1,721,019 research outputs found
Determinants of long-term functional prognosis after stroke in young adults
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159469.pdf (Publisher’s version ) (Open Access)The long-term outcome in young stroke patients is not favourable. This is in contrast with the general opinion in neurologists, which is based on studies describing lower short-term mortality rates in young stroke patients compared to older patients. A substantial proportion of patients, even in the long run after stroke (on average 14 years after stroke), stays dependent in daily living, despite their young age. This especially holds true for women and patients with severe neurological deficits at admission. Fatigue and depression after stroke are associated with a lower quality of life. Therefore, it is important that health care professionals actively assess the presence of these symptoms. Unexpectedly, in contrast, the effect of post-stroke cognitive disorders on the daily life after a stroke at young age is less clear. A new, preliminary insight is the association between kidney dysfunction and the occurrence of recurrent strokes after a young stroke. The results of these studies enable health care professionals to give patients and their relatives more accurate information on the long-term functional prognosis after a stroke at young age.RU Radboud Universiteit, 28 september 2016Promotores : Klijn, C.J.M., Leeuw, H.F. de Co-promotor : Kort, P.L.M. d
Cognitive recovery after stroke
No full textStroke is one of the leading causes of death and long-term disability worldwide. The incidence of ischemic stroke in The Netherlands alone is 35.000 per year, translating to roughly 100 new patients with ischemic stroke every day. Apart from the physical consequences, up to 75% of the patients have cognitive deficits after ischemic stroke. Cognitive deficits after ischemic stroke are independently associated with lower quality of life, poorer functional outcome, and worse community reintegration.
Fortunately, roughly half of the patients with cognitive deficits after ischemic stroke show recovery over time. The other half, however, remains cognitively impaired or even deteriorates. Predicting cognitive recovery in patients with a cognitive disorder after ischemic stroke could have important consequences for daily practice: it could help in providing realistic psycho-education for patients and their families, and it could ultimately help in matching the goals in rehabilitation programs to the patient’s potential for recovery.
However, prediction of cognitive recovery after ischemic stroke on clinical features alone is still inaccurate. Measures of brain connectivity have emerged in the literature as important markers of various types of brain injury that are relevant for cognition, and may add value to conventional predictors in predicting cognitive recovery after stroke.
When looking more specifically at the cognitive deficits that are often seen after ischemic stroke, these can involve the ‘traditional’ cognitive domains memory, executive functioning, visuospatial functioning, language, and attention and processing speed. Another cognitive domain, social cognition, has been studied less frequently following stroke. Social cognition involves the psychological processes by which one perceives, processes and interprets social information, and it involves adequately responding to this social information. There is emerging evidence that ischemic stroke is also associated with deficits in social cognition.
In the work described in this thesis we assessed 1) whether measures derived from the structural brain network predict cognitive recovery after ischemic stroke and 2) how often impairments in social cognition occur after ischemic stroke, and more precisely, emotion recognition.
This thesis described the development of the lesion impact score, a score that combines information on lesion size with network topology, which was an independent predictor of cognitive recovery after ischemic stroke. By contrast, we could not show there was additional value of more global brain connectivity measures in predicting cognitive recovery over other conventional predictors. We conclude that measures of brain connectivity do not appear to be ready for implementation in daily practice yet, although our findings do show promise. However, further research is needed to assess how these measures can add value in daily practice.
In this thesis we also showed that emotion recognition is impaired in one out of three patients, while it is often not recognized by the clinician or the patient. Clinicians should be aware that these impairments occur often and should routinely inform patients about changes in social behavior. If there are signs of changes in a patient’s social behavior or empathy, patients or their caregivers should be provided with psychoeducation and referral to a neuropsychologist should be considered
Going Beyond Counting First Authors in Author Co-citation Analysis
Get PDFThe 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
Get PDF“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
Get PDFWe 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
Get PDFWe 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
The Neuropsychology of Acute Stroke : Characterisation and Prognostic Implications
No full textIn this thesis, a longitudinal study was performed in a large cohort of patients with a first symptomatic stroke who had no neurological, psychiatric, and/or cognitive history prior to the stroke. The patient cohort was examined in a very early phase (mean interval eight days post-stroke) with a neuropsychological evaluation covering 7 major cognitive domains. The examination was feasible in 168 of 190 included patients (88%). At hospital admission, demographic data, lesion characteristics, clinical factors at admission, and pre-existent vascular risk factors were also recorded. The follow-up examination was administered after six to ten months, in which we examined cognitive outcome, functional outcome, emotional outcome, and quality of life. A demographically matched healthy control group (N=75) was also examined with the same time interval between baseline and follow-up assessment to obtain a reference sample for the neuropsychological examination.
The first part of this thesis (Chapters 2-5) reports a series of studies on the phenomenology, course, and prognostic implications of cognitive disorders in the early phase of stroke. The most important finding in this section is that cognitive disorders at baseline are powerful predictors of long-term dependence in daily life, long-term cognitive impairment, and a reduced quality of life, beyond that of well-known medical predictors. Particularly disorders in executive functioning and visual perception/ construction predict poor outcome in the long term. We recommend neuropsychological assessment as a standard evaluation on the stroke unit, and plead for a detailed characterisation of the cognitive disorder(s) rather than classifying all impairment under one general header.
The second part of this thesis (Chapters 6-7) studies the prevalence and clinical determinants of depressive symptoms (DS) after stroke. No evidence was obtained for a direct relation between DS and lesion location, neither in the acute phase nor in the long term. Conversely, a close association between long-term DS and (i) acute cognitive impairment and (ii) vascular risk factors could be demonstrated. It is concluded that DS are a psychological reaction to the devastating consequences of stroke. In addition, vascular risk factors may play a role in exacerbating DS in the long term.
In the third part (Chapter 8), we examined whether thrombolytic treatment has a favourable effect on cognitive and functional outcome after six months post-stroke. Multivariate logistic regression adjusted for stroke severity, age, education, and sex based on 117 first-ever stroke patients demonstrated that thrombolytic treatment is associated with a favourable basic and instrumental ADL outcome, but not with a beneficial cognitive outcome after six months.
Apart from the clinical merits, the neuropsychological examination in the first weeks allowed for the early identification of two patients with uncommon cognitive disorders (Chapter 9-10). In Chapter 9, the neuropsychological correlates of spontaneous confabulation are studied. This case study suggests that mental flexibility rather than executive functioning in general is related to spontaneous confabulation in amnesic patients. In chapter 10, fMRI was used to examine the neuro-anatomical correlates of visual hallucinations in a hemianopic patient. Bilateral activation was observed in the calcarine fissure and medially in the left and right occipital cortex adjacent to the infarcted areas, in line with fMRI findings from hallucinating patients with Charles Bonnet and Lewy body dementia.
In the final part (Chapter 11), a general discussion is presented comprising an integration of the main findings of this thesis, in addition to a discussion on our methodology and some future recommendations
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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