1,720,984 research outputs found
Time trends in mechanical thrombectomy (2017–2021): do real-world data reflect advances in evidence?
No full textBackground In recent years, we have witnessed a continuous, evidence-based expansion of indications for endovascular therapy (EVT) in the treatment of ischaemic stroke, driven by advancements in extended time windows and target vessel occlusion. Our study aimed to evaluate the temporal changes in patients’ characteristics, treatment, and outcomes in clinical practice. Methods We used data from the German Stroke Registry, a large national multicentre prospective registry, which includes all patients receiving EVT for ischaemic stroke at its participating centers. We analysed baseline factors, treatment details, and clinical outcomes [Modified Rankin Scale (mRS) at 3 months] over a 5-year period (2017–2021). Results We included 6,251 patients from eight centres. Over time, the characteristics of patients undergoing EVT changed in several aspects (2017 vs. 2021). Patients became older (median age from 76 [IQR: 65–82] to 77 [65–84 years]; p trend = 0.02), and less severely affected (NIHSS from 15 [11–19] to 13 [8–18]; p trend <0.001). There was an increase in patients treated more than 6 h after last seen well (22.0% to 28.3%; p trend <0.001), and more patients were treated for medium vessel occlusion (16.1% to 28.1%; p trend <0.001). The use of intravenous thrombolysis decreased (52.4% to 40.4%; p trend <0.01). Good functional outcome declined (percentage of patients with mRS ≤ 2 from 36.0 to 34.9%; aOR 0.94 per year [0.89–0.99]), while mortality at 3 months increased from 25.3% in 2017 to 34.7% in 2021; aOR 1.13 per year [1.07–1.19]. Conclusion Between 2017 and 2021, there were significant shifts in the demographic and clinical profiles of patients undergoing EVT, along with an expansion in EVT indications. Despite these patients presenting with less severe stroke symptoms, improvements in functional outcomes were not observed, and mortality rates increased. These trends may reflect willingness to treat patients with more severe underlying health conditions
Cardiac Troponin T and severity of cerebral white matter lesions in acute ischemic stroke
Full text linkIn the literature, there is evidence of an association between cardiac diseases and clinical cognitive impairment as well as subclinical brain injury. We examined whether there is a link between elevated cardiac troponin levels (hs-cTnT) as a marker of subclinical myocardial injury and severity of white matter lesions (WML) as a marker of subclinical brain injury in stroke patients since those patients are a high-risk population in terms of both cognitive decline and cardiac comorbidity.
We conducted a retrospective analysis of consecutive acute ischemic stroke patients admitted to Charité-University Hospital, Berlin from 2011-2013. All included participants underwent 3T-cMRI and serial hs-cTnT measurements as part of the clinical routine. Severity of WML was graded using the age- related white matter severity score (ARWMS). Patients with hs-cTnT >52ng/l or dynamic change of hs- cTnT >50%, which may indicate acute myocardial damage, were excluded. We performed unadjusted and adjusted quantile regression models to determine whether there is an association between hs- cTnT (dichotomized at the 99th percentile of a healthy reference population, 14ng/l) and WML.
The data of 860 patients were examined (median age 73 years, 44.8% female, median ARWMS 6). In patients with elevated hs-cTnT, WML were more severe than in patients with normal hs-cTnT (median ARWMS 8 vs. 5, adjusted beta for the 50th percentile 1.12, 95% CI 0.41-1.84). There was a more pronounced association between WML and elevated hs-cTnT in patients with moderate to severe WML (beta 1.77, 95% CI 0.26-3.27 for 80th percentile). Further division of patients with elevated hs- cTnT values showed that the association was independent of the severity of hs-cTnT elevation.
Our data indicate an association between subclinical myocardial injury and severity of white matter lesions. Longitudinal studies are needed to assess the impact of risk-modifying therapy on the prevention of cognitive impairment and the value of hs-cTnT as a parameter for therapy monitoring.In der Literatur finden sich Hinweise auf einen Zusammenhang zwischen kardialen Erkrankungen und sowohl kognitiver Beeinträchtigung als auch subklinischer Schädigung des Gehirns. In dieser Arbeit wurde untersucht, ob ein Zusammenhang zwischen einer Erhöhung des kardialen Troponins (hs-cTnT) als Marker einer subklinischen Myokardschädigung und dem Schweregrad zerebraler „white matter lesions“ (WML) als Marker einer subklinischen Hirnschädigung bei Schlaganfallpatienten besteht. Es handelt sich um eine retrospektive Auswertung von Patienten mit akutem ischämischem Schlaganfall, die von 2011-2013 am Campus Benjamin Franklin stationär behandelt worden sind. Bei allen eingeschlossenen Patienten wurden im Rahmen der klinischen Routine ein 3T-cMRT und serielle Bestimmungen der Troponinwerte durchgeführt. Der Schweregrad der zerebraler WML wurde anhand des „age-related white matter severity scores“ (ARWMS) bestimmt. Patienten mit einem hs-cTnT > 52 ng/l oder einer Änderung des hs-cTnT > 50% in seriellen Kontrollen wurden ausgeschlossen, da diese Konstellationen auf einen akuten Myokardschaden hindeuten. Es wurden unadjustierte und adjustierte Quantilsregressionsanalysen durchgeführt, um festzustellen, ob ein Zusammenhang zwischen erhöhtem hs-cTnT (cut-off 14 ng/l, entsprechend der 99. Perzentile einer gesunden Kontrollpopulation) und WML besteht.
Insgesamt wurden die Daten von 860 Patienten untersucht (medianes Alter 73 Jahre, 44.8% weibliches Geschlecht, medianer ARWMS 6). Patienten mit erhöhtem hs-cTnT hatten ein größeres Ausmaß an WML als Patienten mit normwertigem hs-cTnT (medianer ARWMS 8 vs. 5, adjustiertes beta für die 50. Perzentile 1.12, 95% CI 0.41-1.84). Der Zusammenhang zwischen WML und erhöhtem hs-cTnT war stärker bei Patienten mit höherem Schweregrad an WML (beta 1.77, 95% CI 0.26-3.27 für die 80. Perzentile). Eine weitere Aufteilung der Studienpopulation nach hs-cTnT-Werten zeigte, dass der Zusammenhang unabhängig vom Ausmaß der hs-cTnT-Erhöhung war.
Die Ergebnisse weisen auf einen Zusammenhang zwischen subklinischem Myokardschaden und zerebralen WML hin. Es braucht longitudinale Studien, um den Einfluss einer risikomodifizierenden Therapie zur Vorbeugung einer kognitiven Einschränkung und den möglichen Stellenwert von Troponin als Marker eines Therapieerfolgs zu untersuchen
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
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
Author-wise bibliometric analysis based on entropy.
No full textAuthor-wise bibliometric analysis based on entropy.</p
- …
