Correlation Between H-Index, M-Index, and Academic Rank in Urology

OBJECTIVE

To evaluate the h- and m-indices of academic urologists across all U.S. accredited urology residency programs to determine the relationship between these metrics and an author's academic rank, academic degrees, and gender.

METHODS

A total of 136 urology residency programs with available faculty information on their websites were evaluated. The academic rank, academic degrees, and gender were recorded for each clinical and research faculty member. Each author's h-index was determined using the Scopus database. The m-indices for each author were then calculated. Statistical analysis was performed using the Wilcoxon rank-sum test.

RESULTS

This study demonstrated that the h- and m-indices positively correlate with an author's academic rank. Among the 2253 academic urologists evaluated, chairs/chiefs and professors had the highest median h- and m-indices (h-index 26, m-index 1.046 for chairs/chiefs; h-index 30, m-index 1.094 for professors). This was followed by associate professors (h-index 14, m-index 0.750), assistant professors (h-index 6, m-index 0.667), and clinical instructors (h-index 6, m-index 0.511). The median h- and m-indices were overall statistically higher for males than females. Faculty members with only a PhD were found to have the highest h- and m-indices followed by MD PhD, MD MBA, MD MPH, MD only, and DO only in descending order of index value.

CONCLUSION

The h- and m-indices of academic urologists positively correlate with their academic rank. These metrics may serve as an additional tool in measuring an individual's academic productivity in consideration of job hirings, positional promotions, societal memberships, achievement awards, research grants, and more.

Endovascular balloon usage in endoscopic third ventriculostomy for hydrocephalus during a national shortage: case series and technical note

Endoscopic third ventriculostomy (ETV) is a well-established surgical technique for treating hydrocephalus. Many providers have transitioned to utilizing the specialized Neuroballoon for the stoma dilation in ETV; however, these devices are intermittently unavailable during supply chain shortages. We present the experience of employing cardiac angioplasty and neurovascular balloons as substitutes for the Neuroballoon in 3 patients. The scepter balloon (Microvention), priced at $1800 compared to the standard $300 Neuroballoon (Integra), proved effective, but its pliability presented technical challenges. The substantial cost differential compared to a Neuroballoon ($300) raises economic considerations. The Cardiac TREK balloon (Abbott) was similarly effective, while also being easier to manage endoscopically and cheaper at $158. These experiences support the viability of non-neuroendoscopic specialized balloons as alternatives for ETV dilation of the floor of tuber cinereum.

The genetic basis of hydrocephalus: genes, pathways, mechanisms, and global impact

Hydrocephalus (HC) is a heterogenous disease characterized by alterations in cerebrospinal fluid (CSF) dynamics that may cause increased intracranial pressure. HC is a component of a wide array of genetic syndromes as well as a secondary consequence of brain injury (intraventricular hemorrhage (IVH), infection, etc.) that can present across the age spectrum, highlighting the phenotypic heterogeneity of the disease. Surgical treatments include ventricular shunting and endoscopic third ventriculostomy with or without choroid plexus cauterization, both of which are prone to failure, and no effective pharmacologic treatments for HC have been developed. Thus, there is an urgent need to understand the genetic architecture and molecular pathogenesis of HC. Without this knowledge, the development of preventive, diagnostic, and therapeutic measures is impeded. However, the genetics of HC is extraordinarily complex, based on studies of varying size, scope, and rigor. This review serves to provide a comprehensive overview of genes, pathways, mechanisms, and global impact of genetics contributing to all etiologies of HC in humans.

Association of Statin and Antiplatelet Use with Survival in Patients with AAA with and without Concomitant Atherosclerotic Occlusive Disease

OBJECTIVES

Statin therapy has been associated with improved clinical outcomes in patients undergoing treatment for vascular disease. Current guidelines do not address statin therapy in isolated abdominal aortic aneurysm (AAA) in the absence of other atherosclerotic cardiovascular disease (ASCVD). This study aims to elucidate effects of statin therapy, either as monotherapy or combined with antiplatelet agents, on the long-term mortality of patients with and without ASCVD who undergo elective AAA repair.

METHODS

A retrospective review was performed on all AAA patients treated electively with endovascular (EVAR) and open aortic repair (OAR) in the Society for Vascular Surgery Vascular Quality Initiative from 2003-2020. Long-term mortality was evaluated based on the presence of statin and antiplatelet medication use at discharge stratified by those with and without a history of ASCVD. Unadjusted survival was estimated by Kaplan Meier methodology. Cox proportional hazards modeling was used to determine mortality risk after adjusting for key factors.

RESULTS

A total of 47,012 AAA repairs were selected for analysis: 80.7% EVAR (N=40,153) and 19.3% OAR (N=6,859). EVAR patients on combined statin/antiplatelet (AP) therapy had significantly better survival irrespective of whether they had known ASCVD. In the presence of ASCVD, EVAR patients on statin alone had improved survival compared to those not on a statin (10.9±0.5 vs 10.5±0.4 years, Log Rank <.001), with survival being even greater among those receiving combined statin/AP therapy (12.2±0.2 vs 10.5±0.4 years, Log Rank <.001). In the absence of ASCVD, EVAR patients on statin alone also had better mean survival compared to patients not on a statin (8.7±0.5 vs 8.4±0.4 years, Log Rank<.001), with higher survival among statin/AP therapy patients (9.4±0.2 years vs 8.7±0.5 years, Log Rank <.001). Comparison of adjusted survival via Cox multivariable regression demonstrated a protective effect of statins (HR=0.737, p=0.04, vs no medication) and combined statin/AP therapy (HR=0.659, p=0.001, vs no medication) in patients with ASCVD history. A similar protective effect (statin: HR 0.826, p=0.05. Combination statin/AP: HR 0.726, p<.001, vs no medication) was identified in patients without ASCVD history. Within the OAR cohort, statin therapy was not associated with improved survival among patients without ASCVD; however, combined statin/AP therapy had a protective effect for patients with a known ASCVD diagnosis. Based on KM analysis, OAR patients with ASCVD on combined statin/AP therapy had significantly higher mean survival compared to isolated statin therapy (12.7±0.2 vs 10.3±0.65 years) and no medical therapy (10.5±0.8 years, Log Rank <.001). In KM analysis, OAR patients without known ASCVD indications (N=3591) had no significant survival differences based on the presence of combined statin/AP therapy (8.4 ± .07 vs. 8.5 ± .11 years, Log Rank=.638).

CONCLUSION

Isolated statin therapy and combined statin/AP therapy showed significant survival benefit in all EVAR and OAR patients with ASCVD indications, as well as among EVAR patients without a known ASCVD diagnosis. OAR patients without ASCVD did not have a significant survival benefit from statin therapy, but low numbers in this group may have confounded the findings. Combined statin/AP therapy appears to have significant post-repair survival benefits even in isolated AAA without ASCVD, as demonstrated in post-EVAR patients in this study. Expansion of statin use recommendations within aneurysm treatment guidelines may be warranted.

Examining the Correlation Between Altmetric Score and Citations in the Urology Literature

OBJECTIVE

To determine if article Altmetric scores correlate with journal impact factor and citation count in the urologic literature.

METHODS

We identified the top 10 most-cited articles for the 15 urology journals with the highest impact factor in 2013 and 2016. Citation count and Altmetric scores were recorded for each of the articles. The journal impact factor and date of Twitter account development were recorded for each of the journals. The variables were analyzed in Microsoft excel using Pearson's correlation testing.

RESULTS

A total of 300 articles were analyzed. In 2013, Altmetric scores and citation number showed a significant positive correlation (r = 0.164, P = .045), although Altmetric scores did not correlate with journal impact factor (r = 0.005, P = .957). In 2016, there was significant positive correlation between Altmetric scores and citation number (r = 0.268, P = .0009), as well as between Altmetric scores and journal impact factor (r = 0.201, P = .014). The total citation count decreased from 15,235 in 2013 to 8622 in 2016 while the total Altmetric score increased from 1135 in 2013 to 2563 in 2016. Older Twitter accounts were not associated with increasing correlations between Altmetric score and bibliometrics in either 2013 (r = 0.221, P = .54) or 2016 (r = 0.083, P = .819).

CONCLUSION

At this point in time, Altmetric score is only weakly correlated with citation counts in the urology literature. Altmetrics and traditional bibliometrics should be viewed as complements to one another rather than surrogates when determining research dissemination and impact.