55,056 research outputs found
The UN-SUSTAINABLE Match in HCV Recipients. Evidences from the Italian D-MELD Study on Balancing Donor-Recipient Risk Factors
No full textThe UN-SUSTAINABLE Match in HCV Recipients. Evidences from the Italian D-MELD Study on Balancing Donor-Recipient Risk Factor
Tagging of Biomedical Articles on CiteULike: A Comparison of User, Author and Professional Indexing
Get PDFThis paper examines the context of online indexing from the viewpoint of three different groups: users, authors, and professional indexers. User tags, author keywords and descriptors were collected from academic journal articles, which were both indexed in Pubmed and tagged on CiteULike, and analysed. Descriptive statistics, informetric measures, and thesaural term comparison shows that there are important differences in the use of keywords between the three groups in addition to similarities which can be used to enhance support for search and browse. While tags and author keywords were found that matched descriptors exactly, other terms which did not match but provided important expansion to the indexing lexicon were found. These additional terms could be used to enhance support for searching and browsing in article databases as well as to provide invaluable data for entry vocabulary and emergent terminology for regular updates to indexing systems. Additionally, the study suggests that tags support organisation by association to task, projects and subject while making important connections to traditional systems which classify into subject categories
Fast identification of biological pathways associated with a quantitative trait using group lasso with overlaps.
Get PDFWhere causal SNPs (single nucleotide polymorphisms) tend to accumulate within biological pathways, the incorporation of prior pathways information into a statistical model is expected to increase the power to detect true associations in a genetic association study. Most existing pathways-based methods rely on marginal SNP statistics and do not fully exploit the dependence patterns among SNPs within pathways.We use a sparse regression model, with SNPs grouped into pathways, to identify causal pathways associated with a quantitative trait. Notable features of our "pathways group lasso with adaptive weights" (P-GLAW) algorithm include the incorporation of all pathways in a single regression model, an adaptive pathway weighting procedure that accounts for factors biasing pathway selection, and the use of a bootstrap sampling procedure for the ranking of important pathways. P-GLAW takes account of the presence of overlapping pathways and uses a novel combination of techniques to optimise model estimation, making it fast to run, even on whole genome datasets.In a comparison study with an alternative pathways method based on univariate SNP statistics, our method demonstrates high sensitivity and specificity for the detection of important pathways, showing the greatest relative gains in performance where marginal SNP effect sizes are small
Pulse oximetry adoption and oxygen orders at paediatric admission over 7 years in Kenya: a multihospital retrospective cohort study
Get PDFObjectives To characterise adoption and explore specific clinical and patient factors that might influence pulse oximetry and oxygen use in low-income and middle-income countries (LMICs) over time; to highlight useful considerations for entities working on programmes to improve access to pulse oximetry and oxygen.
Design A multihospital retrospective cohort study.
Settings All admissions (n=132 737) to paediatric wards of 18 purposely selected public hospitals in Kenya that joined a Clinical Information Network (CIN) between March 2014 and December 2020.
Outcomes Pulse oximetry use and oxygen prescription on admission; we performed growth-curve modelling to investigate the association of patient factors with study outcomes over time while adjusting for hospital factors.
Results Overall, pulse oximetry was used in 48.8% (64 722/132 737) of all admission cases. Use rose on average with each month of participation in the CIN (OR: 1.11, 95% CI 1.05 to 1.18) but patterns of adoption were highly variable across hospitals suggesting important factors at hospital level influence use of pulse oximetry. Of those with pulse oximetry measurement, 7% (4510/64 722) had hypoxaemia (SpO2 <90%). Across the same period, 8.6% (11 428/132 737) had oxygen prescribed but in 87%, pulse oximetry was either not done or the hypoxaemia threshold (SpO2 <90%) was not met. Lower chest-wall indrawing and other respiratory symptoms were associated with pulse oximetry use at admission and were also associated with oxygen prescription in the absence of pulse oximetry or hypoxaemia.
Conclusion The adoption of pulse oximetry recommended in international guidelines for assessing children with severe illness has been slow and erratic, reflecting system and organisational weaknesses. Most oxygen orders at admission seem driven by clinical and situational factors other than the presence of hypoxaemia. Programmes aiming to implement pulse oximetry and oxygen systems will likely need a long-term vision to promote adoption, guideline development and adherence and continuously examine impact
Assessing the scientific integrity of the collected work of one author or author group
No full textObjectives: No published methods for research integrity review include both statistical techniques applied to groups of randomized trials and individual assessment of papers. We propose a method based on practical experience of investigating data integrity across the collected papers of an author or author group. Study Design and Setting: We report our approach to investigating the collected papers of an author or author group suspected of academic misconduct. Results: In the investigation of the work of an author or author group, we recommend a systematic search for the work of the involved authors in PubMed, Google Scholar, and the Retraction Watch database, as well as a search of trial registries for unpublished clinical trials. Summary information from studies should be tabulated to assess consistency between study registration, execution, and publication. Each paper should be investigated for unfeasible features of the governance, methodology, execution, results, and reporting of the study. Pairwise comparison of baseline and outcome tables between papers may reveal data duplication or unfeasibly large differences between baseline characteristics in similar studies. Assessment of baseline characteristics from multiple randomized trials using Carlisle's method can determine whether the data are consistent with a properly executed randomization process, as can checking whether reported baseline characteristics follow expected patterns for random variables such as Benford's law. If serious concerns are raised, a more thorough investigation should be performed by journals, publishers, and institutions. Conclusion: These methods provide a systematic and reproducible way to assess the collected work of an author or group of authors. Plain Language Summary: It is increasingly accepted that papers reporting on clinical studies may contain fraudulent or falsified data, often multiple papers by a single author or author group. Based on our experience assessing the research integrity of collections of papers by one author or author group, we present an approach to these investigations that combines published statistical methods with pragmatic assessment of study feasibility. This will help journals and publishers better identify groups of potentially untrustworthy studies
Assessing the scientific integrity of the collected work of one author or author group
No full textObjectives: No published methods for research integrity review include both statistical techniques applied to groups of randomized trials and individual assessment of papers. We propose a method based on practical experience of investigating data integrity across the collected papers of an author or author group. Study Design and Setting: We report our approach to investigating the collected papers of an author or author group suspected of academic misconduct. Results: In the investigation of the work of an author or author group, we recommend a systematic search for the work of the involved authors in PubMed, Google Scholar, and the Retraction Watch database, as well as a search of trial registries for unpublished clinical trials. Summary information from studies should be tabulated to assess consistency between study registration, execution, and publication. Each paper should be investigated for unfeasible features of the governance, methodology, execution, results, and reporting of the study. Pairwise comparison of baseline and outcome tables between papers may reveal data duplication or unfeasibly large differences between baseline characteristics in similar studies. Assessment of baseline characteristics from multiple randomized trials using Carlisle’s method can determine whether the data are consistent with a properly executed randomization process, as can checking whether reported baseline characteristics follow expected patterns for random variables such as Benford’s law. If serious concerns are raised, a more thorough investigation should be performed by journals, publishers, and institutions. Conclusion: These methods provide a systematic and reproducible way to assess the collected work of an author or group of authors.Jeremy Nielsena, Esmée M. Bordewijka, Lyle C. Gurrinc, Siddharth Shivanthad, Madeline Flanagana, Sue Liud, May M. Linna, Kelly X. Zhoua, Rik van Eekelenb, Nicholas J.L. Browne, Jim Thorntonf, Ben W. Mo
Examining which clinicians provide admission hospital care in a high mortality setting and their adherence to guidelines: An observational study in 13 hospitals
Get PDFBackground:
We explored who actually provides most admission care in hospitals offering supervised experiential training to graduating clinicians in a high mortality setting where practices deviate from guideline recommendations.
Methods:
We used a large observational data set from 13 Kenyan county hospitals from November 2015 through November 2018 where patients were linked to admitting clinicians. We explored guideline adherence after creating a cumulative correctness of Paediatric Admission Quality of Care (cPAQC) score on a 5-point scale (0–4) in which points represent correct, sequential progress in providing care perfectly adherent to guidelines comprising admission assessment, diagnosis and treatment. At the point where guideline adherence declined the most we dichotomised the cPAQC score and used multilevel logistic regression models to explore whether clinician and patient-level factors influence adherence.
Results:
There were 1489 clinicians who could be linked to 53 003 patients over a period of 3 years. Patients were rarely admitted by fully qualified clinicians and predominantly by preregistration medical officer interns (MOI, 46%) and diploma level clinical officer interns (COI, 41%) with a median of 28 MOI (range 11–68) and 52 COI (range 5–160) offering care per study hospital. The cPAQC scores suggest that perfect guideline adherence is found in ≤12% of children with malaria, pneumonia or diarrhoea with dehydration. MOIs were more adherent to guidelines than COI (adjusted OR 1.19 (95% CI 1.07 to 1.34)) but multimorbidity was significantly associated with lower guideline adherence.
Conclusion:
Over 85% of admissions to hospitals in high mortality settings that offer experiential training in Kenya are conducted by preregistration clinicians. Clinical assessment is good but classifying severity of illness in accordance with guideline recommendations is a challenge. Adherence by MOI with 6 years’ training is better than COI with 3 years’ training, performance does not seem to improve during their 3 months of paediatric rotations
Effectiveness of brief schema group therapy for borderline personality disorder symptoms : a randomized pilot study
Get PDFBackground and objectives Schema group therapy is a potentially cost-effective treatment for borderline personality disorder (BPD). We piloted the feasibility and effectiveness of a 20-session schema group therapy without individual therapy among psychiatric BPD outpatients in a randomized pilot study registered as a clinical trial (ISRCTN76381242). Methods Altogether 42 psychiatric outpatients diagnosed with BPD were randomized 2:1 to a 20-session weekly schema group therapy plus treatment as usual (TAU) (n = 28) vs. a control group with TAU alone (n = 14). The primary outcome was decline of BPD symptoms in the short Borderline Symptom List (BSL-23) score. Secondary outcomes were decline in symptoms of anxiety, depression, alcohol use, and improvement in functioning and schema modes. Two external experts evaluated validity of the intervention based on videotaped sessions. Results Overall, 23 schema group therapy patients (82%) and 12 controls (86%) completed their treatment. Treatment validity good or very good. However, no significant differences emerged in the primary outcome mean BSL-23 decline (6.95 [SE 5.91] in group schema therapy vs. 12.55 [4.85] in TAU) or in any of the secondary outcome measures. Limitations Despite randomization, the TAU subgroup had non-significantly higher baseline scores in most measures. Small sample size predisposing to type II errors; reliance on self-reported outcomes. Conclusions Schema group therapy was feasible for psychiatric outpatients with BPD. However, in this small pilot study we did not find it more effective than TAU. Effectiveness of this short intervention remains open.Peer reviewe
A Connectionist and Multivariate Approach to Science Maps: Som, Clustering and Mds Applied to Library & Information Science Research.
Get PDFThe visualization of scientific field structures is a classic of scientometric studies. This paper presents a domain analysis of the library and information science discipline based on author co-citation analysis (ACA) and journal cocitation analysis (JCA). The techniques used for map construction are the self-organizing map (SOM) neural
algorithm, Ward’s clustering method and multidimensional
scaling (MDS). The results of this study are compared with
similar research developed by Howard White and Katherine
McCain [1]. The methodologies used allow us to confirm that
the subject domains identified in this paper are, as well,
present in our study for the corresponding period. The appearance of studies pertaining to library science reveals
the relationship of this realm with information science.
Especially significant is the presence of the management on the journal maps. From a methodological standpoint, meanwhile, we would agree with those authors who consider
MDS, the SOM and clustering as complementary methods
that provide representations of the same reality from different analytical points of view. Even so, the MDS representation is the one offering greater possibilities for the structural representation of the clusters in a set of variables
Antifungal susceptibility profiles of Candida isolates from a prospective survey of invasive fungal infections in Italian intensive care units
No full textThe antifungal susceptibility pattern of 302 Candida isolates collected during an Italian survey on invasive fungal infections in an intensive care setting was investigated. The results were correlated with some epidemiological data and compared with the antifungal profiles obtained in a previous survey. No resistance to echinocandins was detected. The overall resistance levels to fluconazole, posaconazole and voriconazole were 12.6, 6.0 and 7.1 %, respectively. Candida tropicalis and Candida parapsilosis accounted for more than half of all the fluconazole resistant isolates. Reduced susceptibility to fluconazole is not uncommon among isolates (12.3 %) and appears to be increasing, particularly among C. parapsilosis isolates, which showed an increase in resistant isolates from 2 % in the 1990s to 25.8 % in the present study. Routine antifungal susceptibility testing of this species is therefore recommended
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