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PurposeTo assess left radial artery size, technical feasibility and safety of ldTRA in the anatomical snuffbox for percutaneous image-guided procedures.Materials and MethodsA retrospective single-center study was performed from November 2016 to June 2018 on all patients undergoing ldTRA for interventional radiology procedures.ResultsA total of 287 patients (91 female and 196 male), aged 18–94 years (mean age 64 years), were included. 389 procedures were performed which included hepatic chemoembolization (n = 161), selective internal radiation therapy Y-90 mapping (n = 74), selective internal radiation therapy Y-90 administration (n = 48), diagnostic angiography (n = 34), mesenteric and pelvic embolization (n = 59), stent insertion (n = 8) and miscellaneous (n = 5). Mean sonographic measurement of the left radial artery size at the conventional site at the wrist was 2.55 mm (range 1.4–3.3 mm) and 2.34 mm (range 1.4–3.2 mm) at the anatomical snuffbox (p < 0.001). Technical success rate was 100%, a single small hematoma occurred in the first patient (0.3%). 74.2% of patients had follow-up for radial artery patency (mean 46 days, range 0–66 days), which did not reveal radial artery occlusions or pseudoaneurysm formation.ConclusionThe left distal radial artery in the anatomical snuffbox is smaller in comparison with the conventional access site at the wrist. The difference however is small and does not require intentional downsizing of vascular access equipment to facilitate utilization of ldTRA. Assessment of the vessel size is imperative for appropriate equipment selection and optimizing procedural success. This study supports that ldTRA is technically feasible and safe.

Background  Despite the number of female medical-school applicants reaching an all-time high and the increasing number of females in surgical training, males retain an overwhelming majority in senior surgical academic positions and formal leadership positions. This study aims to better understand the extent of and influences for gender disparity in general surgical societies throughout North America, Europe, and Oceania.  Methods  Data collection for this retrospective cross-sectional study took place between June and December 2017. Committee and subcommittee members from the eight selected general surgical societies that met the inclusion criteria (n = 311) were compiled into an Excel spreadsheet in which the data was recorded. Analyzed metrics included university academic ranking, surgical society leadership position, h-index, number of citations, and total publications. SCOPUS database (Elsevier, Amsterdam, Netherlands) was used to generate author metrics, and STATA version 14.0 (StataCorp, College Station, TX) was used for statistical analysis. Results Overall, 83.28% of members of the entities we studied were male and 16.72% were females. Males had significantly higher representation than females in all societies (Pearson chi = 29.081; p-value = 0.010). Females were underrepresented in all society leadership positions and university academic rankings. Male members had a higher median h-index, more number of citations, and more total publications. Conclusions The composition of the general surgical societies included in this study demonstrated significant gender disparity. Female inclusivity initiatives and policies must be initiated to promote greater research productivity and early career opportunities for female surgeons in the specialty of general surgery.

Background In the 1960s, less than 10% of medical school graduates were women. Today, almost half of all medical school graduates are women. Despite the significant rise in female medical school graduates, there continues to be a large gender gap in most subspecialties, particularly surgical subspecialties such as neurosurgery. Objective The purpose of our study was to assess the factors contributing to differences in the academic ranks of male and female staff in academic neurosurgery programs in Canada and the United States (US). Methods Data about women in academic neurosurgery was collected from a number of sources, including Fellowship and Residency Electronic Interactive Database (FREIDA), Accreditation Council for Graduate Medical Education (ACGME), Canadian Resident Matching Service (CaRMS) FRIEDA, ACGME, CaRMS, Pubmed, and Scopus, to create a database of all neurosurgeons in the US and Canada. The analysis included neurosurgeons in academic and leadership ranks and also the H index, citations, publications, citations per year, and publications per year. Results Women represent only 12% of neurosurgeons in the US and Canada. When gender is further analyzed by academic appointment, women represent just over 12% of neurosurgeons at the assistant and associate professor levels (15.44% and 13.27%, respectively) but significantly less at the full professor level (5.84%). Likewise, only 7.45% of women hold first-in command leadership positions while 4.69% hold second-in-command positions within their institutions. Conclusions The existing data shows that women are significantly under-represented in academic neurosurgery. Lack of role models, experience, limited scientific output, and aspirations of a controlled lifestyle could be the potential contributing factors.

ObjectiveAchieving gender equity in academic medicine is not only a matter of social justice but also necessary in promoting an innovative and productive academic community. The purpose of this study was to assess gender distribution in dual MD/PhD academic programme faculty members across North America.MethodsAcademic metrics were analysed to quantify the relative career success of academic faculty members in MD/PhD programmes. Measured parameters included academic and leadership ranks along with nominal research factors such as peer-reviewed research publications, H-index, citation number and years of active research.ResultsΧ² analysis revealed a statistically significant (p<0.0001, χ²=114.5) difference in the gender distribution of faculty and leadership across North American MD/PhD programmes. Men held 74.2% of full professor positions, 64% of associate professor positions, 59.4% of assistant professor positions and 62.8% of lecturer positions. Moreover, men occupied a larger share of faculty leadership roles with a statistically significant disparity across all ranks (p<0.001, χ²=20.4). A higher proportion of men held positions as department chairs (79.6%), vice chairs (69.1%) and programme leads (69.4%).ConclusionGender disparity was prevalent in the MD/PhD programmes throughout North America with women achieving a lower degree of professional stature than men. Ultimately, steps must be taken to support women faculty to afford them better opportunities for academic and professional advancement.

BackgroundThe issue of gender disparity is particularly important in the domain of public health where the tone of its leadership is pivotal in bringing about impactful change to research, policies, and the wellbeing of our various populations. Our aim is to explore the gender disparity of author metrics and academic rankings of public health physician faculty through a cross-sectional study.MethodsData collection for this retrospective cross-sectional study took place during June and July of 2017. Public health and preventive medicine residency training programs in the United States and Canada were to compiled and all faculty members that met the inclusion criteria were recorded (n = 973). Variables of interest include gender, h-index, years of active research, and academic appointments. SCOPUS database (Elsevier, Amsterdam, the Netherlands) was used to generate author metrics, and all statistical tests were performed using Statistical Package for the Social Sciences (SPSS) software version 20 (IBM Corp., Armonk, NY).ResultsOverall, 31.14% (n = 303) of faculty members we studied were from Canada, and 68.86% (n = 670) were from the United States. In both countries, males made up the majority of all faculty members. Female faculty comprised most of the early career positions, and their proportions tapered off with higher academic rank, whereas male faculty trended in the opposite direction. Males generally were higher in all academic measures across all appointments. Conclusions Gender disparity exists within the North American public health and preventive medicine discipline. There are underlying factors preventing women from moving beyond early career positions or engaging in academic research.

ObjectiveTo present a detailed exploratory data analysis for critically investigating the patterns in medical doctor (MD) to disposition time, pre and post 24/7/365 attending radiologist coverage, for patients presenting to an emergency department (ED).Materials and methodsThe process involved presenting several modeling techniques. To share an understanding of concepts and techniques, we used proportions, medians, and means, Mann-Whitney U test, Kaplan-Meier’s (KM) survival analysis, linear and log-linear regression, log-ranked test, Cox proportional hazards model, Weibull parametric survival models and tertile analysis. Retrospective chart review was conducted to obtain a data set which was used to determine the trends in MD to disposition time. Data comprised of patients who had visited the emergency department (ED) during two distinct time periods and whose imaging studies were read by an attending emergency and trauma radiologist.ResultsMedian provided more insight into the data as compared with the mean. The Mann-Whitney U test was appropriate to evaluate MD to disposition time, but provided limited information. The Kaplan-Meier (KM) was able to offer more insight into the data since it did not assume an underlying model and that is the reason why it was appropriate. However, KM had limited ability to handle measured confounders and was unable to describe the magnitude of difference between curves. The Cox proportional hazards semi-parametric model or some other parametric model such as the Weibull could handle multiple measured confounders and described the magnitude of difference between two (survival) groups in the data set. However, both methods assumed underlying models that may not apply to the data set such as the one used in this study. Linear regression was unlikely to be appropriate due to the shape of survival time distributions, but log transforming the outcome could address the distribution issue. Nearly all the results of the KM subgroup analyses were consistent with the results of the log-transformed linear regression subgroup analyses and the interpretation of the results was the same for both.ConclusionDifferent statistical procedures may be applied to conduct exploratory subgroup analysis for a data set from a pre and post 24/7/365 attending coverage model. This could guide potential areas of further research to compare trends in MD to disposition time in ED. Pattern analysis provides evidence for various stakeholders to rethink the discourse about trends in MD to disposition time, pre and post 24/7/365 attending coverage.

IntroductionGender disparity in academic and organizational settings has been the topic of numerous studies, which have attributed under representation of females within medicine to both individual and institutional reasons. The main objective of our study was to assess gender disparity in leadership positions in committees of professional societies of family medicine (FM).MethodsIn this cross-sectional observational study, we collected publicly available information from 3 major FM societies (College of Family Physicians of Canada, the Royal Australian College of General Practitioners, and the World Organization of Family Doctors) and also collected the academic/leadership information for each committee member, including bibliometric parameters of their research productivity.ResultsIn total, our sample size was 960 and composed of 58% men (556) and 42% women (404). There was a significant difference found in all the research productivity variables. Men had a greater number of publications, number of citations, years since first publication, years of active research, and had a larger h-index.ConclusionIn conclusion, gender disparity within FM societies is less significant compared to other professional medical societies and creating an environment that supports women and supports research can aid in achieving gender parity.

The above article has an error in Figure 6 online (already correct in the PDF version) including the Graphical abstract figure. The original article has been corrected.

BackgroundWomen remain relatively underrepresented in all subspecialties of academic medicine. While sex disparity is prevalent in a number of specialties, the association between academic productivity and sex in academic cardiology has not been assessed in the Canadian context.MethodsAcademic faculty of accredited Canadian Resident Matching Service (CaRMS) programs were included from cardiology division websites across 17 universities. Cardiology faculty members’ names, academic ranks, leadership positions, and sex were obtained from each institutions’ website. The Elsevier database Scopus© was used to extract the Hirsch index (H-index), years of active research, and number of publications of each faculty member. The H-index was used as a metric of academic output and research productivity. Univariate regression was run with the H-Index as the outcome of interest, and multiple linear regression analysis was used to determine factors associated with higher H-index.ResultsSex was identified for 1,040 members, of whom 836 (80%) were male. Male members had higher numbers of publications (p <0.001). There was a trend for males in a leadership position to have a higher H-index (p = 0.07). Median H-index was lower for women (p = 0.02). Males across assistant and associate professor ranks had a higher H-index. Women achieving professor rank demonstrated greater productivity with a higher median H-index (p = 0.002).ConclusionsThere is a prevalent sex gap in academic cardiology with regard to scholarly productivity and academic achievement. Factors that may help narrow the sex gap need to be identified and corrective measures implemented to enhance sex equity.

BackgroundWomen physicians continue to comprise the minority of leadership roles in Academic Family Medicine (AFM) faculty across North American medical schools. Our study quantified the current state of gender disparity by analyzing academic position, leadership ranking, and research productivity.MethodsWe generated a database for 6,746 AFM faculty members. Gender and academic profiles were obtained for 2,892 academic ranks and 1,706 leadership roles by searching faculty listings enlisted in Fellowship and Residency Electronic Interactive Database (FREIDA) and Canadian Resident Matching Service (CaRMS). To measure research productivity, we obtained bibliometric data: h-index, citations, and tenure from 2,383 faculty members using Elsevier’s SCOPUS archives. Data analysis and h-index were formulated using Stata version 14.2 (StataCorp LP, College Station, TX).ResultsOur results indicated that women hold 46.11% (3,110/6,746) of faculty positions. The proportional composition decreased with increasing academic ranking (49.84% assistant, 46.78% associate, and 41.5% full professor). The same decreasing trend was demonstrated with leadership rank (57.14% minor leadership, 47.65% second-in-command, and 36.61 first-in-command). Compared to their gender counterparts, women in AFM demonstrated lower publication productivity as measured by citation number (p=0.04) and years of study (p=0.008). The final prediction equation model after multivariable analyses included gender, publications, citations, country of graduation, and years of active research (p<0.05).ConclusionsThe composition of academic family medicine faculty members included in this study demonstrated gender disparity. Inclusivity initiatives and policies to tackle the issue of female retention, promotion, and recruitment need to be further explored.