Background Esophageal atresia (EA) and tracheoesophageal fistula (TEF) represent a spectrum of relatively rare and complex malformations, which remain a major therapeutic challenge for most involved specialists. Whereas the number of EA/TEF-related publications is constantly growing, no thorough assessment of the global research architecture has been performed yet. Hence, this study aimed to critically evaluate the scientific EA/TEF activities in relation to geographical developments and existing research networks using a combination of scientometric methodologies and visualization tools. Methods A comprehensive search strategy for the Web of Science™ database was designed to retrieve bibliographic data on scientific EA/TEF publications for the time span between January 1900 and December 2018. The total reseach output of countries, institutions, individual authors, and collaborative networks was analzyed. Semiqualitative research measures, including citation rate and h-index, were assessed. Choropleth mapping and network diagrams were employed to visualize results. Results A total of 4586 publications on EA/TEF were identified, originating from 86 countries (79.0% written in English). The largest number was published by the USA (n = 799; 17.4%), the UK (n = 260; 5.7%), and Canada (n = 190; 4.1%). The USA produced the highest number of co-operative articles (n = 73) and the most productive collaborative networks were established between USA/Canada (n = 22), USA/Netherlands (n = 19), and USA/Germany (n = 13). Scientific papers from the UK received the highest average citation rate, with 17.6 citations per item, whereas the USA, with 47, had the highest country-specific h-index. Eighty-two articles were published under the auspices of multicenter research consortiums and national study groups. The most productive institutions and authors were based in the UK, the USA, France, Canada, Australia, the Netherlands, Finland, and Spain. Conclusions This is the first in-depth analysis of the worldwide EA/TEF research activity, offering unique insights into the global scientific landscape in this field. Over the past decades, EA/TEF research has increasingly become multidisciplinary but the main research endeavors continue to be concentrated in a few high-income countries. International EA/TEF collaborations and translational research should be strengthened to foster true scientific progress with this rare condition.
Introduction Increasingly in pediatric surgical practice, patients, their parents, and surgeons alike use the Internet as an easily and quickly accessible source of information about conditions and their treatment. The quality and reliability of this information may often be unregulated. We aim to objectively assess the online information available relating to esophageal atresia and its management. Methods We performed searches for ‘oesophageal atresia’ and ‘esophageal atresia’ using the Google, Yahoo, and Bing engines to encompass both European and American spellings. We assessed the first 20 results of each search and excluded duplicates or unrelated pages. The DISCERN score and the Health on the Net Foundation Code (HONcode) toolbar were utilized to assess the quality of information on each website. We evaluated readability with the Flesch reading ease (FRE) and the Flesch–Kincaid grade (FKG). Results Of the original 120 hits, 61 were excluded (51 duplicates, 10 unrelated). Out of 59 individual sites reviewed, only 13 sites were HONcode approved. The mean overall DISCERN score was 52.55 (range: 22–78). The mean DISCERN score for the search term ‘oesphageal atresia’ was 57 (range: 22–78) in comparison to 59.03 for ‘esophageal atresia’ (range: 27–78). Google search had the lowest overall mean DISCERN score at 54.83 (range: 35–78), followed by Yahoo at 58.03 (range: 22–78), and Bing with the highest overall mean score of 61.2 (range: 27–78). The majority of websites were graded excellent (≥63) or good (51–62), 43% and 27%, respectively; 20% were scored as fair (39–50), with 10% being either poor (27–38) or very poor (≤26). In terms of readability, the overall Flesch Reading Ease score was 33.02, and the overall Flesch–Kincaid grade level was 10.3. Conclusions The quality of freely available online information relating to esophageal atresia is generally good but may not be accessible to everyone due to being relatively difficult to read. We should direct parents towards comprehensive, high-quality, and easily readable information sources should they wish to supplement their knowledge about esophageal atresia and its management.
e21645 Background: Cancer related insomnia (CRI) includes difficulty with sleep onset, maintenance or non-restorative sleep. CRI is common with prevalence up to 95%. Consequences include cognitive dysfunction, fatigue, increased hospitalisation and lost work productivity. Early detection may help. CRI remains under-investigated as objective assessment has needed specialised laboratories. Mobile technology may provide a solution. This study aimed to determine the feasibility and acceptability of a wireless bedside monitor (SleepMinder [ResMed Sensor Technologies Ltd, Dublin]) to evaluate CRI. Methods: A prospective observational study recruited 10 consecutive hospice inpatients (IP) and 20 consecutive community participants (CP) with cancer. Participants used a wireless non-contact bedside sleep monitor for 3 consecutive nights. Three insomnia features were examined (sleep onset, maintenance, early awakening). Computerised algorithm-generated metrics were compared to visual inspection of the monitor sleep/activity report. Acceptability questionnaires were completed by patient, nurse and family. Results: The device successfully recorded sleep patterns in all 30 participants. No technical difficulties were experienced. IP: Mean age was 63 +/- 9 years. 7/10 had one or more insomnia features with delayed sleep onset most common. The monitor over-estimated Sleep Latency (77% nights), Duration (77% nights) and Final Awakening (63% nights). CP: Mean age was 64 +/- 10 years. 15/20 had one or more insomnia features with poor sleep maintenance most common. The monitor overestimated Sleep Duration (62% nights) and Final Awakening (45% nights). Lower levels were noted in CP as they spent less time in bed. Patients, nurses and family members reported high (100%) device acceptability. Conclusions: A wireless bedside monitor effectively measured sleep in seriously ill cancer patients in both inpatient and outpatient settings without the use of a sleep laboratory High reliability and acceptability supports routine clinical use Sensitivity of wakefulness detection was reduced as the device incorrectly identified sleep during awake but motionless periods Concurrent use of sleep diary and a monitor is recommended for comprehensive assessment
Climate Change as a threat to human healthClimate change is the biggest threat to human health. 1 Over 300 Local authorities across the United Kingdom have declared climate emergencies, 2 and there have been over 1500 declared by equivalent local authorities across the globe. 3 Local authorities recognise the scale of the challenge and have set targets to reach 'net zero'. Net zero, that is, not releasing more carbon dioxide than is captured, necessitates significantly reducing the amount of carbon dioxide emitted. 4 Local authorities and the communities they serve are well placed to address this challenge both in terms of carbon emissions, as they "have powers or influence over roughly a third of emissions in their local areas" (p.3). 5 and also through their connection and knowledge of their communities. This article asks the question: how can communities come together to make sustained change and accelerate progress towards net-zero?
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