bluuebunny/crossref_metadata_2025_split huggingface dataset:
In-shoe Plantar Pressure Distribution in Nonneuropathic Type 2 Diabetic Patients in Singapore
Authors: Tong Jasper W. K. , Acharya U. Rajendra , Chua Kuang C. , Tan Peck H. 
Published: April 2014

Background:We sought to establish the in-shoe plantar pressure distribution during normal level walking in type 2 diabetic patients of Chinese, Indian, and Malay descent without clinical evidence of peripheral neuropathy.Methods:Thirty-five patients with type 2 diabetes mellitus without loss of tactile sensation and foot deformities and 38 nondiabetic individuals in a control group had in-shoe plantar pressures collected. Maximum peak pressure and peak pressure-time integral of each foot were analyzed as separate variables and were masked into 13 areas. Differences in pressure variables were assessed by analysis of covariance, adjusting for relevant covariates at the 95% confidence interval.Results:No significant differences were noted in maximum peak pressures after adjusting for sex, race, age, height, and body mass. However, patients with diabetes mellitus had significantly higher mean ± SD pressure-time integrals at the right whole foot (309.50 ± 144.17 kPa versus 224.06 ± 141.70 kPa, P &lt; .05) and first metatarsal (198.65 ± 138.27 kPa versus 121.54 ± 135.91 kPa, P &lt; .05) masked areas than did those in the control group after adjustment.Conclusions:Patients without clinical observable signs of foot deformity (implying absence of motor neuropathy) and sensory neuropathy had similar in-shoe maximum peak pressures as controls. This finding supported the notion that either component of neuropathy needs to be present before plantar pressures are elevated. Patients with diabetes mellitus demonstrated greater pressure-time integrals, implying that this variable might be the first clinical sign observable even before peripheral neuropathy could be tested. (J Am Podiatr Med Assoc 101(6): 509–516, 2011)
Surgical Treatment of Diaphyseal Stress Fractures of the Fifth Metatarsal in Competitive Athletes
Authors: Pecina Marko , Bojanic Ivan , Smoljanovic Tomislav , Ivkovic Alan , Mirkovic Maja , Jelic Miroslav 
Published: April 2014

Background:Proximal diaphyseal stress fractures of the fifth metatarsal are common in athletes. Conservative treatment has been shown to result in high rates of delayed union, nonunion, and refracture, so internal fixation has become the treatment of choice in competitive athletes.Methods:Twenty top-level athletes with diaphyseal stress fractures fixed with intramedullary malleolar screws were evaluated. Functional outcome was assessed by American Orthopaedic Foot and Ankle Society midfoot score. Static and dynamic maximum vertical force and peak plantar pressures were evaluated with a computerized pedobarograph.Results:Mean follow-up from surgery to interview was 10.3 years (range, 3.5–19.0 years). Clinical healing was 95%, and there has been one refracture (5%). The mean time from surgery to return to sport was 9 weeks (range, 5–14 weeks). Twelve athletes (60%) returned to a higher level of training, 7 (35%) to the same level, and 1 (5%) to a lower level compared with the level of training before injury. Average American Orthopaedic Foot and Ankle Society midfoot score was 93.8 (range, 85–100). During the computerized pedobarographic evaluations, 18 patients (90%) presented with varus of the metatarsus and the midfoot and 2 (10%) presented with a normal plantigrade foot.Conclusions:Intramedullary malleolar screws can yield reliable and effective healing of fifth metatarsal stress fractures in athletes. Varus of the metatarsus and the midfoot were predisposing factors for stress fractures in this population of competitive athletes, and all were recommended to wear orthoses until their competitive careers were completed. (J Am Podiatr Med Assoc 101(6): 517–522, 2011)
Fear of Falling Is Prevalent in Older Adults with Diabetes Mellitus But Is Unrelated to Level of Neuropathy
Authors: Kelly Carolyn , Fleischer Adam , Yalla Sai , Grewal Gurtej S. , Albright Rachel , Berns Dana , Crews Ryan , Najafi Bijan 
Published: April 2014

Background:Patients with diabetic peripheral neuropathy (DPN) demonstrate gait alterations compared with their nonneuropathic counterparts, which may place them at increased risk for falling. However, it is uncertain whether patients with DPN also have a greater fear of falling.Methods:A voluntary group of older adults with diabetes was asked to complete a validated fear of falling questionnaire (Falls Efficacy Scale International [FES-I]) and instructed to walk 20 m in their habitual shoes at their habitual speed. Spatiotemporal parameters of gait (eg, stride velocity and gait speed variability) were collected using a validated body-worn sensor technology. Balance during walking was also assessed using sacral motion in the mediolateral and anteroposterior directions. The level of DPN was quantified using vibration perception threshold from the great toe.Results:Thirty-four diabetic patients (mean ± SD: age, 67.6 ± 9.2 years; body mass index, 30.9 ± 5.7; hemoglobin A1c, 7.9% ± 2.3%) with varying levels of neuropathy (mean ± SD vibration perception threshold, 34.6 ± 22.9 V) were recruited. Most participants (28 of 34, 82%) demonstrated moderate to high concern about falling based on their FES-I score. Age (r = 0.6), hemoglobin A1c level (r = 0.39), number of steps required to reach steady-state walking (ie, gait initiation) (r = 0.4), and duration of double support (r = 0.44) were each positively correlated with neuropathy severity (P &lt; .05). Participants with a greater fear of falling also walked with slower stride velocities and shorter stride lengths (r = −0.3 for both, P &lt; .05). However, no correlation was observed between level of DPN and the participant’s actual concern about falling.Conclusions:Fear of falling is prevalent in older adults with diabetes mellitus but is unrelated to level of neuropathy. (J Am Podiatr Med Assoc 103(6): 480–488, 2013)
Hallux Valgus Surgery May Produce Early Improvements in Balance Control
Authors: Sadra Saba , Fleischer Adam , Klein Erin , Grewal Gurtej S. , Knight Jessica , Weil Lowell Scott , Weil Lowell , Najafi Bijan 
Published: April 2014

Background:Hallux valgus (HV) is associated with poorer performance during gait and balance tasks and is an independent risk factor for falls in older adults. We sought to assess whether corrective HV surgery improves gait and balance.Methods:Using a cross-sectional study design, gait and static balance data were obtained from 40 adults: 19 patients with HV only (preoperative group), 10 patients who recently underwent successful HV surgery (postoperative group), and 11 control participants. Assessments were made in the clinic using body-worn sensors.Results:Patients in the preoperative group generally demonstrated poorer static balance control compared with the other two groups. Despite similar age and body mass index, postoperative patients exhibited 29% and 63% less center of mass sway than preoperative patients during double-and single-support balance assessments, respectively (analysis of variance P =.17 and P =.14, respectively [both eyes open condition]). Overall, gait performance was similar among the groups, except for speed during gait initiation, where lower speeds were encountered in the postoperative group compared with the preoperative group (Scheffe P = .049).Conclusions:This study provides supportive evidence regarding the benefits of corrective lower-extremity surgery on certain aspects of balance control. Patients seem to demonstrate early improvements in static balance after corrective HV surgery, whereas gait improvements may require a longer recovery time. Further research using a longitudinal study design and a larger sample size capable of assessing the long-term effects of HV surgical correction on balance and gait is probably warranted. (J Am Podiatr Med Assoc 103(6): 489–497, 2013)
Balance Rehabilitation
Authors: Grewal Gurtej S. , Sayeed Rashad , Schwenk Michael , Bharara Manish , Menzies Robert , Talal Talal K. , Armstrong David G. , Najafi Bijan 
Published: April 2014

Background:
Individuals with diabetic peripheral neuropathy frequently experience concomitant impaired proprioception and postural instability. Conventional exercise training has been demonstrated to be effective in improving balance but does not incorporate visual feedback targeting joint perception, which is an integral mechanism that helps compensate for impaired proprioception in diabetic peripheral neuropathy.

Methods:
This prospective cohort study recruited 29 participants (mean ± SD: age, 57 ± 10 years; body mass index [calculated as weight in kilograms divided by height in meters squared], 26.9 ± 3.1). Participants satisfying the inclusion criteria performed predefined ankle exercises through reaching tasks, with visual feedback from the ankle joint projected on a screen. Ankle motion in the mediolateral and anteroposterior directions was captured using wearable sensors attached to the participant’s shank. Improvements in postural stability were quantified by measuring center of mass sway area and the reciprocal compensatory index before and after training using validated body-worn sensor technology.

Results:
Findings revealed a significant reduction in center of mass sway after training (mean, 22%; P = .02). A higher postural stability deficit (high body sway) at baseline was associated with higher training gains in postural balance (reduction in center of mass sway) (r = −0.52, P &lt; .05). In addition, significant improvement was observed in postural coordination between the ankle and hip joints (mean, 10.4%; P = .04).

Conclusions:
The present research implemented a novel balance rehabilitation strategy based on virtual reality technology. The method included wearable sensors and an interactive user interface for real-time visual feedback based on ankle joint motion, similar to a video gaming environment, for compensating impaired joint proprioception. These findings support that visual feedback generated from the ankle joint coupled with motor learning may be effective in improving postural stability in patients with diabetic peripheral neuropathy. (J Am Podiatr Med Assoc 103(6): 498–507, 2013)
Overview of the Regulation of Disulfide Bond Formation in Peptide and Protein Folding
Authors: Hidaka Yuji 
Published: April 2014

AbstractDisulfide bonds play a critical role in the maintenance of the native conformation of proteins under thermodynamic control. In general, disulfide bond formation is associated with protein folding, and this restricts the formation of folding intermediates such as misbridged disulfide isomers or kinetically trapped conformations, which provide important information related to how proteins fold into their native conformation. Therefore, numerous studies have focused on the structural analysis of folding intermediates in vitro. However, isolating or trapping folding intermediates, as well as the entire proteins, including mutant proteins, is not an easy task. Several chemical methods have recently been developed for examining peptide and protein folding and for producing, e.g., intact, post‐translationally modified, or kinetically trapped proteins, or proteins with misbridged disulfide bonds. This overview introduces chemical methods for regulating the formation of disulfide bonds of peptides and proteins in the context of the thermodynamic and kinetic control of peptide and protein folding. Curr. Protoc. Protein Sci. 76:28.6.1‐28.6.6. © 2014 by John Wiley & Sons, Inc.
Expression and Purification of Haemophilus influenzae Rhomboid Intramembrane Protease GlpG for Structural Studies
Authors: Panwar Pankaj , Lemieux M. Joanne 
Published: April 2014

AbstractRhomboid proteases are membrane‐embedded proteases that cleave peptide bonds of transmembrane proteins. They play a variety of roles in cell signaling events. The rhomboid protease GlpG from Haemophilus influenzae (hiGlpG) is a canonical form of rhomboid protease having six transmembrane segments. In this unit, detailed protocols are presented for optimization of hiGlpG expression using the araBAD promotor system in the pBAD vector. The parameters for optimization include concentration of inducing agent, induction temperature, and time. Optimization of these key factors led to the development of a protocol yielding 1.6 to 2.5 mg/liter protein purified after ion metal affinity chromatography (IMAC). Further purification can include size exclusion chromatography (SEC). Curr. Protoc. Protein Sci. 76:29.9.1‐29.9.25 © 2014 by John Wiley & Sons, Inc.
An Earth System Science Program for the Baltic Sea Region
Authors: Meier H. E. M. , Rutgersson A. , Reckermann M. 
Published: April 2014

From Russia in the east to Sweden, Denmark, and Germany in the west, reaching south to the tips of the Czech Republic, Slovakia, and Ukraine, the Baltic Sea watershed drains nearly 20% of Europe (see Figure 1). In the highly populated south, the temperate climate hosts intensive agriculture and industry. In the north, the landscape is boreal and rural. In the Baltic Sea itself, complex bathymetry and stratification patterns as well as extended hypoxic and anoxic deep waters add to the diversity. Yet in recent history, the differences across the Baltic Sea region have been more than physical: In the mid‐20th century, the watershed was split in two.
Clinical Evaluation in Multidisciplinary Settings
Authors: Volkmar Fred R. , Booth Leah Langford , McPartland James C. , A. Wiesner Lisa 
Published: April 2014

AbstractWell‐integrated multidisciplinary and transdisciplinary assessments can be of significant benefit to children with autism and their families. In this chapter we summarize the range of approaches used depending on the purpose(s) of the assessment as well as the individual's age and level of ability. Attention to integration of findings and incorporation of parents, teachers, and others in the process is reviewed, as are the various challenges faced by multidisciplinary teams.
Assessing Communication in Autism Spectrum Disorders
Authors: Paul Rhea , Fahim Donia 
Published: April 2014

AbstractCommunication deficits are a core symptom or ASD, and the assessment of individuals with these disorders requires both formal testing and careful observation of natural and seminatural communicative activities. For children in prelinguistic phases of communication, assessment is aimed at establishing the communicative basis for a formal language system and looking at the frequency, range, and means of expression of communicative acts. Children in the early stages of language use will need to be assessed not only in terms of their vocabularies and sentence structures, but with regard to the unusual communicative patterns that often accompany ASD, such as echolalia, pronoun errors, and significant deficits in pragmatics and receptive language. Some children at this level may require evaluation to determine the best alternative mode of communication if speech has not yet emerged, and an augmentative and alternative communication (AAC) system should be considered. For individuals at advanced language levels, assessment will focus on social uses of communication (particularly pragmatic, narrative, and prosodic skills), and may include an assessment of their written language. For people at all developmental levels and at all points along the autistic spectrum, a comprehensive evaluation of strengths and needs in the area of communication is essential to the development of an effective plan for improving communicative competence.
Behavioral Assessment of Individuals With Autism: Current Practice and Future Directions
Authors: Powers Michael D. , Palmieri Mark J. , Egan Shaunessy M. , Rohrer Jessica L. , Nulty Elizabeth C. , Forte Solandy 
Published: April 2014

AbstractUnderstanding of behaviors of people with ASDs can serve treatment planning and outcome evaluation, and help to develop new, more adaptive functional responses in learning and social situations. Predictive, formative, and summative information and reliable data are essential to the study of behaviors. Among many methods, this chapter discusses a functional ecological approach. Multidimensional assessment considers various contextual factors for behaviors. Assessments of learning characteristics, skill acquisition, stimulus preference, reinforcement, and social skills are discussed in this chapter. A descriptive data resource and interdisciplinary collaboration are essential to a more complete understanding of an individual's needs. More accurate behavioral assessment and individualized interventions can assist individuals with ASDs to reduce behaviors such as self‐injurious behaviors and to achieve improvements in activities of daily life, independent completion of tasks, and social and educational interactions.
Evidence‐Based Psychosocial Interventions for Individuals With Autism Spectrum Disorders
Authors: Reichow Brian , Barton Erin E. 
Published: April 2014

AbstractEvidence‐based practice is a multistep process of incorporating empirical evidence, clinical expertise, and patient values to make clinical decisions. In the United States, there are legal mandates (i.e., No Child Left Behind [Public Law 107‐110], Individuals with Disabilities Education Act [Public Law 108‐446]) requiring the use of scientifically based practices. Insurance companies in the United States are increasingly requiring all treatments that provide reimbursement to be evidence‐based, including coverage of treatment of autism spectrum disorders. There is also growing (and possibly greater) recognition of the importance of providing evidence‐based practices globally. Hence, there is a great need to identify which treatments for individuals with autism spectrum disorders are evidence‐based. This chapter is devoted to providing an overview of the current state of the science related to evidence‐based psychosocial interventions (both comprehensive and focal in nature), and concludes with an overview of essential curricular components for treatment programs for individuals who have autism spectrum disorders.
Developing and Implementing Practice Guidelines
Authors: McClure Iain 
Published: April 2014

Abstract
Practice guidelines in autism appeared beginning in the early 1990s. First developed in the United States, they mainly arose due to increasing professional concern that pressurized clinical services, faced with increasing demand, needed to be allocated according to the available evidence base. Initially, practice guidelines were produced by regional or professional organizations; however, national guideline networks, such as SIGN and NICE, soon utilized their considerable expertise to validate available evidence. Major gaps in research knowledge were thereby exposed, and remain significant. Practice‐based guidance has now become a fundamental resource for clinicians, researchers, governments (regional and state), as well as for people with autism.
Preparing Teachers and Professionals
Authors: Eren Ruth Blennerhassett , Groskreutz Mark P. 
Published: April 2014

AbstractThe focus of this chapter is high‐quality preparation of teachers and related service professionals on the preservice (undergraduate and graduate) and professional development levels. The field of education continues to strive for successful outcomes for children on the spectrum despite the identification of sound evidenced‐based practices for this population. The content and process of teacher preparation and professional development in this chapter focus on some core, basic instructional foundations that define quality teaching that yields successful student outcomes.
Economic Aspects of Autism
Authors: Knapp Martin , Buescher Ariane 
Published: April 2014

AbstractIn these times of ever‐tightening budgets, the paucity of economic evidence is already disadvantaging the autism community. The “Is it worth it\quest” question facing decision‐makers considers effectiveness and cost. This chapter discusses efficiency, achieving the maximum effect from resources (such as a budget); effectiveness, the outcomes achieved from an intervention or a preventive initiative; and outcomes, in this context the symptoms alleviated, needs met, educational standards attained, or quality of life improved. It reviews economic research on ASD and urges more well‐researched and well‐communicated arguments in terms of outcomes and cost‐effectiveness.
Translating Research Into Effective Social Policy
Authors: Doehring Peter 
Published: April 2014

Abstract
Social policy is one of the primary mechanisms through which research is translated into meaningful outcomes for people living with autism spectrum disorder (ASD). Research that establishes the prevalence of features of ASD and their associated outcomes, identifies effective interventions, and tracks the successful dissemination of these interventions across a population is especially valuable to shaping policy. In the majority of cases, research can only contribute to improved outcomes at the individual and societal level through the development of services and related programs of training. Barriers to the translation of research into effective social policy may be overcome only through cross‐discipline and cross‐agency collaboration, as illustrated through a detailed case study presented in the chapter.
Medication Adherence in Gout: A Systematic Review
Authors: De Vera Mary A. , Marcotte Greg , Rai Sharan , Galo Jessica S. , Bhole Vidula 
Published: April 2014

ObjectiveRecent data suggesting the growing problem of medication nonadherence in gout have called for the need to synthesize the burden, determinants, and impacts of the problem. Our objective was to conduct a systematic review of the literature examining medication adherence among patients with gout in real‐world settings.MethodsWe conducted a search of Medline, Embase, International Pharmaceutical Abstracts, PsycINFO, and CINAHL databases and selected studies of gout patients and medication adherence in real‐world settings. We extracted information on study design, sample size, length of followup, data source (e.g., prescription records versus electronic monitoring versus self‐report), type of nonadherence problem evaluated, adherence measures and reported estimates, and determinants of adherence reported in multivariable analyses.ResultsWe included 16 studies that we categorized according to methods used to measure adherence, including electronic prescription records (n = 10), clinical records (n = 1), electronic monitoring devices (n = 1), and self‐report (n = 4). The burden of nonadherence was reported in all studies, and among studies based on electronic prescription records, adherence rates were all below 0.80 and the proportion of adherent patients ranged from 10–46%. Six studies reported on determinants, with older age and having comorbid hypertension consistently shown to be positively associated with better adherence. One study showed the impact of adherence on achieving a serum uric acid target.ConclusionWith less than half of gout patients in real‐world settings adherent to their treatment, this systematic review highlights the importance of health care professionals discussing adherence to medications during encounters with patients.