The Epistemic Limits of Impactful Dreams: Metacognition, Metaphoricity, and Sublime Feeling.

Taxonomic studies of dreams that continue to influence the dreamer's thoughts and feelings after awakening have distinguished three types of impactful dreams: nightmares, existential dreams, and transcendent dreams. Of these, existential dreams and transcendent dreams are characterized by recurrent metacognitive appraisal of the epistemic tension between complementary (a) metaphoric (A "is" B) assertions and (b) literal (A "is not" B) assertions. Metacognitive appraisal of such complementary metaphoric and literal assertions is detectable as the felt sense of inexpressible realizations. The poesy of such inexpressible realizations depends upon the juxtaposition of a metaphoric topic and vehicle that are both "semantically dense" but at an abstract level "distant" from each other. The result is "emergence" of attributes of the metaphoric vehicle that are sufficiently abstract to be attributes also of the metaphoric topic. The cumulative effect of successive metaphoric/literal categorical transformations produces a higher-level form of metacognition that is consistent with a neo-Kantian account of sublime feeling. Sublime feeling occurs as either sublime disquietude (existential dreams) or as sublime enthrallment (transcendent dreams). The aftereffects of these two dream types are thematically iterative "living metaphors" that have abstract (but not "totalizing") ontological import.

Shaping Our Understanding of Malignant Peripheral Nerve Sheath Tumor: A Bibliometric Analysis of the 100 Most-Cited Articles.

BACKGROUND: Malignant peripheral nerve sheath tumors (MPNSTs) are rare yet highly aggressive soft tissue sarcomas of mesenchymal origin, characterized by a heterogeneous pathological spectrum, limited therapeutic options, and high metastatic potential. METHODS: Here, the authors conducted a comprehensive bibliometric analysis of the 100 most-cited MPNST articles by utilizing Elsevier's Scopus to identify all relevant published and indexed articles referring to MPNST, thereby aiming to elucidate the pertinent research findings regarding the disease's pathophysiology and therapeutic advancements. Articles were classified as basic science or clinical and analyzed for various bibliometric parameters. RESULTS: The majority of articles (75%) focused on clinical aspects, reflecting the extensive clinicopathological characterization of MPNSTs. Notable studies investigated prognostic factors, histological and immunohistochemical features, and diagnostic modalities. The identification of loss of function mutations in the polycomb repressive complex 2 emerged as a pivotal role, as it opened avenues for potential targets for novel therapeutic interventions. Newer articles (published in or after 2006) demonstrated higher citation rates, suggesting evolving impact and collaboration. CONCLUSIONS: This bibliometric analysis showed how developments in the understanding of MPNST pathophysiology and the creation of novel therapeutic strategies occurred throughout time. Changes that have been noticed recently could portend future innovative therapeutic approaches.

The composition of choroid plexus tumor research: a bibliometric analysis of the 100 most impactful studies to date.

PURPOSE: Choroid plexus tumors (CPT) are relatively rare CNS tumors that primarily occur in children. They are classified as low-grade choroid plexus papilloma, including atypical ones, and high-grade choroid plexus carcinoma based on histological characteristics. There has been extensive academic research regarding these complex tumors. The goal of this work was to identify the 100 most-cited articles pertaining to CPTs in order to better understand the most impactful studies to date. METHODS: In August 2023, Elsevier's Scopus database was searched for the 100 most-cited articles about CPT. To look for trends, articles were classified as either basic science or clinical, and the earliest 50 articles were separated from the latest 50 articles and then were compared. Various bibliometric parameters were summarized and compared using Pearson's chi-square exact test and Wilcoxon rank sum test/Mann-Whitney U test. RESULTS: The 100 most-cited articles were published between 1955 and 2016 in 53 different scientific journals, originating from 16 distinct countries. Over 75% of the articles were clinical in nature, and overall mean (range) values were as follows: citation count 78.5 (42-371), citation rate per year 3.4 (0.9-12), number of authors 6.2 (1-28). Newer articles had statistically higher citation rate (P < 0.01) and number of authors (P < 0.01) compared to their older counterparts. Additionally, while there was no significant difference in article focus (P = 0.64), there was a difference in study design (P < 0.01). CONCLUSION: This study used citation number as a surrogate for article impact and identified the 100 most-cited CPT articles. New mutational analyses have allowed for further subgrouping and positive trends in collaboration shine hope for improvement in treatment outcomes and long-term survival.

Aiming at low nitrogen leaching diets based on nitrogen fertilizer regulatory policy: A regional bio-economic assessment of the Zayandeh-Rud river basin-Iran.

Negative environmental impacts of nitrogen (N) intensive diets have triggered global debates on sustainable nitrogen management. Solutions such as dietary transitions, cropland reallocation and N Regulatory Policy (NRP) have been proposed to mitigate the adverse environmental impacts of N use in food production. However, there is still insufficient understanding of how NRPs could be designed to minimize negative environmental impact across diverse agro-ecological zones without sacrificing human dietary requirements. To increase this understanding, we evaluated the consequences of three NRP scenarios (low, moderate, and high N fertilizer rates) on the amount of livestock and non-livestock diet components as well as the associated N leaching and farmers' Gross Margin (GM) by optimizing the allocation of cropland between food and feed crops. We developed a bio-economic Interval Fuzzy Multi-Objective Programming (bio-economic IFMOP) model for the Zayandeh-Rud river basin, Iran, and a procedure that accounts for annual average availability of calories per capita, calorie sources from livestock and non-livestock components of three dietary preferences, and inequality in calorie distribution. The interaction among soil, climate and weather variability and NRPs across nine sub-regions of the case study region was handled by crop yield simulation using the DSSAT software. The solution of farmers' GM, derived from the optimization problem across possibilities of water fluctuations, was assessed to determine the uncertainty in GM. We also introduced an N leaching per Block of Distributed Calories (BDC) criterion based on solutions of supplied calories and associated N leaching. The upper bound of the moderate NRP scenario resulted in the smallest N leaching per BDC. This corresponded to ∼0.34, ∼0.34, ∼3.77 and 19.00 million BDC of meat, dairy, wheat and potato, respectively. Also, the upper bound of this scenario satisfied the lowest instability in farmers' GM against water fluctuation compared with low and high NRP scenarios. The affordable volume of N leaching per BDC varied across sub-regions between [1.53,3.49], [1.52,3.33], [0.76,0.99] and [0.05,0.08] kg for meat, dairy, wheat and potato, respectively. Our results highlighted both optimistic and pessimistic prospects of producing low N leaching diets. The approach of this study could also be applied to other regions and countries.

The Most Impactful Articles on Cauda Equina Syndrome.

Cauda equina syndrome (CES) is an uncommon condition that can lead to permanent neurological deficits if not diagnosed and addressed promptly. Varying prognoses, including retropulsed fracture fragments, disc herniations, and epidural abscesses, can result in CES. Our objective was to identify the top 50 most impactful articles on CES and analyze the characteristics of these publications. In August of 2021, we used the Web of Science Core Collection bibliographic database to query the phrase "cauda equina syndrome." Articles between 1900 and 2021 were included in the search, and these articles were ranked based on the number of citations. The following variables were recorded: title, first author, journal, year of publication, number of citations, country of origin, the institution of publication, and topic of the paper. A total of 2096 articles matched the search criteria. The top 50 most impactful articles ranged from 43 to 439 in their number of citations. All articles on the list were published in English, with the year of publication ranging from 1938 to 2014. The United States accounted for the greatest number of articles published at 27. The medical journal Spine accounted for the greatest number of publications at nine. And the 2000s was the decade with the most cited articles. It is generally acknowledged that the clinical signals for CES are diverse with no predictive value on patient outcomes. Similar uncertainty exists in the etiology of the condition, though CES induced by spinal anesthesia is a factor of particular interest. Additionally, it is generally recognized that delayed diagnosis of the condition often results in permanent neurological deficits. Identification of the most impactful articles on CES is critical in drawing attention to this significant condition.

Impactful publications of critical care medicine research in China: A bibliometric analysis.

Background: Although publications have been increasing rapidly, the research quality has yet to improve in the field of critical care medicine (CCM) in China. This study aimed at investigating the current status of and the influential factors for impactful publications in CCM research by Chinese authors. Methods: Publications by authors with the affiliation of critical care medicine department or intensive care unit (CCM/ICU) in Chinese as well as American hospitals from 2001 to 2020 were retrieved from the Web of Science Core Collection (WoSCC) database for this bibliometric analysis. Moreover, statistical analyses to test factors affecting impactful publications by Chinese authors were performed. Results: Of 13,487 articles retrieved by this search strategy, 6,622 were published by Chinese authors as first or corresponding authors. The annual publications by Chinese authors have been rapidly increasing from 2001 to 2020, and so did the citations to these articles. However, the proportion in the world of publications by Chinese authors was much less than that by American authors each year [M (IQR): 1.85 (9.592) vs. 27.77 (7.3), p < 0.001]. In addition, impactful articles were significantly less published by Chinese than by American authors, including articles either in journals with a high impact factor (p < 0.001) or in the top 10 journals in the field of CCM (5.4 vs 13.4%, p < 0.001), and articles with high citation frequency as well (p < 0.001). Moreover, the percentage of impactful publications by Chinese authors was likely associated with academic background and regions of the author's affiliations, funds support, public health events of COVID-19, and collaboration between authors. Conclusion: Our results demonstrated that CCM research in China grew rapidly in the recent 20 years. However, the impactful publications remained limited, largely owing to the shortage of comprehensive research training, inactive collaboration, and underfunded CCM research.

Impactful scientists have higher tendency to involve collaborators in new topics.

In scientific research, collaboration is one of the most effective ways to take advantage of new ideas, skills, and resources and for performing interdisciplinary research. Although collaboration networks have been intensively studied, the question of how individual scientists choose collaborators to study a new research topic remains almost unexplored. Here, we investigate the statistics and mechanisms of collaborations of individual scientists along their careers, revealing that, in general, collaborators are involved in significantly fewer topics than expected from a controlled surrogate. In particular, we find that highly productive scientists tend to have a higher fraction of single-topic collaborators, while highly cited-i.e., impactful-scientists have a higher fraction of multitopic collaborators. We also suggest a plausible mechanism for this distinction. Moreover, we investigate the cases where scientists involve existing collaborators in a new topic. We find that, compared to productive scientists, impactful scientists show strong preference of collaboration with high-impact scientists on a new topic. Finally, we validate our findings by investigating active scientists in different years and across different disciplines.

Top 50 Cited Bone Graft Orthopedic Papers.

The purpose of this research is to recognize the highest 50 most-mentioned articles in the literature concentrating on bone grafts. That has been accomplished with the use of the Scopus database and the search slogan "bone grafts," and we inquired for the 50 most-cited articles on bone grafting. The study was completed in September 2020. We investigated the articles issued between 1970 and 2020. The articles were organized and classified based on the total number of citations. We appraised the following information relating to each article: first author, year of publication, journal, and title. A total of 1,580 studies matched our search standards, of which the 50 most-cited extended between 1,862 and 403 citations. Seven articles were cited more than 1,000 times. The article by Marx et al. was the maximum-cited article, with 1,862 citations, followed by Younger et al.'s with 1,461 and Giannoudis et al.'s with 1,245. The majority of the studies originated from the United States (n = 30) and were published in the 2000s. Biomaterials was the most regular destination journal (n = 8), followed by the Journal of Bone and Joint Surgery American series (n = 7). A maximum of the articles focused on the different types of bone grafts and their alternatives including bone tissue engineering (n=29). Our investigation of the highest 50 articles linking to bone grafting has emphasized the most significant papers in the field. These cover a wide-ranging variety of topics including types, management, and mechanism of action of bone grafts. To recognize the present treatment guidelines and how the use of bone grafting has grown, it is vital to know the most-cited articles relating to this grafting.

Long-Term Treatment with Dimethyl Fumarate for Plaque Psoriasis in Routine Practice: Good Overall Effectiveness and Positive Effect on Impactful Areas.

INTRODUCTION: Dimethyl fumarate (DMF) is an oral compound to treat plaque psoriasis. Data on the treatment of patients with psoriasis affecting impactful areas are scarce. In this interim analysis of the prospective, noninterventional SKILL study, we summarized results of DMF treatment regarding effectiveness (overall and in impactful areas) and safety. METHODS: Data from 676 patients suffering from moderate-to-severe plaque psoriasis were analyzed after 52 weeks of DMF treatment. Of these, 257 had data available after 52 weeks. The considered impactful areas were nails, palms, soles, and scalp. Data analysis included observed cases (OC) and last observation carried forward (LOCF). RESULTS: All effectiveness parameters improved after 52 weeks. The Psoriasis Area and Severity Index score was reduced by 79.5% (OC) and 65.7% (LOCF). Compared with baseline, improvements were shown for 70.2% of the patients in their nail psoriasis [nail-Physician Global Assessment (PGA)] and for 57.3% in palmoplantar disease (palmoplantar-PGA). The proportion of patients with scalp-PGA 0/1 (clear/almost clear) increased significantly to 79.8% (OC) and 69.3% (LOCF, both p < 0.001) (versus 37.5% and 36.6% at baseline, respectively). Significant reduction of pruritus (p < 0.001) was also observed. No unexpected adverse drug reactions were observed. CONCLUSION: Long-term treatment with DMF in routine practice showed good overall effectiveness and safety, and a positive effect on plaque-psoriasis-affected impactful areas.

Higher education strategy in digital transformation.

Digital transformation in the global higher education industry determines the future roadmap to a sustainable education management strategy. This research paper aims to develop a qualitative model that advocates how digital transformation as a propelling force could be used to build competitive advantages for universities. Building competitive advantage is a relative, evolving, and important concept in strategy formulation. In recent years, specifically in the education industry, the notion of building competitive advantage is challenged by global phenomena such as digital transformation globalization, information exchange, digitization and social media in most of the global industries. These phenomena have collectively made the process of building competitive advantage rapidly changing, short-term and contextual. These findings aid the evolution of strategic management practices in universities by providing empirical insights in determining the impactful changes and their connection to evolutionary learning. It also stresses the importance of using the developed model as a decision support system to generate, regulate and retain student experience and expectations. This research paper provides first-hand insight into the impactful changes affecting universities' vision and how they can turn these changes to their advantages and set a road map to design-develop models to integrate and regulate these essential changes in their strategies using evolution learning mechanism and digital transformation strategy.

Shaping Our Understanding of Medulloblastoma: A Bibliometric Analysis of the 100 Most Cited Articles.

The clinical management of medulloblastoma has undergone significant transformation since the recent dawn of the molecular era. The aim of this analysis was to evaluate citation and other bibliometric characteristics of the 100 most cited medulloblastoma articles in the literature to better understand the current state of our research efforts into this diagnosis. Elsevier's Scopus database was searched for the 100 most cited articles that focused on medulloblastoma. Articles were dichotomized as either primarily basic science (BSc) or clinical (CL) articles. Various bibliometric parameters were summarized and compared between BSc and CL articles using Pearson's Chi-square and Mann Whitney U tests. Of the 100 most cited articles, 52 were characterized as BSc articles and 48 as CL articles. Overall median (range) values were as follows: citation count 252 (164-1,270); citation rate per year 17.5 (2.5-110); number of authors 11 (1-135); and publication year 2005 (1925-2014). Articles were published in a total of 40 different journals, and the majority originated in the US (n = 60). When compared to CL articles, BSc articles reported significantly greater citation rates per year (P < 0.01), and more recent years of publication (P < 0.01). In summary, although similar in overall proportion, BSc articles demonstrated significantly increased bibliometric parameters of impact in this field by the successful clustering molecular subtypes. Moving forward, it will be of great interest to see how the findings from these impactful BSc articles will translate into future clinical initiatives and subsequently high-impact CL articles.

The top 100 classic papers on adolescent idiopathic scoliosis in the past 25 years: a bibliometric analysis of the orthopaedic literature.

STUDY DESIGN: Bibliometric analysis. OBJECTIVES: To identify the 100 most cited orthopedic papers in adolescent idiopathic scoliosis (AIS) over the past 25 years and characterize them by study type, topic, and country and assess study quality (design, level of evidence, and impact factor) to provide an updated account of the most impactful AIS evidence. AIS represents a three-dimensional deformity that drives a significant number of investigations. Although available evidence continues to grow, recent impactful studies pertaining to AIS have not been identified; their quality has not been thoroughly assessed. METHODS: Web of Science was reviewed to identify the top 1000 cited AIS studies published from 1992 to 2017. Articles were organized by number of citations. Titles and abstracts were screened for inclusion/relevance, and the top 100 articles by citation count were identified, and study and publication characteristics were extracted. RESULTS: Among the top 100 articles, 42 were cited ≥ 100 times. Mean number of authors and citations of these studies was 5.6 and 118.3, respectively. Study types were predominantly retrospective (n = 53), followed by prospective (n = 18), cross-sectional (n = 13), and systematic review/meta-analysis (n = 7). Topics covered in these studies included clinical/patient outcomes (n = 47), methodology/validation (n = 22), basic science (n = 15), radiographic analyses (n = 12), and gait/biomechanics (n = 4). Most studies originated in the United States of America (n = 65) and were published in Spine (n = 76), with 8266 total citations. Most studies were of Level III (n = 55) or Level II (n = 23) evidence. Mean impact factor was 3.47. CONCLUSIONS: Despite recent studies' shorter time frames for impact, citations of AIS research have progressively increased during the past 25 years. The top 100 cited orthopedic studies were predominantly Level III, retrospective, nonrandomized studies, and therefore, were subject to biases. The low proportion of prospective studies (18%) reflects an area of future improvement, underscoring the need for higher-quality studies to support our practice. LEVEL OF EVIDENCE: N/A.

The Top 50 Most-Cited Articles on Thoracolumbar Fractures.

OBJECTIVE: To identify the top 50 most-cited articles in the literature focusing on thoracolumbar spine fractures. METHODS: Using the ISI Web of Science version 5.11 database and the search phrase "thoracolumbar fracture," we queried for the 50 most-cited articles on thoracolumbar fractures. The study was performed in September 2017. We searched for articles published between 1900 and 2017. Articles were sorted and ranked based on the total number of citations. We evaluated the following information pertaining to each article: first author, year of publication, journal, and title. RESULTS: A total of 2718 studies matched our search criteria, of which the top 50 most-cited ranged between 267 and 81 citations. Twelve articles were cited more than 200 times. The article by McLain et al. was the most-cited article, with 267 citations, followed by Vaccaro et al. with 237 and Mumford et al. with 236. The majority of the studies originated from the United States (n = 26) and were published in the 1990s. Spine was the most frequent destination journal (n = 26), followed by the Journal of Bone and Joint Surgery (n = 7). Most of the articles focused on the clinical management of thoracolumbar fracture (82%). Vaccaro and McAfee were the most cited first authors, with 3 articles each. CONCLUSIONS: Thoracolumbar fractures are the most common injuries of the spine, and the incidence is increasing globally. To understand current treatment guidelines and how treatment of these fractures has evolved, it is important to know the most-cited articles pertaining to these fractures.

A Categorical Content Analysis of Highly Cited Literature Related to Trends and Issues in Special Education.

This investigation employs categorical content analysis processes as a mechanism to examine trends and issues in a sampling of highly cited (100+) literature in special education journals. The authors had two goals: (a) broadly identifying trends across publication type, content area, and methodology and (b) specifically identifying articles with disaggregated outcomes for students with learning disabilities (LD). Content analyses were conducted across highly cited (100+) articles published during a 20-year period (1992-2013) in a sample ( n = 3) of journals focused primarily on LD, and in one broad, cross-categorical journal recognized for its impact in the field. Results indicated trends in the article type (i.e., commentary and position papers), content (i.e., reading and behavior), and methodology (i.e., small proportions of experimental and quasi-experimental designs). Results also revealed stability in the proportion of intervention research studies when compared to previous analyses and a decline in the proportion of those that disaggregated data specifically for students with LD.