1,720,959 research outputs found
Revisiting stimulant use for emotional dysregulation in attention-deficit/hyperactivity disorder (ADHD)
No full textIntroductionEmotional dysregulation (ED) symptoms are present in a considerable portion of patients with attention-deficit/hyperactivity disorder (ADHD). In recent years, an increasing number of studies investigated the effects of stimulant medications on ED in patients with ADHD.Areas coveredA narrative review of the literature on stimulant treatment for ED is provided, including controlled and observational clinical studies conducted on pediatric and adult samples and neurobiological investigations. Positive effects of stimulants on irritability have been demonstrated in children. Comorbidity with disruptive behavior disorders (DBD) and disruptive mood dysregulation disorder does not prevent stimulant effectiveness. Methylphenidate has also been found to reduce temper problems, affective instability, and emotional over-reactivity in adults with ADHD, although with variable effect sizes. A variety of adverse emotional effects have been reported, especially at high doses and in special populations. However, several possible confounders of treatment-emergent ED have been highlighted. Finally, according to neuroimaging studies, stimulants may mitigate emotional processing anomalies associated with ADHD.Expert opinionThe findings are consistent with models including ED within the core features of ADHD. Stimulant treatment should be prioritized over antipsychotics in ADHD-DBD. It remains to be elucidated whether other medications may be more effective in specific populations with ADHD and/or ED
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
Response to electroconvulsive therapy in elderly patients with late‐onset bipolar disorder: The impact of cerebral small vessel disease
No full textObjectivesCerebral Small Vessel Disease (CSVD) is a chronic, progressive vascular disorder that confers increased vulnerability to psychiatric syndromes, including late-life mood disorders. In this study, we investigated the impact of CSVD on electroconvulsive therapy (ECT) outcomes in patients with late-onset bipolar disorder (BD).MethodsA sample of 54 non-demented elderly patients (>= 60 years) with late-onset BD and treatment-resistant major depression, mixed state, or catatonia who underwent bilateral ECT were included in this naturalistic observational study. A diagnosis of CSVD was established based on brain neuroimaging performed before ECT. All patients were evaluated before and after ECT using the Brief Psychiatric Rating Scale (BPRS), the Hamilton Rating Scale for Depression (HAM-D), and the Clinical Global Impression scale (CGI).ResultsOf the total sample, 19 patients were diagnosed with CSVD (35.2%). No significant differences were observed at baseline between patients with and without CSVD. Overall, a response was obtained in 66%-68.5% of patients, with remission in 56.2%. No significant differences in ECT outcomes were found between those with and without CSVD, and both groups exhibited substantial improvements in symptom severity following ECT.ConclusionsThe outcome of ECT in late-onset BD was not influenced by the presence of CSVD. This finding aligns with previous research on unipolar depression. Accordingly, ECT should be considered for elderly patients with late-onset BD, regardless of the presence of CSVD.CSVD was found in 19 out of 54 (35.2%) elderly with late-onset BD referred to ECT. Response to ECT was achieved in about two-thirds of patients with late-onset BD. ECT was equally effective in patients with and without CSVD
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
VALUTAZIONE DEL RISCHIO ARITMICO NEL PAZIENTE PSICHIATRICO
No full textBackground
NRL e TCA sono farmaci correlati ad un aumentato rischio di prolungamento del QT.
Il QT prolongation viene considerato come indice di rischio aritmico e ciò porta ad uno stretto monitoraggio elettrocardiografico del paziente in terapia. Ad oggi, l’effettivo rischio di VA e\o SCD associata alla mono o politerapia non è definito in modo univoco in letteratura. Il meccanismo fisiopatologico alla base dell’allungamento del tratto QT indotto da questi farmaci è correlato ad un blocco dei hERG del K+ e non è classe dipendente. Il QT è un parametro strettamente dipendente dalla frequenza cardiaca e per tale motivo va corretto (QTc). La formula più utilizzata è la formula di Bazett, che tende a sovrastimarne l’allungamento. In letteratura, ad ogni modo, il QTc appare come un marker di rischio aritmico imperfetto. La QTd è la dispersione dell'intervallo QT sull'ECG ed è considerata un’importante fattore predittivo di mortalità cardiovascolare qualora risulti >58; ne viene raccomandato l’uso come marker di rischio aritmico. L’HRV è la variabilità della frequenza cardiaca e la sua analisi ci fornisce un indice del bilancio simpatico/vagale, del rischio di aritmie e di IMA. L’Heart Rate Variability sembra sia ridotta nel paziente psichiatrico indipendentemente dalla terapia in atto. L’unica categoria di farmaci che determina una sua significativa riduzione appare, in letteratura, quella dei TCA.
Materiale e Metodo
Valutare, in 3 fasi, l’effetto dei farmaci NRL e TCA sui markers di rischio aritmico: QT Interval, QTc corretto tramite tre formule alternative alla Bazett (Fridericia, Framingham e Hodges), QT Dispersion e HRV, tramite ECG dinamico Holter.
FASE 1: revisione delle cartelle di 84 pazienti ricoverati in DH, per rilevare: sesso, età, BMI, diagnosi, terapia, FC, RR, QTc e calcolare la QT dispersione a mano sui tracciati.
FASE 2: reclutamento di 83 inpatients, per i quali si è proceduto, oltre alla revisione delle cartelle, ad eseguire un ECG al momento della dimissione, come confronto.
FASE 3: esecuzione di un ECG dinamico Holter delle 24h in 17 pazienti selezionati, per la valutazione dell’incidenza di aritmie e lo studio della HRV (LF power, HF power, TOTAL power, LF/HF, SDNN, pNN50, RMSSD).
L’analisi statistica è stata eseguita usando il pacchetto SPSS.
Risultati
La popolazione idonea è risultata essere composta da 167 pazienti, tutti volontari, di sesso maschile e femminile, di età compresa tra 16 e 80 anni, affetti da differenti disturbi mentali e trattati con NRL, TCA, Litio e stabilizzanti dell’umore. La distribuzione dell’età e del sesso erano normali, gli esami ematochimici e il BMI risultavano nel range. Non sono state riscontrate differenze significative dei markers aritmici tra i campioni male e female, né in correlazione alla terapia in atto al ricovero, o confrontandola con quella in dimissione; nemmeno i confronti tra mono e politerapia hanno evidenziato un impatto sui markers analizzati. L’applicazione di formule alternative ha confermato che la formula di Bazett sovrastima il QTc. La QTd è lievemente alterata in 51 pazienti su 167 (QTd ≥50), di questi solo 12 pazienti presentano un valore superiore a 60, ma il valore di QTd non sembra correlato alla terapia. L’HRV risulta leggermente più basso nel paziente psichiatrico in terapia.
Conclusioni
La terapia con NRL e TCA non determina significative interferenze sugli indicatori di rischio aritmico presi in analisi. Tali farmaci appaiono abbastanza sicuri dal punto di vista cardiologico, anche a dosaggio pieno, nonostante la letteratura riporti la necessità di essere cauti nel loro utilizzo. Il rischio aritmico nel paziente psichiatrico è basso, in assenza di altri risk factors e patologie concomitanti, sebbene vi sia un warning sull’utilizzo dei NRL, soprattutto di prima generazione. Il numero di elettrocardiogrammi effettuati in questa popolazione è elevato rispetto alle evidenze cliniche, per questo motivo si propongono strategie alternative come: correzione del QT con la formula di FRI o HOD; calcolo della QTd, se QTc alterato (>450-470 ms.); studio della HRV, come indice alternativo di rischio aritmico. Il limite principale dello studio è legato al ristretto numero di pazienti per ciascun raggruppamento per terapie in atto. L’indicazione è quella di implementare i dati per QTd e HRV, in modo da estrapolare un algoritmico predittivo di rischio aritmico più utile del solo QT allo scopo di ridurre drasticamente il numero degli esami eseguiti su questa popolazione di pazienti
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