bims-evares Biomed News
on Evaluation of research
Issue of 2019‒03‒24
eighteen papers selected by
Thomas Krichel
Open Library Society


  1. PLoS One. 2019 ;14(3): e0214047
      We used a retrospective cohort study to measure the impact of caring for children on female Australian researchers. Our aim was to see whether caring for children was associated with reduced outputs and collaboration. Women were randomly selected for inclusion if they published a first author paper in one of three Australian journals during 2007 to 2015, women who did not publish during this time were not included. One-hundred and sixty women were approached and 95 (59%) completed a survey on their history of caring for children. Two key outcomes were the women's publication and citation counts, which were accessed from Scopus. We also examined the number of authors, affiliations and countries on their published papers, as a reduction in these numbers could indicate an impaired ability to collaborate. We examined the probability of being first or last author as a measure of esteem. There was a small increase in publication counts after the first child that was reversed after the second child. Average citations counts declined after children, particularly after the second child. There was some evidence of a reduced collaboration with overseas collaborators after the first child. The probability of being the last author increased after the second child. Three women were identified as statistically influential and all three had children and were in the top 10% of overall publications and citations. After removing these women the estimated changes in outcomes were noticeably different for most of the outcomes. The repeated presence of statistically influential women shows that it may be impossible to find an "average impact" of caring for children when considering research output. Adjustments may need to be made individually, with women explaining how caring for children has altered their career.
    DOI:  https://doi.org/10.1371/journal.pone.0214047
  2. PLoS One. 2019 ;14(3): e0201634
      The association between GRE scores and academic success in graduate programs is currently of national interest. GRE scores are often assumed to be predictive of student success in graduate school. However, we found no such association in admission data from Vanderbilt's Initiative for Maximizing Student Diversity (IMSD), which recruited historically underrepresented students for graduate study in the biomedical sciences at Vanderbilt University spanning a wide range of GRE scores. This study avoids the typical biases of most GRE investigations of performance where primarily high-achievers on the GRE were admitted. GRE scores, while collected at admission, were not used or consulted for admission decisions and comprise the full range of percentiles, from 1% to 91%. We report on the 32 students recruited to the Vanderbilt IMSD from 2007-2011, of which 28 completed the PhD to date. While the data set is not large, the predictive trends between GRE and long-term graduate outcomes (publications, first author publications, time to degree, predoctoral fellowship awards, and faculty evaluations) are remarkably null and there is sufficient precision to rule out even mild relationships between GRE and these outcomes. Career outcomes are encouraging; many students are in postdocs, and the rest are in regular stage-appropriate career environments for such a cohort, including tenure track faculty, biotech and entrepreneurship careers.
    DOI:  https://doi.org/10.1371/journal.pone.0201634
  3. Mayo Clin Proc Innov Qual Outcomes. 2019 Mar;3(1): 35-42
      Objective: Studies with authors trained in research methods are of higher quality than those without. We examined inclusion of authors with master's or doctoral degrees incorporating advanced research methods training on original research articles in high-impact journals, investigating differences between journals and by first-author sex.Methods: Using all original research articles from 1 issue of The New England Journal of Medicine (NEJM), Journal of the American Medical Association (JAMA), Annals of Internal Medicine (Annals), and JAMA-Internal Medicine/Archives of Internal Medicine (Archives) every alternate month, February 1994 to October 2016, we assessed the prevalence of articles listing authors with master's/doctoral research degrees and its adjusted associations with time of publication, journal, and first-author sex via multivariable logistic regression models (accounting for number of authors, study type, specialty/topic, and continent and for interactions between journal and time of publication, study type, and continent).
    Results: Of 3009 articles examined, 84.4% (n=2539) had authors listing research degrees. After adjustment, the prevalence of such articles increased from 1994 to 2016 (P<.001), but patterns differed among journals. Annals and NEJM increased to approximately100% by 2016; JAMA and Archives peaked around 2010 to 2011, then declined. Articles with female first authors were more likely to list authors with research degrees (adjusted odds ratio=1.66; 95% CI, 1.29-2.13; P<.001).
    Conclusion: The prevalence of original research articles listing authors trained in research methods in high-impact journals increased significantly but is now declining at some journals, with potential effects on quality. The greater prevalence among female first-authored articles suggests possible sex differences in structuring/crediting research teams or subconscious sex bias during review.
    DOI:  https://doi.org/10.1016/j.mayocpiqo.2018.11.001
  4. AJR Am J Roentgenol. 2019 Mar 19. 1-7
      OBJECTIVE: This study aimed to determine the effect of academic productivity measured using surrogate metrics, including h-index, publication number, and citation number, on the advancement of academic interventional radiology (IR) staff.MATERIALS AND METHODS: Publicly available data on faculty members in IR departments across academic institutions in Canada and the United States were collected. Gender, academic ranking, leadership position (if any), publication number, citation number, years of active research, and h-index were collected for each faculty member, and these data were used to create a prediction equation.
    RESULTS: Four hundred twenty IR faculty members met the inclusion criteria for this study. Overall, women were the minority, representing 10% of all IR faculty. Women in academic IR attained academic ranks at a rate comparable to that of men, with 59% of women attaining the rank of assistant professor and 32% attaining associate professor, compared with 59% of men at the assistant professor and 25% at the associate professor level. A trend toward lower female representation was present at the full professor level (women, 8%; men, 15%) but this difference did not reach statistical significance. Leadership position by gender as a percentage of their overall representation in the field was also similar between women and men (first-in-command women, 15%; first-in-command men, 15%; second-in-command women, 2%; second-in-command men, 2%). No significant difference was found between women and men in terms of academic achievement metrics, including publication number, citation number, h-index, and years of active research.
    CONCLUSION: Women in academic IR achieve similar publication metrics as men and attain promotion to higher academic rank and leadership positions equal to their overall representation in the field. However, women remain the minority among academic IR faculty across North America.
    Keywords:  academic productivity; gender disparity; h-index; interventional radiology; research productivity
    DOI:  https://doi.org/10.2214/AJR.18.20130
  5. Rev Assoc Med Bras (1992). 2019 Feb;pii: S0104-42302019000200232. [Epub ahead of print]65(2): 232-239
      OBJECTIVE: We sought to understand the landscape of published articles regarding medical schools' learning environments (LE) worldwide, with an explicit focus on potentially harmful aspects of the LE as an effort to identify areas specifically in need of remediation or intervention that could prevent future unprofessional behaviors, burnout, violence and mistreatment among students and physicians.METHODS: A bibliometric analysis was conducted in six electronic databases (PubMed/Medline, Web of Science, Cochrane Library, SCOPUS, ERIC-ProQuest, and PsycINFO) up to December 31, 2016, including 12 themes: learning environment - general, hidden curriculum (harmful), unethical behaviors, bullying/hazing, violence, sexual discrimination, homophobia, racism, social discrimination, minorities discrimination, professional misconduct, and other negative aspects.
    RESULTS: Of the 9,338 articles found, 710 met the inclusion criteria. The most common themes were general LE (233 articles), unprofessional behaviors (91 articles), and sexual discrimination (80 articles). Approximately 80% of articles were published in the 21st century.
    CONCLUSION: There is a definite increase in scientific articles on negative aspects of the medical school LE in high-quality journals, especially in the 21st century. However, more studies are needed to investigate negative LE aspects with greater attention to experimental, longitudinal, and cross-cultural study designs.
    DOI:  https://doi.org/10.1590/1806-9282.65.2.232
  6. Air Med J. 2019 Mar - Apr;38(2):pii: S1067-991X(18)30321-3. [Epub ahead of print]38(2): 115-124
      Since its inception in the latter part of the 20th century, the rapid expansion of helicopter emergency medical services (HEMS) has been accompanied by remarkable growth in the relevant evidence base. There are many review articles describing lessons contained within the various arenas of HEMS literature, but there is little or no characterization of the numbers and types of publications comprising the HEMS-related evidence base. This study analyzed all indexed publications mentioning HEMS (with abstract included) in the United States National Library of Medicine's PubMed collection. The aims of the analysis were to provide quantitative, qualitative, and longitudinal trend information regarding the 1972 to 2017 evidence base relevant to HEMS.
    DOI:  https://doi.org/10.1016/j.amj.2018.11.016
  7. Traffic Inj Prev. 2019 Mar 19. 1-8
      OBJECTIVE: The objective of this study was to explore the evolution footprints of simulated driving research in the past 20 years through rigorous and systematic bibliometric analysis, to provide insights regarding when and where the research was performed and by whom and how the mainstream content evolved over the years.METHODS: The analysis began with data retrieval in Web of Science with defined search terms related to simulated driving. BibExcel and CiteSpace were employed to conduct the performance analysis and co-citation network analysis; that is, probe of the performance of institutes, journals, authors, and research hotspots.
    RESULTS: A total of 3,766 documents were filtered out and presented an exponential growth from 1997 to 2016. The United States contributed the most publications as well as international collaborations followed by Germany and China. In addition, several universities in The Netherlands and the United States dominated the list of contributing institutes. The leading journals were in transportation and ergonomics. The leading researchers were also recognized among the 8,721 contributing authors, such as J. D. Lee, D. L. Fisher, J. H. Kim, and K. A. Brookhuis. Finally, the co-citation analysis illuminated the evolution of simulated driving research that covered the following topics roughly in chronological order: task-induced stress, drivers with neurological disorders, alertness and sleepiness while driving, trust toward driving assistance systems, driver distraction, the effect of drug use, the validity of simulators, and automated driving.
    CONCLUSIONS: This article employed bibliometric tools to probe the contributing countries, institutes, journals, authors, and mainstream hotspots of simulated driving research in the past 20 years. A systematic bibliometric analysis of this field will help researchers realize the panorama of global simulated driving and establish future research directions.
    Keywords:  Simulated driving; bibliometrics; co-citation network analysis; driving simulator
    DOI:  https://doi.org/10.1080/15389588.2018.1511896
  8. Malays J Med Sci. 2018 May;25(3): 40-55
      Objective: We carried out a bibliometric study on the scientific papers related to second-generation antipsychotic drugs (SGAs) in Malaysia.Methods: With the SCOPUS database, we selected those documents made in Malaysia whose title included descriptors related to SGAs. We applied bibliometric indicators of production and dispersion, as Price's law and Bradford's law, respectively. We also calculated the participation index of the different countries. The bibliometric data were also been correlated with some social and health data from Malaysia (total per capita expenditure on health and gross domestic expenditure on R&D).
    Results: We found 105 original documents published between 2004 and 2016. Our results fulfilled Price's law, with scientific production on SGAs showing exponential growth (r = 0.401, vs. r = 0.260 after linear adjustment). The drugs most studied are olanzapine (9 documents), clozapine (7), and risperidone (7). Division into Bradford zones yields a nucleus occupied by the Medical Journal of Malaysia, Singapore Medical Journal, Australian and New Zealand Journal of Psychiatry, and Pharmacogenomics. Totally, 63 different journals were used, but only one in the top four journals had an impact factor being greater than 3.
    Conclusion: The publications on SGAs in Malaysia have undergone exponential growth, without evidence a saturation point.
    Keywords:  Malaysia; atypical anti-psychotics; bibliometrics; bipolar disorder; schizophrenia; second-generation anti-psychotics
    DOI:  https://doi.org/10.21315/mjms2018.25.3.5
  9. Fa Yi Xue Za Zhi. 2019 Feb;35(1): 30-38
      OBJECTIVES: To analyze the literature on forensic sciences indexed in Science Citation Index Expanded (SCIE) in recent 10 years, and to understand the research status, characteristics and trends in the field of forensic sciences.METHODS: Literature on forensic sciences from 2008 to 2017 in Web of Science (WoS) was retrieved. The documents number and geographical distribution, document types, source titles, organizations, research areas, authors, funding agencies, and the high cited articles were detected. The impact factors (IF) of journals were retrieved in Journal Citation Reports (JCR). The data were analyzed with descriptive statistics.
    RESULTS: From 2008 to 2017, there were 21 001 documents on forensic sciences in SCIE. The main document type was articles, with English as the major language. With regards to research areas, pathology has the largest number of papers worldwide, and genetics and heredity has the largest number of publications in mainland China. Among the 18 journals where the documents was published, Forensic Science International ranks the first on publication count, and Forensic Science International Genetics has the highest IF (5.637) in the JCR 2017. In 2017, the number of papers from mainland China increased by 48.50% compared with 2016, which was higher than the global increase (32.63%) and the top-5 countries in terms of number of publications (the US, Germany, the UK, Australia, Italy). The average document count per organization is 1.98 worldwide and 1.17 in mainland China, respectively. The publication number per author is 0.53 worldwide and 0.36 in mainland China, respectively. Around 28.17% of the publications were funded, with National Natural Science Foundation of China (NSFC) as the Top 1 funding agency (192 papers). Among the documents with citations, the most cited publication has been cited for 366 times.
    CONCLUSIONS: The yearly numbers of publications on forensic sciences are increasing during recent 10 years. Focusing on the mainland China, there would be more high-quality papers with the steady funding of NSFC.
    Keywords:  forensic medicine; bibliometrics; science citation index; journal citation reports
    DOI:  https://doi.org/10.12116/j.issn.1004-5619.2019.01.006
  10. Environ Sci Pollut Res Int. 2019 Mar 19.
      Straw burning has become a hot topic in recent years as it poses a great risk not only to the lung health of residents in exposed areas but also to large-scale haze events. In order to have a more comprehensive understanding of straw burning research, based on the bibliometric analysis of Science Citation Index Expanded from Web of Science, the research progress of straw burning pollution from 1972 to 2016 and the future research trends were carried out in this paper. The research focuses on the document type, language, publication year, times cited and its output characteristics, subject category, journal, national and institutional distribution, author, etc. The results show that the study of straw burning pollution has shown a significant increase over the past 45 years. A total of 813 publications were found, and English was the most commonly used language. Articles were the most frequently appeared document types, and the researches were strongly embracing with the top 3 popular subject categories of "environmental sciences and ecology," "agriculture," and "meteorology and atmospheric sciences." We identified that the major journals publishing straw burning pollution research were Atmospheric Environment, followed by Atmospheric Chemistry and Physics. China as a leader in paper quantity played an important role in the research field of straw burning pollution, while the USA and India were located in the second and third positions. The most productive institution was Chinese Academy of Sciences, followed by Peking University and University Arkansas. Based on our analysis and the consideration of current environmental problems, more studies should focus on the following three aspects in the future: driving mechanism of emission characteristics, construction of high-resolution emission inventories, and the influencing mechanism of straw burning pollutants on climate change and human health. Our analysis and prospects can be served as a useful reference for future studies.
    Keywords:  Bibliometric analysis; Research trends; SCI-Expanded; Social network analysis; Straw burning pollution
    DOI:  https://doi.org/10.1007/s11356-019-04768-0
  11. Environ Sci Pollut Res Int. 2019 Mar 21.
      To give a basic overview of research publications on air pollution and human health, a bibliometric analysis of 2179 documents published during the last two decades (year 1998 to 2017) was carried out. The relevant data was retrieved from the Web of Science Core Collection (WoSCC) and analyzed by using the software such as VOSviewer 1.6.7, Tableau Public 2018.1, and Origin Pro 9.0 for visualization and mapping. The publication trend showed a drastic increase during the second decade. The most productive countries working in the field of air pollution and human health were the USA, China, Italy, England, and Canada, whereas top institutions were Chinese Academy of Sciences, US EPA, Harvard University, Peking University, and University of Sao Paulo. Likewise, leading authors in the context of number of documents published and co-citation were Michael Bell and C. Arden Pope respectively. Majority of the researches were published in the journals like Atmospheric Environment, Science of the Total Environment, and Environmental Science and Pollution Research whereas most common author keywords in the publications were "air pollution," "particulate matter," and "PM2.5."
    Keywords:  Air pollution; Bibliometric analysis; Human health; VOSviewer; Web of Science
    DOI:  https://doi.org/10.1007/s11356-019-04482-x
  12. J Endourol. 2019 Mar 20.
      INTRODUCTION: There has been a surge in robotic surgery research publications over the past 20 years. However, to date there has been no characterisation of urology's contribution to the robotic field, and there is a lack of bibliometric literature to guide future investigation. We conducted this bibliometric analysis to characterise the distributions and characteristics of robotic surgery research in the urological field, with sub-analysis of the top 100 articles.MATERIALS AND METHODS: The Web of Science Core Collection of the ISI Web of Science (WOS) was searched and analysed to determine distributions and characteristics of robotic urological surgery research. The top 100 articles were categorized by urological subfield and organ of pathology, with a level of evidence rating system applied (adapted from the Center of Evidence Based Medicine).
    RESULTS: The total number of articles retrieved was 1294 from 1999 - 2018. The number of articles published in the last decade has increased by 845.75%, with 153 articles published in the preceding decade. The USA leads countries in publication with 699 (54.02%) articles across the field, and 71 within the top 100 articles. The Journal of Endourology published most articles (n = 292, 22.57%) within the field, while European Urology published most (n = 36) within the top 100 articles. Top 100 articles where generally associated with cancer (n = 76), with prostate cancer dominating literature (n = 38). The most common level of evidence for top 100 articles was that of a level 3 study (n = 31).
    CONCLUSIONS: This analysis of research activity has the potential to guide future robotic surgery research trends in the field of urology. There has been an explosion in robotic surgery urological research activity over the last decade, with level 3 evidence dominating the top 100 articles of the field.
    DOI:  https://doi.org/10.1089/end.2018.0866
  13. World Neurosurg. 2019 Mar 18. pii: S1878-8750(19)30763-6. [Epub ahead of print]
      BACKGROUND: There is no previous report regarding the assessment of neurosurgical publications from Africa. Bibliometric analysis was performed in this study to evaluate the contribution of African authors in neurosurgical journals worldwide and to discuss the approaches that can be used to enhance quantity and quality of publications on this issue.METHODS: A literature search of neurosurgical publications by the African authors was performed using PubMed database from 1999 to 2018. The total number of articles per country was tabulated and normalized by number of neurosurgeons of each country.
    RESULTS: A total of 974 articles were identified and analyzed between 1999 and 2018 from 31 African countries. African neurosurgical publications have grown remarkably during the last decade. However, there is a wide disparity between the countries productivity especially when normalized by number of neurosurgeons. Most of the research publications are case-series and case-reports with very few clinical trials, meta-analysis, and international collaboration. According to neurosurgical research areas, the most representative sub-specialties were spine, intracranial tumor, hydrocephalus, and head injury.
    CONCLUSION: African neurosurgeons are able to meet the challenges of the new century with appropriate use of its resources and staff regardless of the difficulties they face. However, African neurosurgical research needs to be improved by teaching research methodology and medical writing as well as to be more focused on modern neurosurgical topics by highlighting continental particularities. African neurosurgeons should collaborate with each other (locally, regionally, and abroad) and with foreign centers for better quality research and international visibility.
    Keywords:  Africa; Bibliometrics; Medical Publication; Neurosurgery; PubMed; Research; Scientific Productivity
    DOI:  https://doi.org/10.1016/j.wneu.2019.03.095
  14. J Chin Med Assoc. 2019 Mar 20.
      BACKGROUND: Since Taiwan's national health insurance system provides residents with easy and affordable access to clinical acupuncture treatment, this study sought to analyze trends in the publication of acupuncture-related research in Taiwan from 1988 to 2017 using a bibliometric method.METHODS: Data on the scholarly literature from 1988 to 2017 was retrieved through Web of Science searches for the keywords acupunct*, acupoint*, electroacupunct*, electro-acupunct*, acupre*, auricular acupunc*, and auricular needle* in study titles.
    RESULTS: A total of 539 acupuncture-related articles published from 1988 to 2017 were identified and analyzed. The articles had an h-index of 38 and were cited in subsequent studies 7250 times, meaning that Taiwan ranked sixth in the production of such publications among countries/regions globally. Among those articles, 99 (18.4%) had no subsequent citations, six (1.1%) were highly cited (over 100 citations), and 141 (26.1%) were cited 4 to 10 times. The highly cited papers discussed the possible pathways of acupuncture stimulation and efficacy, and received 1103 (15.2%) of the citations.
    CONCLUSION: The China Medical University in Taichung, Taiwan, was the most active educational institution in Taiwan in terms of acupuncture-related research. Professor Lin Jaung-Geng was the leading acupuncture-related researcher, having the most publications, citations, and the highest h-index value. These results provided a context for analyzing the strengths of the existing research and informing prospective strategies for further studies.This is an open access article under the CC BY-NC-ND license (http://creativecommons.org/licenses/by-nc-nd/4.0/).
    DOI:  https://doi.org/10.1097/JCMA.0000000000000093
  15. Orthop Traumatol Surg Res. 2019 Mar 14. pii: S1877-0568(19)30069-6. [Epub ahead of print]
      BACKGROUND: The French peer-reviewed journal Revue d'Orthopédie founded on 1st January 1890 extended its scope in 2009 by creating the English-language, online-only, indexed journal Orthopaedics & Traumatology: Surgery & Research (OTSR). Bibliometric data help authors and readers assess the citation potential of articles published in a given journal. We found no bibliometrics for the first 10years of OTSR. The objectives of this bibliometric study were to identify (i) the 100 most-cited OTSR articles and (ii) the specialties or article types most often involved in citations.METHODS: The Scopus database was used to determine the citation rates of the 2158 articles published in OTSR during the journal's first 10years. A bibliometric analysis was performed on the 100 most-cited articles.
    RESULTS: Mean time since publication of the 100 most-cited articles was 6.60±1.66years (range: 2-10years) and mean number of citations per article was 49.59±24.16 (range: 30-169). Mean number of citations per year was 7.75±3.26 (range: 4-18.78) and mean number per author was 5.52±3.14 (range: 1-21). The first author was French in 89/100 cases. Of the 100 articles, 56 were based on a multi-centre study and 21 on an international study. Finally, 22/100 articles reported studies sponsored by a scientific society.
    DISCUSSION: The 100 articles identified in this study deserve to be viewed as influential. The number of citations will continue to rise, thereby amplifying the impact of OTSR on worldwide research in orthopaedic surgery.
    LEVEL OF EVIDENCE: IV, systematic retrospective analysis.
    Keywords:  Bibliometrics; Citations; Orthopaedics & Traumatology: Surgery & Research; Surgical journal
    DOI:  https://doi.org/10.1016/j.otsr.2019.01.016
  16. J Int Med Res. 2019 Mar 19. 300060519835974
      OBJECTIVE: Citation analysis represents one of the best available methods to identify the most influential articles. This study aimed to identify and characterize the top 100 highly cited articles (T100) that focus on hepatocellular carcinoma and to reveal the trends in accomplishments within this field.METHODS: A search of the Thomson Reuters Web of Science citation indexing database was conducted using terms related to hepatocellular carcinoma. The T100 were selected and analyzed further based on the number of citations, authorship, year of publication, journal, country of origin, institution, and article type.
    RESULTS: Hepatology published the highest number of papers (n = 15), and the United States produced the highest number of contributions (n = 31). Barcelona University was the institution with the highest number of articles in the T100 (n = 9). The T100 articles included 35 observational studies, 13 randomized control studies, 25 basic research articles, 18 reviews, seven clinical guidelines, and two meta-analyses.
    CONCLUSIONS: This is the first bibliometric study to identify the most influential papers in hepatocellular carcinoma research. This report presents major advances and changes in research regarding hepatocellular carcinoma and can serve as a guide for writing a citable article.
    Keywords:  Hepatocellular carcinoma; authorship; bibliometrics; citations; gastroenterology; liver neoplasms; publications
    DOI:  https://doi.org/10.1177/0300060519835974
  17. Ann Plast Surg. 2019 Mar 13.
      BACKGROUND: A substantial global inequality exists between surgical need and the availability of safe, affordable surgical care. Low- and middle-income countries have the greatest burden of untreated surgical disease and addressing this inequity is the goal of the Global Surgery movement. Reconstructive surgery is a fundamental component of Global Surgery as it is central to the appropriate treatment of trauma, burns, wounds, and congenital malformations. The objective of this study was to analyze the most frequently cited articles in the field of global reconstructive surgery to understand the main publication trends.METHODS: The 25 most cited articles relating to global reconstructive surgery were identified from all available journals through the Web of Science online database. The following data were extracted from each included article: title, source journal, publication year, total citations, average citations per year, authors, main subject, reconstructive surgery subspecialty, country, and institution of origin.
    RESULTS: The average number of citations per article was 21.7 (median, 19; range, 10-40). Most articles originated from the United States, and only 1 originated from a low-income country. The majority of the articles focused on cleft lip and palate (CLP) (72%), with few articles discussing burns or trauma. The main discussion themes were the quality of care provided in low- and middle-income countries both by local and visiting teams, the burden of diseases in relation to global reconstructive surgery, and the impact of surgical interventions economically and on patients.
    CONCLUSIONS: The number of research articles and citations related to global reconstructive surgery are limited. Despite having a lower incidence than burns or trauma, there is a preponderance of reports focusing on missions treating CLP. These findings suggest that more research funding could be invested in global reconstructive surgery for conditions other than CLP.
    DOI:  https://doi.org/10.1097/SAP.0000000000001787