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Optiskā neiromielīta klīniskās norises un ārstēšanas raksturojums. Promocijas darba kopsavilkums
No full textThis work has been carried out at the following locations: The first part was done at the Walton Centre for Neurology and Neurosurgery, Liverpool, UK, and the second one – in collaboration with Riga Eastern Clinical University hospital “Gaiļezers”– MS unit. Defence: at the public session of the Doctoral Committee of Medicine on 7 December 2015 at 15.00 in Hippocrates Lecture Theatre, 16 Dzirciema Street, Rīga Stradiņš University, Latvia.The doctoral theses “The clinical and treatment characteristics of neuromyelitis optica” has been dedicated to cover a topic about a condition called neuromyelitis optica (NMO) or Devic’s disease, which is a disease that is not fully understood yet. NMO is a relapsing inflammatory demyelinating disease of the central nervous system, and clinically it affects predominantly the optic nerves and spinal cord. Despite significant work, which has been previously made to diagnose NMO, it is still often not recognised, or accidentally diagnosed as multiple sclerosis. In fact, many clinical, laboratory or radiological characteristics are common in both NMO and multiple sclerosis. Devic’s disease, if not treated promptly or accidentally treated as multiple sclerosis, is a very disabling disease with a high mortality rate (Palace, Leite et al. 2010, Barnett, Prineas et al. 2012, Jacob, Hutchinson et al. 2012, Kleiter, Hellwig et al. 2012, Min, Kim et al. 2012, Izaki, Narukawa et al. 2013, Jurynczyk, Zaleski et al. 2013, Lee, Laemmer et al. 2014, Dubey, Kieseier et al. 2015). Treatment of the disease is based on anecdotal case reports. Due to severity and high disability of the disease, randomised placebo controlled treatment trials are unethical (Jacob, McKeon et al. 2013, Mealy, Wingerchuk et al. 2014). Many characteristics of NMO have probably not been identified and studied yet. Criteria to select the best treatment for patients with different phenotypes are also unknown. The purpose of this work was to analyse and characterise clinical features, efficacy of treatment of NMO/NMO spectrum, as well as to analyse the data entered into the Latvian MS register, for the purpose to improve diagnostic accuracy, treatment efficacy, and the outcomes of patients with NMO/NMOS. As a result of this work, several previously ignored NMO features have been described which may lead to earlier identification of the disease and therefore an earlier initiation of treatment. This is the first report describing NMO seasonality in western populations. The results, in contrast to MS, indicated higher NMO relapse activity during October and November but lower in June and July (Koziol and Feng 2004, Fonseca, Costa et al. 2009, Handel, Disanto et al. 2011, Damasceno, Von Glehn et al. 2012). For the first time it has been established that gradual NMO onset over 4 or more weeks represents around one fifth of the cases. The study also confirmed that secondary progressive disease occurs in 4% of the patients (Wingerchuk, Pittock et al. 2007). This is the first report describing the frequency and characteristics of neuropathic pruritus (NP) in patients with NMO/NMOS. Results showed that NP and also tonic spasms are common representing features of NMO/NMOS and can be the first sign of upcoming relapse. This study also looked at clinical phenotype of patients tested positive for MOG-IgG. In contrast to the previous reports (Kitley, Woodhall et al. 2012, Kitley, Waters et al. 2014), it was found that MOG-IgG are present in the sera of both, monophasic and relapsing NMO patients. Results confirmed that azathioprine is an effective immunosupresant in up to 89% (relapse free 61%) of patients (Mandler, Ahmed et al. 1998, Bichuetti, Lobato de Oliveira et al. 2010, Costanzi, Matiello et al. 2011), but also showed that its efficacy is significantly reduced in patients with more active and frequently relapsing disease (relapse free 44%). Despite its good efficacy, side effects were the most common reason for discontinuation of azathioprine. These are the first case series-describing efficacy of intravenous immunoglobulins in treatment of NMO relapse. IVIG were effective if used early in almost half of the patients. The analysis of Latvian MS register showed that the quality and quantity of data entered into the register is not sufficient for retrospective identification of suspected NMO/NMOS cases. As the result of work, recommendations to improve the quality of Latvian MS register, early recognition and treatment of NMO were made.The doctoral thesis was supported by ESF project “Support for doctoral students in obtaining the scientific degree at RSU” and national NMO UK programme
The Clinical and Treatment Characteristics of Neuromyelitis Optica. Doctoral Thesis
No full textPromocijas darbs izstrādāts Valtonas Neiroloģijas un neiroķirurģijas centrā Liverpūlē, Lielbritānijā sadarbībā ar Rīgas Austrumu klīniskās universitātes slimnīcas klīniku “Gaiļezers”, MS vienību. Aizstāvēšana: 2015. gada 7. decembrī plkst. 15.00 RSU Medicīnas promocijas padomes atklātā sēdē Rīgā, Dzirciema ielā 16, Hipokrāta auditorijā.Promocijas darbs ir veltīts aktuālai, tomēr līdz šim nepietiekami izpētītai slimībai – optiskajam neiromielītam (NMO) jeb Devika slimībai. NMO ir iekaisīga un demielinizējoša centrālās nervu sistēmas slimība, kas klīniski izpaužas galvenokārt ar recidivējošu redzes nervu un muguras smadzeņu bojājumu. Tomēr, neskatoties uz diagnostisko metožu uzlabošanos, slimība joprojām ir nepietiekami atpazīta un nereti sākotnēji kļūdaini uzskatīta par multiplo sklerozi (MS). To apgrūtina fakts, ka daudzas klīniskās, laboratoriskās un radioloģiskās pazīmes abām slimībām ir līdzīgas. Savlaicīgi neārstēta vai ārstēta ar medikamentiem, kas paredzēti MS ārstēšanai, Devika slimība ir ar augstu invaliditātes un mirstības risku (Palace, Leite et al. 2010, Barnett, Prineas et al. 2012, Jacob, Hutchinson et al. 2012, Kleiter, Hellwig et al. 2012, Min, Kim et al. 2012, Izaki, Narukawa et al. 2013, Jurynczyk, Zaleski et al. 2013, Lee, Laemmer et al. 2014, Dubey, Kieseier et al. 2015). Randomizēti, placebo kontrolēti pētījumi slimības smagās norises un augstā invaliditātes riska dēļ būtu neētiski, tādēļ ārstēšanas izvēle balstās uz atsevišķu gadījumu aprakstiem un klīnicistu iepriekšējo pieredzi (Jacob, McKeon et al. 2013, Mealy, Wingerchuk et al. 2014). Daudzas NMO klīniskās un norises īpatnības joprojām nav apzinātas. Pietiekami nav apzinātas arī NMO terapijā pielietojamo medikamentu priekšrocības un riski pacientiem ar dažādu klīnisko norisi. Šī darba mērķis ir izpētīt un raksturot NMO/NMOS klīniskās norises īpatnības un ārstēšanas efektivitāti, kā arī Latvijas MS reģistrā ievadāmos datus, ar nolūku uzlabot NMO/NMOS pacientu diagnostiku, ārstēšanu un slimības iznākumu. Apkopojot promocijas darbā iegūtos rezultātus, raksturotas iepriekš mazāk pazīstamas NMO klīniskās pazīmes, kas varētu ietekmēt savlaicīgu NMO diagnostiku un līdz ar to agrīnu terapijas uzsākšanu. Pētījuma rezultātā pirmo reizi izpētīta NMO sezonalitāte rietumu populācijā un noskaidrots, ka augstāka NMO/NMOS paasinājumu aktivitāte, pretēji MS, reģistrēta oktobrī un novembrī, bet zemāka – jūnijā un jūlijā (Koziol and Feng 2004, Fonseca, Costa et al. 2009, Handel, Disanto et al. 2011, Damasceno, Von Glehn et al. 2012). Pirmo reizi noskaidrots, ka piektdaļai NMO/NMOS slimnieku pirmie simptomi attīstās progresējoši – 4 un vairāk nedēļu laikā, un apstiprināts, ka sekundāri progresējoša slimības norise attīstās līdz 4% slimnieku (Wingerchuk, Pittock et al. (2007). Pirmo reizi izpētīts neiropātiskās niezes (NN) biežums un īpatnības, un noskaidrots, ka NN un toniskas spazmas ir raksturojoši NMO/NMOS simptomi, kas var izpausties kā paasinājuma pirmā pazīme. Pētījuma rezultātā izpētīts MOG-IgG pozitīvu pacientu fenotips un, pretēji iepriekš uzskatītajam, secināts, ka MOG-IgG antivielas sastop gan monofāzisku, gan recidivējošu NMO slimnieku serumā (Kitley, Woodhall et al. 2012, Kitley, Waters et al. 2014). Vienlaicīgi pētījuma rezultāti parādīja, ka azatioprīns, līdzīgi kā ziņots iepriekš (Mandler, Ahmed et al. 1998, Bichuetti, Lobato de Oliveira et al. 2010, Costanzi, Matiello et al. 2011), samazina slimības aktivitāti līdz pat 89% slimnieku (pilnīga klīniska remisija 61%), tomēr tā efektivitāte ir ievērojami zemāka slimniekiem ar izteiktāku slimības aktivitāti pirms ārstēšanas etapā (pilnīga klīniska remisija 44%). Noskaidrots, ka blakusefekti ir biežākais azatioprīna pārtraukšanas iemesls. Pirmo reizi izpētīts un, pētījuma rezultātā noskaidrots, ka intravenozi imūnglobulīni ir efektīvi NMO/NMOS paasinājumu agrīnā terapijā. Savukārt, izanalizējot Latvijas MS reģistrā ievadāmo datu kvalitāti un kvantitāti, jāsecina, ka tie nav pietiekami, lai retrospektīvi atklātu NMO/NMOS gadījumus. Darba noslēgumā sniegtas rekomendācijas gan Latvijas MS reģistra uzlabošanā, gan klīniski praktiskas rekomendācijas NMO/NMOS slimnieku diagnostikas un ārstēšanas uzlabošanai.Promocijas darbs veikts ar ESF projekta “Atbalsts doktorantiem studiju programmas apguvei un zinātniskā grāda ieguvei RSU” un Lielbritānijas NHS nacionālās NMO programmas atbalstu
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
koamabayili/VECTRON-author-checklist: VECTRON author checklist
No full textWe 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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