1,720,970 research outputs found

    Functional impairment of systemic scleroderma patients with digital ulcerations: results from the DUO Registry.

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    Objective. Digital ulcers (DUs) are frequent manifestations of systemic scleroderma (SSc). This study assessed functional limitations due to DUs among patients enrolled in the Digital Ulcer Outcome (DUO) Registry, an international, multicentre, observational registry of SSc patients with DU disease. Methods. Patients completed at enrolment a DU-specific functional assessment questionnaire with a 1-month recall period, measuring impairment in work and daily activities, and hours of help needed from others. Physician-reported clinical parameters were used to describe the population. For patients who completed at least part of the questionnaire, descriptive analyses were performed for overall results, and stratified by number of DUs at enrolment. Results. This study included 2327 patients who completed at least part of the questionnaire. For patients with 0, 1-2, and DUs at enrolment, mean overall work impairment during the prior month among employed/self-employed patients was 28%, 42%, and 48%, respectively. Across all included patients, ability to perform daily activities was impaired on average by 35%, 54%, and 63%, respectively. Patients required a mean of 2.0, 8.7, and 8.8 hours of paid help and 17.0, 35.9, and 63.7 hours of unpaid help, respectively, due to DUs in the prior month. Patients with DUs had more complications and medication use than patients with no DUs. Conclusion. With increasing number of DUs, SSc patients reported more impairment in work and daily activities and required more support from other

    Going Beyond Counting First Authors in Author Co-citation Analysis

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    The 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

    Burden of illness of bulimia nervosa in the United States : an evaluation of the prevalence, incidence, and treatment costs of bulimia nervosa

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    Hunsche E. Burden of illness of bulimia nervosa in the United States : an evaluation of the prevalence, incidence, and treatment costs of bulimia nervosa. Bielefeld (Germany): Bielefeld University; 2007.Ziel dieser Dissertation ist es - basierend auf dem Prävalenzansatz - die medizinischen Kosten der Bulimie in den USA zu schätzen und in einen globalen Kontext zu stellen. Zu diesem Zweck wurde eine eingehende Literaturrecherche bezüglich der globalen epidemiologischen Evidenz zur Bulimie vorgenommen sowie - anhand einer großen amerikanischen Krankenversicherungsdatenbank - eine gesundheitsökonomische Analyse der Behandlungskosten pro Patient. Die Ergebnisse dieser beiden Forschungsansätze wurden kombiniert, um die medizinischen Kosten der Bulimie in den USA zu projizieren. Implikationen für die klinische Praxis sowie zukünftiger Forschungsbedarf werden diskutiert. In den 80er Jahren wurde in Erhebungen die Prävalenz der Bulimie unter Erwachsenen in westlichen Ländern auf 8 Prozent - 13 Prozent geschätzt, während nach jüngsten Studien diese nur ungefähr 1 Prozent beträgt, vermutlich bedingt durch die strengeren diagnostischen Kriterien. Des Weiteren sind auch nicht westlich orientierte Länder von dieser Krankheit betroffen, wie eine begrenzte Anzahl von Studien belegt. Sehr limitierte Evidenz existiert derzeit bezüglich der Lebenszeitprävalenz, die auf mindestens 2 Prozent bei Frauen in westlichen Ländern geschätzt werden kann. Bezüglich der Inzidenz können keine verlässlichen Aussagen getroffen werden, da es zu wenige gut geplante Studien gibt. Bei amerikanischen Patienten mit privater, vom Arbeitgeber gesponsorter Krankenversicherung wurden die jährlichen leistungsbezogenen Gesamtkosten im Jahre 2002 - einschließlich ambulanter, hospitärer und medikamentöser Behandlung der Bulimie und ihrer Komplikationen und Komorbiditäten - auf 3.577proPatientgescha¨tzt.Davonwaren3.577 pro Patient geschätzt. Davon waren 1.865 direkt der ambulanten und hospitären Therapie der Bulimie zurechenbar. Von den Gesamtkosten entfielen 42 Prozent auf die medikamentöse, 25 Prozent auf die ambulante und 33 Prozent auf die stationäre Therapie. Mit Hilfe eines multivariaten Regressionsmodells wurde ermittelt, dass Alter und Komorbidität einen signifikanten Einfluss auf die Höhe der täglichen Kosten haben mit einem Kostenanstieg um 1,0 Prozent pro zusätzlichem Altersjahr und 1,6 Prozent mit jeder weiteren Diagnose. Bei Patienten mit Krankenversicherungen, die ganz oder teilweise über Kopfpauschalen abrechnen, wurden die Gesamtkosten auf der Grundlange von leistungsäquivalenten Kosten auf 4.238proPatientproJahrgescha¨tzt,vondenen4.238 pro Patient pro Jahr geschätzt, von denen 2.113 direkt der Bulimie zurechenbar waren. Die Anzahl amerikanischer Erwachsener, die im Jahre 2002 an Bulimie litten, wurde auf 0,5 bis 1,0 Millionen geschätzt und die jährlichen Behandlungskosten für Patienten mit privater Krankenversicherung auf 1,7Milliarden,vondenen1,7 Milliarden, von denen 0,9 Milliarden direkt der Bulimie zurechenbar waren. Die Gesamtkosten könnten jedoch bis auf 3,5Milliardenansteigen,wennalleBetroffenen,unabha¨ngigvonihremKrankenversicherungsstatus,diagnostiziertundtherapiertwu¨rden.DajedochdiemeistenBetroffenenindenUSAnichtbehandeltwerden,istdieserScha¨tzwertehereinIndizfu¨rpotentiellezuku¨nftigeKosten.WeitererForschungsbedarfbestehtderzeitbezu¨glichderIdentifikationvonTherapiebarrierensowieStrategienzuderenBewa¨ltigung.DesWeiterenmu¨sstendiefu¨rdieBehandlungderBulimieverfu¨gbarenRessourcenermitteltwerden,umdenungedecktenBedarfbestimmenzuko¨nnen.SchließlichsindLangzeitstudienerforderlich,dieAussagenu¨berdenVerlaufderEpidemiologiederBulimieermo¨glichen.TheobjectiveofthisthesisistoassessthemedicalburdenofbulimianervosaintheU.S.usingaprevalencebasedapproach,andtoplacethisburdeninaglobalcontext.Tothisaim,athoroughliteraturereviewoftheglobalevidenceontheepidemiologyofbulimianervosawasperformed,aswellashealtheconomicanalysisoftheperpatienttreatmentcostsinalarge,U.S.claimsdatabase.ResultsofthesetworesearchapproacheswerecombinedtoprojectthemedicalcostsofbulimianervosaintheU.S.Implicationsoffindingsforclinicalpracticeandfutureresearchneedsarediscussed.EstimatesoftheprevalenceofbulimianervosaintheadultpopulationofWesterncountrieshavedroppedfrom8percent13percentinsurveysinthe1980stoapproximately1percentinrecentstudies,likelybecausediagnosticcriteriabecamemorestringentovertime.ThelimiteddataavailabledemonstratethatbulimianervosaalsoexistsinnonWesternanddevelopingcountries.Estimatesofalifetimeprevalenceofbulimianervosaofatleast2percentamongwomeninWesterncountriesarebasedonasmallerevidencebasethantheamountofresearchconductedonthepointprevalence.Therearecurrentlytoofewwelldesignedstudiesontheincidenceofbulimianervosatodrawreliableconclusions.InpatientswithprivateemployersponsoredhealthcareplansinU.S.,thetotalannualperpatientfeeforservicetreatmentcostin2002,includinginpatient,outpatient,anddrugtreatmentofbulimianervosaaswellasitscomplicationsandcomorbidities,wasestimatedat3,5 Milliarden ansteigen, wenn alle Betroffenen, unabhängig von ihrem Krankenversicherungsstatus, diagnostiziert und therapiert würden. Da jedoch die meisten Betroffenen in den USA nicht behandelt werden, ist dieser Schätzwert eher ein Indiz für potentielle zukünftige Kosten. Weiterer Forschungsbedarf besteht derzeit bezüglich der Identifikation von Therapiebarrieren sowie Strategien zu deren Bewältigung. Des Weiteren müssten die für die Behandlung der Bulimie verfügbaren Ressourcen ermittelt werden, um den ungedeckten Bedarf bestimmen zu können. Schließlich sind Langzeitstudien erforderlich, die Aussagen über den Verlauf der Epidemiologie der Bulimie ermöglichen.The objective of this thesis is to assess the medical burden of bulimia nervosa in the U.S. using a prevalence-based approach, and to place this burden in a global context. To this aim, a thorough literature review of the global evidence on the epidemiology of bulimia nervosa was performed, as well as health economic analysis of the per-patient treatment costs in a large, U.S. claims database. Results of these two research approaches were combined to project the medical costs of bulimia nervosa in the U.S. Implications of findings for clinical practice and future research needs are discussed. Estimates of the prevalence of bulimia nervosa in the adult population of Western countries have dropped from 8 percent - 13 percent in surveys in the 1980s to approximately 1 percent in recent studies, likely because diagnostic criteria became more stringent over time. The limited data available demonstrate that bulimia nervosa also exists in non-Western and developing countries. Estimates of a lifetime prevalence of bulimia nervosa of at least 2 percent among women in Western countries are based on a smaller evidence base than the amount of research conducted on the point prevalence. There are currently too few well-designed studies on the incidence of bulimia nervosa to draw reliable conclusions. In patients with private employer-sponsored healthcare plans in U.S., the total annual per-patient fee-for-service treatment cost in 2002, including inpatient, outpatient, and drug treatment of bulimia nervosa as well as its complications and comorbidities, was estimated at 3,577, of which 1,865weredirectlyattributabletoinpatientandoutpatientcareoftheeatingdisorder.Pharmaceuticalservicesaccountedfor42percentofthetotalcosts,whileinpatientandoutpatientcarecontributed25percentand33percent,respectively.Basedonamultivariateregressionmodel,onlyageandcomorbiditywerefoundtobesignificantpredictorsofthedailyperpatientcosts,withcostsincreasingby1.0percentwitheachadditionalyearofageandby1.6percentwitheachadditionaldiagnosis.Forpatientswithpartiallyorfullycapitatedhealthcareplans(encounterclaims),costshadtobeapproximatedbyfeeforserviceequivalents,yieldingestimatedperpatientannualcostsof1,865 were directly attributable to inpatient and outpatient care of the eating disorder. Pharmaceutical services accounted for 42 percent of the total costs, while inpatient and outpatient care contributed 25 percent and 33 percent, respectively. Based on a multivariate regression model, only age and comorbidity were found to be significant predictors of the daily per-patient costs, with costs increasing by 1.0 percent with each additional year of age and by 1.6 percent with each additional diagnosis. For patients with partially or fully capitated healthcare plans (encounter claims), costs had to be approximated by fee-for-service equivalents, yielding estimated per-patient annual costs of 4,238, of which 2,113weredirectlyattributabletotheoutpatientandinpatienttreatmentofbulimianervosa.Followingaprevalencebasedapproach,itwasestimatedthatin2002between0.5and1.0millionadultssufferedfrombulimianervosa,leadingtoatotalannualcostof2,113 were directly attributable to the outpatient and inpatient treatment of bulimia nervosa. Following a prevalence-based approach, it was estimated that in 2002 between 0.5 and 1.0 million adults suffered from bulimia nervosa, leading to a total annual cost of 1.7 billion in patients with private employer-based health insurance, of which 0.9billionweredirectlyattributabletotheoutpatientandinpatienttreatmentofbulimianervosa.However,theburdentopayerswouldriseto0.9 billion were directly attributable to the outpatient and inpatient treatment of bulimia nervosa. However, the burden to payers would rise to 3.5 billion if all predicted sufferers, irrespective of insurance status, were diagnosed and treated. Since most cases currently go untreated, this estimate provides an indication of potential future costs. Additional research is needed to identify barriers to care and strategies to overcome them. Determining the need for additional resources will require research to quantify healthcare resources currently available for the treatment of bulimic individuals, as well as studies to identify long-term trends in the epidemiology of bulimia nervosa

    Variations on the Author

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    “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

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    We 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

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    We 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

    Author Index

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    koamabayili/VECTRON-author-checklist: VECTRON author checklist

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    We 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
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