scholarly journals Evaluating a theory-based hypothesis against its complement using an AIC-type information criterion with an application to facial burn injury.

2020 ◽  
Vol 25 (2) ◽  
pp. 129-142
Author(s):  
Leonard Vanbrabant ◽  
Nancy Van Loey ◽  
Rebecca M. Kuiper
Keyword(s):  
Burn Injury ◽  
Information Criterion ◽  
Type Information ◽  
Facial Burn

scholarly journals Evaluating a theory-based hypothesis against its complement using an AIC-type information criterion with an application to facial burn injury

2021 ◽  
Author(s):  
Leonard Vanbrabant ◽  
Nancy Van Loey ◽  
Rebecca M. Kuiper
Keyword(s):  
Sample Size ◽  
Simulation Study ◽  
Effect Size ◽  
Burn Injury ◽  
Strong Support ◽  
Information Criterion ◽  
Effect Sizes ◽  
Order Restricted ◽  
Type Information ◽  
Facial Burn

An information criterion (IC) like the Akaike IC (AIC), can be used to select the best hypothesis from a set of competing theory-based hypotheses. An IC developed to evaluate theory-based order-restricted hypotheses is the GORIC. Like for any IC, the values themselves are not interpretable but only comparable. To improve the interpretation regarding the strength, GORIC weights and related evidence ratios can be computed. However, if the unconstrained hypothesis (the default) is used as competing hypothesis, the evidence ratio is not affected by sample-size nor effect-size in case the hypothesis of interest is (also) in agreement with the data. In practice, this means that in such a case strong support for the order-restricted hypothesis is not reflected by a high evidence ratio. Therefore, we introduce the evaluation of an order-restricted hypothesis against its complement using the GORIC (weights). We show how to compute the GORIC value for the complement, which cannot be achieved by current methods. In a small simulation study, we show that the evidence ratio for the order-restricted hypothesis versus the complement increases for larger samples and/or effect-sizes, while the evidence ratio for the order-restricted hypothesis versus the unconstrained hypothesis remains bounded. An empirical example about facial burn injury illustrates our method and shows that using the complement as competing hypothesis results in much more support for the hypothesis of interest than using the unconstrained hypothesis as competing hypothesis.

Total full-thickness skin grafting for treating patients with extensive facial burn injury: A 10-year experience

Burns ◽  
2020 ◽  
Author(s):  
Sergey B. Bogdanov ◽  
Irina V. Gilevich ◽  
Karina I. Melkonyan ◽  
Alexander S. Sotnichenko ◽  
Sergey N. Alekseenko ◽  
...  
Keyword(s):  
Burn Injury ◽  
Skin Grafting ◽  
Full Thickness ◽  
Full Thickness Skin ◽  
Thickness Skin ◽  
Facial Burn

69 Defining Numerical Cutoff Values for Mild, Moderate, and Severe Pain in Adult Burn Survivors

2021 ◽  
Vol 42 (Supplement_1) ◽  
pp. S48-S49
Author(s):  
Gretchen J Carrougher ◽  
Alyssa M Bamer ◽  
Claudia Baker ◽  
Stephanie A Mason ◽  
Barclay T Stewart ◽  
...  
Keyword(s):  
Pain Intensity ◽  
Severe Pain ◽  
Burn Injury ◽  
Short Form ◽  
Information Criterion ◽  
Pain Interference ◽  
Cut Points ◽  
Burn Survivors ◽  
Average Pain ◽  
F Statistics

Abstract Introduction Pain is a common and often debilitating sequelae of a significant burn injury. Clinicians and researchers need clinically valid, reliable pain measures to guide treatment decisions and to provide evidence for study protocol development. Pain rating scores that represent mild, moderate, and severe pain in the burn survivor population have not been established. The aim of this study was to determine the numerical pain intensity rating scores that best represent mild, moderate, and severe pain in adult burn survivors. Methods Average pain intensity visual analog scale (VAS; 0–10) and customized PROMIS pain interference short form was administered to adult burn survivors (age ≥18) treated at a regional burn center at hospital discharge and at 6, 12, and 24-months postburn. To identify the optimal VAS scores for mild, moderate, and severe pain we computed F values and Bayesian Information Criterion (BIC) statistics associated with multiple ANOVA comparisons for mean pain interference scores by various VAS pain intensity cut points. Six possible cut points (CP) were compared: CP 3,6; CP 3,7; CP 4,6; CP 4,7; CP 2,5; and CP 3,5. For example, CP 3,6 refers to pain categorized as mild (0–3), moderate (4–6), and severe (7–10). Optimal cutoffs were those with the highest ANOVA F statistics. Models with similar F statistics were compared using changes in BIC. Results 178 participants (85% white, 65% male, mean age of 46 years) with pain intensity and interference scores at one or more timepoints comprised the study sample. The optimal classification for mild, moderate, and severe pain at baseline and 12-months was CP 2,5. Although CP 3,6 had the highest F value at 6-months, there was not strong evidence to support CP 3,6 over CP 2,5 (BIC difference: 2.9); similarly, CP 3,7 had the highest value at 24-months, but the BIC difference over CP 2,5 was minimal (2.2). Conclusions We recommend that visual analog pain intensity scores for adult burn survivors be categorized as mild (0–2), moderate (3–5), and severe (6–10). These findings advance our understanding regarding the meaning of pain intensity ratings following a burn injury and provide an objective definition for clinical management, quality improvement, and pain research.

scholarly journals Oral health-related quality of life and related factors among facial burn injury patients in Pakistan.

2020 ◽  
Author(s):  
Farooq Ahmad Chaudhary ◽  
Basaruddin Ahmad ◽  
Ulfat Bashir ◽  
Mohd Zulkarnain Sinor
Keyword(s):  
Quality Of Life ◽  
Oral Health ◽  
Burn Injury ◽  
Health Behaviours ◽  
Health Related Quality ◽  
Oral Health Behaviours ◽  
Related Quality ◽  
Health Related ◽  
Facial Burn

Abstract Background: There is a limited understanding of the long-term effect of facial burn injury on oral health. This study was aimed to describe the oral health-related quality of life of patients with facial burn injury and determine the associated risk factors.Methods: Patients with facial burn who attended the Burn Care Center in Islamabad, Pakistan were systematically and randomly selected and invited to participate in this cross-sectional study. They underwent extra- and intra-oral examinations and, completed self-administered questionnaires. The severity of disfigurement and, caries (DMFT), periodontal (CPI) and oral hygiene (OHI-S) statuses were assessed. Validated Urdu language instruments were used to collect information on sociodemographic background, oral health behaviours, oral health-related quality of life (OHIP-14) and satisfaction with appearance (SWAP). Information relating to the time of burn injury event and, cause and severity (type, TBSA) of burn were obtained from medical records. The OHIP- 14 severity (add-score) and prevalence of impact measures were derived and analysed using simple and multiple linear regression.Results: A total of 271 patients had participated in the study. The OHIP-14 prevalence of impact was 94% mean the mean add-score 37 = unit (sd = 8.5). The domains with the greatest impact prevalence were the physical pain (87%), psychological disability (87%), social disability (85%) and physical discomfort (83%). Poor clinical oral health status – particularly dental caries, oral health behaviours, severe burn injury, psychological distress and time of burn event, were associated with poor oral health-related quality of life (p< 0.05).Conclusion: Poor oral conditions, particularly caries, and severity of burn injury are the main factors that affect the oral health-related quality of life in facial burn patients. Addressing issues related to oral health behaviours, especially dental visit, may reduce the impact.

scholarly journals DIETARY MANAGEMENT OF 30% TBSA FLAME BURN PATIENT WITH FACIAL BURN WITH T2DM WITH HTN IN A TERTIARY CARE HOSPITAL

2021 ◽  
Vol 10 (6) ◽  
pp. 3827-3830
Author(s):  
Rupali Das
Keyword(s):  
Burn Injury ◽  
Tertiary Care ◽  
Wound Management ◽  
Dietary Management ◽  
Care Hospital ◽  
Dietary Counseling ◽  
Adequate Treatment ◽  
Mortality And Morbidity ◽  
Flame Burn ◽  
Facial Burn

In developing countries like India, burn injury is as yet a significant and regular reason for mortality and morbidity. Nutrition therapy aims to provide satisfactory and early nourishment to patients experiencing burn injuries. Metabolic help during increased inflammatory state is essential to make sure adequate treatment of burn patients. Nutritional sustain is a fundamental and indispensable part of consume care that requires an aggressive multifaceted approach. Impeded injury, dysfunction of multiple organs, increased chances of infection, and death are largely prevented by an adequate nutrition care along with proper wound management. In this study we detailed a patient having 30% TBSA flame burn with facial burn with T2DM & HTN and observed all require parameter in dietary management. The patient was suggested with high protein, moderate calorie, and moderate fat diet. As the sugar level of the patient was high i.e. ranges between 250-350 mg/dl, 5 ml Insulin was given to him at 3hr interval. With time, along with regular therapeutic diet the patient was took curd, paneer, chena etc. Albumin, globulin, total protein level of the patient was decreased so he also took coconut water, fruit juices (sugar free), milk, vegetable soups etc. As the sugar level of the patient was high i.e. ranges between 150-250 mg/dl, 3ml Insulin was given to him at 6hr interval. The wounds of the patient were started healing and he was active & fresh. The patient undertook a dietary counseling for 17 days and dietary modification was done according to the patient condition.

853 Microblading in Patients with Facial Burn Injuries

2020 ◽  
Vol 41 (Supplement_1) ◽  
pp. S264-S265
Author(s):  
Melissa Brown ◽  
Lori Turgeon ◽  
Branko Bojovic
Keyword(s):  
Body Image ◽  
Burn Injury ◽  
Scar Tissue ◽  
Self Esteem ◽  
Post Treatment ◽  
Non Invasive ◽  
Patient Reported ◽  
The Impact ◽  
Over Time ◽  
Facial Burn

Abstract Introduction The experience of a burn injury is devastating. Physical and emotional recovery can be lengthy and often difficult. Many patients tire of constant surgical interventions required to achieve optimal functional and cosmetic outcomes. Identifying non-invasive interventions for patients with extensive facial burns that positively affect quality of life is appealing. Microblading, semi-permanent eyebrow tattooing, is one such option. Little research exists on the durability and longevity of microblading in burns, or its impact on body-image and self-esteem. The purpose of this case review is to identify possible benefits microblading may have physically and psychologically. Methods Case report looking at the impact of microblading on a young adult female over 18 years, who sustained a facial burn injury at age one year. Following consultation with her plastic surgeon, she was referred to a licensed body art facility to assess the viability of microblading over scar tissue. First treatment occurred at the facility in March of 2019 with a second session in May, as is standard practice. Patient photos obtained before and after procedures assessed longevity of microblading over scar tissue. Self-reported patient outcomes obtained following the procedure addressed the impact on perceived self-esteem and body-image. Results Photos were taken pre-treatment, directly post-treatment, 2 months, and 6 months post-treatment. Comparisons of photos immediately post treatment to those 6 months out showed appearance of tattooing remains the same. Eyebrows did not fade with time and continue to hold the same color and shape. Assessment of psychological impact was conducted through patient interview and self-report. Patient reported satisfaction with the procedure and cosmetic appearance following initial treatment. Over time, patient noted feeling more positive about body image and improvement in self-esteem. Conclusions Eyebrows are a critically important part of facial expression, which can be lost following a devastating facial burn. Initial data demonstrate the effectiveness of tattooing in recreating the appearance and function of eyebrows over scar tissue. Over time, the eyebrows maintained color without fading and shape did not change, demonstrating durability and longevity in this patient population. Early reports of improved self-image also remained unchanged over time. Microblading presents a possible low risk, inexpensive, effective alternative to expensive or potentially ineffective cosmetic surgery. This case establishes a need for further research on efficacy of microblading over scar tissue, with the hope of incorporating it into burn reconstruction as an alternative therapy and advocate for insurance coverage for qualifying patients. Applicability of Research to Practice Research supports microblading as a potential non-invasive, inexpensive treatment modality for loss of eyebrows.

638 Auricular Splinting Following Severe Facial Burn Injury and Reconstruction

2020 ◽  
Vol 41 (Supplement_1) ◽  
pp. S164-S164
Author(s):  
Lisa LePage
Keyword(s):  
Low Temperature ◽  
Burn Injury ◽  
Surgical Reconstruction ◽  
Transposition Flap ◽  
Thermoplastic Material ◽  
Contracture Release ◽  
Scar Management ◽  
The Many ◽  
User Friendly ◽  
Facial Burn

Abstract Introduction With a severe facial burn, injury often involves the ear(s) resulting in damage or loss which may require reconstruction. In consideration of the functional and psychological effect that loss of a defined ear lobe may entail, reconstruction is an important consideration for the burn survivor. Two cases described in detail with illustration will highlight an auricular contracture release; one with V-Y Advancement and the other with a transposition flap. Preservation of the auricular reconstruction is accomplished by implementing necessary splinting. The auricular splint fabricated was made from a combination of silicone and low-temperature thermoplastic material. A step-by-step process will illustrate the needed materials and techniques to fabricate a worthy splint in order to preserve what was surgically achieved. The splint maintains the space between the ear and head to properly position and prevent contracture through the healing and scar maturation process. It secured with a one-inch head band that is sublime enough to foster compliance with wear. The auricular splint material also serves as scar management with the many proven benefits of silicone. Methods Two case studies are reviewed with auricular contractures that required release and reconstruction. The auricular splints were fabricated to stabilize and preserve the reconstructed ear lobe. The wear schedule was intermittent during the day and overnight in combination with scar massage. The patients reported good compliance with wear and stability of splint position with overnight wear. Skin integrity was not compromised with overnight or intermittent wear. The splint fabrication process is reviewed and illustrated with a simplistic innovative end result that is user friendly. Results Surgical reconstruction was required following development of auricular contractures and partial loss. With post-operative bandage removal and wound closure, positioning was a necessary consideration to preserve post-surgical reconstruction. Conclusions In conclusion, the peri-auricular splint is fabricated with low temperature splinting material lined in silicone proved worthy for effective positioning and reported comfort with wear. Effective splinting is necessary for the preservation of surgical reconstruction and to prevent contracture from sabotaging surgical efforts. Applicability of Research to Practice Consideration of fabrication of silicone auricular splints to preserve the accomplishments of auricular surgical reconstruction.

scholarly journals Evaluation of Inequality Constrained Hypotheses Using a Generalization of the AIC

2021 ◽  
Author(s):  
Yasin Altinisik ◽  
Caspar J. Van Lissa ◽  
Herbert Hoijtink
Keyword(s):  
Null Hypothesis ◽  
Structural Equation ◽  
Information Criterion ◽  
Equation Model ◽  
P Value ◽  
Simulation Studies ◽  
Multilevel Regression ◽  
The Social ◽  
Order Restricted ◽  
Type Information

In the social and behavioral sciences, it is often not interesting to evaluate the null hypothesis by means of a p-value. Researchers are often more interested in quantifying the evidence in the data (as opposed to using p-values) with respect to their own expectationsrepresented by equality and/or inequality constrained hypotheses (as opposed to the null hypothesis). This article proposes an Akaike-type information criterion (AIC; Akaike, 1973, 1974) called the generalized order-restricted information criterion approximation (GORICA) that evaluates (in)equality constrained hypotheses under a very broad range of statistical models. The results of five simulation studies provide empirical evidence showing that the performance of the GORICA on selecting the best hypothesis out of a set of (in)equality constrained hypotheses is convincing. To illustrate the use of the GORICA, the expectations of researchers are investigated in a logistic regression, multilevel regression, and structural equation model.

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