1,721,174 research outputs found
No room to breathe: the importance of lung hyperinflation in COPD
No full textPatients with chronic obstructive pulmonary disease (COPD) are progressively limited in their ability to undertake normal everyday activities by a combination of exertional dyspnoea and peripheral muscle weakness. COPD is characterised by expiratory flow limitation, resulting in air trapping and lung hyperinflation. Hyperinflation increases acutely under conditions such as exercise or exacerbations, with an accompanying sharp increase in the intensity of dyspnoea to distressing and intolerable levels. Air trapping, causing increased lung hyperinflation, can be present even in milder COPD during everyday activities. The resulting activity-related dyspnoea leads to a vicious spiral of activity avoidance, physical deconditioning, and reduced quality of life, and has implications for the early development of comorbidities such as cardiovascular disease. Various strategies exist to reduce hyperinflation, notably long-acting bronchodilator treatment (via reduction in flow limitation and improved lung emptying) and an exercise programme (via decreased respiratory rate, reducing ventilatory demand), or their combination. Optimal bronchodilation can reduce exertional dyspnoea and increase a patient’s ability to exercise, and improves the chance of successful outcome of a pulmonary rehabilitation programme. There should be a lower threshold for initiating treatments appropriate to the stage of the disease, such as long-acting bronchodilators and an exercise programme for patients with mild-to-moderate disease who experience persistent dyspnoea
An International Study of Adherence to Guidelines for Patients Hospitalised with a COPD Exacerbation
No full textGuideline adherence rates for the treatment of chronic obstructive pulmonary disease (COPD) exacerbation are low. The aim of this study is to perform an importance-performance analysis as an approach for prioritisation of interventions by linking guidelines adherence rates to expert consensus rates for the in-hospital management of COPD exacerbation. We illustrate the relevance of such approach by describing variation in guideline adherence across indicators and hospitals. A secondary data analysis of patients with an acute COPD exacerbation admitted to Belgian, Italian and Portuguese hospitals was performed. Twenty-one process indicators were used to describe adherence to guidelines from patient record reviews. Expert consensus on the importance for follow-up of these 21 indicators was derived from a previous Delphi study. Three of the twenty-one indicators had high level of expert consensus and a high level of adherence. Eleven of the twenty-one indicators had high level of expert consensus but a low level of adherence. For none of the 378 patients included in this study were all process indicators adhered to, patients received 41.0% of the recommended care on average, and only 34.1% of the patients received 50% or more of the care they should receive. There was also a large variation within and between hospitals regarding the care received. This study confirms the findings of previous studies, indicating that COPD exacerbations are largely undertreated. Importance-performance analysis provides a decision-making tool for prioritising indicators. All hospitals in this study would benefit from having in place a quality framework for systematic follow-up of these indicators
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
Bio-akoestiek als maat voor de status van levende organismen
No full textBoth the increasing demand in objective data and the availability of cheap technology result in better monitoring practices for animal and human applications. Especially due to the high demand of meat, worldwide, and the occurrence of disease epidemics on a global scale -both among animals and from animals to humans there will be an increasing demand for monitoring systems. Technology that can indicate the health or welfare status of individuals can contribute to a more efficient management or treatment. This thesis investigates how sound features can be used to monitor various species in real time, from group level to individual level.The first objective was to assess the possibility to extract physiological information of a group of animals during growth, only taking into account spectral information. The second objective was to assess if sound is capable of distinguishing short term changes in the status of living organisms both taking into account spectral information and the shape of the waveform of the examined sound signal. The third objective was to examine the importance of dynamics in vocalization on the behavioral state of individual organisms looking to the interaction between spectral information and shape of the waveform.In Chapter 2, a method is developed to monitor the growth stage of a group of chicken embryos in an industrial incubator. By knowing the moment that chicken embryos start hatching and the spread of the hatching in the entire incubator, incubation specialists can optimize their process management. Using spectral sound information of a group of 19.200 embryos, it was shown that real time sound analysis allowed the detection of internal pipping, the moment at which embryos start breathing with their lungs.In Chapters 3 and 4, the monitored species is the pig. Respiratory problems contribute for up to 8% of the mortality in commercial pig houses, causing considerable financial losses. By using sound analysis, a classification system was set up to classify and localize sick pig cough sounds based on their acoustic features. Chapter 3 only uses spectral information to distinguish sick from healthy cough sounds, while Chapter 4 assesses the dynamics of the energy envelope of the waveform as an indicator for sick cough sound. In Chapter 5, human cough sounds are analyzed at different degrees of lung inflammation. Instead of evaluating differences of acoustic parameters between groups of individuals, the effect of lung inflammation on acoustic parameters within every individual was assessed. Compared to Chapters 2, 3 and 4, the intra-subject variability, or individual monitoring, is very important to monitor the progression of lung inflammation. Furthermore, the technique developed on pig coughs to assess the dynamics of the energy envelope of the waveform was also extrapolated to human cough sounds.In Chapter 6, the degree of decoupling between energy envelope of the waveform and fundamental frequency variation in infant cry sounds is assessed towards a pain score basedon theModified Behavioural Pain Scale. Although no significant relation between the degree of decoupling of the sound features with the pain scores was observed, the technique developed in this chapter allows a new way of quantifying infant cry sounds and opens the door to longitudinal studies to monitor cortical development based on cry sound features.The overall conclusion of this thesis is that, depending on the complexity of the sound signal and the level on which organisms are monitored (in group or individual), spectral information alone; the combination of spectral and time domain information or the interaction between them, allows quantification of the biological status of living organisms in real time.status: Publishe
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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