The Use of the h-Index in Academic Orthopaedic Surgery.

BACKGROUND: The Hirsch index (h-index), widely considered a valuable measure of assessing academic productivity, has been studied in various medical and surgical specialties and has shown strong associations between higher h-indices and academic promotion, as well as with National Institutes of Health (NIH) awards. Additionally, the m-index and e-index may complement the h-index in this assessment of merit. The purpose of this study was to investigate the relationship between the h, m, and e-indices and academic rank for 2,061 academic orthopaedic surgeons in the United States. METHODS: The h-indices of faculty members from 120 academic orthopaedic surgery residency programs were organized and calculated using the Scopus and Google Scholar databases. Additionally, m-index and e-index scores were calculated from Google Scholar. After application of exclusion criteria, 2,061 academic orthopaedic surgeons were included. RESULTS: Academic rank (assistant professor, associate professor, professor, and chair) increases as mean h-index, m-index, and e-index scores increase. Among 976 assistant professors, 504 associate professors, 461 professors, and 120 chairs, mean h, m, and e-indices increased with each academic rank. In the comparison of male and female surgeons, there was no significant difference in h, m, or e-index scores, with the exception of increased h-index scores among male assistant professors. CONCLUSIONS: Scholarly impact, as defined by academic productivity and scientific relevance, can be classified by the h-index and supplemented by the m and e-indices. This study has revealed well-defined differences in h, m, and e-indices with regard to academic rank among orthopaedic surgeons. Although the h, m, and e-indices may be of value as adjunct assessment devices for scholarly merit, careful consideration of their limitations must be maintained.

A gender-based comparison of promotion and research productivity in academic dermatology.

PURPOSE: Gender disparities within academic promotion have been reported in several medical specialties. Female representationin association with research productivity has not been reported among academic dermatologists. As research productivity is a heavily weighted factor in determining promotion, we sought to determine whether gender disparities in academic rank and scholarly impact, measured by the h-index, exist in academic dermatology. METHODS: In 2015, the authors determined gender and academic rank using academic dermatology department websites. H- index and publication range were determined using the Scopus database. Rank, h-index, and publication range were compared between male and female academic dermatologists. RESULTS: The h-index of academic dermatologists increased with successive academic rank from Assistant Professor through Professor (p<0.001), although no significant difference existed between Chairs and Professors. Publication range also increased with each successive rank from Assistant Professor through Professor (p<0.001), with no statistical significant difference between publication range of Chairs and Professors. Overall, men had higher h-indices than female colleagues (p<0.001). This difference was maintained when controlling for academic rank among Assistant Professors, Professors, and Chairs and when controlling for publication range in years. CONCLUSION: Women in academic dermatology are underrepresented among senior academic ranks. The difference in scholarly productivity between male and female academic dermatologists may contribute to this disparity. Recommendation for earlyinvolvement in research activities may help minimize this gap.

The impact of fellowship training on scholarly productivity in academic dermatology.

An increasing number of dermatology residents are pursuing postresidency fellowships to augment their knowledge in dermatology subspecialties. The purpose of this study was to determine whether fellowship training affects the scholarly impact of academic dermatologists, as measured by the h-index. A secondary objective was to compare scholarly productivity among different dermatology subspecialties. Overall, fellowship training is associated with increased scholarly impact; however, when stratifying for academic rank and years of publication activity, this difference does not exist.

Impact of fellowship training on research productivity in academic ophthalmology.

OBJECTIVES: To assess whether scholarly impact of academic ophthalmologists, as measured using the h-index, is affected by fellowship training status and to further characterize differences in productivity among the various subspecialties and by departmental rank. DESIGN: A descriptive and correlational design was used. In total, 1440 academic ophthalmologists from 99 ophthalmology training programs were analyzed. The h-index data were obtained from the Scopus database. Faculty members were classified by academic rank and grouped into 10 categories based on fellowship training: anterior segment, corneal and external disease, glaucoma, uveitis and ocular immunology, vitreoretinal disease, ophthalmic plastic surgery, pediatric ophthalmology, neuro-ophthalmology, ophthalmic pathology, and "other." A one-way analysis of variance or Student t test using Microsoft Excel and "R" statistical software were used for comparison of continuous variables, with significance set at p < 0.05. SETTINGS: Faculty working in academic ophthalmology residency training programs in the United States whose information is stored in the American Medical Association's Fellowship and Residency Electronic Interactive Database. RESULTS: Fellowship-trained ophthalmologists had significantly higher research productivity, as measured using the h-index, than non-fellowship-trained ophthalmologists in this study (p < 0.0005). Academic ophthalmologists trained in vitreoretinal disease or ophthalmic pathology had the highest scholarly productivity compared with those in other ophthalmology subspecialties (p < 0.05). There was a significant increase in scholarly productivity with increasing academic rank from Assistant Professor to Professor (p < 0.05). A significant difference in productivity between fellowship-trained and non-fellowship-trained ophthalmologists existed individually only at the level of Assistant Professor (p < 0.0005). CONCLUSION: Academic ophthalmologists with fellowship training have significantly higher scholarly output than non-fellowship-trained ophthalmologists do, as measured using the h-index. Research productivity increases with departmental academic rank from Assistant Professor to Professor.

Gender differences in promotion and scholarly impact: an analysis of 1460 academic ophthalmologists.

OBJECTIVES: In recent years, gender differences in academic promotion have been documented within surgical fields. To the best of our knowledge, gender discrepancies in association with scholarly productivity have not been well assessed among academic ophthalmologists. Because research productivity is strongly associated with academic career advancement, we sought to determine whether gender differences in scholarly impact, measured by the h-index, exist among academic ophthalmologists. DESIGN: Academic rank and gender were determined using faculty listings from academic ophthalmology departments. h-index and publication experience (in years) of faculty members were determined using the Scopus database. SETTING: Academic medical center. RESULTS: From assistant professor through professor, the h-index increased with subsequent academic rank (p < 0.001), although between chairpersons and professors no statistical difference was found (p > 0.05). Overall, men had higher h-indices (h = 10.4 ± 0.34 standard error of mean) than women (h = 6.0 ± 0.38 standard error of mean), a finding that was only statistically significant among assistant professors in a subgroup analysis. Women were generally underrepresented among senior positions. When controlling for publication range (i.e., length of time publishing), men had higher h-indices among those with 1 to 10 years of publication experience (p < 0.0001), whereas women had scholarly impact equivalent to and even exceeding that of men later in their careers. CONCLUSION: Women in academic ophthalmology continue to be underrepresented among senior faculty. Although women surpass men in scholarly productivity during the later stages of their careers, low scholarly impact during the earlier stages may impede academic advancement and partly explain the gender disparity in senior academic positions.

The association between scholarly impact and National Institutes of Health funding in ophthalmology.

OBJECTIVE: To examine whether there is an association between scholarly impact, as measured by the h-index, academic rank, and National Institutes of Health (NIH) awards in academic ophthalmology. DESIGN: Retrospective analysis of NIH RePORTER and Scopus databases. PARTICIPANTS: Not applicable. METHODS: Five hundred seventy-three NIH awards to 391 primary investigators (PIs) in ophthalmology departments were examined. Grant recipients were organized by academic rank, obtained from online listings, and h-index, calculated using the Scopus database. Non-NIH-funded faculty from 20 randomly chosen academic ophthalmology departments also were organized by rank and h-index for comparison with their NIH-funded colleagues. MAIN OUTCOME MEASURES: Scholarly impact, as measured by the h-index, and NIH funding. RESULTS: The h-index increased with successive academic rank among non-NIH-funded and NIH-funded faculty, as did NIH funding among the latter group. The NIH-funded faculty had higher scholarly impact, as measured by the h-index, than their non-NIH-funded PIs (h = 18.3 vs. 7.8; P <0.0001), even when considering publications only in the prior 5 years; h-index increased with increasing NIH funding ranges. The h-indices of those holding an MD degree (21.4±1.6 standard error of mean) were not statistically higher than those of PhD holders (17.9±0.6) and those with both an MD and PhD degree (18.1±1.7; P = 0.14). CONCLUSIONS: The h-index increases with increasing academic rank among NIH-funded and non-NIH-funded faculty in ophthalmology departments. This bibliometric is associated strongly with NIH funding because NIH-funded PIs had higher scholarly impact than their non-NIH-funded colleagues, and increasing impact was noted with higher funding. The h-index is an objective and easily calculable measure that may be valuable as an adjunct in assessing research productivity, a significant factor for academic promotion in academic ophthalmology.

Formation and reversible dissociation of coiled coil of peptide to the C-terminus of the HSV B5 protein: a time-resolved spectroscopic analysis.

An understanding of the molecular mechanisms of the newly characterized herpes simplex virus (HSV) B5 protein is important to further elucidate the HSV cell entry and infection. The synthetic peptide of B5 (wtB5) was functionalized with the nonlinear optical chromophore cascade yellow and its molecular dynamics was probed at physiological and endosomal pH (pH 7.4 and 5.5, respectively). Steady-state CD spectroscopy was utilized to characterize the peptides at different pH. These spectra showed structural changes in the peptide with time measured over several days. Nonlinear optical measurements were carried out to probe the interactions and local environment of the labeled peptide, and the increase in the two-photon cross section of this system suggests an increase in chromophore-peptide interactions. Time-resolved fluorescence upconversion measurements reflected changes in the hydrophilic and hydrophobic local environments of the labeled peptide-chromophore system. Ultrafast depolarization measurements gave rotational correlation times indicative of a reversible change in the size of the peptide. The time-resolved results provide compelling evidence of a reversible dissociation of the coiled coils of the wtB5 peptide. This process was found to be pH-insensitive. The data from this unique combination of techniques provide an initial step to understanding the molecular dynamics of B5 and a framework for the development of novel imaging methods based on two-photon emission, as well as new therapeutics for HSV.

[What do family medicine residents expect of their tutors? A qualitative approach]. / Qué esperan de sus tutores los residentes de medicina de familia? Una aproximación cualitativa.

OBJECTIVE: To find the view of family and community medicine (FCM) residents on the kinds of relationship between tutors and residents and their training. DESIGN: The methodology employed was qualitative; and the technique chosen, that of focus groups. SETTING AND PARTICIPANTS: FCM residents belonging to the teaching units in Murcia and Cartagena. INTERVENTION: Five groups were organised, two second-year resident groups, two third-year ones, and one first-year one. At the start of each group the objectives and norms of the meeting were explained. Residents were then asked four questions about their relationship with their tutor and the training received during their residency. The information arising was classified as a function of the time of debate, the number of residents expressing the same view and the intensity of their emotional involvement on expressing their views. RESULTS: The tutor's confidence in the resident's work was what residents valued most highly, along with the exchange of views as equals. The participants stated that they wanted to take part in planning their training and that they needed to participate in the clinical and organisational decisions taken in the tutor's clinic. CONCLUSIONS: Trust between tutor and resident is essential. Communication between the two must be on an equal basis. Training procedures are valued higher than training content. Residents want to intervene in planning their training. Tutors are models for training.

¿Qué esperan de sus tutores los residentes de medicina de familia? Una aproximación cualitativa / What do family medicine residents expect from their tutors? a qualitative approach

Objetivo. Conocer la opinión de los residentes de medicina familiar y comunitaria (MFyC) sobre los estilos de relación entre tutores y residentes y su formación. Diseño. La metodología empleada es cualitativa y la técnica elegida los grupos focales. Emplazamiento y participantes. Residentes de MFyC pertenecientes a las Unidades Docentes de Murcia y Cartagena. Intervención. Se convocaron 5 grupos, dos de residentes de segundo y tercer año y uno de primero. Al inicio de cada grupo se explicaron los objetivos y normas de la reunión y posteriormente se realizaron 4 preguntas acerca de su relación con el tutor y la formación recibida durante la residencia. La información resultante se ordenó en categorías en función del tiempo de debate, del número de residentes coincidentes en la misma opinión y de la intensidad de la implicación emocional al expresar las opiniones. Resultados. La confianza del tutor en el trabajo del residente es el valor más apreciado por los residentes, así como el intercambio de opiniones entre iguales. Los participantes expresan su deseo de colaborar en la planificación de su formación y la necesidad de participar en las decisiones clínicas y organizativas de la consulta del tutor. Conclusiones. La confianza entre tutor y residente es fundamental y la comunicación entre ambos debe ser de igualdad. Se valora mejor el proceso de formación que el contenido de dicha formación. Los residentes quieren intervenir en la planificación de su formación. Los tutores son modelos para la formación (AU)

[Minor surgery in primary care: consumer satisfaction]. / Cirugía menor en atención primaria: la satisfacción de los usuarios.

OBJECTIVE: To find the satisfaction of patients undergoing minor surgery at health centres and describe the processes. DESIGN: Retrospective study of population seeking the service. SETTING: Health district. PATIENTS: 160 people who had minor surgery during a year. MEASUREMENTS AND MAIN RESULTS: Descriptive variables of everyone who had minor surgery were analysed: age, sex, type of intervention, pre-surgical diagnosis, anatomical-pathological diagnosis and informed consent. Over three weeks the patients were interviewed by phone with use of a satisfaction questionnaire. 160 interventions took place, 80% of which were then studied histologically, with an 83.16% concordance index. 65% of patients were interviewed. 15% had no telephone, 20% were not found, 95.56% considered they were well attended and 3.17% badly attended. 92.06% would choose the health centre again for procedures of a similar nature. 89.9% thought that the explanations they had received were sufficient. 4.4% thought that the room's hygiene was poor. CONCLUSIONS: Minor surgery in primary care was favourably received by users. Activity at our centre had good anatomical-pathological concordance.

Cirugía menor en atención primaria: la satisfacción de los usuarios / Minor surgery in primary care: user satisfaction

Objetivo. Conocer la satisfacción de los pacientes sometidos a técnicas de cirugía menor en un centro de salud y describir los procesos atendidos. Diseño. Estudio retrospectivo sobre población demandante del servicio. Emplazamiento. Zona básica de salud. Pacientes. Las 160 personas sometidas a cirugía menor en el período de un año. Mediciones y resultados principales. Se analizan variables descriptivas de todos los intervenidos (edad, sexo, tipo de intervención, diagnóstico prequirúrgico, diagnóstico anatomopatológico y consentimiento informado). Se entrevista telefónicamente a los pacientes en un período de 3 semanas, utilizando una encuesta de satisfacción. Se practicaron 160 intervenciones, remitiéndose el 80 por ciento a estudio histológico, con un índice de concordancia del 83,16 por ciento. Se entrevista al 65 por ciento de los pacientes. Un 15 por ciento no disponía de teléfono, no localizándose al 20 por ciento. Un 95,56 por ciento considera que fueron bien atendidos y el 3,17 por ciento mal atendidos. En un 92,06 por ciento elegiría de nuevo el centro de salud para procesos de características similares. El 89,9 por ciento opina que las explicaciones recibidas fueron bastantes. La higiene de la sala es calificada como mala por un 4,4 por ciento. Conclusiones. La realización de cirugía menor en atención primaria tiene una aceptación favorable entre los usuarios. La actividad realizada en nuestro centro tiene alta concordancia anatomopatológica (AU)

[The validation of a questionnaire for measuring the organizational climate in health centers]. / Validación de un cuestionario para la medición del clima organizacional en centros de salud.

OBJECTIVE: To check the reliability and to analyse the validity of a questionnaire on organisational atmosphere (OA). DESIGN: Crossover and observational. SETTING: Primary care teams (PCTs). PARTICIPANTS: Two questionnaires were offered to all the doctors, nurses and social workers (548 professionals) from the 29 PCTs in an autonomous community. One questionnaire was on the OA and the other was a subjective assessment of satisfaction with the structure and functioning of their own team. MEASUREMENTS AND MAIN RESULTS: When the results were analysed (initial factorial analysis), 3 items with only slight discrimination were eliminated from the OA questionnaire. Construction validity (factorial analysis with varimax method), reliability of the questionnaire (Cronbach's alpha and Spearman-Brown coefficient) and of criterion (correlation between OA and variables in the subjective assessment questionnaire) were calculated. The overall response rate was 77.5% (402 professionals). Three dimensions which explained 57% of total variability and which confirmed adequate construction validity were identified: team-work, cohesion and commitment. "Team-work" comprised 9 items and explained 27.18% of total variability. "Cohesion" had 7 items, which explained 16.55% of variability. Lastly, "Commitment" explained 13.47% of variability, with 5 items. The validity of criterion was adequate (close correlation between OA and subjective assessment of structure and operation). Reliability was high (0.89 alpha and 0.92 Spearman-Brown for the entire questionnaire and > 0.7 for the dimensions). CONCLUSIONS: The reliability and validity of the adapted questionnaire are sufficient and permit its routine primary care use in our health system to be recommended.