1,720,973 research outputs found
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
Fluid therapy in mechanically ventilated critically ill children: the sodium, chloride and water burden of fluid creep
Full text linkBackground: Fluid therapy is a cornerstone of pediatric intensive care medicine. We aimed at quantifying the load of water, sodium and chloride due to different fluid indications in our pediatric intensive care unit (PICU). We were particularly interested in the role of fluid creep, i.e. fluid administered mainly as the vehicle for drugs, and the association between sodium load and water balance.
Methods: Critically ill children aged ≤3 years and invasively ventilated for ≥48 h between 2016 and 2019 in a single tertiary center PICU were retrospectively enrolled. Need for renal replacement therapy, plasmapheresis or parenteral nutrition constituted exclusion criteria. Quantity, quality and indication of fluids administered intravenously or enterally, urinary output and fluid balance were recorded for the first 48 h following intubation. Concentrations of sodium and chloride provided by the manufacturers were used to compute the electrolyte load.
Results: Forty-three patients (median 7 months (IQR 3-15)) were enrolled. Patients received 1004 ± 284 ml of water daily (153 ± 36 ml/kg/day), mainly due to enteral (39%), creep (34%) and maintenance (24%) fluids. Patients received 14.4 ± 4.8 mEq/kg/day of sodium and 13.6 ± 4.7 mEq/kg/day of chloride, respectively. The majority of sodium and chloride derived from fluid creep (56 and 58%). Daily fluid balance was 417 ± 221 ml (64 ± 30 ml/kg/day) and was associated with total sodium intake (r2 = 0.49, p < 0.001).
Conclusions: Critically ill children are exposed, especially in the acute phase, to extremely high loads of water, sodium and chloride, possibly contributing to edema development. Fluid creep is quantitatively the most relevant fluid in the PICU and future research efforts should address this topic in order to reduce the inadvertent water and electrolyte burden and improve the quality of care of critically ill children
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
Effectiveness in pain control of ropivacaine and levobupivacaina during continuous epidural infusion: a prospective, randomized, double blind controlled trial
No full textAppropriate 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
Nutritional requirements and gas-exchange: is it possible to perform indicrect calorimetry in children undergoing nasal CPAP?
No full textIntroduction. Nutrition plays a pivotal role in critically ill children and personalized nutritional therapy requires the measurement of resting energy expenditure (REE) [1-2]. Indirect calorimetry (IC) is the gold standard for REE assessment and is based on VO2 and VCO2 measurements. Furthermore, IC provides information on carbohydrates/lipids consumption by defining the respiratory quotient (RQ). In spontaneously breathing patients, IC is performed using a transparent helmet (Canopy mode). The helmet is placed on patients’ head and is connected to the calorimeter through a tube. An aspiration flow generated by the calorimeter allows gas collection and analysis. In mechanically ventilated patients, the measurements are performed connecting IC analyzers to
the ventilator circuit. However, while IC is validated for spontaneously breathing and mechanically ventilated patients, it is not for patients undergoing CPAP (continuous positive airway pressure) [3]. This limitation is of great clinical relevance, as the use of CPAP and other non-invasive modes of ventilation is increasing in the pediatric intensive care units (PICUs).
The aim of the present study is therefore to validate IC in children undergoing nasal CPAP (n-CPAP) by comparing IC results obtained during spontaneous breathing with data gathered during n-CPAP.
Methods. Patients (age <6 years) admitted to our PICU from February to May 2019 and treated with n-CPAP were enrolled. Patients were studied during the weaning phase, i.e., once they were able to maintain spontaneous breathing in room air. In order to test the validity of IC during n-CPAP, two measurements were performed in Canopy mode for 20 minutes, in randomized order with the following settings: 1) Spontaneous breathing (SB), 2) n-CPAP of 4 cmH2O. A turbine-driven ventilator with a single-limb circuit and a vented nasal mask was used to deliver n-CPAP. Of note, in this way, both intentional and non-intentional leaks remained in the canopy helmet.
Total minute flow delivered by the ventilator was measured by a Fleisch pneumotachograph connected to the respiratory circuit, in order to personalize the aspiration flow setting [4]. Average values for VCO2, VO2, RQ and REE were obtained in these two conditions. Comparison between groups was performed via paired t-test.
Agreement was assessed via Bland-Altman analysis. Statistical significance was defined as p<0.05.
Results. Five patients (median age 16 months, IQR 9 months, median weight 8.5 kg, IQR 0.6 kg) were enrolled.
All patients were in resting state during both measurements, thus allowing for standardized conditions. VCO2, VO2, RQ and REE did not differ significantly between groups. Bias and Limits of Agreement (LOA) indicate a good agreement between the two measures (Table 1).
Conclusions. Our preliminary data suggest that IC can be accurately performed in children undergoing n-CPAP using a single limb circuit with intentional leaks. These results need to be confirmed on a broader cohort of critically ill children.
References
1. De Cosmi V et al. Nutrients. 2017
2. Mehta NM et al. Pediatr Crit Care Med. 2017
3. Taku Oshima et al. Clinical Nutr. 2017
4. Smallwood CD et al. J Parenter Enteral Nutr. 201
Gas-exchange and resting energy expenditure measurement with indirect calorimetry in children supported with non-invasive ventilation
No full textIntroduction. Nutrition plays a fundamental role in critically ill children and personalized nutritional therapy requires the measurement of resting energy expenditure (REE) [1-2]. Indirect calorimetry (IC) is the gold standard for REE assessment and is based on VO2 and VCO2 measurements. Furthermore, IC provides information on carbohydrates/lipids consumption by defining the respiratory quotient (RQ). However, while IC is validated for spontaneously breathing and mechanically ventilated patients, it is not for patients undergoing non-invasive ventilation (NIV) [3].
Aim of the study is therefore to validate IC for children undergoing NIV by comparing IC results obtained during spontaneous breathing with data gathered during NIV-CPAP (continuous positive airway pressure).
Methods. Patients (age <6 years) admitted to our pediatric intensive care unit (PICU) and weaning from NIV-CPAP were enrolled. Two IC measurements (Canopy mode) were performed for 20 minutes in randomized order in the following conditions: 1) Spontaneous breathing (SB), 2) NIV-CPAP (performed by single-limb circuit and vented mask). Average values for VCO2 , VO2, RQ and REE were obtained in the two conditions. Comparison between groups was performed via paired t-test. Agreement was assessed via Bland-Altman analysis. Statistical significance was defined as p<0.05.
Results. Four patients (median age 8 months, median weight 8 kg) were enrolled. VCO2 , VO2, RQ and REE did not differ significantly between groups. Limits of agreement (LOA) and BIAS indicate a good agreement between the two measures (Table 1).
Conclusions. Our preliminary data suggest that IC can be accurately performed in children undergoing NIV using a single limb circuit with intentional leaks. These results need to be confirmed on a broader cohort of critically ill children.
References
1. De Cosmi V et al. Nutrients. 2017, 18:9
2. Mehta NM et al. Pediatr Crit Care Med. 2017, 18:675-715
3. Taku Oshima et al. Clinical Nutr 2017; 36:651-66
Intraperitoneal Nebulization of Ropivacaine for Pain Control After Laparoscopic Surgery: a Dose Finding Study
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