1,720,967 research outputs found
Differences in family caregiver experiences and expectations of end-of-life heart failure care across providers and settings: a systematic literature review
Full text linkAbstract Heart failure impacts patients’ quality of life and life expectancy and significantly affects the daily behaviours and feelings of family caregivers. At the end-of-life, the burden for family caregivers depends on their emotional and sentimental involvement, as well as social costs. Objectives: The aim of this work is to determine whether and how family caregivers’ experiences and expectations vary in relation to the places of care and teams involved in heart failure management. Methods: A systematic literature review was conducted, by screening manuscripts dealing with the experience of Family Care Givers’ (FCGs) of patients with Advanced Heart failure. Methods and results were reported following the PRISMA rules. Papers were searched through three databases (PubMed, Scopus and Web of Science). Seven topics were used to synthetize results by reporting qualitative information and quantitative evidence about the experience of FCGs in places of care and with care teams. Results: Thirty-one papers, dealing with the experience of 814 FCGs, were selected for this systematic review. Most manuscripts came from the USA (N = 14) and European countries (N = 13) and were based on qualitative methods. The most common care setting and provider profile combination at the end of life was home care (N = 22) and multiprofessional teams (N = 27). Family caregivers experienced “psychological issues” (48.4%), impact of patients’ condition on their life (38,7%) and “worries for the future” (22.6%). Usually, when family caregivers were unprepared for the future, the care setting was the home, and there was a lack of palliative physicians on the team. Discussion: At the end-of-life, the major needs of chronic patients and their relatives are not health related. And, as we observed, non-health needs can be satisfied by improving some key components of the care management process that could be related to care team and setting of care. Our findings can support the design of new policies and strategies
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
PET and Cardiac Amyloidosis
No full text: PET has recently demonstrated promising capabilities in the diagnosis and differentiation of various forms of CA. Tracers labeled with 18F, such as 18F-flutemetamol, 18F-florbetapir, and 18F-florbetaben, are being increasingly researched due to their extended half-life, eliminating the requirement for on-site cyclotrons. Unlike bone tracers, PET amyloid-binding tracers exhibit a higher affinity for light-chain fibrils, potentially enabling accurate differentiation between various types of CA. The methodology for measuring tracer uptake in PET imaging, whether dynamic or static, facilitates the quantification of disease severity and could act as a marker for monitoring the disease, assessing treatment response
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
CHADS2 and CHA2DS2-VASc scores to predict morbidity and mortality in heart failure patients candidates to cardiac resynchronization therapy
No full textAimsCHADS2 and CHA2DS2-VASc scores are pivotal in assessing the risk of stroke in atrial fibrillation patients, and were recently proved to predict hospitalizations and mortality in specific clinical settings. Aim of this study was to evaluate whether these scores could predict clinical outcomes [first hospitalization for heart failure (HF) and a combined event of HF hospitalization and death for any cause] in patients candidates to cardiac resynchronization therapy and implantable defibrillator (CRT-D).Methods and resultsIn a retrospective multicentre Italian study, we enrolled 559 consecutive HF patients candidates to CRT-D, and we grouped them in three pre-specified risk classes: low (CHADS2/CHA2DS 2-VASc 1-2), moderate (CHADS2/CHA2DS 2-VASc 3-4), and high (CHADS2 5-6/CHA2DS 2-VASc 5-8). All patients underwent regular follow-up at implanting centres every 6 months; data collection was extended till the 72th month of follow-up. At a median FU of 30 months, 143 patients (25.4%) were hospitalized for HF and 110 (19.5%) died. Event-free survival analysis showed a significant difference according to baseline CHADS2 and CHA2DS 2-VASc scores (Log-Rank for HF P < 0.001 for CHADS2 and CHA2DS2-VASc; Log-Rank for combined end-point P = 0.001 for CHADS2, P < 0.001 for CHA2DS2-VASc). At multivariate analysis, independent predictors of endpoints were: previous atrial fibrillation (AF) or AF at implant, NYHA class, QRS duration and the CHA 2DS2-VASc score (for HF hospitalization P = 0.013; for the combined event, P = 0.007), while the CHADS2 score was not independently associated with either the end-points.ConclusionIn CRT-D patients, pre-implant CHA2DS2-VASc score is an independent predictor of major clinical events at 30-month follow-up. © 2013 The Author
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
Frazioni della gamma-glutammiltrasferasi plasmatica: valori di riferimento, correlazioni con fattori di rischio cardiovascolare, alterazioni indotte dall'abuso di alcool
No full textRIASSUNTO
La determinazione sierica dell'attività dell'enzima gamma-glutamiltrasferasi (GGT) è un test di laboratorio di basso costo, sensibile ed accurato, frequentemente utilizzato come indice di disfunzione epatobiliare e di abuso di alcool. Valori di GGT nell'intervallo di riferimento correlano positivamente con il rischio di insorgenza ed evoluzione del processo aterosclerotico, malattie ad esso correlate, ipertensione, diabete mellito di tipo 2 e sindrome metabolica. La rilevanza del valore predittivo della GGT sierica è stata recentemente incrementata da studi che hanno mostrato il ruolo di quest'enzima nella prognosi di malattia renale, malattia epatobiliare e tumori, confermando così un valore della GGT come predittore indipendente di mortalità. La GGT è considerato anche un marcatore di stress ossidativo e la sua attività è in grado di modulare alcuni importanti elementi cellulari tra cui fattori di trascrizione e proteine di membrana.
Sebbene il test di laboratorio comunemente utilizzato per la sua determinazione sia altamente riproducibile e sensibile, la GGT possiede comunque una scarsa specificità, che ne limita il valore diagnostico e prognostico.
È noto che l'attività totale di GGT sierica è dovuta a numerosi complessi molecolari contenenti GGT; una migliore comprensione della natura, del significato fisiopatologico e delle correlazioni cliniche di questi complessi, di diversa natura e dotati di distinte proprietà chimico-fisiche, potrebbe migliorare l'utilizzo della determinazione della GGT.
I metodi utilizzati fino ad ora per analizzare le diverse frazioni di GGT sono scarsamente sensibili e riproducibili e inoltre hanno portato a risultati contrastanti riguardo al numero stesso di frazioni presenti nel plasma; in più consentono la determinazione delle frazioni soltanto in presenza di alti valori di GGT e ciò in tutte quelle situazioni (ad esempio malattie epatobiliari) in cui è noto un aumento dei valori dell'enzima, ma non in presenza di valori nell'intervallo di riferimento.
Recentemente è stato messo a punto un nuovo metodo per la separazione e la quantificazione delle frazioni circolanti di GGT nel siero o nel plasma. Tale tecnica prevede l'utilizzo della cromatografia per esclusione molecolare per separare le frazioni in base al loro peso molecolare ed una reazione enzimatica post-colonna specifica per la GGT. Questo metodo consente la determinazione, con elevata sensibilità e riproducibilità, di quattro frazioni di GGT (b-, m-, s-, ed f-GGT).
Lo scopo della mia tesi è stato quello di studiare il potenziale clinico di questo metodo e cercare così di stabilire valori di riferimento e determinanti fisiopatologiche delle frazioni di GGT in un gruppo di soggetti sani (200 soggetti, 100 uomini e 100 donne) reclutati all'interno di una popolazione di donatori di sangue e in un gruppo di trenta alcolisti.
I risultati di questa analisi mostrano che all'interno dei soggetti sani tutte le quattro frazioni sono significativamente più rappresentate negli uomini rispetto alle donne; la f-GGT è la frazione prominente in soggetti con bassi valori di GGT, ma all'aumentare degli stessi si accompagna principalmente l'aumento dalle frazioni s- e b-GGT. Tutte le frazioni correlano positivamente con ALT (P <0,01), ma la b-GGT è la frazione che più di tutte correla con i già noti fattori di rischio cardivascolare in entrambi i generi (indice di massa corporea, pressione diastolica, acido urico, colesterolo LDL); m- e f-GGT correlano con colesterolo LDL mentre solo la f-GGT correla significativamente con i valori di trigliceridi negli uomini (P <0,01). Nel gruppo degli alcolisti si sono riscontrati valori significativamente più elevati in tutte le frazioni, ma la s-GGT si è dimostrata di gran lunga la maggiore responsabile dell'aumento dei valori di GGT rispetto alla popolazione sana.
In conclusione l'analisi delle quattro frazioni con la cromatografia ad esclusione molecolare è un metodo riproducibile e sensibile che può migliorare la bassa specificità dell'attuale saggio standard di laboratorio e permettere così nella pratica clinica uno studio più approfondito sull'effetivo ruolo di questo enzima in molte delle condizioni fisiopatologiche sopra menzionate
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