bluuebunny/crossref_metadata_2025_split huggingface dataset:
Physical Activity in Adults With Type 1 Diabetes
Authors: McCarthy Margaret M. , Whittemore Robin , Grey Margaret 
Published: December 2015

Purpose The purpose of this study was to examine sociodemographic, clinical, and psychological factors associated with engaging in regular physical activity (PA) in adults with type 1 diabetes. Methods Secondary cross-sectional analysis based on data from the Type One Diabetes Exchange clinic registry was conducted. Adults ≥18 years old enrolled in the clinic registry who had completed PA self-report data (n = 7153) were included in this study. Results Mean age was 37.14 ± 17 years, and 54% (n = 3840) were men. Type 1 diabetes duration was 19.5 ± 13.5 years, and mean A1C level was 7.9% ± 1.5% (62 mmol/mol). Twelve percent (n = 848) of the sample reported no PA; 55% (n = 3928) reported PA 1 to 4 days per week; and 33% (n = 2377) reported PA ≥5 days per week. Factors that were associated with increased odds of no PA were older age, less-than-excellent general health, increased body mass index, longer duration of diabetes, and increased depressive symptoms. More blood glucose meter checks per day decreased odds of no PA. Factors associated with lower odds of ≥5 days of PA included minority race/ethnicity, education, less-than-excellent general health, presence of a foot ulcer, increased body mass index, and depressive symptoms. Male sex, less-than-full-time employment, and being single increased the odds of ≥5 days of PA. Conclusions Several demographic, clinical, diabetes-related, and psychosocial factors were related to PA. Potential interventions may target those with depressive symptoms or self-reported poor general health, or they may be tailored to working adults who may find it harder to be physically active.
Impact of iterative reconstructions on image noise and low-contrast object detection in low kVp simulated abdominal CT: a phantom study
Authors: Holmquist Fredrik , Nyman Ulf , Siemund Roger , Geijer Mats , Söderberg Marcus 
Published: December 2015

Background Low kilovoltage (kVp) computed tomography (CT) may be used to reduce contrast medium dose in patients at risk of contrast nephropathy, at the cost of increased image noise. Purpose To evaluate: (i) the impact of iterative reconstructions (Siemens SAFIRE) on low-contrast object detection to compensate for increased noise instead of increased tube loading when decreasing tube potential; and (ii) the change in iodine attenuation in simulated abdominal CT. Material and Methods A phantom was scanned at 70, 80, 100, and 120 kVp at fixed effective tube loading (170 mAsEFF) and fixed radiation dose (CTDIVOL 10 mGy). Images were reconstructed with filtered back-projection (FBP) and SAFIRE strengths S1–S5. Iodine attenuation, objective image noise, contrast-to-noise ratio (CNR), noise power spectrum (NPS), spatial resolution, and subjective detectability of low-contrast objects were evaluated. Results Compared with 120 kVp iodine attenuation increased by a factor 1.6 and 2.0, and image noise increased by a factor 1.9 and 2.5 at 80 and 70 kVp, respectively. Compared with FBP, SAFIRE showed objective reduction in image noise and increased CNR without loss of spatial resolution or any significant NPS alteration, with general tendency to improve subjective detectability of low-contrast objects. At 170 mAsEFF the number of discernible 1.0% contrast objects at 70 kVp/S5 and 80 kVp/S5 was similar to that at 120 kVp/FBP. Conclusion With the SAFIRE algorithm image noise, CNR and detectability of low-contrast objects may be kept unchanged without increased tube loading when using low kVp settings to reduce contrast medium dose in azotemic patients.
Breast ultrasonography for detection of metachronous ipsilateral breast tumor recurrence
Authors: Park Woon-Ju , Kim Eun-Kyung , Moon Hee Jung , Kim Min Jung , Kim Seung Il , Park Byeong-Woo 
Published: December 2015

Background Early detection of recurrence improves the survival rate of patients treated with breast conservation therapy (BCT). Therefore, ultrasonography (US) may be useful for metachronous ipsilateral breast tumor recurrence (MIBTR) obscured on mammography by dense breast tissue and distortion. Purpose To evaluate clinical, radiologic, and pathologic findings of MIBTR retrospectively, and to assess the role of surveillance US additional to mammography for MIBTR detection. Material and Methods During 2000 to 2012, 28 MIBTR were collected and reviewed among 2958 women treated for primary breast cancer with conservation surgery. The detection rates of imaging studies for identifying metachronous ipsilateral lesions were assessed and compared. MIBTR tumor staging was evaluated according to imaging modality for detection of MIBTR, palpability, and recent imaging surveillance. Results No significant difference was observed in the detection rate between mammography and US for overall MIBTR (84.2% vs. 85.7%; P = 0.898) or non-palpable MIBTR (88.2% vs. 81.0%; P = 0.566). US alone identified 33.3% of non-palpable MIBTRs (seven of 21). Among these cases, two had negative mammograms. All 14 MIBTRs with recent imaging surveillance were stage T2 or less, and all seven MIBTRs detected by US alone were in situ or T1; 33% of MIBTRs without recent imaging surveillance were T3 or T4. Conclusion The overall MIBTR detection rate by US was not higher than the detection rate of mammography, although combined surveillance with US and mammography found MIBTRs slightly earlier than mammography alone.
Gene-based pleiotropy across migraine with aura and migraine without aura patient groups
Authors: Zhao Huiying , Eising Else , de Vries Boukje , Vijfhuizen Lisanne S ,   for the International Headache Genetics Consortium, Anttila Verneri , Winsvold Bendik S , Kurth Tobias , Stefansson Hreinn , Kallela Mikko , Malik Rainer , Stam Anine H , Ikram M Arfan , Ligthart Lannie , Freilinger Tobias , Alexander Michael , Müller-Myhsok Bertram , Schreiber Stefan , Meitinger Thomas , Aromas Arpo , Eriksson Johan G , Boomsma Dorret I , van Duijn Cornelia M , Zwart John-Anker , Quaye Lydia , Kubisch Christian , Dichgans Martin , Wessman Maija , Stefansson Kari , Chasman Daniel I , Palotie Aarno , Martin Nicholas G , Montgomery Grant W , Ferrari Michel D , Terwindt Gisela M , van den Maagdenberg Arn M J M , Nyholt Dale R 
Published: December 2015

Introduction It is unclear whether patients diagnosed according to International Classification of Headache Disorders criteria for migraine with aura (MA) and migraine without aura (MO) experience distinct disorders or whether their migraine subtypes are genetically related. Aim Using a novel gene-based (statistical) approach, we aimed to identify individual genes and pathways associated both with MA and MO. Methods Gene-based tests were performed using genome-wide association summary statistic results from the most recent International Headache Genetics Consortium study comparing 4505 MA cases with 34,813 controls and 4038 MO cases with 40,294 controls. After accounting for non-independence of gene-based test results, we examined the significance of the proportion of shared genes associated with MA and MO. Results We found a significant overlap in genes associated with MA and MO. Of the total 1514 genes with a nominally significant gene-based p value ( pgene-based ≤ 0.05) in the MA subgroup, 107 also produced pgene-based ≤ 0.05 in the MO subgroup. The proportion of overlapping genes is almost double the empirically derived null expectation, producing significant evidence of gene-based overlap (pleiotropy) ( pbinomial-test = 1.5 × 10–4). Combining results across MA and MO, six genes produced genome-wide significant gene-based p values. Four of these genes ( TRPM8, UFL1, FHL5 and LRP1) were located in close proximity to previously reported genome-wide significant SNPs for migraine, while two genes, TARBP2 and NPFF separated by just 259 bp on chromosome 12q13.13, represent a novel risk locus. The genes overlapping in both migraine types were enriched for functions related to inflammation, the cardiovascular system and connective tissue. Conclusions Our results provide novel insight into the likely genes and biological mechanisms that underlie both MA and MO, and when combined with previous data, highlight the neuropeptide FF-amide peptide encoding gene ( NPFF) as a novel candidate risk gene for both types of migraine.
Arthroscopic Stabilization of Chronic Acromioclavicular Joint Dislocations
Authors: Tauber Mark , Valler Dennis , Lichtenberg Sven , Magosch Petra , Moroder Philipp , Habermeyer Peter 
Published: December 2015

Background: Arthroscopically assisted single-bundle (SB) or double-bundle coracoclavicular (CC) ligament reconstruction using autologous tendon grafts has been reported to provide acromioclavicular (AC) joint (ACJ) stability in chronic instability cases. Recently, additional AC ligament reconstruction to provide triple-bundle (TB) stabilization has been introduced but lacks a comparison of clinical and radiological outcomes. Hypothesis: Arthroscopically assisted anatomic TB CC and AC reconstruction yields superior clinical and radiological results when compared with nonanatomic SB CC reconstruction. Study Design: Cohort study; Level of evidence, 2. Methods: Twenty-six patients (mean [±SD] age, 46.9 ± 12.8 years) suffering from chronic high-grade ACJ instability underwent ACJ stabilization using autologous hamstring grafts. Twelve patients underwent combined anatomic TB CC and AC reconstruction using a semitendinosus tendon with clavicular interference screw fixation (TB group), and 14 underwent isolated SB CC reconstruction using the AC GraftRope system with a gracilis tendon (SB group). After a minimum follow-up of 2 years (mean, 29.0 ± 7.4 months), patients were evaluated radiologically and clinically using the Constant, American Shoulder and Elbow Surgeons (ASES), Taft, and Acromioclavicular Joint Instability Score (ACJI) outcome measures. Results: The mean Constant score increased significantly in both groups, from 71.6 preoperatively to 88.8 postoperatively in the TB group and from 67.8 to 82.6 in the SB group ( P ≤ .009). No intergroup difference was found regarding the final Constant or ASES scores. Regarding the ACJ-specific scores, the final outcomes were significantly different: 10.9 (TB group) versus 9.0 (SB group) for the mean Taft score ( P = .018) and 84.7 versus 58.4, respectively, for the mean ACJI score ( P = .0001). No significant radiological difference was found regarding the mean CC distance (10.7 mm [TB group] vs 13.1 mm [SB group]). The TB group showed superior horizontal ACJ stability ( P = .011), which was associated with a better clinical outcome according to the ACJI and Taft scores. In the SB group, the rate of ACJ instability recurrence was higher (21% vs 8% [TB group]). Conclusion: Combined arthroscopically assisted anatomic TB CC and AC ligament reconstruction using an autologous semitendinosus tendon graft provides superior clinical and radiological results compared with isolated nonanatomic SB CC ligament reconstruction using the AC GraftRope system. In particular, the TB technique can better restore horizontal ACJ stability, which is associated with superior ACJ-specific outcome scores.
Patients with antiphosholipid syndrome and thrombotic recurrences: A real world observation (the Piedmont cohort study)
Authors: Bazzan M , Vaccarino A , Stella S , Sciascia S , Montaruli B , Bertero M T , Carignola R , Roccatello D ,   for the Piedmont APS Consortium
Published: December 2015

Background Patients with antiphospholipid syndrome (APS) often have thrombotic recurrences, sometimes despite appropriate ongoing anticoagulant treatment. Identifying APS vascular patients at high risk for thrombotic recurrences is still an unsolved issue. Objectives To report the real-life experience of thrombotic recurrences in APS patients included in the Piedmont observational cohort study, and evaluate clinical and laboratory risk factors for thrombotic recurrences. Patients A multi-centre observational study was performed by enrolling 177 patients with vascular APS (primary APS in 99 subjects (56%)); the median follow-up was five years (range 1–26 years). Results The observed thrombotic recurrence rate was about 7.5/100 patient years in the first five years after the first thrombotic event. While the first recurrence often occurred (45%) in patients who were not on oral anticoagulant therapy (OAT), the second recurrence mainly occurred despite ongoing OAT (80%). However, due to the real-life observational nature of this study, treatment was based on the treating physician’s judgement, and no structured therapeutic protocol was applied. Moreover, compliance with OAT was not available. No differences in antiphospholipid antibodies (aPL) profile were observed between patients with or without thrombotic recurrences, but a high risk aPL profile (Miyakis type 1 and 2a) was present in 96% of our patients, 26% of whom had triple positivity. Diabetes ( p < 0.01, OR 10), inherited thrombophilia ( p < 0.0078, OR 4) and OAT withdrawal were independent risk factors for recurrences. Conclusions With the limit of a real-life observational cohort study, the thrombotic recurrence rate in APS was as high as 7.5/100 patient years in the first five years after the first thrombotic event. OAT discontinuation, diabetes and inherited thrombophilia, when associated with a high-risk aPL profile, are risk factors for thrombotic recurrences.
Conjoint Analysis of Option and Volatility Models
Authors: Singh Vipul Kumar 
Published: December 2015

This study endeavours to find an impeccable option-pricing model to meet the requirements of ‘Options’ practitioners during a tumultuous period. It encompasses ‘smile’ and ‘skew’ characters exhibiting price bias across moneyness and maturity. For the same, we compared and contrasted the classical Black–Scholes model with deterministic and stochastic volatility models. In order to make applicability of models more prominent, the hypothetical model has been put into practical implication of Nifty index options of India. Also, to ensure the model’s all-round applicability, they all have been passed through the most dramatic phase of the Indian financial economy spanning 2006–11, an ideal time to examine the sustainability of such models. Accuracy of model prices has been testified relative to the market, using the well-known error metrics. This research suggests that the deterministic volatility function (DVF) is the most suitable framework to price the Nifty index options. It not only out passes the benchmark Black–Scholes model but also dominates its stochastic counterpart the stochastic alpha, beta and rho (SABR) model. JEL Classification: C01, C13, C52, C53, G17
A Markov-Switching Model for Indian Stock Price and Volume
Authors: Chaudhuri Kausik , Kumar Alok 
Published: December 2015

Using weekly data from the Indian stock market, we examine the relationship between stock price and trading volume. Our framework is Markov Switching-Vector Error Correction Model (MS-VECM). We justify the use of nonlinear model using the Brock, Dechert and Scheinkman (BDS) test and the information criteria. The long-run dynamics are characterised by one cointegrating vector relating the price to trading volume. We find that stock price is weakly exogenous only in the high volatility regime. The MS-VECM with two regimes provides a good characterisation of the Indian stock market and performs well relative to the other linear and nonlinear models. JEL Classification: C32, G12, E32
Cardiotoxicity in targeted therapy for breast cancer: A study of the FDA adverse event reporting system (FAERS)
Authors: Wittayanukorn Saranrat , Qian Jingjing , Johnson Brandon S , Hansen Richard A 
Published: December 2015

Purpose Cancer chemotherapy-induced cardiotoxicity is concerning. Certain anthracyclines and targeted therapies are known to have potential for cardiotoxicity, but existing trial evidence is inadequate to understand real-world patterns of cardiotoxicity with newer targeted therapies and their common combinations with older agents. This study evaluated chemotherapy-related cardiotoxicity reports for targeted therapies and their combinations in breast cancer patients. Methods The US Food and Drug Administration Adverse Event Reporting System (FAERS) database from January 2004 through September 2012 was used to summarize characteristics of reported cardiotoxicity events and their health outcomes. Disproportionality analyses with reporting odds ratios (ROR) and 95% confidence intervals (95% CI) were conducted to detect event signals using a case/non-case method for each targeted therapy and combination. Results A total of 59,739 cases of cardiotoxicity reports were identified; 937 cases identified targeted therapy as the suspect drug. Trastuzumab had the highest number of reports followed by bevacizumab and lapatinib. Proportions of reports of death and disability outcomes for each targeted therapy were approximately 20–25% of the total reports of serious events. Trastuzumab had the highest ROR as a single agent (ROR = 5.74; 95% CI = 5.29–6.23) or combination use of cyclophosphamide (ROR = 16.83; 95% CI = 13.32–21.26) or doxorubicin (ROR = 17.84; 95% CI = 13.77–23.11). Relatively low cardiotoxicity reporting rates were found with lapatinib, regardless of use with combination therapy. Conclusions Analysis of FAERS data identified signals for adverse cardiotoxicity events with targeted therapies and their combinations. Practitioners should consider factors that may increase the likelihood of cardiotoxicity when assessing treatment. Findings support continued surveillance, risk factor identification, and comparative studies.
Serum 25-OH Vitamin D Level in Psoriatic Patients and Comparison With Control Subjects
Authors: Maleki Masoud , Nahidi Yalda , Azizahari Sahar , Meibodi Naser Tayyebi , Hadianfar Ali 
Published: December 2015

Background: Vitamin D has been shown to have immunomodulatory effects, and previous studies have proposed a role of vitamin D deficiency in multiple autoimmune diseases, including psoriasis. Objectives: The aim of this study was to investigate serum vitamin D levels in psoriatic patients and compare them with levels in controls. Methods: This study was carried out in 50 psoriasis patients. Serum vitamin D was measured by enzyme-linked immunosorbent assay. Results: The mean serum vitamin D levels in psoriatic patients and controls were 14.92 ± 6.31 and 12.52 ± 4.54 ng/mL, respectively. The difference was not statistically significant ( P = .06). The prevalence of vitamin D deficiency (<20 ng/mL) was 84.0% in psoriatic patients and 93.0% in controls ( P = .21). Conclusions: Most of the patients with psoriasis had vitamin D deficiency, which may have contributed to the evolution of their psoriasis. However, considering the high prevalence of vitamin D deficiency in Iran, no difference was noted between the psoriatic patients and the controls.
The determinants of time spent on self-care
Authors: Forbes Hannah , Sutton Matt , Richardson Gerry , Rogers Anne 
Published: December 2015

Purpose More input from the individual into the management of their health has the potential to reduce demand on the formal care system and improve health outcomes. A variety of interventions have been developed to encourage such ‘self-care', particularly for populations with long-term conditions. However the equity consequences of such initiatives are relatively unknown as there is little evidence on the social and economic determinants of time spent on self-care. Key methods We estimate the social and economic determinants of time spent on self-care. We also examine whether patients spend time on self-care because they are compensating for lack of access to formal health care. We undertook regression analyses of eight self-care and formal care measures from a dedicated survey of 300 patients with long-term conditions. Main results We found that higher income is associated with less time spent on self-care. Various measures of access to formal health care are found to not be associated with time spent on self-care. Main conclusion People from a lower socioeconomic position spend more time managing their condition even when there is universal entitlement to health care.
Decontamination of breast pump milk collection kits and related items at home and in hospital: guidance from a Joint Working Group of the Healthcare Infection Society & Infection Prevention Society
Authors: Price E , Weaver G , Hoffman P , Jones M , Gilks J , O’Brien V , Ridgway G 
Published: December 2015

Introduction: A variety of methods are in use for decontaminating breast pump milk collection kits and related items associated with infant feeding. This paper aims to provide best practice guidance for decontamination of this equipment at home and in hospital. It has been compiled by a joint Working Group of the Healthcare Infection Society and the Infection Prevention Society. Methods: The guidance has been informed by a search of the literature in Medline, the British Nursing Index, the Cumulative Index to Nursing & Allied Health Literature, Midwifery & Infant Care and the results of two surveys of UK neonatal units in 2002/3 and 2006, and of members of the Infection Prevention Society in 2014. Since limited good quality evidence was available from these sources much of the guidance represents good practice based on the consensus view of the Working Group. Key recommendations: Breast pump milk collection kits should not be reused by different mothers unless they have been sterilized in a Sterile Services Department between these different users. When used by the same mother, a detergent wash followed by thorough rinsing and drying after each use gives acceptable decontamination for most circumstances, as long as it is performed correctly. Additional decontamination precautions to washing, rinsing and drying may be used if indicated by local risk assessments and on advice from the departmental clinicians and Infection Prevention and Control Teams. The microbiological quality of the rinse water is an important consideration, particularly for infants on neonatal units. If bottle brushes or breast/nipple shields are used, they should be for use by one mother only. Decontamination should be by the processes used for breast pump milk collection kits. Dummies (soothers, pacifiers or comforters) needed for non-nutritive sucking by infants on neonatal units, should be for single infant use. Manufacturers should provide these dummies ready-to-use and individually packaged. They must be discarded at least every 24 hours or immediately if soiled with anything other than the baby’s saliva. No attempt should be made to decontaminate the dummies, either before or during use. Conclusion: This guidance provides practical recommendations to support the safe decontamination of breast pump milk collection kits for healthcare professionals to use and communicate to other groups such as parents and carers.
Pharmacologic Therapies for Pediatric Concussions
Authors: Halstead Mark E. 
Published: December 2015

Context: Pediatric concussions are common, and emphasis on correct diagnosis and management is stressed in consensus guidelines. Medications may have a role in management of concussion, but no consensus exists regarding appropriate pharmacologic therapy. Evidence Acquisition: Nonsystematic review. Study Design: Clinical review. Level of Evidence: Level 4. Results: There is limited evidence for hypertonic saline to improve posttraumatic headache in the emergency department setting. There is essentially no evidence for the use of any other medication in management of pediatric sport-related concussion. Conclusion: Further research is necessary to determine whether there is benefit to the use of any pharmacotherapy in the management of pediatric-aged athletes with concussions.