Benchmarking scientific performance by decomposing leadership of Cuban and Latin American institutions in Public Health

This is a post-peer-review, pre-copyedit version of an article published in Scientometrics. The final authenticated version is available online at: http://dx.doi.org/10.1007/s11192-015-1831-z”.Comparative benchmarking with bibliometric indicators can be an aid in decision-making with regard to research management. This study aims to characterize scientific performance in a domain (Public Health) by the institutions of a country (Cuba), taking as reference world output and regional output (other Latin American centers) during the period 2003–2012. A new approach is used here to assess to what extent the leadership of a specific institution can change its citation impact. Cuba was found to have a high level of specialization and scientific leadership that does not match the low international visibility of Cuban institutions. This leading output appears mainly in non-collaborative papers, in national journals; publication in English is very scarce and the rate of international collaboration is very low. The Instituto de Medicina Tropical Pedro Kouri stands out, alone, as a national reference. Meanwhile, at the regional level, Latin American institutions deserving mention for their high autonomy in normalized citation would include Universidad de Buenos Aires (ARG), Universidade Federal de Pelotas (BRA), Consejo Nacional de Investigaciones Cientı´ficas y Te´cnicas (ARG), Instituto Oswaldo Cruz (BRA) and the Centro de Pesquisas Rene Rachou (BRA). We identify a crucial aspect that can give rise to misinterpretations of data: a high share of leadership cannot be considered positive for institutions when it is mainly associated with a high proportion of non-collaborative papers and a very low level of performance. Because leadership might be questionable in some cases, we propose future studies to ensure a better interpretation of findings.This work was made possible through financing by the scholarship funds for international mobility between Andalusian and IberoAmerican Universities and the SCImago GroupPeer reviewe

Patients with Crohn's disease have longer post-operative in-hospital stay than patients with colon cancer but no difference in complications' rate

BACKGROUNDRight hemicolectomy or ileocecal resection are used to treat benign conditions like Crohn's disease (CD) and malignant ones like colon cancer (CC).AIMTo investigate differences in pre- and peri-operative factors and their impact on post-operative outcome in patients with CC and CD.METHODSThis is a sub-group analysis of the European Society of Coloproctology's prospective, multi-centre snapshot audit. Adult patients with CC and CD undergoing right hemicolectomy or ileocecal resection were included. Primary outcome measure was 30-d post-operative complications. Secondary outcome measures were post-operative length of stay (LOS) at and readmission.RESULTSThree hundred and seventy-five patients with CD and 2,515 patients with CC were included. Patients with CD were younger (median = 37 years for CD and 71 years for CC (P < 0.01), had lower American Society of Anesthesiology score (ASA) grade (P < 0.01) and less comorbidity (P < 0.01), but were more likely to be current smokers (P < 0.01). Patients with CD were more frequently operated on by colorectal surgeons (P < 0.01) and frequently underwent ileocecal resection (P < 0.01) with higher rate of de-functioning/primary stoma construction (P < 0.01). Thirty-day post-operative mortality occurred exclusively in the CC group (66/2515, 2.3%). In multivariate analyses, the risk of post-operative complications was similar in the two groups (OR 0.80, 95%CI: 0.54-1.17; P = 0.25). Patients with CD had a significantly longer LOS (Geometric mean 0.87, 95%CI: 0.79-0.95; P < 0.01). There was no difference in re-admission rates. The audit did not collect data on post-operative enhanced recovery protocols that are implemented in the different participating centers.CONCLUSIONPatients with CD were younger, with lower ASA grade, less comorbidity, operated on by experienced surgeons and underwent less radical resection but had a longer LOS than patients with CC although complication's rate was not different between the two groups

SUCCOR Risk: Design and Validation of a Recurrence Prediction Index for Early-Stage Cervical Cancer

Objective: Based on the SUCCOR study database, our primary objective was to identify the independent clinical pathological variables associated with the risk of relapse in patients with stage IB1 cervical cancer who underwent a radical hysterectomy. Our secondary goal was to design and validate a risk predictive index (RPI) for classifying patients depending on the risk of recurrence. Methods: Overall, 1116 women were included from January 2013 to December 2014. We randomly divided our sample into two cohorts: discovery and validation cohorts. The test group was used to identify the independent variables associated with relapse, and with these variables, we designed our RPI. The index was applied to calculate a relapse risk score for each participant in the validation group. Results: A previous cone biopsy was the most significant independent variable that lowered the rate of relapse (odds ratio [OR] 0.31, 95% confidence interval [CI] 0.17–0.60). Additionally, patients with a tumor diameter >2 cm on preoperative imaging assessment (OR 2.15, 95% CI 1.33–3.5) and operated by the minimally invasive approach (OR 1.61, 95% CI 1.00–2.57) were more likely to have a recurrence. Based on these findings, patients in the validation cohort were classified according to the RPI of low, medium, or high risk of relapse, with rates of 3.4%, 9.8%, and 21.3% observed in each group, respectively. With a median follow-up of 58 months, the 5-year disease-free survival rates were 97.2% for the low-risk group, 88.0% for the medium-risk group, and 80.5% for the high-risk group (p < 0.001). Conclusion: Previous conization to radical hysterectomy was the most powerful protective variable of relapse. Our risk predictor index was validated to identify patients at risk of recurrence