bluuebunny/crossref_metadata_2025_split huggingface dataset:
Translating the Diabetes Prevention Program into an Online Social Network
Authors: Sepah S. Cameron , Jiang Luohua , Peters Anne L. 
Published: April 2014

Purpose The purpose of this study was to evaluate the efficacy of Prevent, an online social network-based translation of the Diabetes Prevention Program (DPP) lifestyle intervention, against the Centers for Disease Control and Prevention (CDC) Diabetes Prevention and Recognition Program (DPRP) outcome standards and weight loss outcomes of other DPP translations. Methods Two hundred twenty participants previously diagnosed with prediabetes were recruited online and enrolled in Prevent, a DPP-based group lifestyle intervention that integrates a private online social network, weekly lessons, health coaching, and a wireless scale and pedometer. Participants underwent a core 16-week intensive lifestyle change intervention and were then offered to continue with a post-core lifestyle change maintenance intervention, with the entire intervention (core plus post-core) totaling 12 months. Results One hundred eighty-seven participants met inclusion criteria for the core program and achieved an average of 5.0% and 4.8% weight loss at 16 weeks and 12 months, respectively. They also had a 0.37% reduction in their A1C level at final measurement. One hundred forty-four of these same participants also met inclusion criteria for the post-core program and achieved an average of 5.4% and 5.2% weight loss at 16 weeks and 12 months, respectively, and a 0.40% reduction in A1C at final measurement. Conclusion Results indicate that Prevent meets CDC DPRP outcome standards for diabetes prevention programs and performs favorably to other DPP translations. Considering national initiatives to address the obesity and diabetes epidemics, online delivery platforms like Prevent offer an effective and scalable solution.
Vitamin D replacement therapy in patients with cardiac syndrome X
Authors: Andishmand A , Ansari Z , Soltani MH , Mirshamsi H , Raafat S 
Published: April 2014

Aims: The aim of present study was to assess whether vitamin D, with proven beneficial effects on the cardiovascular system, has any effect on angina and exercise-induced ischemia in patients with cardiac syndrome X and low serum vitamin D. Methods: Patients with cardiac syndrome X and low serum vitamin D3 were studied before and after treatment with an intramuscular injection of vitamin D3 (300,000 units, every other week for 2 months). We determined the angina episode (per day) and several indices of exercise capacity. Results: At the end of the treatment course (75±6 day), a significant increase of serum vitamin D3 occurred and was within the normal range (45±8 ng/ml) and the frequency of angina improved significantly ( p=0.003). Exercise duration and maximal work capacity increased significantly ( p<0.001). Maximal ST-segment depression (mm) decreased significantly ( p=0.001). The calculated Duck treadmill score improved significantly ( p=0.001). Conclusions: Our findings show that vitamin D replacement therapy in patients with cardiac syndrome X and vitamin D deficiency dramatically improves symptoms and signs of ischemia.
Haemodynamic changes with the use of neuromuscular electrical stimulation compared to intermittent pneumatic compression
Authors: Williams KJ , Moore HM , Davies AH 
Published: April 2014

Introduction Enhancement of peripheral circulation has been shown to be of benefit in many vascular disorders, and the clinical effectiveness of intermittent pneumatic compression is well established in peripheral vascular disease. This study compares the haemodynamic efficacy of a novel neuromuscular electrical stimulation device with intermittent pneumatic compression in healthy subjects. Methods Ten healthy volunteers (mean age 27.1 ± 3.8 years, body mass index 24.8 ± 3.6 kg/m2) were randomised into two groups, in an interventional crossover trial. Devices used were the SCD Express™ Compression System, (Covidien, Ireland) and the geko™, (Firstkind Ltd, UK). Devices were applied bilaterally, and haemodynamic measurements taken from the left leg. Changes to haemodynamic parameters (superficial femory artery and femoral vein) and laser Doppler measurements from the hand and foot were compared. Results Intermittent pneumatic compression caused 51% ( p = 0.002), 5% (ns) and 3% (ns) median increases in venous peak velocity, time-averaged maximum velocity and volume flow, respectively; neuromuscular electrical stimulator stimulation caused a 103%, 101% and 101% median increases in the same parameters (all p = 0.002). The benefit was lost upon deactivation. Intermittent pneumatic compression did not improve arterial haemodynamics. Neuromuscular electrical stimulator caused 11%, 84% and 75% increase in arterial parameters ( p < 0.01). Laser Doppler readings taken from the leg were increased by neuromuscular electrical stimulator ( p < 0.001), dropping after deactivation. For intermittent pneumatic compression, the readings decreased during use but increased after cessation. Hand flux signal dropped during activation of both devices, rising after cessation. Discussion The neuromuscular electrical stimulator device used in this study enhances venous flow and peak velocity in the legs of healthy subjects and is equal or superior to intermittent pneumatic compression. This warrants further clinical and economic evaluation for deep venous thrombosis prophylaxis and exploration of the haemodynamic effect in venous pathology. It also enhances arterial time-averaged maximum velocity and flow rate, which may prove to be of clinical use in the management of peripheral arterial disease. The effect on the microcirculation as evidenced by laser Doppler fluximetry may reflect a clinically beneficial target in microvascular disease, such as in the diabetic foot.
Physician-reported practices on continuous deep sedation until death: A descriptive and comparative study
Authors: Papavasiliou Evangelia (Evie) , Chambaere Kenneth , Deliens Luc , Brearley Sarah , Payne Sheila , Rietjens Judith , Vander Stichele Robert , Van den Block Lieve ,   on behalf of EURO IMPACT, Lieve Van den Block , Zeger De Groote , Sarah Brearley , Augusto Caraceni , Joachim Cohen , Anneke Francke , Richard Harding , Irene J Higginson , Stein Kaasa , Karen Linden , Guido Miccinesi , Bregje Onwuteaka-Philipsen , Koen Pardon , Roeline Pasman , Sophie Pautex , Sheila Payne , Luc Deliens 
Published: April 2014

Background: Research on continuous deep sedation until death has focused on estimating prevalence and describing clinical practice across care settings. However, evidence on sedation practices by physician specialty is scarce. Aims: To compare and contrast physician-reported practices on continuous deep sedation until death between general practitioners and medical specialists. Design/participants: A secondary analysis drawing upon data from a large-scale, population-based, retrospective survey among physicians in Flanders, Belgium in 2007. Symptom prevalence and characteristics of sedation (drugs used, artificial nutrition and hydration administered, intentions, and decision-making) were measured. Results: Response rate was 58.4%. The frequency of continuous deep sedation until death among all deaths was 11.3% for general practitioners and 18.4% for medical specialists. General practitioners reported significantly higher rates of severity and mean intensity of pain, delirium, dyspnea, and nausea in the last 24 h of life for sedated patients and a higher number of severe symptoms than medical specialists. No differences were found between groups in the drugs used, except in propofol, reported only by medical specialists (in 15.8% of all cases). Artificial nutrition and hydration was withheld or withdrawn in 97.2% of general practitioner and 36.2% of medical specialist cases. Explicit life-shortening intentions were reported by both groups (for 3%–4% of all cases). Continuous deep sedation until death was initiated without consent or request of either the patient or the family in 27.9% (medical specialists) and 4.7% (general practitioners) of the cases reported. Conclusion: Considerable variation, often largely deviating from professional guidelines, was observed in physician-reported performance and decision-making, highlighting the importance of providing clearer guidance on the specific needs of the context in which continuous deep sedation until death is to be performed.
Analysis of central mechanism of cognitive training on cognitive impairment after stroke: Resting-state functional magnetic resonance imaging study
Authors: Lin Zhi-cheng , Tao Jing , Gao Yan-lin , Yin Da-zhi , Chen A-zhen , Chen Li-dian 
Published: April 2014

Objective To investigate the central mechanism of cognitive training in patients with stroke, using resting state (RS) functional magnetic resonance imaging (fMRI). Methods Patients with stroke and executive function and memory deficit were randomized to receive computer-assisted cognitive training (treatment group; total 60 h training over 10 weeks) or no training (control group). All participants received neuropsychological assessment and RS fMRI at baseline and 10 weeks. Results Patients in the treatment group ( n = 16) showed increased functional connectivity (FC) of the hippocampus with the frontal lobe (right inferior, right middle, left middle, left inferior and left superior frontal gyrus) and left parietal lobe at 10 weeks compared with baseline. Patients in the control group ( n = 18) showed decreased FC of the left hippocampus–right occipital gyrus, and right hippocampus–right posterior lobe of cerebellum and left superior temporal gyrus. Significant correlations were found between improved neuropsychological scores and increased FC of the hippocampus with the frontal lobe and left parietal lobe in the treatment group only. Conclusions Increased RS FC of the hippocampus with the frontal and parietal lobes may be an important mechanism of cognitive recovery after stroke.
Oxygen treatment of cluster headache: A review
Authors: Petersen Anja S , Barloese Mads CJ , Jensen Rigmor H 
Published: April 2014

Purpose Our aim was to review the existing literature to document oxygen’s therapeutic effect on cluster headache. Method A PubMed search resulted in 28 hits, and from these and their references we found in total 11 relevant studies. We included six studies that investigated the efficacy of oxygen treatment. One study is observational and the remaining five are RCTs. Another five studies were on hyperbaric oxygen treatment hereof two case studies. Conclusion Oxygen therapy can be administered at different flow rates. Three studies investigate the effect of low-flow oxygen, 6–7 l/min, and found a positive response in 56%, 75% and 82%, respectively, of the patients. One study investigates high-flow oxygen, 12 l/min, and found efficacy in 78% of attacks. The effect of hyperbaric oxygen therapy has been investigated in a few small studies and there is evidence only for an acute, but not a prophylactic effect. Despite the fact that only a few high-quality RCT studies are available, oxygen treatment is close to an ideal treatment because it is effective and safe. However, sufferers of cluster headache do not always have access to oxygen because of logistic and financial concerns.
Reversible cerebral vasoconstriction syndrome following indomethacin
Authors: Calic Zeljka , Choong Ho , Schlaphoff Glen , Cappelen-Smith Cecilia 
Published: April 2014

Background Reversible cerebral vasoconstriction syndrome (RCVS) is characterized by severe thunderclap headaches and transient segmental cerebral arterial vasoconstriction. Precipitating factors, including the postpartum state and exposure to vasoactive substances are identified in approximately 50% of cases. Non-steroidal anti-inflammatory drugs have rarely been associated with RCVS. Case description We report a case of a 51-year-old female with RCVS after administration of indomethacin given to relieve pain caused by renal colic. Cerebral imaging showed non-aneurysmal cortical subarachnoid hemorrhage, and formal angiography demonstrated widespread multifocal segmental narrowing of medium-sized cerebral arteries. These changes resolved on repeat angiography at 3 weeks. Discussion Indomethacin is a commonly used drug for treatment of certain primary headache disorders. To date, its mechanism of action remains unclear. A well described side effect of indomethacin is headache, which may be secondary to its vasoconstrictive effects. In our case, we postulate indomethacin, either alone or in combination with emotional stress from pain, triggered or exacerbated an underlying predisposition to RCVS.
Accelerated Versus Traditional Rehabilitation After Anterior Talofibular Ligament Reconstruction for Chronic Lateral Instability of the Ankle in Athletes
Authors: Miyamoto Wataru , Takao Masato , Yamada Kazuaki , Matsushita Takashi 
Published: April 2014

Background: Although several reconstruction procedures for chronic lateral ankle instability using autografts have been reported, all have recommended postoperative immobilization and a nonweightbearing period. Hypothesis: Reconstructive surgery with a gracilis autograft using an interference fit anchoring system for chronic lateral ankle instability enables early accelerated rehabilitation and recovery with a return to activity without requiring immobilization. Study Design: Cohort study; Level of evidence, 3. Methods: A total of 33 patients (33 feet) who underwent reconstruction of the anterior talofibular ligament with a gracilis autograft using interference screws were included; 15 were followed for 4 weeks with postoperative cast immobilization (group I), while 18 were followed with accelerated rehabilitation without immobilization (group A). Clinical and radiological results were evaluated based on the Karlsson and Peterson score, talar tilt angle, anterior displacement of the talus on stress radiography, and time between surgery and return to full athletic activity. Results: The mean Karlsson and Peterson scores before and 2 years after surgery were the following: for group I: 62.3 ± 4.7 (range, 54-72) and 94.4 ± 7.1 (range, 76-100), respectively ( P < .001), and for group A: 64.1 ± 4.8 (range, 57-70) and 91.7 ± 7.7 (range, 74-100), respectively ( P < .001). The mean difference in the talar tilt angle compared with the contralateral side and mean displacement of the talus on stress radiography before and 2 years after surgery were the following: for group I: 8.7° ± 2.6° and 7.7 ± 1.8 mm and 3.8° ± 1.5° and 4.0 ± 1.6 mm, respectively, and for group A: 10.5° ± 3.4° and 8.7 ± 2.1 mm and 4.3° ± 1.8° and 4.3 ± 1.2 mm, respectively. Radiography revealed significantly improved postoperative outcomes in both groups ( P < .0001). No significant differences in the score and any parameters on stress radiography were evident at 2 years after surgery between the groups. The mean time between surgery and return to full athletic activity was significantly higher in group I (18.5 ± 3.5 weeks) than in group A (13.4 ± 2.2 weeks) ( P < .0001). No cases of reinjury were reported, and no differences in athletic performance ability were observed between the groups. Conclusion: Patients in group A returned to full athletic activity 5 weeks earlier than those in group I, demonstrating the advantage of accelerated rehabilitation after surgery.
Publication and Level of Evidence Trends in The American Journal of Sports Medicine From 1996 to 2011
Authors: Cvetanovich Gregory L. , Fillingham Yale A. , Harris Joshua D. , Erickson Brandon J. , Verma Nikhil N. , Bach Bernard R. 
Published: April 2014

Background: There has been recent increased emphasis on the publication quality and levels of evidence in orthopaedic sports medicine clinical research. The American Journal of Sports Medicine ( AJSM) began publishing levels of evidence in the abstracts of clinical articles in 2005. Purpose: To analyze trends in the characteristics and levels of evidence of articles published in AJSM. Study Design: Meta-analysis. Methods: All articles in AJSM from 1996, 2001, 2006, and 2011 were analyzed. Articles were analyzed for type: clinical original research, basic science, current concepts review, and case report. Clinical articles were assigned a level of evidence from 1 to 4 and categorized as therapeutic, prognostic, diagnostic, or economic. Descriptive information was collected regarding funding, authorship, and study characteristics. Statistics were calculated using χ2 tests. Results: A total of 795 articles were analyzed. From 1996 to 2011, there has been a significant increase in the percentage of level 1 and 2 articles (9.4% to 23.0%; P = .007) and a significant decrease in the percentage of level 3, 4, and 5 articles (55.1% to 45.1%; P = .037). There was a significant increase in the percentage of therapeutic studies (46.8% to 68.6%; P = .004) and a decrease in prognostic studies (36.7% to 22.2%; P = .03). Publishing authors were from 31 countries, notable for a significant increase in the percentage of studies published by authors from outside the United States from 1996 to 2011 (20.3% to 53.0%; P < .001). The percentage of articles reporting a financial conflict of interest significantly increased during this time (26.1% to 42.2%; P = .006). Conclusion: From 1996 to 2011, the proportion of level 1 and 2 evidence studies published in AJSM has increased significantly. There has been an increase in therapeutic studies and a decrease in prognostic studies. There has been an increase in the number of international studies published.
Semitendinosus Tendon Autograft for Reconstruction of Large Defects in Chronic Achilles Tendon Ruptures
Authors: Dumbre Patil Sampat Shivajirao , Dumbre Patil Vaishali Sampat , Basa Vikas Rajeshwarrao , Dombale Ajay Birappa 
Published: April 2014

Background: Chronic Achilles tendon ruptures are associated with considerable functional morbidity. When treated operatively, debridement of degenerated tendon ends may create large defects. Various procedures to reconstruct large defects have been described. We present a simple technique in which an autologous semitendinosus tendon graft is used to reconstruct defects larger than 5 cm in chronic Achilles tendon ruptures. The purpose of this study was to describe our operative technique and its functional outcome. Methods: Achilles ruptures of more than 6 weeks duration were considered for the study. We treated 35 patients (20 males, 15 females) with symptomatic chronic Achilles tendon ruptures. The mean age was 47.4 years (range, 30 to 59). The smallest defect that we had reconstructed was 5 cm, and the largest was 9 cm in length. The average follow-up duration was 30.7 months (range, 20 to 42). Postoperatively, the strength of gastrocsoleus was measured by manual muscle testing (MMT) in non-weight-bearing and weight-bearing positions. Results: All operated patients showed satisfactory functional outcome, good soft tissue healing, and no reruptures. The preoperative weight-bearing MMT of 2/5 improved to 4/5 or 5/5 postoperatively. In all patients, postoperative non-weight-bearing MMT was 5/5. All patients returned to their prerupture daily activity. Conclusion: We present a technique that is simple, with low morbidity. We believe it is a valuable option especially when allografts are not available. It is inexpensive as suture anchors or tenodesis screws are not used. This can be a useful option if other tendons (flexor hallucis longus, peroneus brevis, etc) are not available for transfer. Level of Evidence: Level IV, retrospective case series.
Judicial Deference and Executive Control Over Administrative Agencies
Authors: Johnson Gbemende 
Published: April 2014

AbstractDo judges defer to executives with increased institutional control over the executive branch? Administrative agencies play a key role in the policy implementation process. Executives could view aggressive judicial review of executive branch activity as a threat to executive power and negatively respond to perceived judicial intrusions. Governors across the country possess varying amounts of institutional authority over the agencies that comprise their states' executive branches. For example, in many states, executive branch officials are elected by the public or appointed by someone other than the governor. Increased fragmentation increases the difficulty of centralized management and decreases gubernatorial influence over the executive branch. I examine whether state supreme courts defer more to agencies in states where governors have more formal control over the executive branch. I find that state supreme courts are more likely to rule in favor of state administrative agencies in states where the governor has increased appointment power and increased power to review agency rulemaking.
The Consortium for NCD Prevention and Control in Sub-Saharan Africa (CNCD-Africa): from concept to practice
Authors: Amuyunzu-Nyamongo Mary , Owuor Jared O. , Blanchard Claire 
Published: April 2014

CNCD-Africa was established in July 2009 in response to and in recognition of the continuously increasing burden of diseases such as injuries, non-communicable diseases (NCDs) and mental health in low- and middle-income countries, and specifically in countries of sub-Saharan Africa. CNCD-Africa aims to comprehensively address specific and common objectives while building capacity in the region to prevent and control NCDs. With support from key partners and funders, and a keen interest in opportunities to address NCDs from health promotion and equity perspectives, the Consortium has excelled in four key areas: convening; knowledge generation and sharing; advocacy; and networking. However, the path to successful and sustainable efforts remains laden with challenges and barriers. Retaining interest of network partners through flagship efforts and continued efforts to ascertain support from local and international partners with interest in NCDs across the region remain essential to CNCD-Africa core activities. A key lesson learnt from the early years of CNCD-Africa is that existing regional platforms can and should be used to showcase what is being done locally, and to share best practices and best-buys. In addition, partnerships and stakeholder involvement have been key for CNCD-Africa and are essential to NCD action. Sustaining such partnerships requires incentives for the various partners to keep actively involved in NCD action. This can be achieved through joint inception, project planning, implementation, monitoring and evaluation. Another ingredient for success seems to be innovative financing for NCD efforts, which is possible through the establishment and sustaining of regional and global partnerships that are robust, locally relevant and respond to country needs.