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Leg Ulcer Outcomes
Get PDFBackground
Venous disease is the most common cause of leg ulceration. Treatment of superficial venous
reflux has been shown to reduce the rate of ulcer recurrence but the effect of early
endovenous ablation of superficial venous reflux on ulcer healing remains unclear. It is
generally accepted that there is considerable global variation in the management of leg ulcers.
Objectives
To determine: the clinical and cost-effectiveness of early endovenous treatment of superficialvenous reflux in addition to standard care compared to standard care alone in patients with venous ulceration; the current standards of global management of venous leg management and the impact on these following the results of the randomised controlled trial.
Methods
i. The Early Venous Reflux Ablation Trial (EVRA) multi-centre randomised clinical trial of
450 participants compared early versus deferred intervention at 12 months and at 3.5 years.
ii. Health professionals treating patients with leg ulcers globally were surveyed before and
after the publication of the RCT results to gain insight on the management of venous leg
ulceration, and subsequent impact on practice.
Results
i. EVRA:
i. time to ulcer healing was shorter in the early group at 12 months; no clear
difference in time to first ulcer recurrence at 3.5 years; early intervention at 3 years is 91%
likely to be cost-effective at £20,000/QALY.
ii. Surveys: ⁃ Pre/post-EVRA UK primary care: 90/643 responses received; Pre/post-EVRA
global clinicians: 799/644 responses were received.
Conclusions
The EVRA RCT showed that early intervention reduces the time to healing of venous leg
ulcers, does not affect the time to recurrent ulceration but is highly likely to be cost-effective
and therefore is beneficial for both patients and healthcare providers. The surveys
demonstrated that the management of venous ulceration is disparate globally. It is likely that
the EVRA RCT results influenced the timing of intervention worldwide.Open Acces
Metabolic profiling in chronic venous ulceration
Get PDFIntroduction: This thesis seeks to determine the potential utility of metabolic profiling in chronic venous ulceration of the lower limb. Venous ulceration is a final common pathway for legs subjected to abnormally sustained and elevated venous pressures either as a consequence of venous obstruction or reflux. What is not clear is how venous abnormalities contribute to the syndrome of tissue loss. This thesis has outlined the present understanding of the pathogenesis of venous ulceration and has sought to outline the role of hypothesis generating metabolic profiling that may be able to shed new light on venous leg ulceration.
Methods: After a pilot study and concurrent development of methods. A cohort of patients with venous ulceration was recruited with the appropriate ethical approval for sequential clinical assessments and sampling of urine, serum and ulcer fluid (captured by sterile filter paper discs). Global metabolic profiling using nuclear magnetic resonance and mass spectrometry was performed and multivariate statistical analysis was performed according to known clinical variables that have been able to predict ulcer healing in the literature.
Results: Multivariate statistical analysis revealed that it was possible to discriminate between clinical prognostic groups based on the global metabolic profile of urine, serum and ulcer fluid. Multiple potential metabolite markers were identified and will be studied in detail in future work in terms of relevance to the pathogenesis of chronic venous ulceration and to prediction of prognosis.
Conclusion: This novel work has demonstrated the utility of metabolic profiling in chronic venous ulceration of the lower limb. When stratified for clinical parameters related to prognosis or ulcer healing status a variable metabolic phenotype was identified. Future work will involve the detailed characterisation of the metabolite features responsible for difference between clinical groups, validate the results of this thesis in a larger cohort as a prognostic tool and consider the role of venous ulcer biopsy.Open Acces
Going Beyond Counting First Authors in Author Co-citation Analysis
Get PDFThe 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
Variations on the Author
Get PDF“Variations on the Author” discusses two of Eduardo Coutinho’s recent films (Um Dia na Vida, from 2010, and Últimas Conversas, posthumously released in 2015) and their contribution to the general question of documentary authorship. The director’s filmography is characterized by a consistent yet self-effacing form of authorial self-inscription: Coutinho often features as an interviewer that rather than express opinions propels discourses; an interviewer that is good at listening. This mode of self-inscription characterizes him as an author who is not expressive but who is nonetheless markedly present on the screen. In Um Dia na Vida, however, Coutinho is completely absent form the image, while Últimas Conversas, on the contrary, includes a confessional prologue that moves the director from the margins to the center of his films. This article examines the ways in which these works stand out in the filmography of a director who offers new insights into the notion of cinematic authorship
Appropriate Similarity Measures for Author Cocitation Analysis
Get PDFWe provide a number of new insights into the methodological discussion about author cocitation analysis. We first argue that the use of the Pearson correlation for measuring the similarity between authors’ cocitation profiles is not very satisfactory. We then discuss what kind of similarity measures may be used as an alternative to the Pearson correlation. We consider three similarity measures in particular. One is the well-known cosine. The other two similarity measures have not been used before in the bibliometric literature. Finally, we show by means of an example that our findings have a high practical relevance.information science;Pearson correlation;cosine;similarity measure;author cocitation analysis
Dispelling the Myths Behind First-author Citation Counts
Get PDFWe conducted a full-scale evaluative citation analysis study of scholars in the XML research field to explore just how different from each other author rankings resulting from different citation counting methods actually are, and to demonstrate the capability of emerging data and tools on the Web in supporting more realistic citation counting methods. Our results contest some common arguments for the continued
use of first-author citation counts in the evaluation of scholars, such as high correlations between author rankings by first-author citation counts and other citation
counting methods, and high costs of using more realistic citation counting methods that are not well-supported by the ISI databases. It is argued that increasingly available digital full text research papers make it possible for citation analysis studies to go beyond what the ISI databases have directly supported and to employ more
sophisticated methods
koamabayili/VECTRON-author-checklist: VECTRON author checklist
No full textWe have done our best to complete the author checklist relating to the use of animals in the hut study. Note that the objective for the hut study was to evaluate the IRS treatment applications for residual efficacy against Anopheles mosquitoes, including the local An. coluzzii mosquito population. Cows were only used to attract mosquitoes into the huts and no tests were carried out directly on the cows. The author checklist is intended for use with studies where experiments are carried out on animals, which is why we have had such difficulty in completing this for the hut study, as many of the questions do not relate to how the cows were used
Author-wise bibliometric analysis based on entropy.
No full textAuthor-wise bibliometric analysis based on entropy.</p
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