bluuebunny/crossref_metadata_2025_split huggingface dataset:
Diabetic ketoacidosis at diagnosis: role of family history and class II HLA genotypes
Authors: Marigliano Marco , Morandi Anita , Maschio Maddalena , Costantini Silvia , Contreas Giovanna , D'Annunzio Giuseppe , Calcaterra Valeria , Maffeis Claudio 
Published: October 2012

ObjectiveTo explore the relationship between family history of diabetes and frequency of diabetic ketoacidosis (DKA) at diagnosis and to analyze the possible association between HLA genotypes and DKA.Design and methodsWe recruited 510 children and adolescents aged <17 years with type 1 diabetes (T1D) and collected information on first-degree relative (FDR) history of T1D. DKA and severe DKA were defined as blood pH <7.30 and <7.10 at diabetes onset respectively. Risk categories for developing T1D were determined according to various HLA DQA1-DQB1 haplotype combination genotypes.ResultsThe frequency of DKA and severe DKA at diagnosis was 34.7 and 7.2% respectively. DKA was more frequent in younger patients (<2 years (60.0%; P<0.001)) and occurred less in children with at least one FDR affected by T1D (13.0 vs 37.4%, P<0.001). The logistic regression showed that age at diagnosis (<2 years) and increased HLA-associated risk genotypes were independent predictors of DKA (P<0.01, odds ratio (OR)=1.068 (95% confidence interval (CI) 1.021–1.117); P<0.05, OR=1.606 (95% CI 1.034–2.475)). Introducing the presence of T1D in at least one FDR in the logistic model, a significant association between DKA and age at diagnosis (<2 years; P<0.01, OR=1.072 (95% CI 1.024–1.123)) and absence of FDRs with T1D (P=0.001, OR=4.287 (95% CI 1.770–10.383)) was found, but no more with increased HLA-associated risk genotype (P=0.06, OR=1.550 (95% CI 0.992–2.423)).ConclusionsHLA-associated high-risk genotypes are associated with a high chance of presenting DKA at diabetes onset. However, having at least one FDR with T1D reduced the risk of DKA regardless of HLA genotype.
Treatment with GH receptor antagonist in acromegaly: effect on cardiac arrhythmias
Authors: Auriemma Renata S , Pivonello Rosario , De Martino Maria Cristina , Cudemo Giuseppe , Grasso Ludovica F S , Galdiero Mariano , Perone Ylenia , Colao Annamaria 
Published: October 2012

ObjectiveTo evaluate the effects of short- and long-term treatment with pegvisomant (PEG) on arrhythmias in acromegalic patients resistant to long-term, high-dose therapy with somatostatin analogs (SA).Materials and methodsThirteen patients entered the study. All patients started PEG at initial dose of 10 mg daily and then titrated to 5 mg every 6 weeks on the basis of IGF1. A standard 24-h electrocardiography registration was performed in all patients at baseline and after 6 and 18 months of PEG to evaluate: mean (HR), maximum (MHR), and minimum (mHR) heart rate; pauses number (P) and duration (PD); supraventricular episodes (SEs) number and duration (SED); and ventricular ectopic beats (EB) number and duration (EBD). Left ventricular mass (LVM) was also evaluated by standard echocardiography.ResultsA slight but not significant decrease in HR, MHR, and mHR was observed after 6-month PEG, whereas a significant decrease in HR (P=0.03), MHR (P=0.05), and mHR (P=0.05) was found after 18-month PEG compared with baseline. LVM significantly (P=0.05) correlated with MRH (r=−0.50) after short-term treatment, and with HR (r=−0.54) and mHR (r=−0.55) after long-term treatment. Long-term PEG induced the complete recovery of arrhythmias recorded at baseline in one patient and the improvement of rhythm disorders developed after 6-month therapy in another patient. The prevalence of conduction disturbances passed from 15 to 7.7% after long-term PEG.ConclusionsLong-term treatment with PEG reduces HR, MHR, and mHR and improves rhythm abnormalities in acromegaly.
Renal Failure in Patients with Left Ventricular Assist Devices
Authors: Patel Ami M. , Adeseun Gbemisola A. , Ahmed Irfan , Mitter Nanhi , Rame J. Eduardo , Rudnick Michael R. 
Published: October 2012

Summary
Implantable left ventricular assist devices (LVADs) are increasingly being used as a bridge to transplantation or as destination therapy in patients with end stage heart failure refractory to conventional medical therapy. A significant number of these patients have associated renal dysfunction before LVAD implantation, which may improve after LVAD placement due to enhanced perfusion. Other patients develop AKI after implantation. LVAD recipients who develop AKI requiring renal replacement therapy in the hospital or who ultimately require long-term outpatient hemodialysis therapy present management challenges with respect to hemodynamics, volume, and dialysis access. This review discusses the mechanics of a continuous-flow LVAD (the HeartMate II), the effects of continuous blood flow on the kidney, renal outcomes of patients after LVAD implantation, dialysis modality selection, vascular access, hemodynamic monitoring during the dialytic procedure, and other issues relevant to caring for these patients.
The Effect of Managers' Enabling Perceptions on Costing System Use, Psychological Empowerment, and Task Performance
Authors: Mahama Habib , Cheng Mandy M. 
Published: October 2012

ABSTRACT:
This study investigates whether and how managers' enabling perceptions of their costing systems affect task performance. We propose that managers who perceive their costing system as more enabling will have higher levels of task performance, and that this relationship occurs through the intensity with which the costing system is used and the level of psychological empowerment experienced by the managers. To test these propositions, we conduct a survey of middle-level managers and analyze the responses using a PLS model. Our results generally support our propositions. Specifically, we find a positive relationship between managers' enabling perceptions and the intensity with which the costing system is used. The intensity of use is further associated with all four dimensions of psychological empowerment (meaning, competence, self-determination, and impact). Finally, the intensity of use also has an indirect impact on task performance via the competence dimension of psychological empowerment. The present study extends prior research on costing systems, and adds to our understanding of the role managers' perceptions play in improving costing system effectiveness.
Data Availability: Data available upon request.
Perioral age-related changes in smile dynamics along the vertical plane
Authors: Singh Bhavna , Ahluwalia Rajiv , Verma Deepa , Grewal Stutee B. , Goel Rupender , Kumar Priyanka S. 
Published: October 2012

ABSTRACT

Objective:
To evaluate the changes in characteristics of perioral musculature at rest and when smiling, with respect to age and gender, measured along the vertical plane in a randomly selected sample of a North Indian population.

Materials and Methods:
Perioral musculature of 195 subjects (divided into three age groups) was recorded using standardized videographic methods. Two frames of each subject—at rest and widest posed smile—were analyzed for a comprehensive list of parameters. Data was evaluated using SPSS version 16 software. Two-way analysis of variance and post hoc least significant difference tests were conducted.

Results:
Significant observations were increased resting upper lip length for females; decreased upper lip thickness, maxillary incisor exposure, and lip elevation for males; and increased smiling upper lip length for both sexes.

Conclusions:
With age, the smile gets narrower vertically, especially for the male population. The pattern of change observed in the present study must be considered and incorporated during treatment planning to deliver healthier and long-lasting results to patients of all age groups.
Ultrasound Imaging Evaluation of Abdominal Muscles After Breast Reconstruction With a Unilateral Pedicled Transverse Rectus Abdominis Myocutaneous Flap
Authors: Liaw Lih-Jiun , Lin Sin-Daw , Guo Lan-Yuen , Hou Yi-You , Hou Ming-Feng , Hsu Ar-Tyan 
Published: October 2012

Background
A muscle-sparing (MS) procedure using a full-width pedicled transverse rectus abdominis (RA) myocutaneous (TRAM) flap was developed to reduce abdominal morbidities after breast reconstruction. However, the effects of this procedure on the morphology of the remnant RA muscle and other abdominal muscles remain unclear.

Objective
Ultrasound imaging was used to evaluate the morphology of the remnant RA muscle and other abdominal muscles in women with the MS pedicled TRAM flap procedure.

Design
A case-control, cross-sectional design was used.

Methods
Thirty-four women with an MS unilateral pedicled TRAM flap procedure after mastectomy (TRAM group) and 25 women who were healthy and matched for age (control group) participated. The curl-up test measured trunk flexor muscle strength. Ultrasound imaging measured the thickness of all abdominal muscles in all participants and the cross-sectional area of the RA muscle at rest and in an isometric position with the head raised in women in the TRAM group. Acoustic echogenicity and border visibility assessed the tissue composition of the remnant RA muscle.

Results
Trunk flexor muscle strength was weaker in the TRAM group than in the control group. Compared with the remnant RA muscle in the contracted state, the remnant RA muscle in the relaxed state was thinner and had a smaller cross-sectional area. The remnant RA muscle in the relaxed state also was thinner, more echoic, and less visible than its contralateral counterpart. No differences in the thickness of the other abdominal muscles were found between the sides. The abdominal muscles in the TRAM group were smaller than those in the control group.

Limitation
Because a prospective, longitudinal design was not used, a definite cause-effect relationship could not be determined.

Conclusions
In women with an MS unilateral pedicled TRAM flap procedure, the remnant RA muscle retains its ability to change in size during contraction, albeit at reduced levels. Muscular atrophy occurs in other ipsilateral and contralateral abdominal muscles as well as the remnant RA muscle. Postoperative immobilization is the most likely cause of generalized weakness of the abdominal musculature.
Effect of Two Different Exercise Regimens on Trunk Muscle Morphometry and Endurance in Soldiers in Training
Authors: Teyhen Deydre S. , Childs John D. , Dugan Jessica L. , Wright Alison C. , Sorge Joshua A. , Mello Jeremy L. , Marmolejo Michael G. , Taylor Adam Y. , Wu Samuel S. , George Steven Z. 
Published: October 2012

BackgroundLimited evidence exists on how strength and endurance exercises commonly used to prevent low back pain affect muscle morphometry and endurance.ObjectiveThe purpose of this study was to analyze the effects of 2 exercise regimens on the morphometry and endurance of key trunk musculature in a healthy population.DesignThe study was designed as a randomized controlled trial.SettingThe study was conducted in a military training setting.ParticipantsA random subsample (n=340; 72% men, 28% women; mean [±SD] age=21.9±4.2 years; mean [±SD] body mass index=24.8±2.8 kg/m2) from the larger Prevention of Low Back Pain in the Military trial (N=4,325) was included.InterventionThe core stabilization exercise program (CSEP) included low-load/low-repetition motor control exercises, whereas the traditional exercise program (TEP) included exercises conducted at a fast pace, with the use of high-load, high-repetition trunk strengthening exercises.MeasurementsBaseline and follow-up examinations included ultrasound imaging of the trunk muscles and endurance tests. Linear mixed models were fitted to study the group and time effect and their interactions, accounting for the clustering effect.ResultsSymmetry generally improved in the rest and contracted states, but there were no differences suggestive of muscle hypertrophy or improved ability to contract the trunk muscles between soldiers receiving the CSEP or the TEP. Total trunk endurance time decreased over the 12-week period, but endurance performance favored soldiers in the CSEP group. Endurance time was not associated with future episodes of low back pain.LimitationsThe lack of morphological changes may not be detectable in an already-active cohort, or a more intensive dose was needed.ConclusionsAlthough improved symmetry was noted, neither the CSEP nor the TEP resulted in muscle hypertrophy. Longer endurance times were noted in individuals who completed the CSEP but were not strongly predictive of future low back pain episodes.
Efficacy of the Addition of Modified Pilates Exercises to a Minimal Intervention in Patients With Chronic Low Back Pain: A Randomized Controlled Trial
Authors: Miyamoto Gisela C. , Costa Leonardo Oliveira Pena , Galvanin Thalissa , Cabral Cristina Maria Nunes 
Published: October 2012

Background
The Pilates method has been used to improve function and reduce pain in patients with chronic nonspecific low back pain, although there is little scientific evidence that describes its efficacy.

Objective
The purpose of this study was to investigate the effectiveness of the addition of modified Pilates exercises to minimal intervention in patients with chronic low back pain.

Design
A randomized controlled trial was conducted.

Setting
The study was done in an outpatient physical therapy department in Brazil.

Patients
Eighty-six patients with chronic nonspecific low back pain participated in the study.

Intervention
All participants received an education booklet containing information about low back pain and were randomly allocated to receive 12 sessions, over 6 weeks, of exercises based upon Pilates principles (n=43) or of education alone (n=43).

Measurements
Primary outcomes were pain intensity and disability measured at 6 weeks and 6 months. Secondary outcomes were patient-specific functional disability, global impression of recovery, and kinesiophobia measured at 6 weeks and 6 months. All outcomes were measured by a blinded assessor in all time points.

Results
There was no loss to follow-up at any of the time points. Improvements were observed in pain (mean difference=2.2 points, 95% confidence interval [CI]=1.1 to 3.2), disability (mean difference=2.7 points, 95% CI=1.0 to 4.4), and global impression of recovery (mean difference=−1.5 points, 95% CI=−2.6 to −0.4) in favor of the Pilates group after intervention, but these differences were no longer statistically significant at 6 months.

Limitations
Treatment provider and participants could not be blinded to the interventions.

Conclusions
The addition of modified Pilates exercises to an educational booklet provides small benefits compared with education alone in patients with chronic nonspecific low back pain; however, these effects were not sustained over time.
People With Stroke Who Fail an Obstacle Crossing Task Have a Higher Incidence of Falls and Utilize Different Gait Patterns Compared With People Who Pass the Task
Authors: Said Catherine M. , Galea Mary P. , Lythgo Noel 
Published: October 2012

BackgroundObstacle crossing is impaired in people following stroke. It is not known whether people with stroke who fail an obstacle crossing task have more falls or whether the gait adjustments used to cross an obstacle differ from those used by people who pass the task.ObjectiveThe purposes of this study were (1) to identify whether a group of people with stroke who failed an obstacle crossing task had a greater incidence of falling and (2) to determine whether people who fail an obstacle crossing task utilize different gait adjustments.DesignThis was a prospective, observational study.MethodsThirty-two participants with a recent stroke were recruited. Participants walked at self-selected speed and stepped over a 4-cm-high obstacle. Performance was rated as pass or fail, and spatiotemporal, center of mass (COM), and center of pressure (COP) data were collected. Prospective falls data were recorded for 20 participants over a 6-month period.ResultsThe incidence of fallers was significantly higher (incidence rate=0.833) in the group that failed the obstacle crossing task than in the group that passed the task (incidence rate=0.143). The group that failed the task had a slower walking speed and greater normalized separation between the trail heel (unaffected support limb) and COM as the affected lead toe cleared the obstacle. This group exhibited greater normalized times from affected lead toe clearance to landing, unaffected trail toe clearance to landing, and affected trail toe-off to toe clearance.LimitationsThe sample size was small, and falls data were available for only 20 participants.ConclusionsObstacle crossing is an important task to consider in people following stroke and may be useful in identifying those at risk of falls.
The First Two Years of Practice: A Longitudinal Perspective on the Learning and Professional Development of Promising Novice Physical Therapists
Authors: Hayward Lorna M. , Black Lisa L. , Mostrom Elizabeth , Jensen Gail M. , Ritzline Pamela D. , Perkins Jan 
Published: October 2012

BackgroundPhysical therapists work in complex health care systems requiring professional competence in clinical reasoning and confidence in decision-making skills. For novice physical therapists, the initial practice years are a time for developing professional identity and practical knowledge.ObjectivesThe study purpose was to extend previous research describing the experiences, learning, and professional development of 11 promising novice therapists during their first year of practice. The present study examined the continued development of the same therapists during their second year of clinical practice.DesignSeven researchers from 4 physical therapist educational programs in the eastern and midwestern United States used a longitudinal, qualitative, multiple case study approach.MethodsEleven physical therapist graduates identified as “promising novices” were recruited using purposive sampling. Participants ranged in age from 24 to 29 years and entered varied practice settings. Data were collected for 2 years using semistructured interviews, reflective journals, and participant observation.ResultsA conceptual model describing the participants' ongoing development during the second year of practice emerged. The 3 themes were formal and informal learning, increasing confidence and expansion of skills, and engagement in an environment characterized by collaborative exchange and opportunities for teaching. The second year represented consolidation and elaboration of practice-based learning and skills. The expansion of confidence, skills, and responsibilities and the externalization of learning the participants experienced promoted professional role formation. Learning previously directed inward and self-focused turned outward, fueled by growing self-confidence.ConclusionsResearch illuminating the professional role formation experienced during early clinical practice is not widely available. The current study and further research into the learning and development of novice practitioners may assist educators in the design of pedagogical strategies and learning environments that enhance the professional development of physical therapists.
Recent progress in understanding, diagnosing, and treating hepatocellular carcinoma
Authors: Maluccio Mary , Covey Anne 
Published: October 2012

AbstractHepatocellular carcinoma (HCC) is one of the few cancers in which a continued increase in incidence has been observed over several years. As such, there has been a focus on safe and accurate diagnosis and the development of treatment algorithms that take into consideration the unique complexities of this patient population. In the past decade, there have been improvements in nonsurgical treatment platforms and better standardization with respect to the diagnosis and patient eligibility for liver transplant. How to navigate patients through the challenges of treatment is difficult and depends on several factors: 1) patient‐related variables such as comorbid conditions that influence treatment eligibility; 2) liver‐related variables such as Child‐Pugh score; and 3) tumor‐related variables such as size, number, pattern of spread within the liver, and vascular involvement. The objectives of this review are to put into perspective the current treatment options for patients with HCC, the unique advantages and disadvantages of each treatment approach, and the evidence that supports the introduction of sorafenib into the multidisciplinary management of HCC. CA Cancer J Clin 2012;. © 2012 American Cancer Society.
Serological Assays Based on Recombinant Viral Proteins for the Diagnosis of Arenavirus Hemorrhagic Fevers
Authors: Fukushi Shuetsu , Tani Hideki , Yoshikawa Tomoki , Saijo Masayuki , Morikawa Shigeru 
Published: October 2012

The family Arenaviridae, genus Arenavirus, consists of two phylogenetically independent groups: Old World (OW) and New World (NW) complexes. The Lassa and Lujo viruses in the OW complex and the Guanarito, Junin, Machupo, Sabia, and Chapare viruses in the NW complex cause viral hemorrhagic fever (VHF) in humans, leading to serious public health concerns. These viruses are also considered potential bioterrorism agents. Therefore, it is of great importance to detect these pathogens rapidly and specifically in order to minimize the risk and scale of arenavirus outbreaks. However, these arenaviruses are classified as BSL-4 pathogens, thus making it difficult to develop diagnostic techniques for these virus infections in institutes without BSL-4 facilities. To overcome these difficulties, antibody detection systems in the form of an enzyme-linked immunosorbent assay (ELISA) and an indirect immunofluorescence assay were developed using recombinant nucleoproteins (rNPs) derived from these viruses. Furthermore, several antigen-detection assays were developed. For example, novel monoclonal antibodies (mAbs) to the rNPs of Lassa and Junin viruses were generated. Sandwich antigen-capture (Ag-capture) ELISAs using these mAbs as capture antibodies were developed and confirmed to be sensitive and specific for detecting the respective arenavirus NPs. These rNP-based assays were proposed to be useful not only for an etiological diagnosis of VHFs, but also for seroepidemiological studies on VHFs. We recently developed arenavirus neutralization assays using vesicular stomatitis virus (VSV)-based pseudotypes bearing arenavirus recombinant glycoproteins. The goal of this article is to review the recent advances in developing laboratory diagnostic assays based on recombinant viral proteins for the diagnosis of VHFs and epidemiological studies on the VHFs caused by arenaviruses.
Misconceptions About Anabolic-Androgenic Steroid Abuse
Authors: Kanayama Gen , Pope Harrison G. 
Published: October 2012

CME Educational Objectives

1.
Recognize which patient populations are most likely to abuse anabolic-androgenic steroids (AAS).

2.
Identify and understand the frequently underestimated adverse symptoms of AAS.

3.
Become familiar with ways patients avoid detection of AAS use.

Although anabolic-androgenic steroids were widely used by elite athletes as early as the 1950s, it was not until the 1980s that anabolic-androgenic steroid abuse began to spread beyond the elite athletic world and into the general population. Because widespread anabolic-androgenic steroid abuse is so new, many clinicians and researchers are not nearly as familiar with this form of substance abuse as they are with other, more venerable drugs.