1,721,298 research outputs found
Assessment of Hemostatic Changes after Initiation of Continuous Venovenous Hemodialysis
No full textBackground: Continuous renal replacement therapy (CRRT) is a standard therapy in critically ill patients suffering from acute kidney injury (AKI). Extracorporeal circulation and exposure to foreign surfaces during CRRT may induce disturbances in hemostasis, particularly in platelet function. The present study described the hemostatic changes associated with CRRT and aimed to identify the independent predictors of premature clotting of the circuit. Methods: In a prospective cohort mono-center study, patients were assessed for eligibility if they were i) diagnosed with AKI and ii) assigned to receive CRRT for the first time. Patients were included in the study if their platelet count was greater than 100/nL prior to inclusion in the study. After initiation of CRRT, aggregometric [Multiplate (R), Roche, Grenzach, Germany: Arachidonic acid (ASPItest)-, ADP (ADPtest)- and Thrombin (TRAPtest)-induced platelet aggregation] and viscoelastic (ROTEM (R) ; TEM International, Munich, Germany) analyses were performed immediately before (Baseline, T1) and 6 hours (T2), 12 hours (T3), 24 hours (T4), and 48 hours (T5) after initiation of CRRT. Conventional laboratory coagulation analyses were routinely performed twice a day. Arachidonic acid- and ADP-induced platelet aggregations were defined as primary endpoints. Results: A total of 127 patients were screened for eligibility, and 50 patients were enrolled in this study. Aggregometric analyses showed that arachidonic acid-induced platelet aggregation was significantly reduced at T2 [532 (210/1105) median (25th/75th percentile) AU min] compared to the Baseline at T1 [780 (297/1156), p = 0.007] and remained unchanged from T2 onward. Platelet aggregation in the ADPtest and TRAPtest remained unchanged during the study period. Viscoelastic and conventional coagulation analyses indicated a progredient increase of clot firmness. In total, 76 filter sets (an average of 1.5 per patient) were used, and 26 filter sets occluded prematurely after an average treatment time of 17 +/- 12 hours. No predictors for premature clotting of the circuit were identified. Conclusions: The results of the present study indicate that CRRT may lead to impaired primary hemostasis as shown by a decrease in ex vivo arachidonic acid-induced platelet aggregation. Moreover, viscoelastic measure indicate a fibrinogen-associated trend of increasing clot firmness during the study period. Further studies are needed to analyze whether these findings are of hemostatic relevance
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
Intracranial hemorrhage in COVID-19 patients during extracorporeal membrane oxygenation for acute respiratory failure: a nationwide register study report
Full text linkAbstract
Background
In severe cases, SARS-CoV-2 infection leads to acute respiratory distress syndrome (ARDS), often treated by extracorporeal membrane oxygenation (ECMO). During ECMO therapy, anticoagulation is crucial to prevent device-associated thrombosis and device failure, however, it is associated with bleeding complications. In COVID-19, additional pathologies, such as endotheliitis, may further increase the risk of bleeding complications. To assess the frequency of bleeding events, we analyzed data from the German COVID-19 autopsy registry (DeRegCOVID).
Methods
The electronic registry uses a web-based electronic case report form. In November 2021, the registry included N = 1129 confirmed COVID-19 autopsy cases, with data on 63 ECMO autopsy cases and 1066 non-ECMO autopsy cases, contributed from 29 German sites.
Findings
The registry data showed that ECMO was used in younger male patients and bleeding events occurred much more frequently in ECMO cases compared to non-ECMO cases (56% and 9%, respectively). Similarly, intracranial bleeding (ICB) was documented in 21% of ECMO cases and 3% of non-ECMO cases and was classified as the immediate or underlying cause of death in 78% of ECMO cases and 37% of non-ECMO cases. In ECMO cases, the three most common immediate causes of death were multi-organ failure, ARDS and ICB, and in non-ECMO cases ARDS, multi-organ failure and pulmonary bacterial ± fungal superinfection, ordered by descending frequency.
Interpretation
Our study suggests the potential value of autopsies and a joint interdisciplinary multicenter (national) approach in addressing fatal complications in COVID-19
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
Functional results of dynamical gait analysis after 1 year of hobby-athletes with a surgically treated ankle fracture
No full textRetrospectively 20 patients with a surgically treated ankle fracture caused by hobby-accidents were examined clinically and radiologically by a score modified to Phillips after 12 months postoperatively. Further they have taken part in a dynamical gait analysis at the same time. A group of 20 healthy adults was used as a control group comparable to age, sex, height and weight. Although 19 patients out of 20 have achieved a good result at the score evaluation and none of them was clinically noticed with any pathological gait, gait analysis has shown a significant slowed gait speed and a decreased stride lenght. The reduction of the plantarflexor moment at the injured ankle joint immediately following heel contact was yet the most remarkable result of the gait analysis. The changes of gait pattern are interpreted as an adapted and internalized motion pattern caused by pain and behaviour of rest at any time while the mobilisation-phase was going on. It could not document any significant correlation between subjective and clinical parameters and parameters registered by gait analysis. However, a significant correlation of gait-analysed parameters was found between the injured and uninjured side. By dynamical gait analysis it is possible to quantify remarkable gait changes, to obtain objektive data, but also to demonstrate asymmetrical loading and motion that were not clinically detectable previously. It follows that it can be relevant to patients with complaints by leading them to specific physiotherapeutical treatment and gait training so that they would be able to carry on their sports-activities again
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
Response to Dual Antiplatelet Therapy in Patients with Peripheral Artery Occlusive Disease Suffering from Critical Limb Ischemia
No full textBackground: Failure to reach the level of therapeutic anticoagulation represents a risk factor for occlusive events in patients suffering from peripheral arterial disease. Our study aimed to analyze the prevalence of nonresponse to dual antiplatelet therapy in a group of patients admitted to our hospital with critical limb ischemia (CLI) following stent-thrombosis. Methods: This prospective study was approved by the local Ethics Review Board. Patients with critical limb ischemia following stent thrombosis were included if dual antiplatelet therapy consisting of 100 mg aspirin and 75 mg clopidogrel per day had been administered over three months prior to enrollment. The antiaggregatory effects were analyzed using the Multiple Electrode Aggregometry (MEA, Multiplate (R), Roche AG, Grenzach, Germany). The primary endpoints were the area under the aggregation curve (AUC) of the ex-vivo-induced platelet aggregation following stimulation with adenosine diphosphate (ADP, ADPtest) and arachidonic acid (ASPItest). Results: Sixty patients were enrolled in this study. Platelet aggregation was 39.6 (24/54) [median (25th/75th percentile)] U in the ADPtest and 22.4 (13/35) U in the ASPItest. Effective aspirin- and ADP-induced therapeutic inhibition of platelet aggregation was confirmed in 78% and 53% of our patients, respectively. Effective dual platelet inhibition was achieved in 27 patients (45%). A non-response to both of the antiaggregatory drugs was found in 14% of the patients. Conclusions: The results of the present study indicate a high prevalence of nonresponse to antiaggregatory medication in our study collective. Further studies are needed to confirm our hypothesis that individual adjustments of both aspirin and clopidogrel dosages may potentially reduce the incidence of CLI in patients suffering from peripheral arterial occlusive disease.University of Frankfur
Einfluss der Hypothermie und der ischämischen Remote-Präkonditionierung auf neurokognitive Funktionen in der frühen und späten postoperativen Phase bei herzchirurgischen Patienten: Eine prospektiv randomisierte kontrollierte Studie
Full text linkEinfluss der Temperatur der Hypothermie auf das Auftreten einer postoperativen kognitiven Dysfunktion sowie Einfluss der ischämischen Fern-Präkonditionierung bei milder Hypothermie im Vergleich zur tiefen Hypothermi
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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