Publication and research trends among neurological residents

Research is a critical aspect of residency training, but many programs lack a robust research component in their curriculum. Research publications are one way that physicians can advance their career in academic medicine, and the number of publications is often used as a criterion for determining suitable fellowship applicants. In this study, we evaluate the relationship between publications during and after residency in the field of neurology as well as analyze the relationship between number of publications and characteristics such as gender and career path. We randomly selected 50 ACGME Neurology residency programs from across the United States and recorded the number of publications, h-index, gender, fellowship choice, and career path for each graduate between 2013-2015. Each publication was sorted into time frames before residency, during residency, and after residency. The study included a total of 379 neurology residents from 25 different residency programs. Residents who pursued academic medicine had a significantly higher mean total publications (M = 10.1, SD 16.4) than those who pursued private practice (M = 4.2, SD 9.0) (t377 =-4.5, p <0.000). The mean total publications for male residents (M = 8.6, SD 16.5) was significantly higher than female residents (M = 4.1, SD 5.6) (t377 =-3.6, p <0.0002). Pearson correlation also revealed a correlation between publications during residency and publications after residency, with a Pearson product moment correlation of 0.61. The positive correlation between number of publications during residency and publications after residency, demonstrates the importance of implementing strong research principles and practice in a residency's curriculum. We also report a higher number of mean total publications by those who pursued academic medicine than those who pursued private practice. In addition, the results show an underrepresentation of females in neurology research, indicating a need to encourage more females to engage in neurology research and possibly STEM fields in general at an earlier stage in their educational career

Consistency of new research with a 2006 Sleep Medicine practice parameter for young childre

Background: Clinical practice guidelines are systematic reviews and syntheses of the scientific literature for specific diagnoses and treatment modalities. They provide important guidance to practitioners and patients. However, if a practice guideline is not updated regularly, then readers may not be aware of changes and newer developments in best practices. We identified a practice guideline that had not been updated since 2006, the American Academy of Sleep Medicine’s Practice Parameters for Behavioral Treatment of Bedtime Problems and Night Wakings in Infants and Young Children. To determine whether the clinical trials and published research since 2006 remain consistent or conflict, we completed a systematic review.Methods: We constructed research questions based on the guideline recommendations using the Participants, Intervention, Comparator, Outcome (PICO) format, developed search strings based on these questions, and searched ClinicalTrials.gov, the World Health Organization’s International Clinical Trials Registry Platform, and PubMed. Studies were screened for eligibility and exclusion criteria based on completion date and relevance. Retained studies were evaluated based on study type and design, stage of completion, and which recommendation they addressed.Results: After the screening process, 36 studies were retained for review. Of these, 28 were completed with published results, including 19 randomized controlled trials, 8 non-randomized intervention studies, and 1 case report. The majority of studies addressed more than 1 recommendation of interest and supported the use of behavioral interventions.Conclusions: Research over the past 15 years continues to support the general effectiveness of behavioral techniques. However, published research and registered clinical studies have not aligned with research gaps that were identified in the 2006 guidelines. To further advance knowledge for clinical care of infants and young children with bedtime and night-waking problems, future research should target the previously identified research gaps as opposed to continuing to replicate well-established practices

Cyclic and heteroclinic flows near general static spherically symmetric black holes

We investigate the Michel-type accretion onto a static spherically symmetric black hole. Using a Hamiltonian dynamical approach, we show that the standard method employed for tackling the accretion problem has masked some properties of the fluid flow. We determine new analytical solutions that are neither transonic nor supersonic as the fluid approaches the horizon(s); rather, they remain subsonic for all values of the radial coordinate. Moreover, the three-velocity vanishes and the pressure diverges on the horizon(s), resulting in a flow-out of the fluid under the effect of its own pressure. This is in favor of the earlier prediction that pressure-dominant regions form near the horizon. This result does not depend on the form of the metric and it applies to a neighborhood of any horizon where the time coordinate is timelike. For anti-de Sitter-like f(R) black holes we discuss the stability of the critical flow and determine separatrix heteroclinic orbits. For de Sitter-like f(R) black holes, we construct polytropic cyclic, non-homoclinic, physical flows connecting the two horizons. These flows become non-relativistic for Hamiltonian values higher than the critical value, allowing for a good estimate of the proper period of the flow