bluuebunny/crossref_metadata_2025_split huggingface dataset:
PETS-D
Authors: Sullivan-Bolyai Susan , Crawford Sybil , Bova Carol , Lee Mary , Quintos J. B. , Johnson Kim , Cullen Karen , Hamm Terri , Bisordi Jean , Ramchandani Neesha , Fletcher Jason , Quinn Diane , Jaffarian Carol , Lipman Terri , Melkus Gail 
Published: August 2015

Objective To evaluate the efficacy of Parent Education Through Simulation–Diabetes (PETS-D; clinical trial registration NCT01517269) for parents of children <13 years old newly diagnosed with type 1 diabetes with 3 parent education vignette sessions using human patient simulation (HPS) as compared with formal parent-nurse education sessions (vignette only) regarding diabetes knowledge, problem-solving skills, hypoglycemia fear, anxiety, and self-efficacy. Design and Methods Subjects were randomized to the HPS parent diabetes education or the vignette-only arm. Using linear mixed modeling, we compared HPS and vignette-only groups at 2, 6, and 14 weeks. Effect modification of treatment by dichotomized child’s age (<6 and ≥6 years old) and parent education (≤high school and >high school) was also tested. All analyses were intent to treat and adjusted for baseline outcome level and clustering within site. Results We recruited 191 parents (116 children). Mean baseline A1C was 12%. Overall treatment-related differences were modest. There was a statistically significant effect modification of HPS by child’s age, with a larger HPS benefit among parents of younger children for several outcomes: A1C (8.16% vs 9.48% in control; P = .006), lower state anxiety ( P = .0094), and higher fear of hypoglycemia ( P = .03) for parents of children <6 years old in the HPS group. Conclusions Modest treatment-related differences may reflect ceiling/floor effects in many of the outcomes; we also compared HPS with another intervention rather than to usual education. Parents of younger children receiving the intervention may feel more comfortable with lower A1C levels because of management awareness gleaned from the HPS experience. Future research will include a retrospective case-control study of very young children.
Detecting and Managing Diabetes Mellitus and Prediabetes in Patients With Acute Stroke
Authors: Liu Aiqun , Carmichael Kim A. , Schallom Marilyn E. , Riley Martha J. , Klinkenberg W. Dean 
Published: August 2015

Purpose The purpose of the study was to determine the prevalence of undiagnosed diabetes mellitus (DM) and prediabetes (pre-DM) in acute stroke patients, to evaluate recommendations of diabetes treatment and follow-up care in a hospital setting, and to examine 1-year readmission rates based on admission A1C measure. Methods This retrospective study comprised 200 patients randomly selected from 1095 patients admitted with an acute stroke and an A1C measurement during admission. DM and pre-DM prevalence levels were determined per A1C level. Recommendations for diabetes treatment during and after hospitalization were assessed; charts were reviewed for readmission. Results Among 200 patients, 43% had known DM, and 0.5% had pre-DM. Among 113 patients without history of DM or pre-DM, 61.9% had A1C 5.7% to 6.4% (39-46 mmol/mol), and 8.8% had A1C ≥6.5% (48 mmol/mol). None of the newly diagnosed pre-DM and 60% of newly diagnosed DM were documented. Only 7 of newly diagnosed DM or pre-DM patients received diabetes education. For patients with known DM and A1C ≥7.0% (53 mmol/mol), 40.5% registered no change of diabetic regimen. Few patients were recommended for diabetes follow-up care. Patients with A1C ≥6.5% or <5.7% were more likely to be readmitted for any reason within 1 year (33.3% and 31.6%, respectively) than patients with A1C levels of 5.7% to 6.4% (16.5%). Conclusions The majority of acutely admitted stroke patients without known DM or pre-DM had A1C ≥5.7%. Newly diagnosed DM or pre-DM patients received inadequate diabetes education and follow-up care. These findings provide significant opportunities for improving acute stroke management.
National Role Delineation Study of the Board Certification for Advanced Diabetes Management
Authors: Schreiner Barb , Kolb Leslie E. , O’Brian Catherine A. , Carroll Sarah , Lipman Ruth D. 
Published: August 2015

Purpose The purpose of this comprehensive role delineation study of the Board Certification for Advanced Diabetes Management (BC-ADM) examination was to ensure its content validity. Method The comprehensive role delineation study was conducted in 3 phases. In the first phase, a panel of 12 currently credentialed BC-ADM subject matter experts produced a list of practice domains, a unique set of content subdomains for each, and a series of knowledge statements for every subdomain. In the second phase, a validation study survey consisting of 3 sections was created. The first section was to rate each subdomain on three factors: criticality, frequency, and point in career at which knowledge is first used. The second section asked respondents to estimate the percentage of the examination to dedicate to the four domains. The third section captured demographic information of the respondents. A total of 667 BC-ADMs and 18 physicians were invited to take the survey. In the third phase, the subject matter expert panel analyzed the survey results and determined the weight that the domains and subdomains should have on the 150-item BC-ADM examination. Results Final domain weights and the corresponding number of items for the BC-ADM examination are provided in this report; these constitute the BC-ADM examination blueprint. Conclusions The national role delineation study reported here for the BC-ADM examination ensures that it is reflective of the current practice and required knowledge of the advanced diabetes manager.
Diagnostic value of serum CA125, CA19-9 and CA15-3 in endometriosis: A meta-analysis
Authors: Shen Airong , Xu Shengnan , Ma Yange , Guo Huanhuan , Li Canyu , Yang Chunli , Zou Shunhong 
Published: August 2015

Aim To evaluate the diagnostic value of serum cancer antigen (CA)125, CA19-9 and CA15-3 concentrations in endometriosis. Methods Case–control studies evaluating CA125, CA19-9 and CA15-3 and endometriosis, published between January 2000 and November 2014 were retrieved from PubMed® and Google Scholar. Standardized mean differences (SMD) and 95% confidence intervals (CI) were calculated. Subgroup analyses were carried out by ethnicity and disease stage (early, stage I/II; advanced, stage III/IV). Results The analysis included 12 case–control studies (963 cases, 855 controls). CA125 was associated with endometriosis in the overall population (SMD 0.82, 95% CI 0.72, 0.92), Caucasian subgroup (SMD 1.08, 95% CI 0.96, 1.19), and early (SMD 1.20, 95% CI 0.93, 1.48) or advanced disease (SMD 1.29, 95% CI 1.04, 1.55). CA19-9 was associated with endometriosis in the overall population (SMD 0.48, 95% CI 0.24, 0.72), Caucasian subgroup (SMD 0.31, 95% CI 0.07, 0.55), Asian subgroup (SMD 9.65, 95% CI 7.88, 11.42) and advanced disease (SMD 0.60, 95% CI 0.34, 0.87). CA15-3 was significantly associated with advanced disease (SMD 0.47, 95% CI 0.09, 0.84). Conclusions Serum CA125 and CA19-9 may represent useful biomarkers for the noninvasive diagnosis of endometriosis.
Antiproliferative and anti-inflammatory properties of diindolylmethane and lupeol against N-butyl-N-(4-hydroxybutyl) nitrosamine induced bladder carcinogenesis in experimental rats
Authors: Prabhu B , Balakrishnan D , Sundaresan S 
Published: August 2015

Introduction: Chemoprevention may involve perturbation of a variety of steps in tumor initiation, promotion, and progression. Objective: To investigate the antiproliferative and anti-inflammatory potential effects of diindolylmethane (DIM) and lupeol on experimental bladder carcinogenesis. Methods: Sixty healthy male Wistar rats were selected and randomly divided into six groups, with 10 rats in each group. Group I: control; group II: N-butyl- N-(4-hydroxybutyl) nitrosamine (BBN; 150 mg/gavage/twice a week) for 8 weeks, and then they were given 100 ppm concentrations of dimethylarsenic acid (DMA) in the drinking water for 28 weeks; group III: BBN + DMA + DIM (5 mg/kg body weight (b.w.)/day) treatment was started after BBN treatment, and it was orally administered for 28 weeks); group IV: BBN + DMA + lupeol (50 mg/kg b.w./day) treatment was started after BBN treatment, and it was orally administered for 28 weeks); and groups V and VI: DIM and lupeol treatment alone for 36 weeks. Bladder tissues were collected after 36th week study protocol for further analysis. Results: Our results revealed that DIM and lupeol treatment showed inhibition of tumor growth in the bladder by histopathological confirmations as well as significantly ( p < 0.001) increased the expression of phosphotensin (PTEN) and significantly ( p < 0.001) decreased the expression of tumor necrosis factor α, nuclear factor κβ (p65) were quantified using Western blot analysis. DIM and lupeol treatment significantly ( p < 0.001) decreased the levels of Cox-2 in bladder tissue samples and NMP 22 in urine samples were quantified using enzyme-linked immunosorbent assay method. Conclusion: Preventive DIM and lupeol administration act as potent Cox-2 inhibitors, which activates the tumor suppressor protein PTEN against experimental bladder carcinogenesis by antiproliferative and anti-inflammatory properties.
Adverse health behaviours are associated with depression and anxiety in multiple sclerosis: A prospective multisite study
Authors: McKay Kyla A. , Tremlett Helen , Fisk John D. , Patten Scott B. , Fiest Kirsten , Berrigan Lindsay , Marrie Ruth Ann ,   for the CIHR Team in the Epidemiology and Impact of Comorbidity on Multiple Sclerosis (ECoMS)
Published: August 2015

Background: Depression and anxiety are common among people with multiple sclerosis (MS), as are adverse health behaviours, but the associations between these factors are unclear. Objective: To evaluate the associations between cigarette smoking, alcohol use, and depression and anxiety in MS in a cross-Canada prospective study. Methods: From July 2010 to March 2011 we recruited consecutive MS patients from four MS clinics. At three visits over two years, clinical and demographic information was collected, and participants completed questionnaires regarding health behaviours and mental health. Results: Of 949 participants, 75.2% were women, with a mean age of 48.6 years; most had a relapsing−remitting course (72.4%). Alcohol dependence was associated with increased odds of anxiety (OR: 1.84; 95% CI: 1.32–2.58) and depression (OR: 1.53; 95% CI: 1.05–2.23) adjusting for age, sex, Expanded Disability Status Scale (EDSS), and smoking status. Smoking was associated with increased odds of anxiety (OR: 1.29; 95% CI: 1.02–1.63) and depression (OR: 1.37; 95% CI: 1.04–1.78) adjusting for age, sex, EDSS, and alcohol dependence. Alcohol dependence was associated with an increased incidence of depression but not anxiety. Depression was associated with an increased incidence of alcohol dependence. Conclusion: Alcohol dependence and smoking were associated with anxiety and depression. Awareness of the effects of adverse health behaviours on mental health in MS might help target counselling and support for those ‘at risk’.
Dysphagia is not a Valuable Indicator of Tumor Response after Preoperative Chemotherapy for R0 Resected Patients with Adenocarcinoma of the Gastroesophageal Junction
Authors: Strandby R. B. , Svendsen L. B. , Bæksgaard L. , Egeland C. , Achiam M. P. 
Published: August 2015

Background: Monitoring treatment response to preoperative chemotherapy is of utmost importance to avoid treatment toxicity, especially in non-responding patients. Currently, no reliable methods exist for tumor response assessment after preoperative chemotherapy. Therefore, the aim of this study was to evaluate dysphagia as a predictor of tumor response after preoperative chemotherapy and as a predictor of recurrence and survival. Methods: Patients with adenocarcinoma of the gastroesophageal junction, treated between 2010 and 2012, were retrospectively reviewed. Dysphagia scores (Mellow-Pinkas) were obtained before and after three cycles of perioperative chemotherapy together with clinicopathological patient characteristics. A clinical response was defined as improvement of dysphagia by at least 1 score from the baseline. The tumor response was defined as down staging of T-stage from initial computer tomography (CT) scan (cT-stage) to pathologic staging of surgical specimen (pT-stage). Patients were followed until death or censored on June 27th, 2014. Results: Of the 110 included patients, 59.1% had improvement of dysphagia after three cycles of perioperative chemotherapy, and 31.8% had a chemotherapy-induced tumor response after radical resection of tumor. Improvement of dysphagia was not correlated with the tumor response in the multivariate analysis (p = 0.23). Moreover, the presence of dysphagia was not correlated with recurrence (p = 0.92) or survival (p = 0.94) in the multivariate analysis. Conclusion: In our study, improvement of dysphagia was not valid for tumor response evaluation after preoperative chemotherapy and was not correlated with the tumor response. The presence of dysphagia does not seem to be a predictor of recurrence or survival.
Association between diabetic retinopathy and subclinical atherosclerosis in China: Results from a community-based study
Authors: Liu Yu , Teng Xiangyu , Zhang Wei , Zhang Ruifeng , Liu Wei 
Published: August 2015

Purpose: To evaluate the association of diabetic retinopathy with subclinical atherosclerosis in middle-aged and elderly Chinese with type 2 diabetes. Methods: A cross-sectional community-based study was performed among 1607 patients aged 40 years or older in Shanghai. Non-mydriatic digital fundus photography examination was used in diabetic retinopathy detection. Presence of elevated carotid intima-media thickness or carotid plaque was defined as subclinical atherosclerosis. Results: The prevalence of diabetic retinopathy was 15.1% in total patients. Patients with diabetic retinopathy were more likely to have elevated carotid intima-media thickness, carotid plaque and subclinical atherosclerosis than those without diabetic retinopathy (37.9% vs 30.7%, 57.6% vs 49.6% and 64.6% vs 57.1%, respectively). The presence of diabetic retinopathy was significantly associated with increased odds of subclinical atherosclerosis (odds ratio = 1.93, 95% confidence interval = 1.03–3.60) after full adjustments. Conclusion: The presence of diabetic retinopathy was significantly associated with subclinical atherosclerosis in middle-aged and elderly patients with type 2 diabetics in China.
Impact of an educational program on knowledge and perceptions of physicians towards generic medicines in Kuala Lumpur, Malaysia
Authors: Kumar Rohit , Hassali Mohamed A , Alrasheedy Alian A , Saleem Fahad , Kaur Navneet , Wong Zhi Y 
Published: August 2015

Objective To evaluate the impact of an educational program on knowledge and perceptions of physicians towards generic medicines. Methods This is a single-cohort pre-/post-intervention study. It was conducted with physicians from different private hospitals in Kuala Lumpur, Malaysia. The intervention was in the form of an interactive lecture that addressed several topics related to generic medicines. A validated questionnaire was used to assess the impact of the intervention on the knowledge and perceptions of physicians. Results A total of 28 out of 30 invited physicians agreed to attend and participate in the program (response rate 93.3%). The intervention improved the knowledge of physicians regarding the bioequivalence regulatory requirements (3.6% vs. 32.1% for pre- and post-intervention respectively, p = 0.008). Moreover, it improved their knowledge about several aspects of generic medicines including their bioequivalence, efficacy and safety ( p = 0.004, p = < 0.001, p = 0.034, respectively). The intervention had also a positive impact on the physicians’ perceptions. Conclusion The study findings showed that a simple, educational intervention could improve the knowledge and perceptions of physicians towards generic medicines.
Use of a Continuous External Tissue Expander in Total Ankle Arthroplasty
Authors: Huh Jeannie , Parekh Selene G. 
Published: August 2015

Despite major improvements in surgical technique and implant designs in total ankle arthroplasty (TAA), wound healing complications are still commonly encountered. Not only do these problems delay postoperative recovery and threaten functional outcomes, they also carry an increased risk of progression to deep wound infection, which can jeopardize ultimate retention of the implant. In an effort to reduce the high frequency of wound-related complications after TAA, we have incorporated the use of continuous external tissue expansion (CETE) to augment our closures of the anterior ankle incision. CETE is an innovative technique that is currently being used to aid in the rapid closure of acute and chronic full thickness soft tissue defects, including fasciotomy wounds, high grade open fractures, and chronic foot ulcers. By exploiting the viscoelastic properties of the skin, this technique not only facilitates wound edge approximation of full thickness defects, it also helps take tension off tenuous incisions, thus allowing them to heal and reducing the chance for wound dehiscence. This is the first description of the use of an external tissue expander for the prevention of wound healing complications in the setting of TAA. Since introducing CETE to the closure of our TAA incisions, we have seen a decrease in the number of postoperative wound complications and time to wound healing. Based on our experience, we believe that the use of CETE for the prophylactic management of tenuous surgical incisions, specifically those used in the anterior approach to the ankle during TAA, is both safe and efficacious. Levels of Evidence: Level V: Technique tip
Sport Specialization, Part I
Authors: Myer Gregory D. , Jayanthi Neeru , Difiori John P. , Faigenbaum Avery D. , Kiefer Adam W. , Logerstedt David , Micheli Lyle J. 
Published: August 2015

Context: There is increased growth in sports participation across the globe. Sports specialization patterns, which include year-round training, participation on multiple teams of the same sport, and focused participation in a single sport at a young age, are at high levels. The need for this type of early specialized training in young athletes is currently under debate. Evidence Acquisition: Nonsystematic review. Study Design: Clinical review. Level of Evidence: Level 4. Conclusion: Sports specialization is defined as year-round training (greater than 8 months per year), choosing a single main sport, and/or quitting all other sports to focus on 1 sport. Specialized training in young athletes has risks of injury and burnout, while the degree of specialization is positively correlated with increased serious overuse injury risk. Risk factors for injury in young athletes who specialize in a single sport include year-round single-sport training, participation in more competition, decreased age-appropriate play, and involvement in individual sports that require the early development of technical skills. Adults involved in instruction of youth sports may also put young athletes at risk for injury by encouraging increased intensity in organized practices and competition rather than self-directed unstructured free play. Strength-of-Recommendation Taxonomy (SORT): C.
Physical restraints among the elderly in the acute care setting: Prevalence, complications and its association with patients’ characteristics
Authors: Ang Shin Yuh , Bakar Aloweni Fazila Abu , Perera Karen , Wee Say Li , Manickam Aines , Lee Julian Hui Min , Haridas Dira , Shamsudin Hanis Farhana , Chan Joon Kai 
Published: August 2015

Aims: This study aimed to identify the prevalence and circumstances of the use of physical restraints, complications associated with its use and its association with patients’ characteristics. Methods: This is a prospective observational study design. A convenience sample of elderly patients (aged 65 and above) who were admitted to an acute care hospital from February 2012 to August 2012 were tracked daily to monitor the use of physical restraints during hospitalization. Patient-related variables and type of physical restraint used were gathered from the medical records and the Multi-Dimensional Dementia Assessment Scale was completed through interviews with nurses who had cared for the patients. Independent t-test or Chi-square (χ2) tests were used to examine the effect of a single variable on the use of physical restraints. Multiple logistic regression was done to predict the patient-related variables to the likelihood of being placed on physical restraints. Results: Altogether, 998 patients accounting for 1048 admission episodes, were included in this study, of which 84 admission episodes involved the use of physical restraints (8%). Major reasons for restraints include ‘Behavioural/confused/violent’ ( n= 55; 65%) and to prevent falls ( n=53; 62%). Regression analysis indicated that male gender, behavioural changes, memory disturbance, impaired physical function, the use of anti-psychotic drugs and higher psychiatric workload predicted the likelihood of being put on physical restraints. The strongest predictor was memory disturbances with an odds ratio of 30. Conclusion: The prevalence of physical restraints used was higher than that in published literature for acute care hospitals. Preventive strategies would need to be targeted for the elderly, who suffered from memory disturbances upon admission.
Identifying an important change estimate for the Multiple Sclerosis Walking Scale-12 (MSWS-12v1) for interpreting clinical trial results
Authors: Mehta Lahar , McNeill Manjit , Hobart Jeremy , Wyrwich Kathleen W , Poon Jiat-Ling , Auguste Priscilla , Zhong John , Elkins Jacob 
Published: August 2015

Background The 12-question Multiple Sclerosis Walking Scale (MSWS-12v1) is a widely-used patient-reported outcome (PRO) measure of walking ability in multiple sclerosis (MS). Objective To estimate the magnitude of an important change in MSWS-12v1 scores for the interpretation of meaningful subject-level improvements across a 6-month trial of MS patients with walking disability. Methods MOBILE was a 6-month exploratory study assessing fampridine’s effect on walking ability in 132 people with MS. Three PRO measures assessed walking ability: MSWS-12v1, EuroQol 5-Dimension-5 Level (EQ-5D-5L) mobility question, and a patient global impression of change (PGIC) in overall walking ability. Pre-specified anchor- and distribution-based analyses estimated the MSWS-12v1 change scores representing an important change for participants. Results were triangulated to propose a single best value indicating meaningful improvement. Results Using baseline to week 2 through week 24 change scores, anchor-based analyses demonstrated mean and median improvements of 5.2–6.6 (PGIC) and 9.7–13.4 (EQ-5D-5L mobility) points on the MSWS-12v1, indicating meaningful improvements. The distribution-based estimate was 6.8 points. Triangulation across the results suggested an 8-point reduction in MSWS-12v1 score represents an important subject-level change in these participants. Conclusion In similar MS clinical trials, an 8-point improvement on the MSWS-12v1 is a reasonable estimate of meaningful improvement in walking ability.