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Prognostic factors in Chronic Inflammatory Diseases:A PhD study within clinical epidemiology
Get PDFBaggrund: Kroniske inflammatoriske sygdomme (CIDs) associeret med en vestlig livsstil inkluderer Crohn’s sygdom, colitis ulcerosa, reumatoid artrit, axial spondylartrit, psoriasis artrit og psoriasis, der alle er tæt relaterede. De er en stor byrde for patienterne og sundhedssystemet og er desværre ikke mulige at kurere. Derfor er målet med behandlingen af disse sygdomme at dæmpe symptomer og forhindre sygdomsforværring og komplikationer. Biologiske lægemidler har revolutioneret behandlingen af CIDs, men succes raten er langt fra optimal.Formål: Det overordnede formål for dette Ph.d. projekt var derfor at forbedre behandlingen af disse sygdomme ved at identificere prognostiske kost faktorer og sikre troværdig evidens. Formålene for de enkelte studier var:I. At undersøge om behandlingsrespons til biologiske lægemidler var associeret med det relative indtag af kostfibre og rødt og forarbejdet kød i patienter med CIDs II. At identificere og karakterisere kostmønstre blandt patienter med CIDs and undersøge om patient karakteristika var associeret med disse mønstre III. At undersøge indflydelsen af patient frafald i randomiserede kliniske forsøg af patienter med CIDs behandlet med biologiske og syntetiske targeterede lægemidler Metode: Patienter med CIDs der skulle opstarte i biologisk behandling blev løbende inkluderet i en prospektiv kohorte. De gennemgik en klinisk undersøgelse inden opstart og efter 14-16 ugers behandling for at vurdere sygdoms aktivitet. Inden behandlingsstart besvarede de et kostspørgeskema hvorfra vi kunne estimere deres kost indtag. Baseret på de longitudinelle data fra kohorten (studie I) undersøgte vi om behandlingsrespons til de biologiske lægemidler var associeret med indtag af kostfibre og rødt og forarbejdet kød ved at opdele patienterne i to grupper baseret på fibre/kød ratioen (en gruppe med højt fibre- og lavt rødt/forarbejdet kød indtag og en gruppe med det modsatte).I en tværsnits analyse af baseline data (studie II) identificerede og karakteriserede vi kostmønstre og de dertil hørende patienter ved hjælp af specifikke statistiske analyser (eksploratorisk faktor analyse, latent profil analyse og deskriptive analyser).I et meta-epidemiologisk studie (studie III) samlede vi randomiserede forsøg, der undersøgte effekten af biologiske og targeterede syntetiske lægemidler til behandling af CIDs. Fra disse indsamlede vi information om behandlingseffekt og patient frafald. Vi kombinerede studierne ved hjælp af metaregressions modeller hvorved vi kunne analysere om frafald og behandlingsrespons var associeret og derved få et mål for frafalds indflydelse på studieresultaterne.Resultater I studie I fandt vi ud af, at et højt indtag af kostfibre i kombination med et lavt indtag af rødt og forarbejdet kød ikke var associeret med behandlingsrespons på tværs af de seks sygdomme (OR=1.48, 95% konfidens interval 0.72-3.05). Men vores resultater indikerede, at der var en gavnlig effekt blandt patienter med reumatoid artrit (OR=9.84, 1.35-71.56). I studie II identificerede vi tre kostmønstre (’Kød og Salt’, ’Grønt’ og ’Blandet’), som varierede i de ernærings-relaterede men ikke i de patient-relaterede karakteristika. Fælles for alle tre kostmønstre var at indtaget af specifikke næringsstoffer og fødevarer var enten for højt eller for lavt som typisk for den vestlige kost.I studie III fandt vi en høj grad af differentieret frafald mellem interventions og kontrol grupperne (OR=0.45, 0.41-0.50) i de randomiserede studier med mere frafald blandt kontrol grupperne. Odds for behandlingseffekt var 4.39 gange højere i interventionsgrupperne (OR=3.94-4.89). Dette estimat var negativt associeret med estimatet for differentieret frafald, hvilket betyder, at studier med et højere frafald i kontrol gruppen viste bedre estimater for behandlingseffekt.Konklusion: Patienterne med CIDs spiste generelt ikke svarende til anbefalingerne for sund kost, og kostmønstre blandt dem var ikke forbundet med en bestemt patient fænotype. Et højt kostfiber- og lavt rødt/forarbejdet kød indtag var ikke prognostisk for bedre behandlingsrespons på tværs af de seks CIDs, men viste et potentiale for patienter med reumatoid artrit, hvilket kræver yderligere bekræftelse i randomiserede forsøg.Målrettede kostændringer som en del af behandlingen af CIDs har et lovende potentiale, men der er brug for evidens-baserede retningslinjer. For at skabe denne evidens base er det vigtigt at vurdere den eksisterende evidens kritisk, hvilket bl.a. involverer en vurdering af om patient frafald har indflydelse på resultaterne.Background: Chronic inflammatory diseases (CIDs) associated with the Western lifestyle include Crohn’s disease, ulcerative colitis, rheumatoid arthritis, axial spondyloarthritis, psoriatic arthritis and psoriasis and are all closely related. These diseases are a considerable burden for patients and society; unfortunately, there is no cure. Thus, the therapeutic goal is to relieve symptoms and prevent disease progression and morbidity. Biological disease-modifying drugs have revolutionised the treatment of CIDs, but remission rates are less than optimal.Aim: Therefore, the generic aim of this PhD was to improve the treatment of these CIDs by identifying dietary prognostic factors and ensuring trustworthy evidence. The aims of the individual studies were: I. To investigate if the treatment response of biological therapy is associated with habitual dietary intakes of fibre and red/processed meat in patients with CIDs II. To identify and characterise dietary patterns among patients with CIDs and investigate whether patient characteristics were associated with these patterns III. To explore the impact of attrition rates in randomised trials of patients with CIDs treated with biological and targeted synthetic disease-modifying drugsMethods: We prospectively enrolled patients with one of the six CID diagnoses and a plan to initiate biological therapy. The patients were clinically assessed before and after 14-16 weeks of treatment. At baseline, patients completed a food frequency questionnaire enabling estimation of habitual dietary intake. Based on the cohort’s longitudinal data, we stratified patients into two groups determined by the ratio of fibre to red/processed meat (a high fibre/low meat group and a low fibre/high meat group) to compare the proportion of clinical response after 14-16 of treatment (study I).In a cross-sectional analysis of the baseline data, we identified and characterised dietary patterns and the dietary pattern membership for each patient using explorative factor, latent profile and descriptive analyses (study II).In a meta-epidemiological study, we synthesised randomised trials testing the effect of biological and synthetic targeted disease-modifying drugs in patients with CIDs (study III). We extracted information on treatment effects and attrition and combined the trials using meta-regression models to analyse the associations between treatment effects and attrition.ResultsIn study I, we found that a high intake of ‘dietary fibre and low intake of red/processed meat’ was not associated with better treatment response across the group of CIDs (OR=1.48, 95% CI 0.72 to 3.05). However, the results indicated a beneficial effect among rheumatoid arthritis patients (OR=9.84, 1.35 to 71.56). In study II, we identified and characterised three dietary patterns, i.e., the ‘Meat and Salt’, the ‘Vegetables’ and the ‘Mixed’ dietary pattern, which varied in nutrient profiles but were similar in patient characteristics. Common for all three patterns were excessive and deficient intake of nutrients typical of the Western diet.In study III, differential attrition prevailed among randomised trials, with more attrition in control than intervention groups (OR=0.45, 0.41 to 0.50). The odds of treatment benefit were 4.39 (3.94 to 4.89) higher in the intervention groups. This estimate was inversely associated with the OR for differential attrition, meaning that trials with the most attrition in the control groups were connected to better treatment effect estimates.Conclusion: In conclusion, CID patients do not generally eat according to recommendations for healthy eating and prevailing dietary patterns among them were not associated with specific phenotypes. A high intake of fibre in combination with a low intake of red/processed meat did not affect the clinical response to biological treatment across the six CIDs but showed a beneficial effect among RA patients, warranting confirmation in randomised trials. Targeting diet as one of the modifiable risk factors for treating CIDs has promising potentials, but evidence-based guidelines are urgently needed. The validity of research findings must be critically appraised to establish such an evidence base, which encompasses assessing the risk of attrition bias, including evaluating the presence of differential attrition. <br/
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
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
Author-wise bibliometric analysis based on entropy.
No full textAuthor-wise bibliometric analysis based on entropy.</p
Author Under Sail The Imagination of Jack London, 1893-1902
No full textIn Author Under Sail, Jay Williams offers the first complete literary biography of Jack London as a professional writer engaged in the labor of writing. It examines the authorial imagination in London's work, the use of imagination in both his fiction and nonfiction, and the ways he defined imagination in the creative process in his business dealings with his publishers, editors, and agents. In this first volume of a two-volume biography, Williams traverses the years 1893 to 1902, from London's "Story of a Typhoon" to The People of the Abyss. The Jack London who emerges in the pages of Author Under Sail is a writer whose partnership with publishers, most notably his productive alliance with George Brett of Macmillan, was one of the most formative in American literary history. London pioneered many author models during the heyday of realism and naturalism, blurring the boundaries of these popular genres by focusing on absorption and theatricality and the representation of the seen and unseen. London created an impassioned, sincere, and extremely personal realism unlike that of other American writers of the time. Author Under Sail is a literary tour de force that reveals the full range of London as writer, creative citizen, and entrepreneur at the same time it sheds light on the maverick side of machine-age literature.Intro -- Title Page -- Copyright Page -- Dedication -- Contents -- Acknowledgments -- Introduction -- 1. Spirit Truth -- 2. From Absorption to Theatricality and Back Again -- 3. "I Will Build a New Present" -- 4. Sons as Authors -- 5. Fathers as Publishers -- 6. The Daughter as Author -- 7. Lovers as Authors -- 8. At Sea with the Family -- 9. Yellow News, Yellow Stories -- 10. The Return Home -- Notes -- Bibliography -- Index -- About Jay WilliamsIn Author Under Sail, Jay Williams offers the first complete literary biography of Jack London as a professional writer engaged in the labor of writing. It examines the authorial imagination in London's work, the use of imagination in both his fiction and nonfiction, and the ways he defined imagination in the creative process in his business dealings with his publishers, editors, and agents. In this first volume of a two-volume biography, Williams traverses the years 1893 to 1902, from London's "Story of a Typhoon" to The People of the Abyss. The Jack London who emerges in the pages of Author Under Sail is a writer whose partnership with publishers, most notably his productive alliance with George Brett of Macmillan, was one of the most formative in American literary history. London pioneered many author models during the heyday of realism and naturalism, blurring the boundaries of these popular genres by focusing on absorption and theatricality and the representation of the seen and unseen. London created an impassioned, sincere, and extremely personal realism unlike that of other American writers of the time. Author Under Sail is a literary tour de force that reveals the full range of London as writer, creative citizen, and entrepreneur at the same time it sheds light on the maverick side of machine-age literature.Description based on publisher supplied metadata and other sources.Electronic reproduction. Ann Arbor, Michigan : ProQuest Ebook Central, YYYY. Available via World Wide Web. Access may be limited to ProQuest Ebook Central affiliated libraries
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