The MTD for 48-h IV BAL101553 was 70 mg/m2. At this dose level, the AUC for BAL27862 was 8580 ng.h/mL and the Cmax was 144 ng/mL. No apparent dose-related effects on blood pressure were observed with 48-h BAL101553 IV infusion. BAL27862 oral bioavailability was >80%. Conclusions Continuous 48-h IV BAL101553 infusion achieved higher exposure of the BAL27862 active metabolite than a 2-h infusion at the RP2D and did not cause vascular toxicity. Clinicaltrials.gov registration: NCT02895360.

Bibliometric analysis and conversion rate of abstracts presented at the Brazilian Congress of Coloproctology into publication of full articles.

INTRODUCTION: the presentation of research at a congress is an interesting means for scientific dissemination, but only with publication in an indexed journal does the data become accessible and disseminated. The conversion rate in published articles of abstracts presented at congresses is an indicator to assess the scientific quality of those events. The aim of this study is to evaluate bibliometric characteristics of abstracts presented at the Brazilian Congress of Coloproctology and to determine the factors that affect publication rates. METHODS: Retrospective evaluation of all abstracts presented at the Brazilian Congresses of Coloproctology from 2015 to 2019. Multiple databases were analyzed to estimate the conversion rate of the presented papers, as well as variables associated with the conversion of abstracts into full manuscripts through bivariate analysis and multivariate variables of these predictors. RESULTS: 1756 abstracts were analyzed. Most studies are retrospective, series or case reports, and even personal experience. The conversion rate was 6.9%. The presence of statistical analysis was twice as high for published abstracts as for unpublished ones. CONCLUSION: the data presented demonstrate a low scientific productivity of the specialty, since the research carried out is, for the most part, not published as complete manuscripts. The predictors of publication of abstracts were: multicenter studies, studies with statistical analysis, study designs with a higher level of evidence and studies awarded by the congress.

Cross-presenting human gammadelta T cells induce robust CD8+ alphabeta T cell responses.

Gammadelta T cells are implicated in host defense against microbes and tumors but their mode of function remains largely unresolved. Here, we have investigated the ability of activated human Vgamma9Vdelta2(+) T cells (termed gammadelta T-APCs) to cross-present microbial and tumor antigens to CD8(+) alphabeta T cells. Although this process is thought to be mediated best by DCs, adoptive transfer of ex vivo antigen-loaded, human DCs during immunotherapy of cancer patients has shown limited success. We report that gammadelta T-APCs take up and process soluble proteins and induce proliferation, target cell killing and cytokine production responses in antigen-experienced and naïve CD8(+) alphabeta T cells. Induction of APC functions in Vgamma9Vdelta2(+) T cells was accompanied by the up-regulation of costimulatory and MHC class I molecules. In contrast, the functional predominance of the immunoproteasome was a characteristic of gammadelta T cells irrespective of their state of activation. Gammadelta T-APCs were more efficient in antigen cross-presentation than monocyte-derived DCs, which is in contrast to the strong induction of CD4(+) alphabeta T cell responses by both types of APCs. Our study reveals unexpected properties of human gammadelta T-APCs in the induction of CD8(+) alphabeta T effector cells, and justifies their further exploration in immunotherapy research.

Imaging of soft tissue sarcomas of the extremities with radiologic-pathologic correlation.

Soft tissue sarcomas are a rare diverse group of mesenchymal malignancies that can arise in any location in the body and have extremely variable presentations. Liposarcoma, pleomorphic undifferentiated sarcoma, leiomyosarcoma, myxofibrosarcoma, and synovial sarcoma constitute 75% of all soft tissue sarcomas. These along with more uncommon sarcomas will be reviewed with emphasis on the 2013 World Health Organization (WHO) classification. Imaging plays a crucial role in the initial staging, monitoring response to chemotherapy and radiation therapy, and surveillance to detect local or distant recurrence. In this review, the imaging, as well as histopathologic findings of various soft tissue sarcomas will be demonstrated with biomarker correlation. Given the rarity and heterogeneous nature of these tumors, they are generally managed in tertiary care hospitals by a sarcoma tumor board comprised of an oncologist, surgical oncologist, pathologist, radiation oncologist, and radiologist. Overall clinical outcomes are improving due to rapid advances in the understanding of soft tissue sarcomas. We also review imaging features of treatment response and recurrence of these tumors including imaging follow-up guidelines.

"At Least They're Workin' on My Case?" Victim Notification in Sexual Assault "Cold" Cases.

Sexual assault is a significantly under-reported, -investigated, and -prosecuted crime in the United States, which criminal justice and advocacy actors across the country are working to address. Law enforcement procedures often involve providing crime victims, including sexual assault victims, with written notification by mail about the status of their case, but little is known about the best practices for victim notification in sexual assault "cold" cases. This qualitative research explored whether this standard law enforcement practice was appropriate for sexual assault victims in "cold cases" particularly when there had been no contact from law enforcement, despite forensic evidence having been tested. The research questions were what do sexual assault victims in cold cases have to say about victim notification protocols and practices? and What do sexual assault victims in cold cases have to say about hypothetical written victim notification protocols? Twenty-three sexual assault victims were asked in focus groups and individual interviews to respond to hypothetical written notification letters for content and the sending authority and to give input on alternative modes of communication. The data were analyzed using grounded theory. Themes related to trust, personal agency, and decision making from notification examples emerged. Recommendations on notification included respecting privacy, including specifics, identifying next steps, normalizing, translating, and providing resources. Implications for developing notification protocols include use of emerging evidence about neurobiology of trauma, use of victim input, and patience for the varying reactions and needs of sexual assault victims.

Moving Toward a Global Age-Friendly Ecosystem.

The designation of "age friendly" has clearly engaged the attention of scholars and leading experts in the field of aging. A search of PubMed references citing the term produced 15 results in the 5-year period from 2006 to 2011; that number increased to 572 in the period from 2015 to 2019. The work, notably led by the World Health Organization with the initiation of age-friendly cities and age-friendly communities, has now sparked a movement for the creation of age-friendly health systems and age-friendly public health systems. Now more than ever, in an era of pandemics, it seems wise to create an ecosystem where each of the age-friendly initiatives can create synergies and additional momentum as the population continues to age. Work of a global nature is especially important given the array of international programs and scientific groups focused on improving the lives of older adults along with their care and support system and our interconnectedness as a world community. In this article, we review the historical evolution of age-friendly programs and describe a vision for an age-friendly ecosystem that can encompass the lived environment, social determinants of health, the healthcare system, and our prevention-focused public health system.

Women's performance in conferences and their publications: a critical analysis

Introduction: Gender inequality occurs in all spheres of society, which is no different in the medical field. Abstract presentations in congress are the vanguard of scientific knowledge, an integral part of topic discussion, and, ideally, culminate in the publication of these works as complete manuscripts. Objective: The objective of this study is to evaluate the role played by women in the presentation of scientific works at the Brazilian Society of Coloproctology congress and in the works published from these presentations. Methods: The bibliometric evaluation of the presented abstracts in the editions from 2015 to 2018 of the Brazilian Congress of Coloproctology was used, along with the works later published from these presentations. Gender identification data was extracted from the authors of the abstracts through their names and research for conference on the Lattes and Google Scholar platforms. The collected data was on the number of female participants and their order of authorship of abstracts and publications, evaluating possible changes when publication occurs. Results: A total of 1,336 abstracts were analyzed, with 91.6% of female authors. When publication occurs, women's presence dropped to 75.2% and suffered a change of order in the position of authorship to one of lesser relevance in 38.1%. Conclusion: Women's participation occurs in most abstracts. However, this proportion undergoes unfavorable changes when these works are published, either by changing the order of authorship, when women leave main positions and become coauthors, or are removed from the complete manuscript's publication. (AU)

Identification of tumor-associated antigens by large-scale analysis of genes expressed in human colorectal cancer.

Despite the high prevalence of colon cancer in the world and the great interest in targeted anti-cancer therapy, only few tumor-specific gene products have been identified that could serve as targets for the immunological treatment of colorectal cancers. The aim of our study was therefore to identify frequently expressed colon cancer-specific antigens. We performed a large-scale analysis of genes expressed in normal colon and colon cancer tissues isolated from colorectal cancer patients using massively parallel signal sequencing (MPSS). Candidates were additionally subjected to experimental evaluation by semi-quantitative RT-PCR on a cohort of colorectal cancer patients. From a pool of more than 6000 genes identified unambiguously in the analysis, we found 2124 genes that were selectively expressed in colon cancer tissue and 147 genes that were differentially expressed to a significant degree between normal and cancer cells. Differential expression of many genes was confirmed by RT-PCR on a cohort of patients. Despite the fact that deregulated genes were involved in many different cellular pathways, we found that genes expressed in the extracellular space were significantly over-represented in colorectal cancer. Strikingly, we identified a transcript from a chromosome X-linked member of the human endogenous retrovirus (HERV) H family that was frequently and selectively expressed in colon cancer but not in normal tissues. Our data suggest that this sequence should be considered as a target of immunological interventions against colorectal cancer.

Processing of tumor-associated antigen by the proteasomes of dendritic cells controls in vivo T-cell responses.

Dendritic cells are unique in their capacity to process antigens and prime naive CD8(+) T cells. Contrary to most cells, which express the standard proteasomes, dendritic cells express immunoproteasomes constitutively. The melanoma-associated protein Melan-A(MART1) contains an HLA-A2-restricted peptide that is poorly processed by melanoma cells expressing immunoproteasomes in vitro. Here, we show that the expression of Melan-A in dendritic cells fails to elicit T-cell responses in vitro and in vivo because it is not processed by the proteasomes of dendritic cells. In contrast, dendritic cells lacking immunoproteasomes induce strong anti-Melan-A T-cell responses in vitro and in vivo. These results suggest that the inefficient processing of self-antigens, such as Melan-A, by the immunoproteasomes of professional antigen-presenting cells prevents the induction of antitumor T-cell responses in vivo.

Coexisting cystic lung disease as a rare extra-renal manifestation of autosomal dominant polycystic kidney disease.

Autosomal dominant polycystic kidney disease (ADPKD) classically presents with multiple bilateral renal cysts and ultimately progresses to end stage renal disease. While many of the extra-renal manifestations of ADPKD are well-documented, associated pulmonary findings are particularly rare, having only been recently been reported in a handful of studies to date. A 69-year-old female with ADPKD presented to our hospital with respiratory complaints. High resolution computed tomography revealed bronchiectasis, cystic lung disease, and interstitial fibrosis. The patient did not have concurrent risk factors or coexisting disease processes to explain the etiology of her airway and cystic lung disease, which we suggest are manifestations of ADPKD. We have not found a previous report of interstitial lung disease in this setting.

Bibliometric analysis and conversion rate of abstracts presented at the Brazilian Congress of Coloproctology into publication of full articles / Análise bibliométrica e taxa de conversão de resumos apresentados no Congresso Brasileiro de Coloproctologia em publicação de artigos completos

ABSTRACT Introduction: the presentation of research at a congress is an interesting means for scientific dissemination, but only with publication in an indexed journal does the data become accessible and disseminated. The conversion rate in published articles of abstracts presented at congresses is an indicator to assess the scientific quality of those events. The aim of this study is to evaluate bibliometric characteristics of abstracts presented at the Brazilian Congress of Coloproctology and to determine the factors that affect publication rates. Methods: Retrospective evaluation of all abstracts presented at the Brazilian Congresses of Coloproctology from 2015 to 2019. Multiple databases were analyzed to estimate the conversion rate of the presented papers, as well as variables associated with the conversion of abstracts into full manuscripts through bivariate analysis and multivariate variables of these predictors. Results: 1756 abstracts were analyzed. Most studies are retrospective, series or case reports, and even personal experience. The conversion rate was 6.9%. The presence of statistical analysis was twice as high for published abstracts as for unpublished ones. Conclusion: the data presented demonstrate a low scientific productivity of the specialty, since the research carried out is, for the most part, not published as complete manuscripts. The predictors of publication of abstracts were: multicenter studies, studies with statistical analysis, study designs with a higher level of evidence and studies awarded by the congress.

RESUMO Introdução: a apresentação de pesquisas em um congresso é meio interessante para disseminação científica, porém apenas com a publicação em revista indexada é que os dados se tornam acessíveis e disseminados. A taxa de conversão em artigos publicados de resumos apresentados em congressos é um indicador para avaliar a qualidade científica de seus eventos. O objetivo deste estudo é avaliar características bibliométricas dos resumos apresentados no Congresso Brasileiro de Coloproctologia e determinar os fatores que afetam as taxas de publicação. Métodos: avaliação retrospectiva de todos os resumos apresentados nos Congressos Brasileiros de Coloproctologia dos anos de 2015 a 2019. Análise de múltiplas bases de dados para estimar a taxa de conversão dos trabalhos apresentados, assim como variáveis associadas à conversão dos resumos em manuscritos completos através de análises bivariadas e multivariadas desses preditores. Resultados: foram analisados 1756 resumos. A maioria dos estudos são retrospectivos, séries ou relatos de casos e até experiência pessoal. A taxa de conversão foi de 6,9%. A presença de análise estatística foi o dobro para os resumos publicados frente aos não publicados. Conclusão: os dados apresentados demonstram uma baixa produtividade científica da especialidade, já que as pesquisas realizadas não são publicadas, em sua maioria, como manuscritos completos. Os fatores preditores de publicação dos resumos foram: estudos multicêntricos, estudos contendo análise estatística, desenhos de estudo de maior nível de evidência e estudos premiados pelo congresso.

Discrepancies of abstracts presented in coloproctology congresses and later publish as full manuscripts: a Brazilian perspective

Introduction: The purpose of this retrospective bibliometric study was to assess the discrepancies between coloproctology surgery meeting abstracts and subsequent full-length manuscript publications. Methods: Abstracts presented at the Brazilian Congress of Coloproctology Surgery from 2015 to 2019 were compared with matching manuscript publications. Discrepancies between the abstract and therefore the subsequent manuscript were categorized as major (changes within the purpose, methods, study design, sample size, statistical analysis, results, and conclusions) and minor (changes within the title, authorship, and number of female authors) variations. Results: The conversion rate of abstracts in published manuscripts was 6,9% (121 abstracts). There were inconsistencies between the study title (66,1%), authorship (69,5%), study design (3,3%), sample size (39,2%), statistical analysis (24,8%), results (25,6%), and conclusions (12,4%) of manuscripts compared with their corresponding meeting abstracts. Conclusion: As changes occur before manuscript publication of coloproctology surgery meeting abstracts, caution should be exercised in referencing abstracts or altering surgical practices based on abstracts content. (AU)

Assessing the level of evidence of presented studies at the Brazilian Congress of Coloproctology

Introduction: Scientific studies in Brazil grew around 10.7% compared to previous years. However, the level of quality of evidence has been decreasing. The aim in our study is to examine the meeting abstracts of the Brazilian congress of coloproctology and analyze the level of evidence in trends and variables. Methods: A descriptive bibliometric study, working with secondary data to review scientific abstracts in the annals of the coloproctology congress from 2015 to 2019. Results: A total of 1756 abstracts of the Brazilian Congress of Coloproctology were analyzed for 5 years (2015-2019). There was a higher trend of abstracts presented with lower levels of evidence (level of evidence 5: 52.3% and 3: 30%), being the majority composed of case reports (49.4%) and retrospective studies (30.4%). The last two years analyzed (2018: 55.2% and 2019: 59.3%) had a predominance above average of case reports. From 2017 to 2019 there was a significant decrease in the number of level 2 evidence studies (18.10%,11.80% and 5.50%), while the number of studies with level 5 evidence showed an increase (45.60%, 56.60% and 61.40%). Statistical analysis occurred in only 17%, with an important decrease for the last two years (2018: 13.6%; 2019: 12.1%). Conclusions: Although the data of this study is from the Brazilian coloproctology point of view, they are important for the global scientific community, as they allow a quantitative evaluation of the relative contribution from the level of evidence of Brazilian coloproctology researchers to the scientific scenario. (AU)