1,721,017 research outputs found
Exercise as an immunomodulatory mechanism in asthma
No full textThe prevalence of asthma remains high worldwide, and despite the development of biological treatments, many patients remain sub optimally controlled, and mortality rates have been static for decades. Exercise immunology is an expanding field, and there is growing evidence that exercise can modulate the inflammatory and immune processes in asthma. Changes in redox status have been linked with asthma severity, and modulation of redox balance via upregulation of the master antioxidant NRF2 has been proposed as the mechanism through which exercise exerts its disease modifying properties. Despite this, and national and international guidance to increase exercise, patients with asthma are less likely to engage in physical activity than non asthmatics. The aim of this thesis was to investigate the effect of an interval exercise training programme on symptom control and inflammation in patients with suboptimally controlled asthma, and the role of NRF2 driven increases in redox buffering capacity in mediating this response. A 12-week exercise intervention resulted in significant improvements in symptom and quality of life scores, in addition to improvements in asthma related inflammatory markers and lung function. In terms of mechanistic investigation, downstream markers of redox regulation increased, with demonstration of association between improvements in fitness, increases in antioxidant capacity and inflammation, through to overall improvements in lung function and asthma symptoms. Given the early exploratory data to support my hypothesis, alongside challenging recruitment and high participant drop out rate, identification of the barriers to exercise for patients with asthma was important. Therefore, I assessed perceived barriers to exercise in the WATCH Cohort of Difficult Asthma. The perceived burden of exercise therapy in patients with difficult asthma was demonstrated to be at a level comparable to those with cardiovascular disease, and higher than in patients with cancer. A high perceived burden of exercise therapy was significantly associated with increased asthma symptoms, anxiety and depression, reduced quality of life and increased number of rescue oral steroid courses whilst more biological markers of disease such as lung function, blood eosinophil count, FeNO and hospitalisations in the previous year were not. This analysis described herein suggests exercise intervention in symptomatic asthma is tolerated and beneficial for physical fitness, and symptom control, with associated improvement in inflammatory parameters and lung function. The mechanism of these improvements may be via improved redox buffering capacity, resulting in increased tolerance to disease related stressors. Demonstration that perceived barriers to exercise are associated with higher symptom scores and psychological burden, but not biological markers of disease severity, suggest that an exercise intervention along with psychological input may help facilitate increased uptake of a disease modifying lifestyle change. Further work is required to validate these exploratory results in a fully powered study, which will require adaptation to accommodate COVID safe protocols
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
Defining a role for exercise training in the management of asthma
No full textThe prevalence of asthma remains high worldwide, with increasing awareness of the morbidity and mortality from asthma in low-income countries. In the UK, despite the development of biological treatments, many patients remain suboptimally controlled, and mortality rates have been static for decades. Therefore, new approaches are needed to treat asthma that are scalable at minimal cost. Exercise immunology is an expanding field, and there is growing evidence that exercise can modulate inflammatory and immune processes in asthma. Whilst exercise is encouraged in current treatment guidelines, there are no specific recommendations as to the intensity, frequency or duration of exercise exposure. Despite national and international guidance to increase exercise, patients with asthma are less likely to engage in physical activity. This review explores the disease modifying benefit of exercise in asthma. We also review the domains in which exercise exerts positive clinical effects in asthma, including the effects of exercise on symptom scores, quality of life, psychosocial health, and in the obese asthma phenotype. Finally, we review the barriers to exercise in asthma, given the benefits it confers. A better understanding of the mechanisms through which exercise exerts its positive effects in asthma may provide more accurate prescription of exercise training programmes as part of broader asthma management, with the potential of identification of new drug targets.</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
An unusual bronchial obstruction in a fit young man
No full textWe describe the case of a previously well young man who presented acutely to hospital with a history of progressive chest symptoms and systemic upset. At admission, clinical evidence of left upper lobe collapse on respiratory examination and chest x-ray gave rise to significant clinical concern. Initial assessment by CT suggested a possible aspirated foreign body in the left upper lobe bronchus with distal left upper lobe collapse. Subsequent rigid bronchoscopy identified a solid abnormality totally occluding the left upper lobe bronchus, which did not appear to be a foreign body. The patient became progressively more unwell with clinical signs of chest sepsis and failed to settle with medical therapy. A decision was made to undertake a lobectomy to remove the collapsed lobe and obstructing endobronchial lesion. Histology confirmed that the cause of bronchial obstruction was a mesenchymoma (pulmonary hamartoma)
Multimorbidity in difficult asthma: the need for personalised and non-pharmacological approaches to address a difficult breathing syndrome
No full textThree to ten percent of people living with asthma have difficult-to-treat asthma that remains poorly controlled despite maximum levels of guideline-based pharmacotherapy. This may result from a combination of multiple adverse health issues including aggravating comorbidities, inadequate treatment, suboptimal inhaler technique and/or poor adherence that may individually or collectively contribute to poor asthma control. Many of these are potentially "treatable traits" that can be pulmonary, extrapulmonary, behavioural or environmental factors. Whilst evidence-based guidelines lead clinicians in pharmacological treatment of pulmonary and many extrapulmonary traits, multiple comorbidities increase the burden of polypharmacy for the patient with asthma. Many of the treatable traits can be addressed with non-pharmacological approaches. In the current healthcare model, these are delivered by separate and often disjointed specialist services. This leaves the patients feeling lost in a fragmented healthcare system where clinical outcomes remain suboptimal even with the best current practice applied in each discipline. Our review aims to address this challenge calling for a paradigm change to conceptualise difficult-to-treat asthma as a multimorbid condition of a "Difficult Breathing Syndrome" that consequently needs a holistic personalised care attitude by combining pharmacotherapy with the non-pharmacological approaches. Therefore, we propose a roadmap for an evidence-based multi-disciplinary stepped care model to deliver this
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