1,721,032 research outputs found
Iron deficiency is related to low functional outcome in patients at early rehabilitation after acute stroke
No full textAbstract Background Iron deficiency (ID) is a common co‐morbidity in patients with cardiovascular disease and contributes to impaired functional capacity. The relevance of ID in patients in recovery after acute stroke is not known. We assessed the prevalence of ID and anaemia in relation to functional capacity and to recovery during early rehabilitation after stroke. Methods This observational study enrolled consecutively 746 patients with ischaemic or haemorrhagic stroke at in‐patient early rehabilitation (age 68 ± 13 years, female 47%, ischaemic stroke 87%). Functional capacity was assessed before and after rehabilitation using Barthel index (reha‐BI), motricity index (MI), trunk control test (TCT), and functional ambulatory category (FAC). ID was defined as ferritin 5 mg/L. Anaemia was defined as Hb < 12 g/dL (women) and <13 g/dL (men). Results The prevalence of ID and anaemia before rehabilitation were 45% and 46%, respectively, and remained high at discharge (after 27 ± 17 days) at 40% and 48%, respectively. Patients with ID had lower functional capacity compared with patients without ID (reha‐BI 20 [±86] vs. 40 [±80], MI 64 [±66] vs. 77 [±41], TCT 61 [±76] vs. 100 [±39], FAC 1 [±4] vs. 4 [±4]; median [IQR], all P < 0.001). ID was related to inflammation (OR 2.68 [95% CI 1.98–3.63], P < 0.001), female sex (OR 2.13 [95% CI 1.59–2.85], P < 0.001), haemorrhagic stroke (OR 1.70 [95% CI 1.11–2.61], P = 0.015), initial treatment on stroke unit (OR 3.59 [95% CI 1.08–11.89], P < 0.001), and anaemia (OR 2.94 [95% CI 2.18–3.96], P < 0.001), while age, BMI, and renal function were not related to ID. In adjusted analysis, ID was associated with low functional capacity in all functional scores: reha‐BI (OR 1.66 [95% CI 1.08–2.54], P = 0.02), motricity index (OR 1.94 [95% CI 1.36–2.76], P < 0.001), trunk control test (OR 2.34 [95% CI] 1.64–3.32, P < 0.001) and functional ambulatory category (OR 1.77 [95% CI 1.2–2.63], P < 0.02). Functional capacity improved during rehabilitation regardless of presence of ID, but functional outcome remained significantly lower in patients with ID at the end of rehabilitation (rehab BI and MI, both P < 0.001). Conclusions Iron deficiency and anaemia are common and persistent findings in patients after acute stroke. ID and anaemia are independently related to lower functional capacity after acute stroke and to poor functional outcome after rehabilitation. Regular assessment of iron status may identify patients at risk of low functional recovery
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
Clinical correlates and prognostic impact of neurologic disorders in Takotsubo syndrome
Full text linkCardiac alterations are frequently observed after acute neurological disorders. Takotsubo syndrome (TTS) represents an acute heart failure syndrome and is increasingly recognized as part of the spectrum of cardiac complications observed after neurological disorders. A systematic investigation of TTS patients with neurological disorders has not been conducted yet. The aim of the study was to expand insights regarding neurological disease entities triggering TTS and to investigate the clinical profile and outcomes of TTS patients after primary neurological disorders. The International Takotsubo Registry is an observational multicenter collaborative effort of 45 centers in 14 countries (ClinicalTrials.gov, identifier NCT01947621). All patients in the registry fulfilled International Takotsubo Diagnostic Criteria. For the present study, patients were included if complete information on acute neurological disorders were available. 2402 patients in whom complete information on acute neurological status were available were analyzed. In 161 patients (6.7%) an acute neurological disorder was identified as the preceding triggering factor. The most common neurological disorders were seizures, intracranial hemorrhage, and ischemic stroke. Time from neurological symptoms to TTS diagnosis was <= 2 days in 87.3% of cases. TTS patients with neurological disorders were younger, had a lower female predominance, fewer cardiac symptoms, lower left ventricular ejection fraction, and higher levels of cardiac biomarkers. TTS patients with neurological disorders had a 3.2-fold increased odds of in-hospital mortality compared to TTS patients without neurological disorders. In this large-scale study, 1 out of 15 TTS patients had an acute neurological condition as the underlying triggering factor. Our data emphasize that a wide spectrum of neurological diseases ranging from benign to life-threatening encompass TTS. The high rates of adverse events highlight the need for clinical awareness
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
Acute complications after ischemic stroke
No full textAkute Komplikationen beeinträchtigen die Prognose nach einem ischämischen
Schlaganfall entscheidend. In den vorgestellten Studien wurden Einflussgrößen
auf neurologische und kardiale Komplikationen bei Patienten mit ischämischem
Schlaganfall untersucht. Im Rahmen einer Thrombolysetherapie wird bei etwa
2-10% aller Patienten eine symptomatische intrazerebrale Blutung (sICB)
beobachtet. Bei Patienten mit multiplen zerebralen Mikroblutungen treten sICBs
deutlich häufiger auf, so dass bei diesen Patienten eine strenge Risiko-Nutzen
Bewertung erfolgen und sehr sorgfältig auf Blutdruckentgleisungen während der
Therapie reagiert werden sollte. Eine vorbestehende Statinbehandlung scheint
das Risiko einer sekundären ICB in der Frühphase nach einem ischämischen
Schlaganfall nicht signifikant zu beeinflussen, und zwar unabhängig ob eine
Behandlung mit rtPA durchgeführt wurde. Eine frühe Statinbehandlung innerhalb
der ersten drei Tage nach dem Insult erhöht das Risiko subakuter ICBs nicht
und ist möglicherweise mit einem besseren funktionellen Outcome verbunden.
Frühe Rezidivereignisse während der ersten 5-7 Tage nach dem initialen
Schlaganfallereignis treten bei etwa 1% der Patienten auf und sind damit
seltener als in historischen Kohorten. Besonders bei einer TIA in der
Anamnese, bei einer ipsilateralen Karotisstenose und seltenerer
Schlaganfallursachen wie Dissektionen oder Vaskulitiden sollte an die Gefahr
früher Rezidivereignisse gedacht werden.Die aktuellen Zertifizierungskriterien
für Stroke Units messen daher zu Recht der frühen Gefäßdarstellung während des
Stroke Unit Aufenthaltes einen hohen Stellenwert bei. Zudem waren Patienten
mit Pneumonien in der Akutphase besonders gefährdet ein frühes Rezidiv zu
bekommen, was die Bedeutung eines aufmerksamen Dysphagie-Screenings in den
ersten Tagen nachdem Akutereignis unterstreicht. Pathologisch erhöhte Werte
des kardialen Biomarkers Troponin T als spezifisches Zeichen einer
koinzidenten Myokardschädigung lassen sich, je nach verwendetem Assay, bei 15-
50% aller Patienten mit akutem ischämischen Schlaganfall nachweisen. Bereits
geringe Troponin-Erhöhungen sind mit einem schlechteren Outcome verbunden.
Insbesondere eine Dynamik der Troponin-Werte in seriellen Messungen zeigt ein
erhöhtes Risiko an, während der Akutphase nach dem ischämischen Hirninfarkt zu
versterben. Die Pathogenese von Troponin-Erhöhungen ist nach einem
ischämischen Schlaganfall in der Regel anders als bei Patienten mit ACS.
Mehrheitlich haben Schlaganfallpatienten mit Troponin-Erhöhungen keine akuten
koronaren Läsionen. Dennoch lassen die koronarangiographischen Befunde bei
immerhin fast einem Viertel der betroffenen Patienten eine koronar-vermittelte
Myokardischämie als Ursache der Troponin-Erhöhung vermuten. Weitere
Untersuchungen sind dringend notwendig, um diese Patienten frühzeitig zu
erkennen und therapeutische Maßnahmen einzuleiten.Occurrence of complications early after ischemic stroke is strongly associated
with poor outcome. The analyses summarized in this ‘Habilitationsschrift’ aim
to identify predictors of neurologic and cardiac complications following acute
ischemic stroke. Symptomatic intracerebral hemorrhage (sICH) can be observed
in about 2-10% of patients treated with intravenous thrombolysis. Patients
with evidence of multiple cerebral microbleeds on pre-treatment T2* MRI had a
high risk of sICH following thrombolysis. Careful evaluation of risks and
benefits of thrombolysis is warranted in these patients and blood pressure
violations should be avoided. Prior treatment with statins did not
significantly affect risk of sICH early after stroke, regardless of
thrombolytis. Initiation of early statin treatment within three days after
stroke did not increase the risk of subsequent ICH and probably improves long-
term functional outcome Early recurrent stroke within 5-7 days after the index
event was observed in approximately 1% of patients. This was less often
compared with historical cohorts. Having a history of TIA, an ipsilateral
carotid stenosis, or other determined causes of stroke like dissection or
vasculitis were associated with early recurrent ischemic stroke. The emphasis
on early vascular imaging of current German recommendations for Stroke Unit
certification can be justified by these findings. Also patients with pneumonia
were at an increased risk of early stroke recurrence. This underlines the
importance of timely screening for dysphagia. Elevation of cardiac troponin
was observed in 15-50% of patients with acute ischemic stroke depending on the
respective troponin assay. Elevated cardiac troponin indicates coincident
myocardial injury. Even minor elevations were independently associated with
unfavorable short-term outcome. Especially, dynamic changes in troponin levels
in serial measurements were associated with increased mortality during the
acute phase after stroke. The etiology of troponin elevation after stroke is
different compared with patients presenting with acute coronary syndromes,
since the majority of ischemic stroke patients did not have acute coronary
lesions on coronary angiograms. Still, approximately one quarter of ischemic
patients had evidence of a coronary cause of troponin elevation. Thus, further
studies are needed to improve timely identification of these patients
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