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Sistematización del diagnóstico y tratamiento de las retracciones cicatriciales severas en población subsahariana.
Get PDFLes retraccions cicatricials severes són una de les causes més freqüents d’inhabilitació funcional a l’Àfrica, tant a nivell laboral com social, i deixen el pacient amb severes limitacions físiques per a la resta de la seva vida. Fins ara no hi ha descrita cap classificació que pugui esser aplicada en zones de baixos recursos i sobre totes las articulacions de un mateix cos humà.
Objectius: Hom planteja la hipòtesi principal que és possible de definir un mètode clar, simple i pragmàtic que permeti classificar de manera universal les retraccions cicatricials sobre qualsevol articulació amb independència de la seva mida, localització anatòmica, sexe, edat o biotip. I una hipòtesi secundària segons la qual és possible de crear un algoritme de tractaments, en àrees que tenen recursos molt limitats, per a les contractures ja classificades.
Material i mètode: La revisió retrospectiva de 306 retraccions cicatricials severes sobre les diverses articulacions del cos ha fet palès i ha concretat uns paràmetres morfològics en la mateixa retracció cicatricial (amplada, llargada i altura) referits sempre a la ampladaa de la articulació afectada i que han permès diferenciar aquesta mena de retraccions en 4 tipus: Tipus A: Estret-Llarga o Curta-Baixa, Tipus B: Estret-Llarga o Curta-Alta, Tipus C: Ample-Curta-Baixa i Tipus D: Ample-Curta-Alta, i dintre de 2 grups (A i B Grup 1-Estret i, C i D, Grup 2 –Ample). Aquesta classificació fou després validada mitjançant una enquesta a doble test a 43 observadors independents. De les 306 retraccions, 169 foren seleccionades per tindre registres concrets sobre la intervenció quirúrgica realitzada.
Resultats: Els resultats donaren a conèixer que el 87,27% de les respostes per a concretar el “Grup” foren correctes: 84,02% per al Grup 1 i el 89,83% per al Grup 2, essent estadísticament significatives (Kappa 0,74, p<0,0005), i concordança “Bona” en l’escala de Landis i Koch. Per al Tipus, es classificà correctament el 62,66%: A=74,46%, B=56,82%, C=48,48% i D=68,40%. (Kappa 0,59, p<0,0005), i concordança “Moderada-Bona” (Landis i Koch).
Del mateix estudi retrospectiu sobre les retraccions operades sorgí un algoritme de tractaments que associava certes tècniques quirúrgiques contrastades i fiables realitzades en hospitals de molt pocs recursos amb els diferents Grups i Tipus de retraccions cicatricials (sens perjudici de la indicació de tècniques més sofisticades en àmbits de grans recursos). La classificació validada fou anomenada MASCCA (Morphological African Scar Contractures Classification and Algorithm)
Conclusió: La MASCCA i ha demostrat ser una eina fiable, consistent i útil per a classificar aquesta mena de retraccions articulació amb independència de la seva mida, localització anatòmica, sexe, edat o biotip i per a orientar sobre les tècniques quirúrgiques per mitjà de les quals poden ser reparades funcionalment.
Aquesta classificació obre un nou camí en la docència d’aquesta patologia, facilita la comunicació entre professionals, permet la creació de bases de dades i possibilita estudis epidemiològics, inexistents fins ara en aquest camp.Las retracciones cicatriciales severas son una causa frecuente de inhabilitación funcional en Africa, dejando al paciente con severas limitaciones físicas para el resto de su vida. No hay descritas clasificaciones que puedan ser aplicadas en medios con escasos recursos (MER) sobre cualquier articulación de un cuerpo humano.
Objetivos: Hipótesis principal: es posible definir un método, simple y pragmático, que permita clasificar las retracciones sobre cualquier articulación independientemente del tamaño de la misma, localización anatómica, edad o biotipo. Hipótesis secundaria: es posible crear un algoritmio de tratamientos en MER, para las contracturas ya clasificadas.
Material y método: La revisión retrospectiva de 306 retracciones cicatriciales sobre las diversas articulaciones del cuerpo (2003-2013), ha desvelado unos parámetros morfológicos en la retracción cicatricial (anchura, longitud y altura) referidos siempre a la anchura de la articulación afectada, que han permitido diferenciar las retracciones en 4 tipos: Tipo A: Estrechas-Largas o Cortas-Bajas. Tipo B: Estrechas-Largas o Cortas-Altas. Tipo C: Anchas-Cortas-Bajas y Tipo D: Anchas-Cortas-Altas, y dentro de 2 grupos (A y B Grupo 1-Estrecho y, C y D, Grupo 2-Ancho). Esta clasificación fue validada mediante una encuesta a doble test por 43 observadores independientes. 169 retracciones de las que habían registros concretos sobre la intervención quirúrgica realizada se seleccionaron para estudiar la hipótesis secundaria.
Resultados: Los resultados arrojaron que el 87,27% de las respuestas para concretar el “Grupo” fueron correctas: 84,02% para el Grupo 1 y el 89,83% para el Grupo 2, siendo estadísticamente significativas (Kappa 0,74, p<0,0005) con una concordancia “Buena” en la escala de Landis y Koch. Para el Tipo, se clasificó correctamente el 62,66%: A=74,46%, B=56,82%, C= 48,48% y D=68,40 (Kappa 0,59, p<0,0005),con una concordancia “Moderada-Buena” (Landis y Koch).
Del estudio de las 169 retracciones operadas se desprendió un algoritmo de tratamientos que asociaba ciertas técnicas quirúrgicas contrastadas y fiables realizadas en hospitales con muy bajos recursos, a los diferentes Grupos y Tipos de retracciones cicatriciales (sin perjuicio de la indicación de técnicas mas sofisticadas en medios con grandes recursos). La clasificación validada se denominó MASCCA (Morphological African Scar Contractures Clasification and Algorithm),
Conclusion: La MASCCA se ha mostrado como una herramienta fiable, consistente y util para clasificar estas retracciones independientemente de su tamaño y localización anatómica, así como para orientar sobre las técnicas con las que pueden repararse funcionalmente. Esta clasificación abre un nuevo camino en la docencia de esta patología, facilita la comunicación entre profesionales, permite la creación de bases de datos y posibilita estudios epidemiologicos.Severe skin scar contractures in populations of developing countries represents one of the main causes of disability in the social and personal spheres of life, as well the workplace. No pragmatic and universal classifications have been described that can be applied in settings with limited resources (SLR) to every joint of the body.
Objectives: Main hypothesis states that different types of contractures affecting any joint of the body, regardless of their anatomical localization, size and biotype, can be organized into a universal classification. Secondary hypothesis states that it is possible to describe an algorithm of treatments for all previously classified contractures.
Materials and methods: Retrospective analysis of 306 post-burn contractures (2003-2013) over the different joints of the body revealed the description of morphological parameters for the contracture itself, in “Width” (narrow or wide), “Length” (long or short) and “Height” (Low or high) always referred to the affected joint’s width that facilitated their classification into 4 types: Type A: Narrow-Long or Short-Low, Type B: Narrow-Long or Short-High, Type C: Wide-Short-Low and Type D: Wide-Short-High, and 2 Groups (A and B, Group 1-Narrow, and C and D, Group 2-Wide). This classification was validated by a double-test with 43 independent observers. 169 skin contractures out of 306 were selected to analyse the surgical outcomes in SLR.
Results: According to “Group” classification, 87.27% were correctly assigned: 84,02% for Group 1 and 89,83% for Group 2, (Kappa coefficient for group was 0.74, p<0.0005) and was considered as “Good” at Landis and Koch scale. Regarding “Types”, 62.66% were correctly classified: Type A, 74.46%, Type B, 56.82%, Type C, 48.48% and Type D, 68.40%. Differences between correct classification for each type were also statistically significant (Kappa coefficient was 0.59, p<0.0005), which can be considered as “Moderate-Good”(Landis and Koch). An algorithm of treatments was also revealed. Surgical techniques that were performed in SLR proved reliable and useful for specific types and groups of skin contractures (without prejudice of more sophisticated techniques would be indicated in settings with full resources). The validated classification was denominated MASCCA (Morphological African Scar Contractures Classification and Algorithm)
Conclusion: MASCCA proved itself as a reliable, consistent and useful tool to classify these types of scar retractions independently to its size and anatomical localization as well as a guide for surgeons. This classification opens a new way of teaching about this pathology, enhances intercommunication, creates the basis for building up databases and gives the opportunity for further epidemiologic studies on this area
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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