1,720,968 research outputs found
Atheroma or ischemia: which is more important for managing patients with stable chest pain?
No full textIn the evaluation and management of patients with stable chest pain/chronic coronary syndrome, cardiologists need to be able to weigh up the relative merits of managing these patients using either optimal therapy alone or optimal therapy plus revascularization. These decisions rely on an understanding of both the presence and the degree of coronary atheroma and myocardial ischemia, and the impact that these have on patients' symptoms and their prognosis. In this review the authors examine the relative impact of the anatomical and physiological assessment of patients with chronic coronary syndrome and how it can be used to achieve optimal and tailored therapy.</p
Invasive management and in-hospital outcomes of myocardial infarction patients in rural versus urban hospitals in the United States
No full textObjectives: The variation in the management and outcome of acute myocardial infarction (AMI) between rural and urban settings has been previously recognized, but there has previously been no nationwide data reported that is inclusive of the whole adult population. Methods: All discharge records between 2004 and 2018 with AMI diagnosis were extracted from the National Inpatient Sample (NIS) database and stratified by hospital location. The primary outcome was in-hospital mortality, and secondary outcomes included (a) major adverse cardiovascular and cerebrovascular events (MACCE), (b) major bleeding, (c) acute ischemic stroke, the utilization of invasive management in the form of (d) coronary angiography (CA), and (e) percutaneous coronary intervention (PCI). The adjusted odds ratios (aOR) and 95 % confidence interval (95 % CI) were determined using multivariable logistic regression. Results: 9,728,878 records with AMI were identified, of which 1,011,637 (10.4 %) discharges were from rural hospitals. Rural patients were older (median of 71 years vs. 67 years, p < 0.001) and had lower prevalence of the highest risk presentations of AMI than their urban counterparts. After multivariable adjustment, patients from rural hospitals had increased aOR of all-cause mortality (aOR 1.15 95 % CI 1.13–1.16) and MACCE (aOR 1.04 95 % CI 1.04–1.05), as well as the decreased aOR of coronary angiography (aOR 0.29, 95 % CI 0.29–0.29, p < 0.001) and PCI (aOR 0.40, 95 % CI 0.39–0.40, p < 0.001), compared to their urban counterparts. Conclusion: Between 2004 and 2018, the risk of in-hospital mortality and MACCE in AMI patients was significantly higher in rural hospitals, with considerably lower utilization of invasive angiography and revascularization.</p
Association of myocardial injury with adverse long-term survival among cancer patients
No full textAims: over time, cardiovascular disease (CVD) deaths increasingly exceed those from malignancy among cancer survivors. However, the association of myocardial injury with long-term survival (beyond 3 years) in cancer patients has not been previously described.Methods and results: the high-sensitivity cardiac troponin (hs-cTn) and morbidities databases from the National Health and Nutrition Examination Survey (1999–2004) were linked with the latest mortality dataset isolating records were respondents reported cancer diagnosis by a healthcare professional. Myocardial injury was then determined by elevated hs-cTn. A total of 16 225 560 weighted records (1058 unweighted) were included in this observational study, with myocardial injury identified in 14.2%. Those with myocardial injury had progressively worse survival at 5 (51.6 vs. 89.5%), 10 (28.3 vs. 76.0%), and 15 years (12.6 vs. 61.4%) compared with those without myocardial injury. After adjusting for baseline characteristics, those with myocardial injury had an adjusted hazard ratio (aHR) of 2.10 [95% confidence interval (CI) 2.09–2.10, P < 0.001] for all-cause mortality, 2.23 (2.22–2.24, P < 0.001) for cardiovascular mortality, and 1.59 (95% CI 1.59–1.60, P < 0.001) for cancer mortality compared with those without myocardial injury. Among patients with no pre-existing CVD, the hs-cTn I Ortho assay was a strong independent predictor of all-cause (aHR 6.29, 95% CI 6.25–6.33, P < 0.001), CVD (aHR 11.38, 95% CI 11.23–11.54, P < 0.001), and cancer (aHR 5.02, 95% CI 4.96–5.07, P < 0.001) mortalities.Conclusion: as a marker for myocardial injury, hs-cTns were independently associated with worse long-term survival among cancer patients with a stronger relationship with all-cause, cardiovascular, and cancer mortalities using hs-cTn I Ortho assay
Invasive management and in-hospital outcomes of myocardial infarction patients in United States safety-net hospitals
No full textAim: safety-net hospitals (SNHs) look after a higher proportion of uninsured patients and are often located in deprived areas. This study aimed to determine whether there are differences in the clinical characteristics, treatments and outcomes of patients presenting with acute myocardial infarction (AMI) in SNHs versus non-SNHs (N-SNHs).Methods: all hospitalizations with a principal diagnosis of AMI in the United States' National Inpatient Sample between 2016 and 2019 were stratified by safety-net hospital status. Multivariable logistic regression with adjusted odds ratios (aOR) and 95 % confidence intervals (95 % CI) was conducted to investigate invasive management and clinical outcomes.Results: a total of 2,544,009 weighted discharge records were analyzed, including 601,719 records from SNHs (23.7 %). Compared with N-SNHs, SNH AMI patients were younger (median 66 years vs. 67 years, p < 0.001), and had a higher proportion in the lowest quartile of median household income (37.3 % vs. 28.5 %, p < 0.001). Patients from SNHs were less likely to receive coronary angiography (aOR 0.92, 95 % CI 0.91–0.93, p < 0.001), percutaneous coronary intervention (aOR 0.94, 95 % CI 0.93–0.95, p < 0.001), and coronary artery bypass grafting (aOR 0.93, 95 % CI 0.92–0.94, p < 0.001). In addition, they had increased all-cause mortality (aOR 1.11, 95 % CI 1.09–1.12, p < 0.001), major adverse cardiovascular/cerebrovascular events (composite of mortality, stroke and reinfarction) (aOR 1.11, 95 % CI 1.09–1.12, p < 0.001), and stroke (aOR 1.11, 95 % CI 1.08–1.14, p < 0.001), while there was no difference in major bleeding (aOR 1.02, 95 % CI 1.00–1.04, p = 0.107).Conclusion: among AMI patients, treatment in SNHs was associated with lower utilization of coronary angiography and revascularization and worse clinical outcomes
Going Beyond Counting First Authors in Author Co-citation Analysis
Full text linkThe 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
Full text link“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
Full text linkWe 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
Full text linkWe 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
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