Explore the vast range of titles available.

Faculty at prestigious institutions produce more scientific papers, receive more citations and scholarly awards, and are typically trained at more-prestigious institutions than faculty with less prestigious appointments. This imbalance is often attributed to a meritocratic system that sorts individuals into more-prestigious positions according to their reputation, past achievements, and potential for future scholarly impact. Here, we investigate the determinants of scholarly productivity and measure their dependence on past training and current work environments. To distinguish the effects of these environments, we apply a matched-pairs experimental design to career and productivity trajectories of 2,453 early-career faculty at all 205 PhD-granting computer science departments in the United States and Canada, who together account for over 200,000 publications and 7.4 million citations. Our results show that the prestige of faculty’s current work environment, not their training environment, drives their future scientific productivity, while current and past locations drive prominence. Furthermore, the characteristics of a work environment are more predictive of faculty productivity and impact than mechanisms representing preferential selection or retention of more-productive scholars by more-prestigious departments. These results identify an environmental mechanism for cumulative advantage, in which an individual’s past successes are “locked in” via placement into a more prestigious environment, which directly facilitates future success. The scientific productivity of early-career faculty is thus driven by where they work, rather than where they trained for their doctorate, indicating a limited role for doctoral prestige in predicting scientific contributions.

A scientist may publish tens or hundreds of papers over a career, but these contributions are not evenly spaced in time. Sixty years of studies on career productivity patterns in a variety of fields suggest an intuitive and universal pattern: Productivity tends to rise rapidly to an early peak and then gradually declines. Here, we test the universality of this conventional narrative by analyzing the structures of individual faculty productivity time series, constructed from over 200,000 publications and matched with hiring data for 2,453 tenure-track faculty in all 205 PhD-granting computer science departments in the United States and Canada. Unlike prior studies, which considered only some faculty or some institutions, or lacked common career reference points, here we combine a large bibliographic dataset with comprehensive information on career transitions that covers an entire field of study. We show that the conventional narrative confidently describes only one-fifth of faculty, regardless of department prestige or researcher gender, and the remaining four-fifths of faculty exhibit a rich diversity of productivity patterns. To explain this diversity, we introduce a simple model of productivity trajectories and explore correlations between its parameters and researcher covariates, showing that departmental prestige predicts overall individual productivity and the timing of the transition from first- to last-author publications. These results demonstrate the unpredictability of productivity over time and open the door for new efforts to understand how environmental and individual factors shape scientific productivity.

Despite the special role of tenure-track faculty in society, training future researchers and producing scholarship that drives scientific and technological innovation, the sociodemographic characteristics of the professoriate have never been representative of the general population. Here we systematically investigate the indicators of faculty childhood socioeconomic status and consider how they may limit efforts to diversify the professoriate. Combining national-level data on education, income and university rankings with a 2017–2020 survey of 7,204 US-based tenure-track faculty across eight disciplines in STEM, social science and the humanities, we show that faculty are up to 25 times more likely to have a parent with a Ph.D. Moreover, this rate nearly doubles at prestigious universities and is stable across the past 50 years. Our results suggest that the professoriate is, and has remained, accessible disproportionately to the socioeconomically privileged, which is likely to deeply shape their scholarship and their reproduction.Studying socioeconomic backgrounds and intergenerational transmission in the US academia, Morgan et al. find that faculty have a parent with a Ph.D. degree a striking 25 times more often than the general population.

How predictable are life trajectories? We investigated this question with a scientific mass collaboration using the common task method; 160 teams built predictive models for six life outcomes using data from the Fragile Families and Child Wellbeing Study, a high-quality birth cohort study. Despite using a rich dataset and applying machine-learning methods optimized for prediction, the best predictions were not very accurate and were only slightly better than those from a simple benchmark model. Within each outcome, prediction error was strongly associated with the family being predicted and weakly associated with the technique used to generate the prediction. Overall, these results suggest practical limits to the predictability of life outcomes in some settings and illustrate the value of mass collaborations in the social sciences.

The composition of the scientific workforce shapes the direction of scientific research, directly through the selection of questions to investigate, and indirectly through its influence on the training of future scientists. In most fields, however, complete census information is difficult to obtain, complicating efforts to study workforce dynamics and the effects of policy. This is particularly true in computer science, which lacks a single, all-encompassing directory or professional organization. A full census of computer science would serve many purposes, not the least of which is a better understanding of the trends and causes of unequal representation in computing. Previous academic census efforts have relied on narrow or biased samples, or on professional society membership rolls. A full census can be constructed directly from online departmental faculty directories, but doing so by hand is expensive and time-consuming. Here, we introduce a topical web crawler for automating the collection of faculty information from web-based department rosters, and demonstrate the resulting system on the 205 PhD-granting computer science departments in the U.S. and Canada. This method can quickly construct a complete census of the field, and achieve over 99% precision and recall. We conclude by comparing the resulting 2017 census to a hand-curated 2011 census to quantify turnover and retention in computer science, in general and for female faculty in particular, demonstrating the types of analysis made possible by automated census construction.

The spread of ideas in the scientific community is often viewed as a competition, in which good ideas spread further because of greater intrinsic fitness, and publication venue and citation counts correlate with importance and impact. However, relatively little is known about how structural factors influence the spread of ideas, and specifically how where an idea originates might influence how it spreads. Here, we investigate the role of faculty hiring networks, which embody the set of researcher transitions from doctoral to faculty institutions, in shaping the spread of ideas in computer science, and the importance of where in the network an idea originates. We consider comprehensive data on the hiring events of 5032 faculty at all 205 Ph.D.-granting departments of computer science in the U.S. and Canada, and on the timing and titles of 200,476 associated publications. Analyzing five popular research topics, we show empirically that faculty hiring can and does facilitate the spread of ideas in science. Having established such a mechanism, we then analyze its potential consequences using epidemic models to simulate the generic spread of research ideas and quantify the impact of where an idea originates on its longterm diffusion across the network. We find that research from prestigious institutions spreads more quickly and completely than work of similar quality originating from less prestigious institutions. Our analyses establish the theoretical trade-offs between university prestige and the quality of ideas necessary for efficient circulation. Our results establish faculty hiring as an underlying mechanism that drives the persistent epistemic advantage observed for elite institutions, and provide a theoretical lower bound for the impact of structural inequality in shaping the spread of ideas in science.

Introduction HIV care providers are often overworked and suffer from burnout and low job satisfaction. Differentiated service delivery (DSD) models for HIV treatment aim to decongest clinics and improve providers’ quality of professional life by reducing the client/provider ratio and allowing for more time with clients in need. We investigated current job satisfaction and perceived changes in job satisfaction among HIV care providers in Malawi, South Africa, and Zambia after the adoption of DSD models of care in each country. Methods We conducted a concurrent, cross-sectional mixed methods survey with clinical and non-clinical HIV care providers between April 2021 and January 2022 at public sector clinics in Malawi ( n  = 12), South Africa ( n  = 21), and Zambia ( n  = 12). Questions investigated the effect of DSD models on provider responsibilities, work burden, time allocation, and job satisfaction. We conducted a principal components analysis of survey responses to create a job satisfaction index and estimated odds ratios (OR) using logistic regression for associations between key variables and low reported job satisfaction. We reported emerging qualitative themes. We used Herzberg’s two-factor theory to organize and interpret results, identifying motivating factors (which lead to job satisfaction) and hygiene factors (which we refer to as maintenance factors, that lead to dissatisfaction if lacking). Results Providers had generally high job satisfaction. Providers from Malawi were more likely to report lower job satisfaction than those from South Africa or Zambia (adjusted OR (aOR) 4.56; 95% confidence interval (CI) [2.12–9.80]). Providers who believed that their jobs became harder after the introduction of DSD models (2.82; [1.14–6.96]) or that their jobs did not change (6.50; [2.50–16.89]) were more likely to report lower job satisfaction than those who believed their jobs became easier. Qualitatively, providers felt DSD models improved their working conditions by easing clinic congestion and allowing them to spend more time on other tasks. Providers were particularly motivated when they could spend more time with clients. Conclusion Findings highlight the importance of DSD models in maintaining or improving healthcare providers' quality of professional life and underscore the need for continued monitoring of the impact of these models on job satisfaction among HIV care providers in resource-constrained settings.

Duchenne muscular dystrophy is caused by dystrophin deficiency and muscle deterioration and preferentially affects boys. Antisense-oligonucleotide-induced exon skipping allows synthesis of partially functional dystrophin. We investigated the efficacy and safety of drisapersen, a 2′-O-methyl-phosphorothioate antisense oligonucleotide, given for 48 weeks. In this exploratory, double-blind, placebo-controlled study we recruited male patients (≥5 years of age; time to rise from floor ≤7 s) with Duchenne muscular dystrophy from 13 specialist centres in nine countries between Sept 1, 2010, and Sept 12, 2012. By use of a computer-generated randomisation sequence, we randomly allocated patients (2:2:1:1; block size of six; no stratification) to drisapersen 6 mg/kg or placebo, each given subcutaneously and either continuously (once weekly) or intermittently (nine doses over 10 weeks). The primary endpoint was change in 6-min walk distance (6MWD) at week 25 in patients in the intention-to-treat population for whom data were available. Safety assessments included renal, hepatic, and haematological monitoring and recording of adverse events. This trial is registered with ClinicalTrials.gov, number NCT01153932. We recruited 53 patients: 18 were given continuous drisapersen, 17 were given intermittent drisapersen, and 18 were given placebo (continuous and intermittent groups combined). At week 25, mean 6MWD had increased by 31·5 m (SE 9·8) from baseline for continuous drisapersen, with a mean difference in change from baseline of 35·09 m (95% CI 7·59 to 62·60; p=0·014) versus placebo. We recorded no difference in 6MWD changes from baseline between intermittent drisapersen (mean change −0·1 [SE 10·3]) and placebo (mean difference 3·51 m [−24·34 to 31·35]) at week 25. The most common adverse events in drisapersen-treated patients were injection-site reactions (14 patients given continuous drisapersen, 15 patients given intermittent drisapersen, and six given placebo) and renal events (13 for continuous drisapersen, 12 for intermittent drisapersen, and seven for placebo), most of which were subclinical proteinuria. None of the serious adverse events reported (one for continuous, two for intermittent, and two for placebo) resulted in withdrawal from the study. Continuous drisapersen resulted in some benefit in 6MWD versus placebo at week 25. The safety findings are similar to those from previous studies. Ambulation improvements in this young population with early-stage Duchenne muscular dystrophy are encouraging but need to be confirmed in larger studies. GlaxoSmithKline, Prosensa Therapeutics BV (a subsidiary of Prosensa Holding NV).

The management of shoulder instability in children and adolescents continues to evolve. The purpose of this study was to evaluate the epidemiology of shoulder stabilization procedures in a large, nationally representative pediatric population. The Pediatric Health Information System (PHIS) database was queried for patients 18 years and younger undergoing surgical shoulder stabilization between 2008 and 2017. Patients undergoing arthroscopic surgery were compared with patients undergoing complex (open or bony augment stabilization) procedures. Annual trends were calculated using linear regression. A total of 3925 procedures were performed, of which 92.9% were arthroscopic Bankart repairs. There was a significant increase in overall pediatric shoulder stabilizations and arthroscopic repairs between 2008 and 2017. Complex procedures were performed most often in the Northeast, but the annual frequency did not increase nationally. [Orthopedics. 2023;46(3):e167–e172.]

A growing number of people living with HIV (PLHIV) also have non-communicable diseases (NCDs). Shifting to an integrated delivery model may facilitate care-seeking and improve outcomes for people with a dual burden of HIV and NCDs. We describe the current state of integration of hypertension and diabetes care into HIV treatment in Malawi, South Africa and Zambia. We administered structured interviews to HIV treatment providers in 41 primary healthcare facilities to evaluate how NCD care is provided to PLHIV accessing antiretroviral therapy (ART). We defined integration as provision of NCD services within the HIV clinic. The potential degree of integration in HIV clinics ranged from not integrated at all (no NCD services) to fully integrated (all NCD services). We also surveyed a sample of ART clients about their access to integrated care. The degree of integration varied across the facilities and countries. All facilities in South Africa reported being fully integrated for HIV care and hypertension and diabetes, and most providers in South Africa identified no barriers to integration. Integration was much less complete in Malawi and Zambia, with most facilities offering hypertension and diabetes screening/diagnosis and support but limited treatment or disease monitoring services. Frequently cited barriers to integration in Malawi and Zambia were limited staff knowledge of integrated care provision and facility space constraints. ART clients' experience with integrated services mirrored provider responses. Over 90% of survey participants in South Africa reported HIV and non-HIV visit and medication collection alignment, compared to less than half in Malawi and Zambia. The level of integration of hypertension and diabetes care with HIV treatment varies widely across facilities in Malawi, South Africa, and Zambia, despite each country having national guidelines that promote integration. Interventions to increase integration must consider differences among facilities at baseline.