1,720,967 research outputs found
Exploring antibacterial consumption and pathogen surveillance over 5 years (including the COVID-19 pandemic) in a tertiary referral adult general intensive care unit
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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
Evaluation of the physiological variables and scoring systems at intensive care discharge as predictors of clinical deterioration and readmission: a single-centre retrospective study
No full textObjectives We aim to determine, using routinely collected data and common scoring systems, whether parameters seen at intensive care unit (ICU) discharge can be predictive of subsequent clinical deterioration.Design/setting A single-centre retrospective study located in a tertiary hospital in the south of England.Participants 1868 patients who were admitted and discharged from ICU between 1 April 2023 and 31 March 2024 were screened for eligibility. A total of 1393 patients were included in the final analysis, including 122 patients who were classified in the ‘deteriorated’ subgroup.Interventions Assessment of vital signs, blood markers of infection and inflammation and three scoring systems (National Early Warning Score 2 (NEWS2), Acute Physiology and Chronic Health Evaluation II Score and Sequential Organ Failure Assessment (SOFA) score) taken within 24 hours prior to ICU discharge.Primary outcomes Assessment of predictors of deterioration after ICU discharge.Secondary outcomes Reasons for readmission to ICU, hospital mortality, ICU length of stay and time before readmission to ICU.Results Heart rate, conscious level (alert, voice, pain, unresponsive scale) and SOFA score were independent predictors of deterioration after ICU discharge (under the curve 0.85, CI 0.79 to 0.90, specificity 82.3%, sensitivity 79.7%) in multivariable models. Of these, a reduced level of consciousness was the most significant predictor of clinical deterioration (OR 19.6, CI 11.4 to 35.0). NEWS2 was an independent predictor for deterioration on univariable analysis. Mortality was significantly increased in patients who experienced deterioration after ICU discharge, as was ICU length of stay.Conclusions Predictive models may be useful in assisting clinicians with ICU discharge decisions. Further research is required to develop patient-tailored scoring systems that incorporate other factors that are needed for decisions around ICU discharge
Pre-hospital critical care for out-of-hospital cardiac arrests with return of spontaneous circulation: a retrospective observational study
No full textBackground/objectives: out-of-hospital cardiac arrests (OHCAs) are common, with return of spontaneous circulation (ROSC) achieved in approximately 25% of patients. However, it remains unknown whether post-ROSC care delivered by a pre-hospital critical care team (CCT) improves patient outcomes. We therefore aimed to investigate this in OHCA patients admitted to our intensive care unit (ICU). Methods: in this retrospective observational study, consecutive adults with ROSC after non-traumatic OHCA admitted to our ICU between 1 September 2019 and 31 August 2022 were included. We compared patients who received post-ROSC care from a CCT to those who received standard care. The primary outcome was a good neurological outcome on hospital discharge (defined as Cerebral Performance Category 1–2). Descriptive statistics, Area Under the Receiver Operating Characteristic Curve (AUC) values, and adjusted Odds Ratios (ORs) are reported. We constructed multivariable logistic regression models that adjusted for the component variables of the MIRACLE2 score. Results: we included 126 OHCAs (median age 63 years, 69% male), which were largely witnessed (82%), involved bystander cardiopulmonary resuscitation (87%), and had an initial shockable rhythm (61%). The prevalence of good neurological outcomes was higher in patients who received post-ROSC care from a pre-hospital CCT (37% vs. 17%, p = 0.012). The MIRACLE2 score was a strong predictor of good neurological outcomes (AUC 0.932), and in our multivariable analysis, good neurological outcome was associated with both CCT presence post-ROSC (aOR 3.77, 95% CI 1.02–13.89) and the delivery of PHEA (aOR 4.10, 95% CI 1.10–15.27, p = 0.035). Furthermore, in patients meeting the Utstein criteria (n = 69), good neurological outcomes were also more prevalent with CCT presence post-ROSC (62% vs. 29%, p < 0.001). Conclusions: we found that post-ROSC care delivered by a pre-hospital CCT was associated with good neurological outcomes on hospital discharge.</p
Severe parainfluenza viral infection-a retrospective study of adult intensive care patients
No full textThere is little known about parainfluenza virus (PIV) infection in adult intensive care unit (ICU) patients. Here, we aim to describe the characteristics, clinical course and outcomes of PIV infection in adults requiring intensive care. In this retrospective study of consecutive patients admitted to our ICU with confirmed PIV infection over a 7-year period, we report the patient characteristics, laboratory tests and prognostic scores on ICU admission. The main outcomes reported are 30-day mortality and organ support required. We included 50 patients (52% male, mean age 67.6 years). The mean PaO2/FiO2 and neutrophil/lymphocyte ratios on ICU admission were 198 ± 82 mmHg and 15.7 ± 12.5. Overall, 98% of patients required respiratory support and 24% required cardiovascular support. The median length of ICU stay was 5.9 days (IQR 3.7-9.1) with a 30-day mortality of 40%. In conclusion, PIV infection in adult ICU patients is associated with significant mortality and morbidity. There were significant differences between patients who presented with primary hypoxemic respiratory failure and hypercapnic respiratory failure.</p
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
Non-invasive ventilation for community-acquired pneumonia: outcomes and predictors of failure from an ICU cohort
No full textBackground and Objectives: the use of non-invasive ventilation (NIV) for community-acquired pneumonia (CAP) remains controversial. NIV failure in the setting of acute hypoxemic respiratory failure is associated with increased mortality, highlighting the need for careful patient selection. Methods and methods: this is a retrospective observational cohort study. We included 140 patients with severe CAP, treated with either NIV or invasive mechanical ventilation (IMV) as their primary oxygenation strategy. Results: the median PaO2/FiO2 ratio and SOFA score upon ICU admission were 151 mmHg and 6, respectively. We managed 76% of patients with NIV initially and report an NIV success rate of 59%. Overall, the 28-day mortality was 25%, whilst for patients with NIV success, the mortality was significantly lower at 13%. In the univariate analysis, NIV failure was associated with the SOFA score (OR 1.33), the HACOR score (OR 1.14) and the presence of septic shock (OR 3.99). The SOFA score has an AUC of 0.75 for NIV failure upon ICU admission, whilst HACOR has an AUC of 0.76 after 2 h of NIV. Conclusions: our results suggest that a SOFA ≤ 4 and an HACOR ≤ 5 are reasonable thresholds to identify patients with severe CAP likely to benefit from NIV.</p
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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