Background: Objective measures of research influence are being increasingly utilized to evaluate and compare academic faculty. However, traditional bibliometrics, such as the Hirsch index and article citation count, are biased by time-dependent factors and are limited by a lack of field normalization. The relative citation ratio (RCR) is a new field- and time-normalized article-level metric developed by the National Institutes of Health (NIH). Purpose/Hypothesis: The purpose of this study was to evaluate the RCR among fellowship-trained academic sports medicine surgeons and to analyze physician factors associated with RCR values. We hypothesized that the mean RCR score for fellowship-trained academic sports medicine surgery faculty will fall above the NIH standard. Study Design: Cross-sectional study. Methods: A retrospective data analysis was performed using the iCite database for all fellowship-trained sports medicine surgery faculty associated with Accreditation Council for Graduate Medical Education–accredited orthopaedic surgery residency programs in December 2021. In eligible faculty, the mean RCR, weighted RCR, and total publication count were compared by sex, career duration, academic rank, and presence of additional degrees. A mean RCR value of 1.0 is the NIH-funded field-normalized standard. The data herein are presented as the median and interquartile range, in addition to the mean and standard deviation, to account for outliers of the mean and weighted RCR scores. Results: A total of 624 fellowship-trained sports medicine surgery faculty members from 160 orthopaedic surgery residency programs were included in the analysis. Overall, faculty produced impactful research, with a median RCR of 1.6 (interquartile range, 1.0-2.2) and a median weighted RCR of 19.3 (interquartile range, 5.1-69.3). Advanced academic rank and career longevity were associated with increased weighted RCR and total publication count. All subgroups analyzed had an RCR value >1.0. Conclusion: Study findings indicate that fellowship-trained academic sports medicine surgery faculty are highly productive and produce impactful research, as evidenced by the high median RCR value relative to the benchmark NIH RCR value of 1.0.
PURPOSE Belize has one of the highest cervical cancer burdens among Latin American and Caribbean countries, despite the implementation of national policies to increase access to prevention and treatment services. This study evaluates the policies, infrastructure, and workforce of the cervical cancer management system in Belize to inform capacity building efforts. METHODS In 2018, health facility assessments were conducted across all six districts of Belize at the national pathology facility and 12 public facilities identified as critical to cervical cancer control. Human and infrastructure resource availability and existing policies related to cervical cancer screening and treatment services were assessed through a structured instrument. RESULTS The public cervical cancer screening workforce in Belize consists of 75 primary care nurses and physicians—one per 1,076 screening-eligible women, with 44% conducting rural outreach. All districts have at least one screening facility, but 50% perform screening services only once per week. Colposcopy and loop electrical excision procedures are available in three and four districts, respectively; radical hysterectomy and chemotherapy are available in two districts; and radiation therapy is unavailable. Of essential pathology equipment, 38.5% were present and functional, 23% were present but nonfunctional, and 38.5% were unavailable. Additionally, 35% of supplies were unavailable at the time of assessment, and 75% were unavailable at least once in the 12 months before assessment. CONCLUSION Public-sector cervical cancer management services differ among districts of Belize, with tertiary service availability concentrated in the largest district. Screening, outreach, and pathology are limited mostly by resource availability. This study characterizes the current capacity of services in Belize and pinpoints health system components for future investment and capacity-building efforts.
Bilateral knee dislocations are exceedingly rare in orthopaedics. Managing these injuries presents a difficult task given their high complication rate and guarded prognosis. We report the case of a 21-year-old male who presented to our institution with bilateral knee dislocations sustained in a motor vehicle collision. The patient subsequently underwent multiligament knee reconstruction surgeries for each knee at one and three weeks following the initial injury. At one-year follow-up, the patient has achieved a successful outcome and has returned to regular activities which include hiking and exercising at the gym.
A Stener-like lesion is defined as the interposition of the sagittal band between the torn collateral ligament of the metacarpophalangeal (MCP) joint of a finger and its origin or insertion. Owing to the rarity of this injury, standardized protocols on the diagnosis and care of these injuries are not currently available. PubMed Central and Google Scholar were searched for published studies from 1962 to 2022. Inclusion criteria admitted any injury of the MCP joints of any nonthumb fingers involving a torn collateral ligament with sagittal band injury that trapped the collateral ligament. Eight studies were ultimately included in our analysis and contained 11 cases of Stener-like lesions. Eight of the 11 cases presented radial collateral ligament injury to the ring and little fingers. All 11 cases presented showed that detailed physical examination was a primary step in diagnosis of these lesions. Metacarpophalangeal joint laxity was present in all cases reported. Imaging-aided diagnosis was used in majority of the cases presented and included arthrography, ultrasound, or magnetic resonance imaging. All cases presented in this review were managed surgically. Following surgical repair, a majority of authors opted to use immobilization techniques immediately postoperatively. As awareness of this injury pattern increases, a standardized treatment algorithm may develop.
Purpose: Belize has among the highest cervical cancer incidence and mortality rates of Latin American and Caribbean countries despite efforts to increase access to prevention and treatment services. This study evaluates the policies, infrastructure, and workforce of the cervical cancer management system in Belize to inform the strengthening of sustainable screening and treatment programs. Methods: In 2018, health facility assessments were conducted across the 6 districts of Belize at the national pathology facility and 12 public facilities identified by Ministry of Health as critical to cervical cancer control. We used a standardized instrument to assess human resources, physical infrastructure, and existing policies related to cervical cancer management. Results: The public cervical cancer screening workforce in Belize consists of 75 nurses and physicians (1 per 1,075 screening-eligible women), and 44% (n=33) are members of the outreach workforce who serve rural areas (1 per 2,537 screening-eligible women). All districts have at least 1 screening facility, 50% (n=6) of which perform screening services including visual inspection with acetic acid and cervical cytology 1 day per week. Cervical cancer diagnosis and treatment service availability differ across districts. At the national pathology facility, 38% (n=5) of essential equipment (e.g. microtomes) were available and functional, 23% (n=3) of equipment were available but non-functional, and 38% (n=5) of equipment were unavailable. Regarding essential pathology supplies (e.g. hematoxylin and eosin), 30% (n=6) of supplies were out of stock at the time of assessment and 75% (n=15) were out of stock at one point in the past 12 months. Conclusion: Public sector cervical cancer management services differ between districts of Belize, with tertiary service availability concentrated in the largest district. Screening, outreach, and pathology are limited by resource availability, and although no standard benchmarks exist for contextualization, this insight into current capacity pinpoints health system components for future investment. Citation Format: Shane Neibart, Tiffany Smith, Jennifer Fang, Taylor Anderson, Abha Kulkarni, Jennifer Tsui, Shawna Hudson, Gregory Peck, Joseph Hanna, Natalia Largaespada Beer, Mark Einstein. An Assessment of Cervical Cancer Prevention and Treatment Infrastructure in Belize [abstract]. In: Proceedings of the 9th Annual Symposium on Global Cancer Research; Global Cancer Research and Control: Looking Back and Charting a Path Forward; 2021 Mar 10-11. Philadelphia (PA): AACR; Cancer Epidemiol Biomarkers Prev 2021;30(7 Suppl):Abstract nr 62.
The metacarpophalangeal (MCP) joint is surrounded by various structures critical to its stability and function. Though the ligamentous injury to the digits is common, rupture of the metacarpophalangeal collateral ligament and a sagittal band of the same finger is not well represented in the literature. We report a chronic case of a concurrent metacarpophalangeal collateral ligament and sagittal band injury. Though surgery would have been the most appropriate treatment soon after the injury, restrictions on elective procedures due to the COVID-19 pandemic precluded surgical treatment. The patient was alternatively treated with buddy tape, and a close follow-up was done. This is the first reported case of a concurrent metacarpophalangeal collateral ligament, and sagittal band injury successfully treated using nonoperative management.
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