bims-evares Biomed News
on Evaluation of research
Issue of 2026–07–19
sixteen papers selected by
Thomas Krichel, Open Library Society



  1. Plast Reconstr Surg. 2026 Jul 03.
       BACKGROUND: Plastic and reconstructive surgery is among the most socially engaged surgical fields, with widespread use of digital platforms to share research. As a result, assessing scholarly impact now extends beyond traditional metrics such as journal impact factor (IF). The Altmetric Attention Score (AAS) provides real-time insight into online engagement, but its ability to predict academic impact in plastic surgery literature remains unclear. This study aims to determine whether AAS can serve as a reliable predictor of citation impact within the field.
    METHODS: A total of 5,418 original research articles published between January 2022 and December 2023 in ten leading plastic surgery journals were analyzed. A mixed linear model was used to evaluate how well AAS, 5-year journal IF, and time since publication (a key factor in citation accrual) predicted Dimensions citation counts. Journal identity was incorporated as a random effect. Predictor strength was assessed using permutation-based relative importance testing.
    RESULTS: Time since publication was the strongest predictor of citation count, accounting for 82% of the model's explanatory power (p < 0.001). AAS was the second most influential predictor, contributing 16% (p < 0.001). In contrast, the 5-year journal impact factor accounted for only 1.6% and was not a statistically significant predictor (p = 0.119).
    CONCLUSION: AAS is a valuable early predictor of academic impact in plastic surgery literature and outperforms journal IF. Altmetrics provide timely insight into research visibility and should be used alongside established metrics to more effectively evaluate scholarly reach in the digital era.
    Keywords:  Altmetric Attention Score; bibliometrics; citations; impact factor; plastic surgery; research metrics; social media
    DOI:  https://doi.org/10.1097/PRS.0000000000013310
  2. Orthop Traumatol Surg Res. 2026 Jul 16. pii: S1877-0568(26)00216-1. [Epub ahead of print] 104795
       BACKGROUND: Bibliometric evaluations based on « top most cited » articles are commonly used to identify publications that have had a major impact in a specific field, as well as to highlight trends and advances. In Web of Science, nearly 900 publications contain the words «Top» and «Cited» in their title. However, this identification method tends to favor older articles because citation counts are cumulative.
    HYPOTHESIS: The use of normalized citation indicators is more relevant to identify high impact articles.
    METHODS: Articles and reviews published in the journal OTSR between 2009 and 2024 were extracted and we compared three bibliometric indexes: total citation count, the Category Normalized Citation Impact (CNCI), and the global Top10% indicator.
    RESULTS: A total of 3404 publications from OTSR were analyzed. Sixteen publications were ranked within the global Top1%, and 280 within the global Top10%. Moderate agreement was observed between the different selection models (Ka = 0.54).
    DISCUSSION: These results are consistent with previous studies: the use of citation indicators normalized for publication year and disciplinary field provides a more reliable approach to identify influential publications within a given research area.
    LEVEL OF EVIDENCE: IV; retrospective study.
    Keywords:  Agreement analysis (Cohen’s kappa/raw vs normalized rankings); French orthopaedic influence (French authors/global highly cited articles); Influential OTSR topics (PROMs/Meniscus/Masquelet technique); Normalized citation metrics (CNCI/percentile ranking/field-year adjustment); OTSR bibliometrics (Web of Science/InCites/Clarivate Analytics/Impact Factor); Top-cited bias (raw citation count/cumulative citation effect/older article advantage)
    DOI:  https://doi.org/10.1016/j.otsr.2026.104795
  3. Orthop Traumatol Surg Res. 2026 Jul 16. pii: S1877-0568(26)00213-6. [Epub ahead of print] 104792
       BACKGROUND: Publication of conference abstracts as full-text articles is considered an indicator of scientific quality and research dissemination. The annual congress of the French Society of Orthopaedic Surgery and Traumatology (SOFCOT) is the leading national meeting in French orthopaedics. This study evaluated publication outcomes of oral presentations from SOFCOT meetings between 2016 and 2024.
    HYPOTHESIS: Publication rates of SOFCOT oral communications would improve over time, reflecting increased research productivity and scientific quality.
    METHODS: Oral presentations accepted at SOFCOT annual meetings from 2016 to 2024 were retrospectively reviewed. Corresponding publications were identified through systematic searches of PubMed and Google Scholar. Publication rate, time to publication, journals, citation metrics, impact factors, and category normalized citation impact (CNCI) were analyzed.
    RESULTS: Among 3,877 oral communications, 1,278 were subsequently published, yielding an overall publication rate of 33%. Of published studies, 92.3% were indexed in PubMed and 86.0% in Web of Science. Publication rates remained stable over time (p = 0.34), despite an increase in presentations after 2021. Median time to publication was 16 months (IQR: 8-28) and progressively decreased during the study period. Nearly 20% of studies were published before congress presentation. Orthopaedics & Traumatology: Surgery & Research (OTSR) was the leading publication journal (29.5%), followed by International Orthopaedics and Knee Surgery, Sports Traumatology, Arthroscopy. Median CNCI was 0.74 (IQR: 0.31-1.46). Arthroplasty generated the largest publication volume, while shoulder surgery, ACL research, and pelvic trauma showed higher citation impact.
    CONCLUSION: One-third of SOFCOT oral communications were published as full-text articles, consistent with other orthopaedic meetings. Although publication rates did not improve over time, delays shortened and international dissemination increased, confirming the scientific value of the SOFCOT congress.
    LEVEL OF EVIDENCE: III.
    Keywords:  Bibliometric metrics (CNCI/times cited/Top 10%/impact factor); International collaboration; Journal dissemination (OTSR/Web of Science/PubMed/Q1-Q4 journals); Orthopaedic research topics (arthroplasty/shoulder/Spine/pelvic trauma).; Publication delay (time to publication/pre-congress publication); SOFCOT publication outcomes (oral communications/full-text publication/publication rate)
    DOI:  https://doi.org/10.1016/j.otsr.2026.104792
  4. J Gastroenterol Hepatol. 2026 Jul 14.
      Publication leadership shapes academic advancement, yet gender inequity persists in gastroenterology and hepatology. We quantified women's first and last authorship across selected journals. We analyzed PubMed-indexed publications from 14 prespecified gastroenterology and hepatology journals from 2013 through 2025. First and last individual authors were used as proxies for lead and senior authorship. Gender was inferred from first names using Genderize.io with manual adjudication of missing or ambiguous cases. We summarized authorship by journal and year and evaluated first-to-last author gender concordance. Among 60 453 publications, women represented 31.5% of first authors and 20.8% of last authors, a 10.7 percentage-point senior-authorship gap. Women's first authorship ranged from 18.7% to 43.8% across journals, and last authorship from 11.5% to 31.3% (both p < 0.001). From 2013 to 2025, women's first authorship increased from 29.5% to 34.6%, and last authorship increased from 17.0% to 24.8%; women's last authorship increased in 11 of 14 journals. Articles with women first authors were more likely to have women last authors than articles with men first authors (29.0% vs. 17.0%; OR 1.99, 95% CI 1.91-2.07). Women's authorship increased, but senior authorship remained lower than first authorship. Equitable sponsorship, research support, and editorial representation may help strengthen publication leadership.
    Keywords:  authorship; bibliometric analysis; endoscopy; gastroenterology; gender disparities
    DOI:  https://doi.org/10.1111/jgh.70552
  5. Clin Invest Med. 2026 Jul;49(2): 7-20
       BACKGROUND: Canadian MD-PhD and Clinician Investigator Program (CIP) pathways both train physician-scientists, yet longitudinal data on graduate research productivity are limited.
    METHODS: We conducted a longitudinal study of McGill University MD-PhD and CIP graduates who completed these programs between 2000 and 2017, using sex- and year-matched MD-only graduates as controls. Outcomes were collected for publications indexed through to December 31, 2022, and included H-index, total publications, total citations, per-paper journal impact factor, per-paper citations, and authorship position (first, second, senior). Productivity was assessed across four time periods: (1) pre-medical/medical training, (2) residency, (3) post-residency/fellowship, and (4) independent practice.
    RESULTS: Among 549 graduates (MD-PhD = 31; CIP = 97; MD-only = 421), research productivity, research impact, and active research involvement (defined as ≥3 first- or senior-author papers in the prior 5 years) were similar between MD-PhD and CIP graduates; both exceeded MD-only graduates across all metrics. Within-group sex differences were not significant. MD-PhD graduates were more productive during pre-medical/medical training, whereas CIP graduates were comparatively more productive during residency. Sustained productivity in independent practice correlated with research engagement during medical school, residency, and fellowship. In both programs, graduates with active research involvement had higher authorship counts in the 10 years immediately following graduation from medical school.
    DISCUSSION: Research productivity and impact were comparable between MD-PhD and CIP graduates, and both groups exceeded MD-only peers across measured research metrics. Across both programs, graduates with active research involvement had higher early-career authorship counts, particularly during residency and post-residency/fellowship time periods. These findings provide descriptive benchmarking data for future studies of physician-scientist training pathways in Canada.
    Keywords:  Clinician Investigator Program (CIP); EDI; MD/PhD programs; career outcomes; diversity; equity; inclusion; physician-scientist training
    DOI:  https://doi.org/10.3138/CIM-2026-0009
  6. Clin Neurol Neurosurg. 2026 Jul 14. pii: S0303-8467(26)00270-2. [Epub ahead of print]270 109578
       BACKGROUND: The aim of this study was to comprehensively evaluate the bibliometric and analytical characteristics of retracted publications on multiple sclerosis (MS) and other demyelinating diseases of the central nervous system.
    METHODS: The PubMed and Web of Science databases were searched for retracted publications. A total of 80 publications met the inclusion criteria and were included in the analysis. The reasons for retraction were classified by two independent researchers into a primary reason (one per paper) and additional contributing factors (multiple allowed). Bibliometric parameters, citation dynamics, and journal metrics were analyzed. Non-parametric statistical tests were used for intergroup comparisons.
    RESULTS: The most common primary reason for retraction was research misconduct, while unreliable conclusions and unreliable data were among the most frequent contributing factors. The median retraction time was 25 months; the duration was significantly longer for publications retracted due to reliability concerns (p = 0.045). Citation counts after retraction were significantly lower but ongoing (p < 0.001). The number of retraction reasons per publication was significantly higher in the misconduct than the non-misconduct group (median 3 [IQR: 2-5] vs. 2 [IQR: 2-2], p < 0.001). When normalized by total publication volume, Iran had the highest retraction rate, followed by China, India, and the USA.
    CONCLUSION: Retractions in the field of MS and related demyelinating diseases of the central nervous system are primarily due to research misconduct and data reliability issues. The retraction period exceeding 2 years and the continued citation of retracted publications indicate that problematic publications can remain in circulation for long periods. Post-publication oversight and enhanced data transparency should be prioritized in publication.
    Keywords:  Bibliometric; Misconduct; Multiple Sclerosis; PubMed; Retraction
    DOI:  https://doi.org/10.1016/j.clineuro.2026.109578
  7. Front Res Metr Anal. 2026 ;11 1816766
       Background: Citation-based indicators are widely used to assess scientific impact, yet they often overlook the temporal dynamics of knowledge dissemination. Time to first citation has gained relevance as an indicator of early research visibility, particularly in emerging research systems.
    Objective: To analyze time to first citation of Ecuadorian medical publications and identify publication characteristics associated with citation timing using a survival analysis approach.
    Methods: A scientometric study was conducted on Ecuadorian medical publications indexed between 2015 and 2024, with citation follow-up through December 31, 2024. Descriptive statistics summarized publication characteristics and citation counts at 2 and 5 years. Time to first citation was analyzed using Kaplan-Meier estimators and Cox proportional hazards regression models, accounting for right-censored data.
    Results: A total of 3,968 publications were included. Most articles were published in open access journals (63.0%) and involved international collaboration (69.3%). Publications were predominantly in English (85.1%). Most records were original research articles (2,917; 73.5%), while 597 (15.0%) were review articles; article type information was unavailable for 454 records (11.4%). The median number of cumulative citations was 3 (IQR 1-7) at 2 years and 6 (IQR 3-14) at 5 years. Kaplan-Meier analysis showed that approximately 50% of articles received their first citation within the first year, and most were cited within 4 years. In the multivariable Cox regression analysis, international collaboration (HR = 0.81; 95% CI: 0.67-0.97), non-English language (HR = 0.53; 95% CI: 0.42-0.65), original article type (HR = 1.40; 95% CI: 1.09-1.79), and number of authors (HR = 1.001; 95% CI: 1.001-1.002) were significantly associated with time to first citation, whereas open access status was not independently associated with citation timing after adjustment.
    Conclusions: Ecuadorian medical publications demonstrated relatively rapid early citation uptake. Publication language, article type, international collaboration, and authorship characteristics were associated with time to first citation. These findings should be interpreted cautiously given the observational design and limitations in metadata completeness. The study highlights structural factors that may influence early research visibility in emerging research systems.
    Keywords:  Ecuador; medical research; scientometrics; survival analysis; time to first citation
    DOI:  https://doi.org/10.3389/frma.2026.1816766
  8. J Am Coll Surg. 2026 Jul 14.
       BACKGROUND: Research productivity has become a critical factor in the neurosurgery residency match process. The Arms Race Control Score (ARCS) was recently proposed by Bowers et al. to standardize the evaluation of research output for quality and effort. This study is the first to evaluate ARCS among all current US neurosurgery residents.
    STUDY DESIGN: We collected bibliometric data for neurosurgery residents completing training between 2025 and 2031 in the US (n = 1,574) and computed and ARCS values. We stratified residents by median ARCS and compared demographic, academic, and institutional factors. Temporal trends in ARCS and its subcomponents were analyzed using linear regression. We also correlated ARCS with existing research metrics and used multivariate modeling to assess its predictivity.
    RESULTS: Residents with above-median ARCS were more likely to hold advanced degrees (23.4% vs 12.0%), graduate from NIH Top 40 schools (44.3% vs 26.4%), and match into Doximity Top 25 residencies (44.4% vs 20.8%) (p<0.0001), but were less likely to be female (24.2% vs 30.0%, p = 0.0107). ARCS increased over time (R²=0.7221, p=0.0155), alongside publication counts (R2= 0.8622, p=0.0025), and the proportion of minimal-effort publications (R2=0.9598, p=0.0001). Of existing metrics, ARCS was most correlated with number of publications (ρ=0.9295, p<0.0001). Adding ARCS to a multivariate model did not change predictive performance (AUC=0.77).
    CONCLUSIONS: With the recent rise in minimal-effort publications, ARCS may be a valuable tool in residency evaluation. However, it presently appears to be more influenced by publication quantity rather than quality and may offer minimal incremental utility.
    DOI:  https://doi.org/10.1097/XCS.0000000000002093
  9. World J Plast Surg. 2026 ;15(1): 9-16
       Background: The aim of this article was to perform a bibliometric analysis of Iranian researchers in orthognathic surgery.
    Methods: A bibliographical search for orthognathic surgery literature on Iran was conducted on Wef of Science. Mendeley and Microsoft Excel were used for tabulation and data visualization. Some statistical tests were performed with a 95% confidence interval, considered significant.
    Results: From 7,535 articles, 86 included at least one Iranian author, making Iran the second highest contributor in the Middle East after Turkey. Notable topics beyond orthodontic treatment included cosmetic surgery, obstructive sleep apnea, blood clotting, and anesthesiology, with complications being the most studied. Emerging themes were Virtual Surgical Planning and technology. Statistical analysis showed a very high Pearson correlation between the number of ranked institutions and both the number of published articles (ρ=0.85) and the quantity of citations (ρ=0.80), and a moderate correlation with the H-index (ρ=0.46). No correlation was found between citations per document and the number of ranked institutions (ρ= -0.27).
    Conclusion: Iran is a leading country in the field of orthognathic surgery, both regionally and globally. This article provides valuable insights for Iranian researchers and academics, highlighting the potential of international collaboration and free open-source technology to advance knowledge in areas like Virtual Surgical Planning. Promoting global partnerships and utilizing innovative technologies can enhance patient outcomes and benefit practitioners in resource-limited regions worldwide.
    Keywords:  Bibliometrics; Iran; Middle East; Orthognathic surgery
    DOI:  https://doi.org/10.61882/wjps.15.1.9
  10. medRxiv. 2026 Jul 07. pii: 2026.07.04.26357187. [Epub ahead of print]
      Retractions attract substantial attention and have become more frequent over time. Retractions reflect the self-correcting nature of science but also wasted resources. The Retraction Watch Database (RWD) includes over 60,000 records. We integrated RWD with NIH funding metadata (RePORTER system). As of July 2026, of the 6,081 U.S. affiliated retracted articles, 1,725 (28.4%) were linked to at least one NIH grant. With a mean attributed cost per retracted NIH-funded article of $255,087 in 2026 dollars, the attributed total cost of NIH-funded retracted research is $440 million in 2026 dollars. Grants associated with retracted papers for which the first or last author of the paper was the principal investigator were awarded $4.03 billion in 2026 dollars. NIH-funded articles take longer to be retracted (mean = 6.3 years) than other US-based articles, which may entail greater downstream implications. NIH funding of retracted authors decreased over the 3 years following retraction, particularly among authors with multiple retractions. We have developed a continuously updated dynamic dashboard ( https://sandovallentisco.shinyapps.io/nih-retractions/ ) for the cost of retractions reflecting NIH-funded work.
    DOI:  https://doi.org/10.64898/2026.07.04.26357187
  11. Plast Reconstr Surg Glob Open. 2026 Jul;14(7): e7835
       Background: Matched plastic surgery (PS) residency applicants report higher mean numbers of abstracts, presentations, and publications than unmatched peers. However, the National Resident Matching Program aggregates these metrics, limiting insight into program-specific trends. Building on an orthopedic surgery model that uses Python scripts interfaced with the Elsevier Scopus Application Programming Interface, this study aims to create a comprehensive database of PS resident research output and demographics.
    Methods: Eighty-eight active integrated PS residency programs were identified via the Accreditation Council for Graduate Medical Education. A total of 1170 residents (postgraduate years 1-6) were identified through official program websites and social media and validated with the National Resident Matching Program data. Resident demographics (degree type, sex, medical school) were verified using the Residency Explorer (RE) tool. A Python script was used to collect bibliometric data, including publication count, authorship role, journal name, impact factor, and citation count. Manual verification was followed to confirm authorship.
    Results: The script identified 38,226 publications, of which 14,385 were verified and attributed to 1055 residents. This methodology captured 90% of residents within multiple queries. Degree type data matched RE data in 80% of programs, and gender data matched RE data in 62% of programs.
    Conclusions: This study demonstrates the feasibility of using automated data mining and public sources to construct a robust, validated database of PS research output. The methodology offers scalability to other specialties and lays the groundwork for predictive tools to support applicants in selecting programs that align with their academic profiles, as well as guiding away-rotation and signaling decisions.
    DOI:  https://doi.org/10.1097/GOX.0000000000007835
  12. J Family Med Prim Care. 2026 Apr;15(4): 1479-1485
      The h-index, despite widespread adoption, inadequately captures the multidimensional nature of scholarly contribution, conflating productivity with impact while ignoring leadership, independence, research integrity, and collaboration quality. We introduce the Complexity-informed Profile for Research Impact and Scholarly Merit (C-PRISM), a comprehensive framework that re-conceptualizes research assessment as a multidimensional profile rather than a scalar metric. C-PRISM integrates seven measurable dimensions; Leadership, Independence, Influence, Momentum, Depth, Integrity, and Collaboration, each capturing distinct epistemic functions within the research ecosystem. Drawing on principles from complex systems thinking, C-PRISM provides context-sensitive evaluation suitable for hiring, promotion, and grant review while maintaining computational feasibility through standard bibliometric databases. We demonstrate C-PRISM's application through detailed calculation examples. The framework offers a paradigm shift from reductionist metrics to holistic assessment, acknowledging that scientific impact is inherently multidimensional and cannot be meaningfully compressed into a single number.
    Keywords:  Bibliometric; C-PRISM; complexity; h-index; multidimensional evaluation; research assessment; research integrity; scientific impact
    DOI:  https://doi.org/10.4103/jfmpc.jfmpc_2287_25
  13. Front Med (Lausanne). 2026 ;13 1817508
       Background: Menstrual migraine (MM) is a subtype of migraine that affects approximately 50-60% of female migraine patients and is closely associated with the menstrual cycle. It is characterized by increased disability, longer attack duration, and more challenging treatment compared with other migraine subtypes. Despite its significant impact on quality of life, the pathophysiological mechanisms of MM are not fully understood, and research in this area is growing rapidly.
    Objective: This study aims to provide a comprehensive bibliometric analysis of MM research from 1994 to February 2026, identifying key trends, research hotspots, and influential publications in the field.
    Methods: We retrieved articles from the Web of Science Core Collection and PubMed from January 1994 to February 2026. Data analysis and visualization were performed using Microsoft Office Excel 2019, CiteSpace 6.2.R3, and VOSviewer version 1.6.20. The analysis included publication trends, geographical distribution, institutional contributions, author collaboration networks, keyword co-occurrence, and citation analysis.
    Results: A total of 1,120 articles were identified. During the study period, the publication volume exhibited a steady upward trend, reaching its peak in 2025 based on the complete annual data from 1994 to 2025. The United States led in publication output (383 articles) and centrality (0.33), followed by Italy (119 articles) and England (82 articles). The University of London (33 articles) and Jefferson University (31 articles) were the most prolific institutions. The most cited authors included Silberstein SD, MacGregor EA, and Stewart WF. Key research topics included "headache," "prevalence," "menstrual migraine," and "women," with emerging keywords such as "episodic migraine" and "sex differences" indicating current research hotspots.
    Conclusion: This bibliometric analysis highlights the growing interest in MM research over the past three decades. The findings reveal key trends, such as increasing publication output, dominant contributions from specific countries and institutions, and evolving research hotspots. Future research should focus on elucidating the pathophysiological mechanisms of MM and exploring more effective treatment strategies. Strengthening international collaboration and interdisciplinary research is recommended to further advance the field.
    Keywords:  CiteSpace; bibliometrics; knowledge mapping; menstrual migraine; research trends
    DOI:  https://doi.org/10.3389/fmed.2026.1817508
  14. Rev Med Inst Mex Seguro Soc. 2026 Jul 13. 64(4): e7237
       Background: Bibliometrics allows for the evaluation of the editorial performance and thematic organization of health journals with an institutional function.
    Objective: To analyze the scientific output of the IMSS Medical Journal, indexed in PubMed (2005-2025), to describe its temporal evolution and publication patterns (productivity, typology, authorship, citations, and topics).
    Materials and methods: A descriptive and longitudinal bibliometric study was conducted using records retrieved from PubMed. Indicator processing was performed using Anne O' Tate; thematic analysis was based on the co-occurrence of keywords and MeSH terms, with clustering and visualization in VOSviewer.
    Results: A total of 2,661 articles were identified. Annual output showed variations, with a peak in 2023 (205), followed by 2024 (171) and 2025 (107). Observational clinical-epidemiological designs predominated. Authorship was primarily collaborative (average: 4.1; median: 4), with a concentration in teams of 3-6 authors. Production was centralized in Mexico, particularly in Mexico City (1276). 47.65% of articles received ≥ 1 citation (iCite), with an estimated 3,592 citations and 1.35 citations per article.
    Conclusions: The journal exhibits a predominantly national, territorially centralized, and methodologically observational profile, with concentrated citations and a broad thematic agenda. These findings provide evidence to guide thematic priorities and actions to strengthen editorial quality and visibility.
    Keywords:  Abstracting and Indexing; Bibliometrics; Bibliometría; Indización y Redacción de Resúmenes; Mexico; Periodical; PubMed; Publicación Periódica
    DOI:  https://doi.org/10.5281/zenodo.19101746
  15. J Pak Med Assoc. 2026 Jul;76(7): 1150-1153
      Editorial boards determine the direction and scope of journals. The objective of this study was to assess the gender composition of the editorial boards of four Pakistani Medline-indexed journals using a descriptive cross-sectional study design. Gender composition of the editorial boards of four Pakistani Medline-indexed journals was assessed using a descriptive cross-sectional study design. The publicly available official editorial board pages were accessed and analysed for: Journal of the Pakistan Medical Association (JPMA), Journal of Ayub Medical College (JAMC), Journal of the College of Physicians and Surgeons of Pakistan (JCPSP), and Pakistan Journal of Pharmaceutical Sciences (PJPS). Cumulatively, 163 individuals comprised the editorial boards in these journals, out of which 112 (68.7%) were males. JPMA had the largest editorial team with 59 individuals, and JCPSP had the smallest team with 25 individuals. The most and least gender-diverse editorial teams were reported by JPMA and JAMC, with 22 (37.3%) and 6 (20.7%) women, respectively. Results augur the need for gender-sensitive training programmes to promote gender balance in the editorial boards of the country's medical journals.
    Keywords:  Medical Journals, Editorial boards, Gender equity, Women, Pakistan.
    DOI:  https://doi.org/10.47391/JPMA.32109