bluuebunny/crossref_metadata_2025_split huggingface dataset:
Effect of Continuous Positive Airway Pressure on Leptin Levels in Patients with Obstructive Sleep Apnea
Authors: Chen Xiong , Niu Xun , Xiao Ying , Dong Jiaqi , Lu Meixia , Kong Weijia 
Published: December 2014

ObjectivesContinuous positive airway pressure (CPAP) is an effective treatment for obstructive sleep apnea hypopnea syndrome (OSAHS), but previous studies assessing the effect of CPAP on leptin in patients with OSAHS yielded conflicting results. In this study, we conducted a meta‐analysis to determine whether CPAP therapy could reduce serum leptin levels.Data SourcesDatabases of PubMed, Elsevier, and SCI were thoroughly searched by 2 independent reviewers.MethodsRevMan (version 5.2) was used for data synthesis. Weighted mean difference (WMD) before and after CPAP therapy was calculated to estimate the effects of CPAP therapy.ResultsA total of 11 studies involving 413 participants were included. Meta‐analysis showed that the total WMD for leptin levels was 1.44 units (95% confidence interval: 1.11‐1.77, P <. 01) before and after CPAP therapy. Subgroup analysis exhibited that leptin was decreased within 3 days after the therapy, and it was further reduced within 1 to 3 months and beyond.ConclusionsThe results of our meta‐analysis showed that CPAP could significantly reduce leptin levels in OSAHS patients without concomitant weight loss.
Association of goals of care meetings for hospitalized cancer patients at risk for critical care with patient outcomes
Authors: Apostol Colleen C , Waldfogel Julie M , Pfoh Elizabeth R , List Donald , Billing Lynn S , Nesbit Suzanne A , Dy Sydney Morss 
Published: December 2014

Background: Caring for cancer patients with advanced and refractory disease requires communication about care preferences, particularly when patients become ill enough to be at risk for critical care interventions potentially inconsistent with their preferences. Aim: To describe the use of goals of care discussions in patients with advanced/refractory cancer at risk for critical care interventions and evaluate associations between these discussions and outcomes. Design: Cohort study describing patients/families’ perceptions of goals of care meetings and comparing health care utilization outcomes of patients who did and did not have discussions. Setting/participants: Inpatient units of an academic cancer center. Included patients had metastatic solid tumors or relapsed/refractory lymphoma or leukemia and were at risk for critical care, defined as requiring supplemental oxygen and/or cardiac monitor. Results: Of 86 patients enrolled, 34 (39%) had a reported goals of care discussion (study group). Patients/families reported their needs and goals were addressed moderately to quite a bit during the meetings. Patients in the study group were less likely to receive critical care (0% vs 22%, p = 0.003) and more likely to be discharged to hospice (48% vs 30%, p = 0.04) than the control group. Only one patient in the study group died during the index hospitalization (on comfort care) (3%) compared with 9(17%) in the control group ( p = 0.08). Conclusion: Goals of care meetings for advanced/refractory cancer inpatients at risk for critical care interventions can address patient and family goals and needs and improve health care utilization. These meetings should be part of routine care for these patients.
Effects of diet on adenosine monophosphate-activated protein kinase activity and disease progression in an amyotrophic lateral sclerosis model
Authors: Zhao Zichun , Sui Yanling , Gao Wenchao , Cai Bin , Fan Dongsheng 
Published: December 2014

Objectives To study the effects of diet on disease progression and activity levels of adenosine monophosphate-activated protein kinase (AMPK), and its downstream targets, in an amyotrophic lateral sclerosis (ALS) animal model. Methods AMPK activity was measured in cerebral cortex, spinal cord, cerebellum and hindlimb muscle tissue using immunohistochemistry in transgenic mice overexpressing human superoxide dismutase-1 (SOD1G93A) fed a high-fat (HFD), standard ad libitum (AL) or calorie-restricted (CR) diet; AMPK activity was also measured in wild-type (SOD1WT) mice. Activity of AMPK and phospho-AMPK, acetyl coenzyme-A carboxylase (ACC), phospho-ACC and heat shock protein-70 (Hsp70) were also measured using Western blot. Food intake and grip strength were recorded; body composition was analysed using dual energy X-ray absorptiometry. Motor neuron survival was observed using Nissl staining. Results AMPK activity increased and Hsp70 expression decreased in AL SOD1G93A mice compared with SOD1WT mice in spinal cord and hindlimb muscle. Compared with AL SOD1G93A mice, CR SOD1G93A mice showed increased AMPK activity, downregulated Hsp70 expression, reduced motor neuron survival in spinal cord and hindlimb muscle and reduced lifespan; HFD SOD1G93A mice showed opposite effects. Conclusions In this mouse model, increased AMPK activity seems to play a negative role in motor neuron survival, possibly through a novel mechanism involving Hsp70 downregulation. These changes can be modified by diet. Inhibition of AMPK may provide a therapeutic strategy for ALS.
Experience of non-breastfeeding mothers
Authors: Fahlquist Jessica Nihlén 
Published: December 2014

Background: Breastfeeding is currently strongly recommended by midwives and paediatricians, and the recommendations are based on documents provided by the World Health Organization and public health authorities worldwide. Research question: The underlying question is, how are non-breastfeeding mothers affected emotionally when informed that breastfeeding is the safest and healthiest option? Research design: The method used is an anonymous web-based qualitative survey exploring the narratives of non-breastfeeding mothers, published on Thesistools.com . The aim is to achieve qualitative knowledge about the emotions of non-breastfeeding mothers. Participants and research context: Participants were based in Sweden, the United Kingdom and the Netherlands and were selected through a purposeful sample. Ethical considerations: The online survey anonymizes responses automatically, and all respondents had to tick a box agreeing to be quoted anonymously in scientific articles. The study conforms to research ethics guidelines. Findings: Respondents describe how they were affected, and the following themes emerged in studying their descriptions: depression, anxiety and pain, feeling failed as a mother and woman, loss of freedom/feeling trapped, relief and guilt. Discussion: The themes are discussed against the background of the ethics of care and a theory of ethically responsible risk communication. Conclusion: Three conclusions are made. First, the message should become more empathetic. Second, information should be given in an attentive dialogue. Third, information providers should evaluate effects in a more inclusive way.
Contribution of the Sural Nerve to Postural Stability and Cutaneous Sensation of the Lower Limb
Authors: Mazzella Natalie L. , McMillan Andrew M. 
Published: December 2014

Background: The sural nerve is a cutaneous nerve of the lower limb that innervates the posterolateral aspect of the lower leg, ankle, and foot. Considering this pattern, it is plausible that it contributes to the maintenance of postural stability. However, the implications of sensory loss following sural nerve injury have yet to be thoroughly investigated. Therefore, the aim of this study was to investigate the immediate effect of sural nerve sensory loss on postural stability and its variability of innervation to the lower limb. Methods: Twenty-five healthy adult subjects participated in an observational study with a repeated-measures design. Each participant underwent a postural stability assessment using the Neurocom Balance Master under 2 conditions: 1) with the sural nerve functioning normally and 2) following a bilateral ultrasound-guided sural nerve block. The cutaneous distribution of the sural nerve was mapped for descriptive purposes. Results: There were no statistically significant differences between conditions for the primary outcome measure (unilateral stance on the dominant leg with eyes closed). A statistically significant reduction in postural stability was detected during unilateral stance on the nondominant leg (with eyes closed) following the nerve block (mean increase, 2.25 deg/s; 95% confidence interval, –0.48 to 2.91; t = 2.75; df = 24; P = .01). The mean area of plantar skin innervated by the sural nerve was 17% ± 11%, and the mean area of lateral skin was 50% ± 6%. Conclusion: Our findings demonstrate that a loss in sural nerve function is unlikely to reduce postural stability during daily activities. The sural nerve has a variable innervation pattern that can involve the third digit and the plantar medial border of the heel. Clinical Relevance: Practitioners should consider this variability when assessing for potential sensory deficits and when planning procedures requiring anesthesia to the plantar surface of the foot.
Puberty in females enhances the risk of an outcome of multiple sclerosis in children and the development of central nervous system autoimmunity in mice
Authors: Ahn Jeeyoon Jennifer , O’Mahony Julia , Moshkova Marina , Hanwell Heather E , Singh Hargurinder , Zhang Monan Angela , Marrie Ruth Ann , Bar-Or Amit , Sadovnick Dessa A , Dunn Shannon E , Banwell Brenda L 
Published: December 2014

Background: For reasons that remain unclear, three times more women develop multiple sclerosis (MS) than men. This preponderance among women is evident only after 12 years of age, implicating pubertal factors in the risk of MS. Objective: To investigate the influence of female puberty on central nervous system (CNS) autoimmunity. Methods: We examined the relationship between age of menarche on MS outcomes in 116 female children (< 16 years old) whom presented with incident ‘acquired demyelinating syndromes’ (ADS) and were followed prospectively in the national Canadian Pediatric Demyelinating Disease Study, from 2004–2013. Furthermore, we directly investigated the effects of puberty on susceptibility to experimental autoimmune encephalomyelitis (EAE) in two groups of female mice that differed only in their pubertal status. Results: In the ADS children, a later age of menarche was associated with a decreased risk of subsequent MS diagnosis. This relationship persisted, after accounting for patient age at ADS presentation and the presence of ≥1 T2 lesions on brain magnetic resonance imaging (MRI), with a hazard ratio (HR) of 0.64; and additional factors that associate with MS outcomes in ADS children, including low vitamin D levels. Furthermore, we found female mice that had transitioned through puberty were more susceptible to EAE than age-matched, pre-pubertal mice. Conclusion: Puberty in females enhances CNS autoimmune mechanisms that lead to MS in humans and EAE in mice.
Structural ‘connectomic’ alterations in the limbic system of multiple sclerosis patients with major depression
Authors: Nigro Salvatore , Passamonti Luca , Riccelli Roberta , Toschi Nicola , Rocca Federico , Valentino Paola , Nisticò Rita , Fera Francesco , Quattrone Aldo 
Published: December 2014

Background: Major depression (MD) is a common psychiatric disorder in multiple sclerosis (MS). Despite the negative impact of MD on the quality of life of MS patients, little is known about its underlying brain mechanisms. Objective: We studied the whole-brain connectivity patterns that were associated with MD in MS. Alterations were mainly expected within limbic circuits. Methods: Diffusion tensor imaging data were collected in 20 MS patients with MD, 22 non-depressed MS patients and 16 healthy controls. We used deterministic tractography and graph analysis to study the white-matter connectivity patterns that characterized MS patients with MD. Results: We found that MD in MS was associated with increased local path length in the right hippocampus and right amygdala. Further analyses revealed that these effects were driven by an increased shortest distance between both the right hippocampus and right amygdala and a series of regions including the dorsolateral and ventrolateral prefrontal cortex, orbitofrontal cortex, sensory-motor cortices and supplementary motor area. Conclusion: Our data provide strong support for neurobiological accounts positing that MD in MS is mediated by abnormal ‘communications’ within limbic circuits. We also found evidence that MD in MS may be linked with connectivity alterations at the limbic-motor interface, a group of regions that translates emotions into survival-oriented behaviors.
Parity is associated with a longer time to reach irreversible disability milestones in women with multiple sclerosis
Authors: Masera S , Cavalla P , Prosperini L , Mattioda A , Mancinelli CR , Superti G , Chiavazza C , Vercellino M , Pinessi L , Pozzilli C 
Published: December 2014

Background: Multiple sclerosis (MS) frequently affects women of childbearing age. While short-term effects of pregnancy on MS course are well-known, whether pregnancy may influence long-term disability progression is debated. Methods: A two-centre retrospective study to investigate long-term effect of pregnancy on disability was performed in a population of MS women. Survival analyses and multivariate Cox proportional regression models (including early predictors of MS severity and exposure to disease-modifying treatments) were performed to compare time to reach well-established disability milestones in nulliparous women and in those with pregnancies after MS onset (‘parous’). Women with pregnancies before MS onset were excluded from analyses as they represent a heterogeneous group. Results: Data about 445 women (261 nulliparous, 184 ‘parous’) were analysed. A longer time to reach Expanded Disability Status Scale (EDSS) 4.0 and 6.0 was observed in parous women; Cox regression models revealed a lower risk for ‘parous’ than nulliparous women in reaching EDSS 4.0 and 6.0 (HR = 0.552, p = 0.008 and HR = 0.422, p = 0.012 respectively). Conclusion: Our findings suggest that pregnancy after MS onset is associated with a slower long-term disability progression. Whether this represents a biological/immunological effect, or reflects a higher propensity toward childbearing in women with milder disease, it remains uncertain deserving further investigations.
Does Public Election Funding Create More Extreme Legislators? Evidence from Arizona and Maine
Authors: Masket Seth E. , Miller Michael G. 
Published: December 2014

AbstractWe investigate whether Maine and Arizona's Clean Elections laws, which provide public funding for state legislative candidates, are responsible for producing a new cadre of legislators who are unusually ideologically extreme. We find that there is essentially no important difference in the legislative voting behavior of “clean” funded legislators and traditionally funded ones in either Arizona or Maine: those who are financed by private donors are no more or less ideologically extreme than those who are supported by the state. This finding calls into question some concerns about the effects on polarization of money generally and public funding in particular.
A review of conservative management of camptodactyly in children and adolescents
Authors: Lethbridge Katrina , Wollin Leslie 
Published: December 2014

Introduction The purpose of this review was to systematically evaluate the best available evidence for the conservative management of children and adolescents diagnosed with camptodactyly and propose recommendations to guide clinical practice. Methods A search of six electronic databases and manual searches were carried out in January 2014. The search strategy aimed to identify any published clinical practice guidelines as well as articles on the conservative management of camptodactyly for children and adolescents. Included articles were appraised using the McMaster Critical Review Forms for quantitative studies and assigned a level of evidence according to the National Health and Medical Research Council guidelines. Results No published clinical practice guidelines were located; however, five quantitative articles met the inclusion criteria from the 31 articles identified. The evidence from all included studies was classified according to the National Health and Medical Research Council guidelines as level IV, pre–post study design. All were retrospective. Included studies demonstrate clinically significant changes in passive joint range of motion following conservative treatment protocols. The results of the literature review, combined with clinical experience, were used to develop recommendations to guide clinical practice in the conservative management of children and adolescents with camptodactyly. Discussion The effectiveness of conservative therapy for camptodactyly is promising but evidence remains weak. More rigorous research is needed and the proposed recommendations could be used to inform future research for the conservative treatment of camptodactyly in children and adolescents.
A Physiology-Based Model Describing Heterogeneity in Glucose Metabolism
Authors: Maas Anne H. , Rozendaal Yvonne J. W. , van Pul Carola , Hilbers Peter A. J. , Cottaar Ward J. , Haak Harm R. , van Riel Natal A. W. 
Published: December 2014

Background: Current diabetes education methods are costly, time-consuming, and do not actively engage the patient. Here, we describe the development and verification of the physiological model for healthy subjects that forms the basis of the Eindhoven Diabetes Education Simulator (E-DES). E-DES shall provide diabetes patients with an individualized virtual practice environment incorporating the main factors that influence glycemic control: food, exercise, and medication. Method: The physiological model consists of 4 compartments for which the inflow and outflow of glucose and insulin are calculated using 6 nonlinear coupled differential equations and 14 parameters. These parameters are estimated on 12 sets of oral glucose tolerance test (OGTT) data (226 healthy subjects) obtained from literature. The resulting parameter set is verified on 8 separate literature OGTT data sets (229 subjects). The model is considered verified if 95% of the glucose data points lie within an acceptance range of ±20% of the corresponding model value. Results: All glucose data points of the verification data sets lie within the predefined acceptance range. Physiological processes represented in the model include insulin resistance and β-cell function. Adjusting the corresponding parameters allows to describe heterogeneity in the data and shows the capabilities of this model for individualization. Conclusion: We have verified the physiological model of the E-DES for healthy subjects. Heterogeneity of the data has successfully been modeled by adjusting the 4 parameters describing insulin resistance and β-cell function. Our model will form the basis of a simulator providing individualized education on glucose control.
Incidence and Nature of Medical Attendance Injuries in English Community Rugby Union
Authors: Roberts Simon P. , Trewartha Grant , England Mike , Stokes Keith A. 
Published: December 2014

Background: Previous research has identified injury patterns during community-level rugby union match play, but none have investigated the frequency and reasons for on-field injury management. Purpose: To establish the frequency, reasons, and patterns of on-field injury management in English community rugby, including differences between different levels of play. Study Design: Descriptive epidemiology study. Methods: Over 3 seasons, injury information was collected from 46 (2009-2010), 67 (2010-2011), and 76 (2011-2012) English community clubs (Rugby Football Union [RFU] levels 3-9). Club injury management staff reported information for all medical attendances during match play, including details on the injury site and type, playing position (seasons 2010-2011 and 2011-2012 only), and whether the player was removed from play. Clubs were subdivided into groups A (RFU levels 3 and 4 [mainly semiprofessional]; n = 39), B (RFU levels 5 and 6 [mainly amateur]; n = 71), and C (RFU levels 7-9 [social and recreational]; n = 79) to differentiate playing levels. Results: The overall medical attendance incidence was 229 per 1000 player-match hours (95% CI, 226-232), with 45 players removed per 1000 player-match hours (95% CI, 44-46). Attendance incidence for group A (294 per 1000 player-match hours; 95% CI, 287-301) was higher compared with group B (213; 95% CI, 208-218; P < .001) and C (204; 95% CI, 200-209; P < .001). There was a higher incidence of attendances to forwards (254; 95% CI, 249-259) compared with backs (191; 95% CI, 187-196; P < .001). The head was the most common specific site of injury (55 per 1000 player-match hours; 95% CI, 53-57) but the lower limb region overall accounted for most attendances (87; 95% CI, 85-89) and the greatest chance of removal from the pitch (22; 95% CI, 21-23). Conclusion: With the likelihood of 1 injury for each team per match severe enough for the player to leave the pitch and with at least 1 attendance for a head injury per match, there is clear evidence that pitch side staff should be trained to recognize potentially serious injuries.
Arthroscopic Repair of Horizontal Meniscus Tears by Vertical Sutures With Packing Technique
Authors: Kaya Alper , Ülkü Tekin Kerem , Kocaoğlu Barış , Gereli Hüseyin Arel , Akan Burak 
Published: December 2014

Objectives: The aim of this study is to report short term results of arthroscopic repair of horizontal meniscus tears by vertical sutures with packing technique Methods: Seventeen patients with an average age of 33 years were treated. Repair was performed to the patients that horizontal component of the tear extends into the capsular zone of the meniscus after excision of the unstable, central or flap components of the tears. The repair was performed after rasping and trephination, with vertical sutures that one leg of the suture is on the superior surface of the menisci and the other leg of the suture is under the inferior surface of the menisci by inside-out technique using the zone-specific curved canulas and all-inside technique using all inside meniscal devices. 9 medial and 8 lateral meniscus tears were treated. Results: Evaluation was performed by Lysholm functional knee scores. All patients were followed clinically and radiological by means of MRI to assess meniscus integrity at the repair site with an average follow-up of 12 months. MRI showed a healed meniscus at the repair sites in only five cases (29%) but with no further disruption of the tear components and osteoarthritic changes in all cases. Mean of Lysholm scores improved from 58 preoperatively to 92 postoperatively that was found statistically significant. Conclusion: Repairing of horizontal meniscus tears that extend into capsular zone instead of resection improves activity level and prevents meniscal loss.