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    Going Beyond Counting First Authors in Author Co-citation Analysis

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    The present study examines one of the fundamental aspects of author co-citation analysis (ACA) - the way co-citation counts are defined. Co-citation counting provides the data on which all subsequent statistical analyses and mappings are based, and we compare ACA results based on two different types of co-citation counting - the traditional type that only counts the first one among a cited work's authors on the one hand and a non-traditional type that takes into account the first 5 authors of a cited work on the other hand. Results indicate that the picture produced through this non-traditional author co-citation counting contains more coherent author groups and is therefore considerably clearer. However, this picture represents fewer specialties in the research field being studied than that produced through the traditional first-author co-citation counting when the same number of top-ranked authors is selected and analyzed. Reasons for these effects are discussed

    Integrated System for the Proactive Analysis on Infection Risk at a University Health Care Establishment Servicing a Large Area in the South of Italy

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    Objectives Our study proposes the use of a proactive system to manage risk combining the new Risk Identification Framework by the World Health Organization, the Lean method, and the hospital's Procedure Analysis. The system was tested for the prevention of surgical site infections in the University Hospital of Naples "Federico II"on the surgical paths, where they were usually applied individually. Methods We conducted a retrospective observational study from March 18, 2019, to June 30, 2019, at the University Hospital "Federico II"of Naples, Italy (Europe). The study is structured in 3 phases: phase 1, application of each proactive risk management tool (March 18-April 15, 2019); phase 2, analysis and integration of the results, and elaboration of an overview of critical and control points (April 15-20, 2019); and phase 3, evaluation of the outcomes as variation of surgical site infection's incidence between the 3-month period of the 2019 and the same period of the 2018, when each tool was implemented separately (April 30-June 30, 2019). Results (1) The application of the single tool has detected different criticalities; (2) the combined system allowed us to draw a risk map and identify "improving"macroareas; and (3) the infection rate, with the application of this system, was equal to 1.9%; in the same period of the previous year, it was equal to 4%. Conclusions Our study demonstrates that "integrated system"has been more effective to proactively identify surgical route risks compared with the application of each single instrument
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