However, successful clinical outcomes depend on a high-quality multidisciplinary network of esophageal and thoracic surgeons, intensivists, psychologists, psychiatrists, and nutritional teams.Surgical intervention either by esophagectomy or esophageal bypass results in durable relief from dysphagia. However, successful clinical outcomes depend on a high-quality multidisciplinary network of esophageal and thoracic surgeons, intensivists, psychologists, psychiatrists, and nutritional teams. Protocols are common in intensive care, however the association between protocol prevalence and outcomes in surgical ICU patients is unclear. We hypothesized that ICUs in a multicenter database using more protocols had better outcomes. This is a retrospective analysis of prospectively collected data from a 2-d prevalence study with 30-d follow up, on surgical and trauma patients in ICUs at 42 trauma centers. Use of forty clinical protocols was queried. Protocol prevalence was categorized by quartile into Low (first), Moderate (second and third), or High (fourth) use ICUs. The primary outcome was in-hospital mortality; secondary outcomes were ventilator, ICU, and hospital days, mechanical ventilation, tracheostomy, renal replacement, transfusion, and hospital-acquired infections. Data from 1044 surgical and trauma patients were analyzed. Protocol use was not different for "closed" (n=20), "open" (n=9), or "semi-open" (n=13) ICUs (P= 0.20). Thirty-day in-hospital mortality was 8.4%, and not associated with number of protocols (OR 1.01 [95% CI 0.98-1.03], P= 0.65). There was no statistically significant difference between High and Low use ICUs for ventilator days (OR 0.86; 0.52-1.43), tracheostomy (OR 0.8; 0.47-1.38), renal replacement therapy (OR 0.66; 0.04-9.82), transfusion (OR 0.95; 0.58-1.57), or hospital-acquired infections (OR 1.07; 0.67-1.7). Higher mortality was seen in open (versusclosed; OR 1.74 [1.05-2.89], P= 0.033), and surgical/trauma (versustrauma; OR 1.86 [1.33-2.61]; P< 0.001). In this multicenter observational study of surgical ICU patients, no association was found between the number of protocols used and patient outcomes.In this multicenter observational study of surgical ICU patients, no association was found between the number of protocols used and patient outcomes. Academic productivity plays a growing role in professional advancement in academic medicine. This study aimed to assess academic productivity among spine surgeons by investigating differences in h indices between neurological and orthopedic spine surgeons. The American Association of Neurological Surgeons (AANS) Neurosurgical Residency Training Program Directory provided names of U.S. and Canadian academic neurological surgeons. The National Institutes of Health (NIH) Research Portfolio Online Reporting Tools database was consulted for NIH funding statuses of the surgeons. Scopus yielded the h indices. Orthopedic spine surgeons were identified at the same institutions as the neurological spine surgeons, and NIH funding statuses and h indices were identified from the same databases. Differences between the disciplines and across the categories of NIH funding receipt, having a Ph.D., and academic rank were analyzed. Inclusion criteria were met by 215 neurological spine surgeons and 513 orthopedic spine surgeons. Neurological spine surgeons had a mean h index of 21.16, and orthopedic spine surgeons had a mean h index of 14.08 (P < 0.0001). Neurological surgeons with NIH funding had higher (P < 0.0001) h indices (34.15) than surgeons without funding (19.29). this website Likewise, orthopedic surgeons with NIH funding had higher (P < 0.001) h indices (42.83) than surgeons without funding (13.39). Analysis of variance showed that department chairmen and professors had higher h indices than associate or assistant professors among neurological (P < 0.01) and orthopedic (P < 0.001) surgeons. These results demonstrate the importance of the h index in measuring academic productivity among neurological and orthopedic spine surgeons.These results demonstrate the importance of the h index in measuring academic productivity among neurological and orthopedic spine surgeons. Several intraoperative imaging methods exist in cerebrovascular surgery to visualize and analyze the vascular anatomy flow. A new method based on multispectral fluorescence (MFL) imaging of indocyanine green (ICG) video angiography (VA) allows real-time, augmented reality (AR) visualization of blood flow superimposed on white-light microscopic images. We describe our single-center experience using MFL AR in cerebrovascular surgery. Case descriptions are provided of cerebrovascular surgery with intraoperative use of MFL AR images performed at our institution from June 2018 to April 2020. MFL superimposes the blood flow in real time on white-light microscopic images. We used MFL AR imaging as well as standard ICG-VA visualization and intraoperative digital subtraction angiography (DSA) as a control. A total of 39 cases (33 aneurysm clippings, 4 arteriovenous malformations, and 2 external carotid-internal carotid bypass surgeries), were performed using MFL technology-based AR visualization of ICG. MFL AR imaging and DSA showed a high correlation concerning aneurysm occlusion and vessel patency. In arteriovenous malformation resection surgery, MFL AR imaging facilitated early identification of the feeding arteries and draining veins. Because of increased sensitivity of MFL AR, a reduced dose of ICG could be used, allowing repeated intraoperative imaging. There were no postoperative complications, side effects, or technical problems related to the use of MFL AR imaging. MFL AR is an easy-to-use adjunct in cerebrovascular surgery and shows a high correlation with intraoperative DSA. No interruption of the surgery is necessary because MFL AR images of the blood flow are superimposed in real time on white-light microscopic images.MFL AR is an easy-to-use adjunct in cerebrovascular surgery and shows a high correlation with intraoperative DSA. No interruption of the surgery is necessary because MFL AR images of the blood flow are superimposed in real time on white-light microscopic images.