Several human characteristics that influence scientific research performance, including set goals, mental and physical abilities, education, and experience, may vary considerably during the life cycle of scientists. We sought to answer the question of whether high-quality research productivity is associated with investigator's age. We randomly selected 300 highly cited scientists (50 from each of 6 different biomedical fields, specifically immunology, microbiology, neuroscience, psychology-psychiatry, clinical medicine, and biology-biochemistry). Then, we identified the top 5 highly cited articles (within 10 yr after publication adjusted for the expansion of the literature) as first author of each of them. Subsequently, we plotted the distribution of the 1500 analyzed articles of the 300 studied scientists in the eight 5-year intervals of investigator's age during the year of article publication (21-25 to 55-60 yr of age), adjusted for person-years of contribution of each scientist in the various age groups. Highly cited research productivity plotted a curve that peaked at the age group of 31-35 yr of age and then gradually decreased with advancing age. However, a considerable proportion of this highly cited research was produced by older scientists (in almost 20% of the analyzed articles, researchers were older than 50 yr). The results were similar in another analysis of the single most cited article of each studied scientist. In conclusion, high-quality scientific productivity in the biomedical fields as a function of investigator's age plots an inverted U-shaped curve, in which significant decreases take place from around 40 yr of age and beyond.
The AMP strategies in day-to-day self-reported practice differ significantly. Uniform, evidence-based practice is warranted, especially in this era of increasing antimicrobial resistance.
Metabolic syndrome (MetS) is correlated with the activity of hypothalamic-pituitary-adrenal axis (HPA), but the underlying mechanism still remains elusive. The aim of this study was to investigate the HPA axis function in patients with MetS. This case-control study included 159 people. They were divided into 2 groups. The first group included 73 healthy volunteers (control group: 19 males, 54 females, mean±SD: 49.9±7.5 years old, with BMI: 27.9±4.42 kg/m2) and the second group included 86 patients with MetS (case group: 48 males, 38 females, mean±SD: 52.2±7.6 years old, with BMI: 30.5±5.35 kg/m2). An oral glucose tolerance test (OGTT) was performed for all subjects after a 12-h overnight fast, and blood samples were obtained for determination of ACTH, cortisol, insulin, C-peptide, and glucose levels. Serum cortisol after an overnight dexamethasone suppression test was determined in both groups. Patients with MetS had serum cortisol levels after an overnight dexamethasone suppression test significantly higher than controls. During OGTT plasma ACTH levels were higher at all time points in patients with MetS compared to controls, whereas serum cortisol levels were comparable between the 2 groups. Plasma ACTH during OGTT was also correlated with most of the components of MetS. The HPA axis in patients with MetS seems to be more active as evidenced by the higher cortisol levels after the overnight dexamethasone suppression test and by the higher ACTH levels during OGTT. This functional hypercortisolism might be involved in the pathogenesis of the metabolic syndrome.
Fractures of the pubic ramus are commonly seen in the emergency room, but they are thought to be minor injuries. Occasionally, these fractures might be associated with massive haemorrhage. Here we report a case of bilateral obturator artery damage due to minimal displaced pubic ramus fracture.
Several aspects of the procedure for obtaining blood cultures are rather controversial. An international survey among 386 experts was performed to investigate the clinical practice of obtaining blood cultures from patients with a central venous catheter (CVC). Among respondents, 64.5% obtain one set of blood cultures from the CVC and one set from the peripheral vein (PV). Other participants answered 'two sets from PV', 'two sets from CVC', 'one from PV', 'one from CVC' and 'other' (9.1%, 4.1%, 8.3%, 7%, and 7%, respectively). Clinicians who, according to the survey, demonstrated that they know the diagnostic performance characteristics of cultures more often obtain one culture from the CVC and one from the PV (73.9% vs. 61.7%, p 0.037).
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