ABSTRACT
La mayoría de las preguntas de investigación (PI), conducirán a un proyecto que apunta a generar nuevo conocimiento, sin embargo el escenario, la población a estudio y la metodología pueden ser muy diferentes, lo que determinará que los resultados obtenidos y por ende, el nivel de evidencia (NE) y el grado de recomendación (GR) puedan variar notablemente. El objetivo de este artículo fue proporcionar recomendaciones para formular una PI asociada al NE y respectivos GR que se pueden desprender a partir de los resultados generados. Este artículo entregará algunos conocimientos sobre la PI y su relación con los NE y GR de la evidencia generada a partir de resultados obtenidos por un proceso de investigación en diferentes escenarios de investigación.
SUMMARY: Most research questions (RQ) will lead to a project that aims to generate new knowledge. However, the setting, study population and methodology may be very different, which will determine the results obtained and therefore, the level of evidence (LOE) and the grade of recommendation (GOR) may vary significantly. The aim of this study was to provide recommendations to formulate a RQ associated with the LOE and respective GOR that can be derived from the generated results. This article will provide some knowledge about the RQ and its relationship with the LEO and GOR of the generated evidence from results obtained by a research process in different research scenarios.
Subject(s)
Research Design , Evidence-Based Medicine , Biomedical Research/methods , Evidence-Based PracticeABSTRACT
Neglecting genotype-by-environment interactions in multienvironment trials (MET) increases the risk of flawed cultivar recommendations for growers. Recent advancements in probability theory coupled with cutting-edge software offer a more streamlined decision-making process for selecting suitable candidates across diverse environments. Here, we present the user-friendly ProbBreed package in R, which allows breeders to calculate the probability of a given genotype outperforming competitors under a Bayesian framework. This article outlines the package's basic workflow and highlights its key features, ranging from MET model fitting to estimating the per se and pairwise probabilities of superior performance and stability for selection candidates. Remarkably, only the selection intensity is required to compute these probabilities. By democratizing this complex yet efficient methodology, ProbBreed aims to enhance decision-making and ultimately contribute to more accurate cultivar recommendations in breeding programs.
Subject(s)
Models, Genetic , Software , Bayes Theorem , GenotypeABSTRACT
This statement revises our earlier "WAME Recommendations on ChatGPT and Chatbots in Relation to Scholarly Publications" (January 20, 2023). The revision reflects the proliferation of chatbots and their expanding use in scholarly publishing over the last few months, as well as emerging concerns regarding lack of authenticity of content when using chatbots. These recommendations are intended to inform editors and help them develop policies for the use of chatbots in papers published in their journals. They aim to help authors and reviewers understand how best to attribute the use of chatbots in their work and to address the need for all journal editors to have access to manuscript screening tools. In this rapidly evolving field, we will continue to modify these recommendations as the software and its applications develop.
Esta declaración revisa las anteriores "Recomendaciones de WAME sobre ChatGPT y Chatbots en Relation to Scholarly Publications" (20 de enero de 2023). La revisión refleja la proliferación de chatbots y su creciente uso en las publicaciones académicas en los últimos meses, así como la preocupación por la falta de autenticidad de los contenidos cuando se utilizan chatbots. Estas recomendaciones pretenden informar a los editores y ayudarles a desarrollar políticas para el uso de chatbots en los artículos sometidos en sus revistas. Su objetivo es ayudar a autores y revisores a entender cuál es la mejor manera de atribuir el uso de chatbots en su trabajo y a la necesidad de que todos los editores de revistas tengan acceso a herramientas de selección de manuscritos. En este campo en rápida evolución, seguiremos modificando estas recomendaciones a medida que se desarrollen el software y sus aplicaciones.
Subject(s)
Artificial Intelligence , Publishing , HumansABSTRACT
INTRODUCTION: The WHO 2030 Immunization Agenda (IA-2030) harmonizes immunization activity plans at community, national, regional and global levels. Additionally, medical societies play an important role. The Latin American Group of Experts on Infant Immunization, established in 2018, advises on the harmonization, update, and optimization of infant vaccination programs in Latin America and the Caribbean (LAC). In September 2021, 41 such experts from 13 LAC countries met to develop recommendations for increasing regional vaccination coverage to avoid the reemergence of vaccine-preventable diseases and/or the occurrence of outbreaks. AREAS COVERED: The following items were evaluated: (i) immunization challenges before and during the COVID-19 pandemic; (ii) the status of current immunization programs, particularly infant pertussis and polio vaccination; (iii) possible solutions for overcoming vaccination challenges and achieving regional vaccination coverage targets. EXPERT OPINION/COMMENTARY: Medical societies provide valuable recommendations to guide and update vaccination schedules. In the LAC region, possible strategies to achieve target vaccination rates include the use of combination vaccines, strengthening surveillance systems, improving school attendance, advancing vaccine education and confidence, striving for vaccination equity, widening operational capacity, creating strategic alliances, and strengthening the role of medical groups. It is hoped that these recommendations will be implemented in the LAC region.
Subject(s)
COVID-19 , Vaccine-Preventable Diseases , Infant , Humans , Latin America/epidemiology , Vaccination Coverage , Vaccine-Preventable Diseases/epidemiology , Vaccine-Preventable Diseases/prevention & control , Pandemics/prevention & control , COVID-19/epidemiology , COVID-19/prevention & control , Vaccination , Immunization , Caribbean Region/epidemiology , Immunization ProgramsABSTRACT
This statement revises our earlier "WAME Recommendations on ChatGPT and Chatbots in Relation to Scholarly Publications" (January 20, 2023). The revision reflects the proliferation of chatbots and their expanding use in scholarly publishing over the last few months, as well as emerging concerns regarding lack of authenticity of content when using chatbots. These recommendations are intended to inform editors and help them develop policies for the use of chatbots in papers published in their journals. They aim to help authors and reviewers understand how best to attribute the use of chatbots in their work and to address the need for all journal editors to have access to manuscript screening tools. In this rapidly evolving field, we will continue to modify these recommendations as the software and its applications develop.
Esta declaración revisa las anteriores "Recomendaciones de WAME sobre ChatGPT y Chatbots en Relation to Scholarly Publications" (20 de enero de 2023). La revisión refleja la proliferación de chatbots y su creciente uso en las publicaciones académicas en los últimos meses, así como la preocupación por la falta de autenticidad de los contenidos cuando se utilizan chatbots. Estas recomendaciones pretenden informar a los editores y ayudarles a desarrollar políticas para el uso de chatbots en los artículos sometidos en sus revistas. Su objetivo es ayudar a autores y revisores a entender cuál es la mejor manera de atribuir el uso de chatbots en su trabajo y a la necesidad de que todos los editores de revistas tengan acceso a herramientas de selección de manuscritos. En este campo en rápida evolución, seguiremos modificando estas recomendaciones a medida que se desarrollen el software y sus aplicaciones.
ABSTRACT
Abstract Introduction Recently, there have been significant advancements in transcanal endoscopic ear surgery (TEES). The combination of rigid and thin otoendoscopes with highdefinition cameras enabled a less invasive transcanal access to the middle ear and a clearer view of the surgical field. Several surgeons have recently published studies about cholesteatoma resection via transcanal endoscopic surgery, even in cases where the disease has extended to the mastoid, requiring transcanal endoscopic mastoidectomy. Objectives To analyze the currently available literature on transcanal endoscopic inside-out mastoidectomy, and to determine its efficacy as a surgical technique by evaluating the disease's relapse/recurrence rate. Data Synthesis Initially, the titles and abstracts of articles identified were analyzed. At this stage, 117 articles were analyzed, 97 of which were excluded for not meeting the inclusion criteria. The 20 remaining articles were further evaluated. The articles were classified on the basis of five levels of scientific evidence. Final Comments The analysis of the studies showed that the transcanal endoscopic approach is effective in providing access to the attic or antrum, especially in cases of sclerotic mastoids. There was only one study with grade A recommendation, which showed the efficacy of endoscopic ear surgery in the treatment of cholesteatoma. Furthermore, there were three studies with grade B recommendation, showing less relapse/recurrence after TEES. More studies with grade A and B recommendations are needed to better evaluate the effectiveness of TEES, especially compared with that of traditional microscopic surgery.
ABSTRACT
Introduction Recently, there have been significant advancements in transcanal endoscopic ear surgery (TEES). The combination of rigid and thin otoendoscopes with high-definition cameras enabled a less invasive transcanal access to the middle ear and a clearer view of the surgical field. Several surgeons have recently published studies about cholesteatoma resection via transcanal endoscopic surgery, even in cases where the disease has extended to the mastoid, requiring transcanal endoscopic mastoidectomy. Objectives To analyze the currently available literature on transcanal endoscopic inside-out mastoidectomy, and to determine its efficacy as a surgical technique by evaluating the disease's relapse/recurrence rate. Data Synthesis Initially, the titles and abstracts of articles identified were analyzed. At this stage, 117 articles were analyzed, 97 of which were excluded for not meeting the inclusion criteria. The 20 remaining articles were further evaluated. The articles were classified on the basis of five levels of scientific evidence. Final Comments The analysis of the studies showed that the transcanal endoscopic approach is effective in providing access to the attic or antrum, especially in cases of sclerotic mastoids. There was only one study with grade A recommendation, which showed the efficacy of endoscopic ear surgery in the treatment of cholesteatoma. Furthermore, there were three studies with grade B recommendation, showing less relapse/recurrence after TEES. More studies with grade A and B recommendations are needed to better evaluate the effectiveness of TEES, especially compared with that of traditional microscopic surgery.
ABSTRACT
OBJECTIVE: To investigate whether or not gender influences letters of recommendation for cardiothoracic surgery fellowship. METHODS: From applications to an Accreditation Council Graduate Medical Education cardiothoracic surgery fellowship program between 2016 and 2021, applicant and author characteristics were examined with descriptive statistics, analysis of variance, and Pearson χ2 tests. Linguistic software was used to assess communication differences in letters of recommendation, stratified by author and applicant gender. An additional higher-level analysis was then performed using a generalized estimating equations model to examine linguistic differences among author-applicant gender pairs. RESULTS: Seven hundred thirty-nine recommendation letters extracted from 196 individual applications were analyzed; 90% (n = 665) of authors were men and 55.8% (n = 412) of authors were cardiothoracic surgeons. Compared with women authors, authors who are men wrote more authentic (P = .01) and informal (P = .03) recommendation letters. When writing for women applicants, authors who are men were more likely to display their own leadership and status (P = .03) and discuss women applicants' social affiliations (P = .01), like occupation of applicant's father or husband. Women authors wrote longer letters (P = .03) and discussed applicants' work (P = .01) more often than authors who are men. They also mentioned leisure activities (P = .03) more often when writing for women applicants. CONCLUSIONS: Our work identifies gender-specific differences in letters of recommendation. Women applicants may be disadvantaged because their recommendation letters are significantly more likely to focus on their social ties, leisure activities, and the status of the letter writer. Author and reviewer awareness of gender-biased use of language will aid in improvements to the candidate selection process.
Subject(s)
Internship and Residency , Male , Humans , Female , Sex Factors , Personnel Selection , Education, Medical, Graduate , SexismABSTRACT
Objetivos: descrever as boas práticas realizadas pela equipe multiprofissional durante a aspiração de vias aéreas inferiores em pacientes adultos, internados na Unidade de Terapia Intensiva. Método: estudo quantitativo, observacional, descritivo e prospectivo, norteado pela ferramenta STROBE, realizado em uma Unidade de Terapia Intensiva adulto, entre maio e agosto de 2022. A amostra foi composta por 25 observações e a coleta de dados através de checklist, incluídos os profissionais de enfermagem, fisioterapia e medicina. Os dados foram processados no Statistical Package for the Social Sciences, sendo calculadas as frequências absolutas e relativas. Resultados: a maioria das aspirações foram realizadas pela equipe de enfermagem, 20 (80%) profissionais não regularam a fração inspirada de oxigênio antes e após o procedimento, 06 (60%) profissionais não clampearam a sonda durante a sua inserção. O uso de máscara (100%), capote (92%) e luva (100%) foram as boas práticas com maior aderência entre os participantes. Conclusão: reforça-se a necessidade de incentivar os treinamentos abordando as boas práticas durante a aspiração endotraqueal.
Objetivos: describir las buenas prácticas realizadas por el equipo multiprofesional durante la aspiración de vías aéreas inferiores en pacientes adultos, ingresados en la Unidad de Cuidados Intensivos. Método: estudio cuantitativo, observacional, descriptivo y prospectivo, guiado por la herramienta STROBE, realizado en una unidad de cuidados intensivos adulta, entre mayo y agosto de 2022. La muestra fue compuesta por 25 observaciones y la recogida de datos a través de checklist, incluidos los profesionales de enfermería, fisioterapia y medicina. Los datos fueron procesados en el Statistical Package for the Social Sciences, siendo calculadas las frecuencias absolutas y relativas. Resultados: la mayoría de las aspiraciones fueron realizadas por el equipo de enfermería, 20 (80%) profesionales no regularon la fracción inspirada de oxígeno antes y después del procedimiento, 06 (60%) profesionales no clampearon la sonda durante su inserción. El uso de máscara (100%), capucha (92%) y guante (100%) fueron las mejores prácticas con mayor adherencia entre los participantes. Conclusión: se refuerza la necesidad de incentivar los entrenamientos abordando las buenas prácticas durante la aspiración endotraqueal.
Objective: to describe the good practices performed by the multiprofessional team during lower airway aspiration in adult patients admitted to the Intensive Care Unit. Method: quantitative, observational, descriptive and prospective study, guided by the STROBE tool, conducted in an adult intensive care unit, between May and August 2022. The sample consisted of 25 observations and data collection through checklist, including nursing, physiotherapy and medicine professionals. The data were processed in the Statistical Package for the Social Sciences, and the absolute and relative frequencies were calculated. Results: most aspirations were performed by the nursing team, 20 (80%) professionals did not regulate the inspired fraction of oxygen before and after the procedure, 06 (60%) professionals did not clamp the tube during its insertion. The use of mask (100%), cloak (92%) and glove (100%) were the best practices with greater adherence among participants. Conclusion: there is the need to encourage training addressing good practices during endotracheal aspiration.
Subject(s)
Humans , Male , Female , Suction/methods , Practice Guideline , Airway Management/methods , Intubation, Intratracheal/nursingABSTRACT
This work aimed to use the Bayesian approach to discriminate 43 genotypes of Coffea canephora cv. Conilon, which were cultivated in two producing regions to identify the most stable and productive genotypes. The experiment was a randomized block design with three replications and seven plants per plot, carried out in the south of Bahia and the north of Espírito Santo, environments with different climatic conditions, and evaluated during four harvests. The proposed Bayesian methodology was implemented in R language, using the MCMCglmm package. This approach made it possible to find great genetic divergence between the materials, and detect significant effects for both genotype, environment, and year, but the hyper-parametrized models (block effect) presented problems of singularity and convergence. It was also possible to detect a few differences between crops within the same environment. With a model with lower residual, it was possible to recommend the most productive genotypes for both environments: LB1, AD1, Peneirão, Z21, and P2.
ABSTRACT
Abstract Background: The increase in the zoonotic epidemic of sporotrichosis caused by Sporothrix brasiliensis, which started in the late 1990s in Rio de Janeiro and is now found in almost all Brazilian states, has been equally advancing in neighboring countries of Brazil. Changes in the clinical-epidemiological profile, advances in the laboratory diagnosis of the disease, and therapeutic difficulties have been observed throughout these almost 25 years of the epidemic, although there is no national consensus. The last international guideline dates from 2007. Objectives: Update the clinical classification, diagnostic methods and recommendations on the therapeutic management of patients with sporotrichosis. Methods: Twelve experts in human sporotrichosis were selected from different Brazilian regions, and divided into three work groups: clinical, diagnosis and treatment. The bibliographic research was carried out on the EBSCOHost platform. Meetings took place via electronic mail and remote/face-to-face and hybrid settings, resulting in a questionnaire which pointed out 13 divergences, resolved based on the opinion of the majority of the participants. Results: The clinical classification and laboratory diagnosis were updated. Therapeutic recommendations were made for the different clinical forms. Conclusions: Publication of the first national recommendation, carried out by the Brazilian Society of Dermatology, aimed at the Brazilian scientific community, especially dermatologists, infectologists, pediatricians, family medicine personnel, and laboratory professionals who work in the management of human sporotrichosis.
ABSTRACT
BACKGROUND: The increase in the zoonotic epidemic of sporotrichosis caused by Sporothrix brasiliensis, which started in the late 1990s in Rio de Janeiro and is now found in almost all Brazilian states, has been equally advancing in neighboring countries of Brazil. Changes in the clinical-epidemiological profile, advances in the laboratory diagnosis of the disease, and therapeutic difficulties have been observed throughout these almost 25 years of the epidemic, although there is no national consensus. The last international guideline dates from 2007. OBJECTIVES: Update the clinical classification, diagnostic methods and recommendations on the therapeutic management of patients with sporotrichosis. METHODS: Twelve experts in human sporotrichosis were selected from different Brazilian regions, and divided into three work groups: clinical, diagnosis and treatment. The bibliographic research was carried out on the EBSCOHost platform. Meetings took place via electronic mail and remote/face-to-face and hybrid settings, resulting in a questionnaire which pointed out 13 divergences, resolved based on the opinion of the majority of the participants. RESULTS: The clinical classification and laboratory diagnosis were updated. Therapeutic recommendations were made for the different clinical forms. CONCLUSION: Publication of the first national recommendation, carried out by the Brazilian Society of Dermatology, aimed at the Brazilian scientific community, especially dermatologists, infectologists, pediatricians, family medicine personnel, and laboratory professionals who work in the management of human sporotrichosis.
Subject(s)
Cat Diseases , Dermatology , Epidemics , Sporothrix , Sporotrichosis , Animals , Brazil/epidemiology , Cat Diseases/epidemiology , Cats , Disease Outbreaks , Humans , Sporotrichosis/diagnosis , Sporotrichosis/drug therapyABSTRACT
La arteritis de células gigantes (ACG) es una vasculitis sistémica que afecta a personas adultas; compromete vasos arteriales de mediano y gran calibre, con potenciales complicaciones de gravedad, como la ceguera, y es considerada una emergencia médica. El objetivo de estas guías fue desarrollar las primeras recomendaciones argentinas para su tratamiento, basadas en la revisión de la literatura mediante metodología GRADE. Un panel de expertos en vasculitis elaboró las preguntas en formato PICO (población, intervención, comparador y outcomes), y luego un panel de expertos en metodología efectuó la revisión de la bibliografía con la extracción de la evidencia para cada una de las preguntas. Se realizó un focus group de pacientes para conocer sus preferencias y experiencias. Finalmente, con la información recabada, el panel de expertos en vasculitis procedió a la votación de las recomendaciones que a continuación se presentan.
Giant cell arteritis (GCA) is a systemic vasculitis affecting adult patients and involving large and medium vessels. Potential serious complications as blindness may occur and it is considered a medical emergency. The objective of elaborating this guideline was to develop first Argentinian GCA treatment recommendations using GRADE methodology. An expert panel generated clinically meaningful questions addressing aspects of the treatment of GCA in the Population, Intervention, Comparator and Outcome (PICO) format and then a group of methodology experts reviewed and extracted data from literature summarizing available evidence. A patient's focus group discussion took place gathering information on their preferences and experiences. Finally, the vasculitis expert panel, with all the information obtained, voted recommendations here presented.
Subject(s)
Giant Cell Arteritis , Rheumatology , Therapeutics , VasculitisABSTRACT
[This corrects the article DOI: 10.3389/fpsyt.2021.745247.].
ABSTRACT
The development and recommendation of single cross maize hybrids (SH) to be used in extensive land areas (mega-environments), and in different crop seasons requires many experiments under numerous environmental conditions. The question we asked is if the data from these multi-environment experiments are sufficient to identify the best hybrid combinations. The aim of this study was to critically analyze the phenotype data of experiments of yield, established by a large seed producing company, under a high level of imbalance. Data from evaluation of 2770 SH were used from experiments conducted over four years, involving the first and second crop seasons, in 50 locations of different years and regions of Brazil. Different types of analysis were carried out and genetic and non-genetic components were estimated, with emphasis on the different interactions of the SH with the environments. Results showed that the coincidence of common hybrids in these experiments is normally small. The estimates of the correlations between of the hybrids coinciding in the environments two by two is of low magnitude. The hybrid × crop season interaction was always expressive; however, the interactions of hybrids and other environmental variables were also important. Under these conditions, alternatives were discussed for making with the information obtained from the experiments, can be more efficient on the process to obtain new hybrids by companies.
Subject(s)
Gene-Environment Interaction , Plant Breeding/economics , Zea mays/geneticsABSTRACT
ABSTRACT: The development and recommendation of single cross maize hybrids (SH) to be used in extensive land areas (mega-environments), and in different crop seasons requires many experiments under numerous environmental conditions. The question we asked is if the data from these multi-environment experiments are sufficient to identify the best hybrid combinations. The aim of this study was to critically analyze the phenotype data of experiments of yield, established by a large seed producing company, under a high level of imbalance. Data from evaluation of 2770 SH were used from experiments conducted over four years, involving the first and second crop seasons, in 50 locations of different years and regions of Brazil. Different types of analysis were carried out and genetic and non-genetic components were estimated, with emphasis on the different interactions of the SH with the environments. Results showed that the coincidence of common hybrids in these experiments is normally small. The estimates of the correlations between of the hybrids coinciding in the environments two by two is of low magnitude. The hybrid × crop season interaction was always expressive; however, the interactions of hybrids and other environmental variables were also important. Under these conditions, alternatives were discussed for making with the information obtained from the experiments, can be more efficient on the process to obtain new hybrids by companies.
ABSTRACT
The development and recommendation of single cross maize hybrids (SH) to be used in extensive land areas (mega-environments), and in different crop seasons requires many experiments under numerous environmental conditions. The question we asked is if the data from these multi-environment experiments are sufficient to identify the best hybrid combinations. The aim of this study was to critically analyze the phenotype data of experiments of yield, established by a large seed producing company, under a high level of imbalance. Data from evaluation of 2770 SH were used from experiments conducted over four years, involving the first and second crop seasons, in 50 locations of different years and regions of Brazil. Different types of analysis were carried out and genetic and non-genetic components were estimated, with emphasis on the different interactions of the SH with the environments. Results showed that the coincidence of common hybrids in these experiments is normally small. The estimates of the correlations between of the hybrids coinciding in the environments two by two is of low magnitude. The hybrid × crop season interaction was always expressive; however, the interactions of hybrids and other environmental variables were also important. Under these conditions, alternatives were discussed for making with the information obtained from the experiments, can be more efficient on the process to obtain new hybrids by companies.
Subject(s)
Phenotype , Zea mays/genetics , Gene-Environment Interaction , Crops, AgriculturalABSTRACT
Narrative letters of recommendation (NLORs) have become key elements of the application process for residency and fellowship. The potential to inadvertently admit bias into these subjective narratives has become an area of research focus across many disciplines. In the present review, we have highlighted the current data regarding bias in NLORs. We also believe that one of the most effective methods to eliminate bias from written recommendations is to first understand that it exists. Thus, the objective measures that have been taken to identify bias in NLORs are important steps in the right direction. We have presented and reflected on the accrued data on bias in NLORs pertaining to surgical training.
Subject(s)
Correspondence as Topic , Education, Medical, Graduate , Fellowships and Scholarships , Internship and Residency , Personnel Selection , Physicians, Women , Prejudice , School Admission Criteria , Social Discrimination , Surgeons/education , Cultural Diversity , Humans , Race Factors , Racism , Sex Factors , SexismABSTRACT
Evaluation of patients for kidney transplant candidacy is a comprehensive process that involves a detailed assessment of medical and surgical issues, psychosocial factors, and patients' physical and cognitive abilities with an aim of balancing the benefits of transplantation and potential risks of surgery and long-term immunosuppression. There is considerable variability among transplant centers in their approach to evaluation and decision-making regarding transplant candidacy. The 2020 KDIGO (Kidney Disease: Improving Guidelines Outcome) clinical practice guideline on the evaluation and management of candidates for kidney transplantation provides practice recommendations that can serve as a useful reference guide to transplant professionals. The guideline, covering a broad range of topics, was developed by an international group of experts from transplant and nephrology through a review of literature published until May 2019. A work group of US transplant nephrologists convened by NKF-KDOQI (National Kidney Foundation-Kidney Disease Quality Initiative) chose key topics for this commentary with a goal of presenting a broad discussion to the US transplant community. Each section of this article has a summary of the key KDIGO guideline recommendations, followed by a brief commentary on the recommendations, their clinical utility, and potential implementation challenges. The KDOQI work group agrees broadly with the KDIGO recommendations but also recognizes and highlights the decision-making challenges that arise from lack of high-quality evidence and the need to balance equity with utility of organ transplantation.