1,721,261 research outputs found
Prognostic evaluation of heart failure in women: insight from the MECKI score database
Full text linkBackground: Heart failure is a multi-organ disease often associated with comorbidities. Heart failure in women assumes extremely peculiar characteristics. The pathophysiology of the damage is profoundly different; the endothelial dysfunction, the damage to the microcirculation and the comorbidities that cause chronic heart failure are in fact frequently associated with a type of decompensation that has a better ejection fraction than those in the male population. Symptoms are often vague and not "typical", which often delays diagnosis, bringing patients to the doctor's attention only belatedly. This aspect frequently leads to having a much older age than the male gender at diagnosis, which determines higher co-pathology degree and polypharmacy. In this situation, female patients are highly exposed to risk of iatrogenic damage and poor compensation and therapeutic unsuccess. Age is often a limiting factor also for enrollment in clinical trials, which therefore frequently have a gender-related bias.
To identify the prognosis, it is necessary to take into account several variables. The cardiopulmonary test allows a comprehensive assessment of the patient during physical activity as physical exercise involves the cardiovascular, hematopoietic, sympathetic/parasympathetic, neuro-hormonal, respiratory and motor systems. The oxygen consumption at the peak and at the anaerobic threshold mainly depend on the cardiovascular and motor systems while the VE/VCO2 is an index not only of ventilatory efficiency and of the ventilation/perfusion mismatch of the lung, but also of activation of metabo- and chemoreceptors.
The proposed risk scores are very numerous but mostly based on data obtained in male populations. Few use the cardiopulmonary exercise test. Among these, the Metabolic Exercise Cardiac Kidney Indexes -MECKI score- was obtained by evaluating about 80 variables of which 6 have independent prognostic significance: hemoglobin, natremia, renal function (MDRD), left ventricular ejection fraction (LVEF), oxygen consumption at the peak of the exercise [%] and VE/VCO2 slope. The MECKI score demonstrated in patients with systolic heart failure, considering the combined cardiovascular death, urgent heart transplant and LVAD as an end-point, AUC = 0.804 (0.754-0.852) at 1 year, 0.789 (0.750-0.828) at 2 years, 0.762 (0.726-0.799) at 3 years and 0.760 (0.724-0.796) at 4 years.
Aim of the study: identify parameters and variables which could be associated to a different prognosis in men and women enrolled in the MECKI Score database. Thus, the objectives of the present study: 1) achievement in 2 years of at least 7000 cases with about 1400 cases of female gender; 2) evaluation of the prognosis in systolic heart failure in the female gender, differentiating by: a) etiology (ischemic non-ischemic), b) presence/absence of atrial fibrillation, c) presence of CRT, d)
presence/absence of diabetes/hypertension/dyslipidemia; 3) evaluation in the female gender of the prognostic cut-offs of the variables that generate the MECKI score.
Results: In reviewing the MECKI Score database, numerous, mostly expected, gender differences emerged which reinforce the initial hypothesis. In the population examined, there is no substantial difference in age, women have, although overweight, a lower BMI than men, a better LVEF, significant differences in renal function and hemoglobin concentration (these parameters are already corrected for sex); no difference in terms of natremia. Other differences were observed about pharmacological therapy among the two groups.
Kaplan-Meier survival curves showed that the MECKI Score is accurate in predicting the risk also in the female population, as there are no overall differences in the prevalence of events in the two sexes at two years. Differences in survival curves begin to be observed over longer follow-up periods.
Conclusions: gender-specific characteristics have a critical impact on heart failure in women and it should be valuable to concentrate future analysis for the identification of any specific subpopulation that have peculiarities that can impact on the prognosis. However, the MECKI Score maintains its prognostic power at two years follow up, even in the female population, guaranteeing appropriate clinical and therapeutic choices
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
Kinetics of plasma SPB and RAGE during mechanical ventilation in patients undergoing major vascular surgery.
No full textReceptor-of-Advanced-Glycation-End-products (RAGE) and Surfactant-Protein-type-B (SPB) are reported as lung injury markers. Unlike SPB, RAGE is secreted by several tissues, so that RAGE specificity as lung injury marker is questionable. We measured SPB and RAGE in 19 patients undergoing major vascular abdominal surgery. SPB and RAGE were measured before mechanical ventilation (T 0), at 1st (T 1), 2nd (T 2) and, when present, 3rd (T 3) hour of mechanical ventilation, and 1h after extubation (T POST). Last data during mechanical ventilation, either T 2 or T 3, are reported as T END. SPB and RAGE values were normalized for total protein (SPB N and RAGE N). SPB N and RAGE N increments from T 0 to T END were 56.2 [39.1] ng/mg (mean [75-25 percentile]) and 10.6[7.1] pg/mg, respectively. SPB values increased progressively during mechanical ventilation, whereas RAGE values increased at T 1 but not thereafter. SPB N increase (T END-T 0), but not RAGE N, was related to ΔPaO 2/FiO 2 changes during mechanical ventilation (r=0.575, p=0.01). Plasma RAGE N and SPB N kinetics in patients undergoing major vascular surgery are different
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
Effetto della terapia beta-bloccante sulla cinetica dell’uptake dell’ossigeno in pazienti affetti da scompenso cardiaco cronico in condizioni di normossia ed ipossia
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