bluuebunny/crossref_metadata_2025_split huggingface dataset:
Technical Challenges and Clinical Outcomes of Using a Closed-Loop Glycemic Control System in the Hospital
Authors: Okabayashi Takehiro , Kozuki Akihito , Sumiyoshi Tatsuaki , Shima Yasuo 
Published: January 2014

According to large randomized trials, results suggest that maintaining normoglycemia postoperatively through tight glycemic control (TGC) and intensive insulin therapy (IIT) can improve surgical outcomes as well as reduce mortality and morbidity in critically ill patients. However, trials examining the effects of TGC have had conflicting results. Systematic reviews and meta-analyses have also led to differing conclusions. The main reason these clinical trials and meta-analyses show negative results for TGC is the high incidence of hypoglycemia induced by IIT. This could not be prevented because there is no reliable technique that can avoid this condition during IIT. The development of accurate, continuous blood glucose monitoring devices and closed-loop systems for computer-assisted blood glucose control in the intensive care unit (ICU) will probably help avoid hypoglycemia in these situations. The STG closed-loop glycemic control system was introduced to our department to be used and evaluated for strict serum glucose control with no hypoglycemic episodes during IIT in the surgical ICU, to reduce the workload of ICU nurses, and to decrease incidents related to the management of blood glucose levels according to manual conventional venous infusion insulin therapy. The goal of our team was to use the STG closed-loop glycemic control system for perioperative TGC in surgical patients to solve the complications of IIT and reduce risk of hypoglycemia. The challenge at our hospital demonstrated that the STG closed-loop glycemic control system can be expected to achieve TGC with no occurrence of hypoglycemia induced by IIT after surgery.
Clinical Implications and Economic Impact of Accuracy Differences among Commercially Available Blood Glucose Monitoring Systems
Authors: Budiman Erwin S. , Samant Navendu , Resch Ansgar 
Published: January 2014

Background: Despite accuracy standards, there are performance differences among commercially available blood glucose monitoring (BGM) systems. The objective of this analysis was to assess the potential clinical and economic impact of accuracy differences of various BGM systems using a modeling approach. Methods: We simulated additional risk of hypoglycemia due to blood glucose (BG) measurement errors of five different BGM systems based on results of a real-world accuracy study, while retaining other sources of glycemic variability. Using data from published literature, we estimated an annual additional number of required medical interventions as a result of hypoglycemia. We based our calculations on patients with type 1 diabetes mellitus (T1DM) and T2DM requiring multiple daily injections (MDIs) of insulin in a U.S. health care system. We estimated additional costs attributable to treatment of severe hypoglycemic episodes resulting from BG measurement errors. Results: Results from our model predict an annual difference of approximately 296,000 severe hypoglycemic episodes from BG measurement errors for T1DM (105,000 for T2DM MDI) patients for the estimated U.S. population of 958,800 T1DM and 1,353,600 T2DM MDI patients, using the least accurate BGM system versus patients using the most accurate system in a U.S. health care system. This resulted in additional direct costs of approximately $339 million for T1DM and approximately $121 million for T2DM MDI patients per year. Conclusion: Our analysis shows that error patterns over the operating range of BGM meter may lead to relevant clinical and economic outcome differences that may not be reflected in a common accuracy metric or standard. Further research is necessary to validate the findings of this model-based approach.
Feasibility of Adjacent Insulin Infusion and Continuous Glucose Monitoring via the Medtronic Combo-Set
Authors: O'Neal David N. , Adhya Sumona , Jenkins Alicia , Ward Glenn , Welsh John B. , Voskanyan Gayane 
Published: January 2014

Background: Subcutaneously infused insulin may interfere with the function of nearby glucose-sensing electrodes and vice versa. The prototype of the Combo-Set device (Medtronic) incorporates a subcutaneous insulin delivery catheter and continuous glucose monitoring (CGM) sensor assembled on the same platform and separated by 11 mm. We aim to evaluate Combo-Set's insulin delivery and glucose-sensing functions. Methods: Ten subjects with type 1 diabetes wore a Combo-Set and a Sof-Sensor inserted subcutaneously in contralateral abdominal areas connected to iPro recorders (Medtronic) for 53.25 ± 0.75 h (mean ± standard deviation). The Combo-Set delivered insulin diluent except during meal tests on days 1 and 3 when insulin lispro was delivered as a meal bolus and postmeal basal. Venous plasma samples were collected at the following time points from meal start: 0, 30, 60, 120, and 180 min for insulin measurements. The accuracy of the Combo-Set sensors was evaluated and compared with that of the Sof-Sensor, with each referenced against capillary glucose values (Contour Link Meter, Bayer). Results: Accuracy of the Combo-Set sensor was comparable to that of the Sof-Sensor. Clarke error grid analysis showed that 97% of Combo-Set and 93% of Sof-Sensor values were in the A+B regions ( p = .20, not significant). The Combo-Set showed the expected postbolus peak insulin time (67 ± 9 min, mean ± standard error). One “no delivery” alarm occurred during the 21 patient days of use. Conclusion: A device providing for simultaneous adjacent placement of an insulin infusion catheter and a CGM sensor is feasible and functions within acceptable limits. The low “no delivery” alarm rate was similar to that of other infusion sets.
Telemedicine Diabetes Consultations are Cost-Effective, and Effects on Essential Diabetes Treatment Parameters are Similar to Conventional Treatment: 7-Year Results from the Svendborg Telemedicine Diabetes Project
Authors: Levin Klaus , Madsen Jette R. , Petersen Inge , Wanscher Christina E. , Hangaard Joergen 
Published: January 2014

Background: The increasing number of patients with diabetes poses a major challenge for the health care system. One instrument to meet these challenges could be the use of telemedicine, which, at the same time, may reduce treatment costs. Since 2005, diabetes patients on the island of Aeroe have been offered expert diabetes care using teleconsultations. This article describes the impact of the telemedicine solution on essential diabetes treatment parameters, patient satisfaction, and cost-effectiveness. Methods: Telemedicine consultations were conducted with the patient and nurse specialist placed in a consultation room of Aeroe Hospital in audiovisual contact with the physician situated at the hospital on the mainland. Consultations were supported by an electronic patient record and a Web-based quality-monitoring diabetes database. Results: Inclusion criteria in this retrospective study were at least 6 months of telemedicine diabetes control with a minimum of two visits and two hemoglobin A1c (HbA1c) values. Results were compared with data from the Danish National Diabetes Registry (DVDD). Data are given in medians. In total, 23 type 1 diabetes mellitus (T1DM) patients, aged 65 (56–74) versus 48 years, diabetes duration 21.0 (10.7–31.3) versus 20.5 years, and 55 type 2 diabetes mellitus (T2DM) patients, aged 67 (64–70) versus 65 years, diabetes duration 14.0 (10.5–17.5) versus 11.7 years, were included. After teleconsultation, HbA1c in T1DM patients was 8.0% (7.4–8.6%) versus 7.9% [64 (57–71) versus 63 mmol/mol], not significant, and in T2DM patients was 7.4% (7.1–7.7%) versus 7.6% [57 (54–61) versus 60 mmol/mol], p < .05. Body mass index, blood pressure, and lipid values were comparable with the DVDD. Patient satisfaction was especially related to the major reduction in transportation time (7 h). Reductions in traveling costs and saved working days were the most important factors in making the telemedicine set-up economically efficient. Conclusion: Telemedicine consultation for remote outpatient diabetes control is feasible, and the interdisciplinary interventions achieved high treatment quality results in essential diabetes treatment parameters. In addition, the telemedicine set-up was associated with improved cost-effectiveness and patient satisfaction.
Mobilizing Your Medications: An Automated Medication Reminder Application for Mobile Phones and Hypertension Medication Adherence in a High-Risk Urban Population
Authors: Patel Samir , Jacobus-Kantor Laura , Marshall Lorraine , Ritchie Clark , Kaplinski Michelle , Khurana Parvinder S. , Katz Richard J. 
Published: January 2014

Background: Hypertension frequently accompanies diabetes mellitus, worsening prognosis and complicating medical care for patients. Low medication adherence with multiple medications is a major factor in the inadequate achievement of blood pressure treatment goals. Widespread access to mobile phones offers a new opportunity to communicate with patients and enhance disease self-management. Methods: We recruited 50 high-risk urban patients with hypertension, who are using at least two prescription medications for hypertension, into an open-label trial using medication reminder software on a mobile phone. Medication adherence was assessed by review of pharmacy refill rates before, during, and after availability of the medication reminder software (pre-activation, activation, and post-activation phase, respectively). Results: Forty-eight patients completed the study. All subjects were insured by Medicaid, 96% were African-American, and the majority had diabetes mellitus. The proportion of days covered for each study phase was as follows: Pre-activation phase = 0.54, activation phase = 0.58, and post-activation phase = 0.46. A significant difference was found between the activation and post-activation phases ( p = .001). The increase in measured adherence between the pre-activation and activation phases approached significance ( p = .057). Forty-six patients completed the pre- and post-Morisky medication adherence survey. The median score rose from 2.0 at baseline to 3.0 at study completion ( p < .001). Average blood pressure and level of control during study period improved significantly after initiation of the study and remained improved from baseline through the course of the study. The 48 subjects who completed the study reported a high level of satisfaction with the medication reminder application at the final study visit. Conclusions: A mobile-phone-based automated medication reminder system shows promise in improving medication adherence and blood pressure in high-cardiovascular-risk individuals.
Substrate Specificity and Interferences of a Direct-Electron-Transfer-Based Glucose Biosensor
Authors: Felice Alfons K. G. , Sygmund Christoph , Harreither Wolfgang , Kittl Roman , Gorton Lo , Ludwig Roland 
Published: January 2014

Objective: Electrochemical sensors for glucose monitoring employ different signal transduction strategies for electron transfer from the biorecognition element to the electrode surface. We present a biosensor that employs direct electron transfer and evaluate its response to various interfering substances known to affect glucose biosensors. Methods: The enzyme cellobiose dehydrogenase (CDH) was adsorbed on the surface of a carbon working electrode and covalently bound by cross linking. The response of CDH-modified electrodes to glucose and possible interfering compounds was measured by flow-injection analysis, linear sweep, and chronoamperometry. Results: Chronoamperometry showed initial swelling/wetting of the electrode. After stabilization, the signal was stable and a sensitivity of 0.21 μA mM−1 cm−2 was obtained. To investigate the influence of the interfering substances on the biorecognition element, the simplest possible sensor architecture was used. The biosensor showed little (<5% signal deviation) or no response to various reported electroactive or otherwise interfering substances. Conclusions: Direct electron transfer from the biorecognition element to the electrode is a new principle applied to glucose biosensors, which can be operated at a low polarization potential of −100 mV versus silver/silver chloride. The reduction of interferences by electrochemically active substances is an attractive feature of this promising technology for the development of continuous glucose biosensors.
Sleep Apnea, Sleep Disturbance, and Fasting Glucose Variability: A Pilot Study
Authors: Tatti Patrizio , Strollo Felice , Passali Desiderio 
Published: January 2014

Background: Disturbed sleep and nocturnal altered breathing are related to disturbances of glucose metabolism. The present uncontrolled observational study explores the role of these factors on the variability of fasting glycemia. Methods: The number and duration of nocturnal awakenings and the fasting glycemia of 97 patients with type 2 diabetes treated with diet, metformin, or gliptins were recorded over seven consecutive days. During the same time period, the main respiratory indexes—oxygen disturbance index, apnea/hypopnea index, and respiratory disturbance index—were recorded for one night. Results: The three respiratory indexes and the number of nocturnal awakenings are highly correlated with the coefficient of variation of the fasting blood glucose recorded over the 7-day period at p < .005 level. A multiple regression analysis showed that the variables in the model explained 86% of the variability. Discussion: Respiratory/sleep disturbances appear to be modulators superimposed on blood glucose levels determined by other factors.
Ponatinib overcomes FGF2-mediated resistance in CML patients without kinase domain mutations
Authors: Traer Elie , Javidi-Sharifi Nathalie , Agarwal Anupriya , Dunlap Jennifer , English Isabel , Martinez Jacqueline , Tyner Jeffrey W. , Wong Melissa , Druker Brian J. 
Published: January 2014

Key Points
FGF 2 promotes IM resistance in vitro and in vivo and is overcome by ponatinib, an FGF receptor and ABL kinase inhibitor.
Identification of a permissible HLA mismatch in hematopoietic stem cell transplantation
Authors: Fernandez-Viña Marcelo A. , Wang Tao , Lee Stephanie J. , Haagenson Michael , Aljurf Mahmoud , Askar Medhat , Battiwalla Minoo , Baxter-Lowe Lee-Ann , Gajewski James , Jakubowski Ann A. , Marino Susana , Oudshoorn Machteld , Marsh Steven G. E. , Petersdorf Effie W. , Schultz Kirk , Turner E. Victoria , Waller Edmund K. , Woolfrey Ann , Umejiego John , Spellman Stephen R. , Setterholm Michelle 
Published: January 2014

Key Points
Mismatches in alleles C*03:03/C*03:04 were most frequent (68.7%) among the transplants with a single allele level mismatch in HLA-C. The 7/8 C*03:03/C*03:04 mismatch group was not significantly different from the 8/8 HLA matched transplants in any transplant outcome.
Beyond cleaved small RNA targets: unraveling the complexity of plant RNA degradome data
Authors: Hou Cheng-Yu , Wu Ming-Tsung , Lu Shin-Hua , Hsing Yue-Ie , Chen Ho-Ming 
Published: January 2014

Abstract

Background
Degradation is essential for RNA maturation, turnover, and quality control. RNA degradome sequencing that integrates a modified 5′-rapid amplification of cDNA ends protocol with next-generation sequencing technologies is a high-throughput approach for profiling the 5′-end of uncapped RNA fragments on a genome-wide scale. The primary application of degradome sequencing has been to identify the truncated transcripts that result from endonucleolytic cleavage guided by microRNAs or small interfering RNAs. As many pathways are involved in RNA degradation, degradome data should contain other RNA species besides the cleavage remnants of small RNA targets. Nevertheless, no systematic approaches have been established to explore the hidden complexity of plant degradome.

Results
Through analyzing Arabidopsis and rice RNA degradome data, we recovered 11 short motifs adjacent to predominant and abundant uncapped 5′-ends. Uncapped ends associated with several of these short motifs were more prevalent than those targeted by most miRNA families especially in the 3′ untranslated region of transcripts. Through genome-wide analysis, five motifs showed preferential accumulation of uncapped 5′-ends at the same position in Arabidopsis and rice. Moreover, the association of uncapped 5′-ends with a CA-repeat motif and a motif recognized by Pumilio/Fem-3 mRNA binding factor (PUF) proteins was also found in non-plant species, suggesting that common mechanisms are present across species. Based on these motifs, potential sources of RNA ends that constitute degradome data were proposed and further examined. The 5′-end of small nucleolar RNAs could be precisely captured by degradome sequencing. Position-specific enrichment of uncapped 5′-ends was seen upstream of motifs recognized by several RNA binding proteins especially for the binding site of PUF proteins. False uncapped 5′-ends produced from capped transcripts through non-specific PCR amplification were common artifacts among degradome datasets.

Conclusions
The complexity of plant RNA degradome data revealed in this study may contribute to the alternative applications of degradome in RNA research.
Health belief model based evaluation of school health education programme for injury prevention among high school students in the community context
Authors: Cao Zhi-Juan , Chen Yue , Wang Shu-Mei 
Published: January 2014

Abstract

Background
Although multifaceted community-based programmes have been widely developed, there remains a paucity of evaluation of the effectiveness of multifaceted injury prevention programmes implemented in different settings in the community context. This study was to provide information for the evaluation of community-based health education programmes of injury prevention among high school students.

Methods
The pre-intervention survey was conducted in November 2009. Health belief model (HBM) based health education for injury prevention started in January 2010 and stopped in the end of 2011 among high school students in the community context in Shanghai, China. A post-intervention survey was conducted six weeks after the completion of intervention. Injury-related health belief indicators were captured by a short questionnaire before and after the intervention. Health belief scores were calculated and compared using the simple sum score (SSS) method and the confirmatory factor analysis weighted score (CFAWS) method, respectively.

Results
The average reliability coefficient for the questionnaire was 0.89. The factor structure of HBM was given and the data fit HBM in the confirmatory factor analysis (CFA) very well. The result of CFA showed that Perceived Benefits of Taking Action (BEN) and Perceived Seriousness (SER) had the greatest impact on the health belief, Perceived Susceptibility (SUS) and Cues to Action (CTA) were the second and third most important components of HBM respectively. Barriers to Taking Action (BAR) had no notable impact on HBM. The standardized path coefficient was only 0.35, with only a small impact on CTA. The health belief score was significantly higher after intervention (p < 0.001), which was similar in the CFAWS method and in the SSS method. However, the 95% confidential interval in the CFAWS method was narrower than that in the SSS method.

Conclusions
The results of CFA provide further empirical support for the HBM in injury intervention. The CFAWS method can be used to calculate the health belief scores and evaluate the injury related intervention. The community-based school health education might improve injury-related health belief among high school students; however, this preliminary observation needs to be confirmed in further research.
Retrospective analysis of the frequency of centrofacial telangiectasia in systemic sclerosis patients treated with bosentan or ilomedin
Authors: Hetzer Sonja , Buhren Bettina Alexandra , Schrumpf Holger , Bölke Edwin , Meller Stephan , Kammers Kai , Gerber Peter Arne , Homey Bernhard 
Published: January 2014

AbstractBackgroundBosentan is a dual endothelin receptor antagonist initially introduced for the treatment of pulmonary arterial hypertension and recently approved for the treatment of digital ulcers in patients with systemic sclerosis (SSc). Our clinical observations indicate that bosentan therapy may be associated with an increased frequency of centrofacial telangiectasia (TAE). Here, we sought to analyze the frequency of TAE in patients with SSc who were treated with either bosentan or the prostacyclin analog iloprost.MethodsWe conducted a retrospective analysis in 27 patients with SSc undergoing therapy with either bosentan (n = 11) or iloprost (n = 16). Standardized photodocumentations of all patients (n = 27) were obtained at a time point ten months after therapy initiation and analyzed. A subgroup of patients (bosentan: n = 6; iloprost: n = 6) was additionally photodocumented prior to therapy initiation, enabling an intraindividual analysis over the course of therapy.ResultsAfter ten months of therapy patients with SSc receiving bosentan showed a significantly (P = 0.0028) higher frequency of centrofacial TAE (41.6 ± 27.8) as compared to patients with SSc receiving iloprost (14.3 ± 13.1). Detailed subgroup analysis revealed that the frequency of TAE in the bosentan group (n = 6 patients) increased markedly and significantly (P = 0.027) by 44.4 after ten months of therapy (TAE at therapy initiation: 10.8 ± 5.1; TAE after ten months of therapy: 55.2 ± 29.8), whereas an only minor increase of 1.9 was observed in the iloprost group (n = 6 patients; TAE at therapy initiation: 18.3 ± 14.5; TAE after ten months of therapy: 20.2 ± 15.5), yet without reaching statistical significance (P = 0.420).ConclusionsThe use of bosentan may be associated with an increased frequency of TAE in patients with SSc. Patients should be informed about this potential adverse effect prior to therapy. Treatment options may include camouflage or laser therapy.
Assessment of parasitic pollution in the coastal seawater of Gaza city
Authors: Hilles Ahmed Hisham , Al Hindi Adnan Ibrahim , Abu Safieh Yousef Attalla 
Published: January 2014

Abstract

Background
The main objective of the study was the assessment of the prevalence and the identification of species of human gastrointestinal parasites as an indicator of the pollution of the seashore of Gaza City.

Methods
The investigation was conducted by analysis of the parasitic contamination of seawater along the study area. A total of 52 samples of seawater were analyzed during the summer period; from June to October 2011. The study area was divided into six zones (A, B, C, D, E and F) according to specific criteria such as the presence of the wastewater discharge points and other geographical characteristics.

Results
The results show that about 48% of the seawater samples from the shoreline region of Gaza City were contaminated with parasites. Zones A, B and D (mouth of Wadi Gaza, Al Sheikh Ejleen discharge and Al Shalehat discharge points respectively) have the highest level of parasitic contamination, while, zones C and E (From Al-Baydar restaurant to Khalel Alwazer Mosque and the basin of the Gaza marina respectively) had a lower level of contamination and zone F (From the northern part of the Gaza marina to the Intelligence Building) was uncontaminated. The parasitic species found were: Ascaris lumbricoides, Giardia lamblia, Strongyloides stercoralis, Hymenolepis nana, Entamoeba histolytica/dispar and Cryptosporidium parvum.

Conclusions
The present study revealed a high level of contamination with parasites at most of the points which were investigated along the Gaza City coast line.