OBJect Various bibliometric indices based on the citations accumulated by scholarly articles, including the h-index, g-index, e-index, and Google's i10-index, may be used to evaluate academic productivity in neurological surgery. The present article provides a comprehensive assessment of recent academic publishing output from 103 US neurosurgical residency programs and investigates intradepartmental publishing equality among faculty members. methOds Each institution was considered a single entity, with the 5-year academic yield of every neurosurgical faculty member compiled to compute the following indices: ih(5), cumulative h, ig(5), ie(5), and i10(5) (based on publications and citations from 2009 through 2013). Intradepartmental comparison of productivity among faculty members yielded Gini coefficients for publications and citations. National and regional comparisons, institutional rankings, and intradepartmental publishing equality measures are presented. results The median numbers of departmental faculty, total publications and citations, ih(5), summed h, ig(5), ie(5), i10(5), and Gini coefficients for publications and citations were 13, 82, 716, 12, 144, 23, 16, 17, 0.57, and 0.71, respective-ly. The top 5 most academically productive neurosurgical programs based on ih(5)-index were University of California, San Francisco, University of California, Los Angeles, University of Pittsburgh, Brigham & Women's Hospital, and Johns Hopkins University. The Western US region was most academically productive and displayed greater intradepartmental publishing equality (median ih[5]-index = 18, median Gini pub = 0.56). In all regions, large departments with relative intradepartmental publishing equality tend to be the most academically productive. Multivariable logistic regression analysis identified the ih(5)-index as the only independent predictor of intradepartmental publishing equality (Gini pub ≤ 0.5 [OR 1.20, 95% CI 1.20-1.40, p = 0.03]). cONclusiONs The ih(5)-index is a novel, simple, and intuitive metric capable of accurately comparing the recent scholarly efforts of neurosurgical programs and accurately predicting intradepartmental publication equality. The ih(5)-index is relatively insensitive to factors such as isolated highly productive and/or no longer academically active senior faculty, which tend to distort other bibliometric indices and mask the accurate identification of currently productive academic environments. Institutional ranking by ih(5)-index may provide information of use to faculty and trainee applicants, research funding institutions, program leaders, and other stakeholders.

http://aasldpubs.onlinelibrary.wiley.com/hub/journal/10.1002/(ISSN)2046-2484/video/14-5-reading-moore a video presentation of this article http://aasldpubs.onlinelibrary.wiley.com/hub/journal/10.1002/(ISSN)2046-2484/video/14-5-interview-moore the interview with the author https://www.wileyhealthlearning.com/Activity/6952108/disclaimerspopup.aspx questions and earn CME

BackgroundObjective-structured teaching encounters (OSTEs) are used across many disciplines to assess teaching ability. The OSTE detailed in this paper assesses 191 fourth-year medical students’ (M4) ability to identify and address lapses in professionalism based on Association of American Medical Colleges’ professionalism competencies. The research questions addressed areHow frequently do M4s address professionalism lapses observed during an OSTE?What factors influence whether M4s provide feedback when they observe professionalism lapses in an OSTE?MethodsStandardized patients (SPs) and standardized learners (SLs) were recruited and trained to participate in a standardized encounter with specific cognitive, social, and behavioral errors, including professionalism lapses. M4s viewed this encounter and then offered feedback to the SL, while remotely observed by faculty. Post-encounter, the SL and faculty completed identical checklists to assess both teaching readiness and ability to address professionalism concerns.ResultsAn analysis of frequencies showed that six of the Association of American Medical Colleges’ nine professional competencies were addressed in the checklist and/or discussed in the focus group. Analysis of transcribed debriefing sessions confirmed that M4s did not consistently address professionalism lapses by their peers.ConclusionsIn focus groups, M4s indicated that, while they noticed professionalism issues, they were uncomfortable discussing them with the SLs. Findings of the current study suggest how medical educators might support learners’ ability to address lapses in professionalism as well as topics for future research.

Summary A 5‐week‐old American Miniature filly was referred due to intermittent neurological signs of 4 weeks' duration. Clinicopathological findings showed increased ammonia and bile acids in venous blood samples. Abdominal ultrasonography detailed a portosystemic shunt (PSS). The foal underwent laparotomy and operative mesenteric portovenography, which further defined the PSS as extrahepatic portocaval in configuration. The PSS was occluded and intraoperative portovenography confirmed successful shunt occlusion. The foal made a good recovery from surgery and had a successful showing career until she succumbed to colic just over 3 years after surgery.

Therapeutic study, level V.

No abstract

We present a unique case of duodeno-duodenal intussusception from a duodenal bulb ulcer. A 38-year-old man presented with nausea, vomiting, and abdominal pain. Computed tomography showed duodenal intussusception. Esophagogastroduodenoscopy (EGD) showed a linear gastric ulcer and a duodenal bulb ulcer with an overlying blood clot. Helicobacter pylori status was positive. Intussusception resolved spontaneously without intervention. He completed treatment for H. pylori infection, and repeat EGD showed ulcer healing. Duodenal intussusception is rarely reported; intussusception from an edematous duodenal ulcer with an overlying blood clot mimicking a mass lesion acting as lead point has never been reported to our knowledge.

Introduction: Fellowship directors (FD) in sports medicine are distinguished leaders and mentors of trainees. There is little literature available regarding their demographics and unique factors and training that have allowed them to rise to their prominent positions. The goal of this study was to identify FDs' demographics, research output, and education with an emphasis on surveying the diversity in these leadership positions. Methods: The Accreditation Council for Graduate Medical Education Public Accreditation Data System was used to identify all accredited and active orthopaedic sports medicine fellowship positions for 2019 to 2020. Primary data points for the FDs included race/ethnicity, age, sex, residency and fellowship training institutions, year of fellowship completion, year of hire at the current institution, year of FD appointment, and H-index. Student t-tests were used to compare FDs who trained at their current institution versus those who did not. Significance was set at P < 0.05. Results: The 87 active sports medicine fellowship programs surveyed were led by 86 FDs and 2 co-FDs. One (1.1%) FD was female, whereas 87 (98.9%) were male. The mean age of the 88 total FDs was 54.5 years (n = 81). FDs were predominantly White (n = 75, 85.2%), followed by Asian American (n = 6, 6.8%), African American (n = 3, 3.4%), Middle Eastern (n = 3, 3.4%), and then Hispanic/Latino (n = 1, 1.1%). Certain associations were observed between FDs' residency and fellowship and future leadership positions. The most frequently reported training locations were Hospital for Special Surgery (residency, N = 10) and the Steadman Clinic (Vail) (fellowship, N = 10). The mean H-index was 22.33 ± 16.88, and FDs leading the fellowship where they trained had significantly lower mean H-indices than FDs who were not (12.57 ± 12.57 versus 24.85 ± 17.56, respectively) (P = 0.02). Conclusion: More diversity is possible among sports medicine FDs, who are prominent leaders. Moreover, certain programs are associated with producing a greater number of FDs.