bluuebunny/crossref_metadata_2025_split huggingface dataset:
Television-Related Injuries to Children in the United States, 1990–2011
Authors: De Roo Ana C. , Chounthirath Thiphalak , Smith Gary A. 
Published: July 2013

OBJECTIVE:
To investigate the epidemiology of television (TV)-related injuries to children in the United States.

METHODS:
Using data from the National Electronic Injury Surveillance System, children aged &lt;18 years treated in United States hospital emergency departments for an injury associated with a TV from 1990 through 2011 were investigated.

RESULTS:
An estimated 380 885 patients aged &lt;18 years were treated in emergency departments for a TV-related injury during the 22-year study period, which equals an annual average of 17 313 children. The median age of patients was 3 years; children &lt;5 years represented 64.3% of patients, and boys comprised 60.8%. The average annual injury rate was 2.43 (95% confidence interval [CI]: 2.07–2.80) injuries per 10 000 children aged &lt;18 years, with a range of 2.15 (95% CI: 1.64–2.66) to 2.90 (95% CI: 2.31–3.49). Although the overall injury rate was steady, the number and rate of injuries associated with falling TVs increased significantly by 125.5% and 95.3%, respectively, during the study period. In addition, there was a significant 344.1% increase in the number of injuries associated with a TV falling from a dresser/bureau/chest of drawers/armoire during 1995–2011.

CONCLUSIONS:
The rate of pediatric injuries caused by falling TVs is increasing, which underscores the need for increased prevention efforts. Prevention strategies include public education, provision of TV anchoring devices at the point of sale of TVs, TV anchoring device distribution programs, strengthening of standards for TV stability, and redesign of TVs to improve stability.
Corneal Transplantation at an Ophthalmological Referral Center in Colombia: Indications and Techniques (2004-2011)
Authors: Galvis Virgilio , Tello Alejandro , Gomez Augusto José , Rangel Carlos Mario , Prada Angélica María , Camacho Paul Anthony 
Published: July 2013

Purpose:
To analize changing trends in indications and surgical techniques of corneal transplantation at an ophthalmological tertiary referral center in Colombia over a 7 year period.

Methods:
A retrospective analysis was performed of medical records from patients who underwent corneal transplantation surgeries at Fundación Oftalmológica de Santander (FOSCAL) in Bucaramanga, Colombia, between August 2004 and August 2011.

Results:
During this period from a total of 450 corneal transplants performed, we had access to 402 medical records (89.4%). The patients’ mean age was 55. Leading indications were: pseudophakic/aphakic bullous kerathopathy (PBK/ABK) (34.6%), corneal scar (15.7%), active infectious keratitis (14.4%) and keratoconus (12.7%). During the first period (2004-2007) PBK/ABK was the leading indication, followed by stromal opacities and keratoconus. During the second period (2008-2011) PBK/ABK remained the leading indication. Infectious keratitis, however, became the second most common indication. Stromal opacities and keratoconus, moved to third and fourth, respectively. All transplants performed in the first period (2004-2007) were penetrating keratoplasties. In the second period (2008-2011) 18.7% of the procedures were performed using the Descemet’s stripping automated endothelial keratoplasty technique (DSAEK).

Conclusions:
Similar to other international results, PBK/ABK was the leading indication for corneal transplantation at our institution. Keratoconus is becoming a less common indication for keratoplasty in our institution. Infectious keratitis remains a frequent indication for corneal transplantation in this geographical area. In our institution we started performing DSAEK in 2009, and it is emerging as the procedure of choice in corneal diseases that involve only the endothelial layers.
Challenges to Healthy Eating for People With Diabetes in a Low-Income, Minority Neighborhood
Authors: Breland Jessica Y. , McAndrew Lisa M. , Gross Rachel L. , Leventhal Howard , Horowitz Carol R. 
Published: July 2013

OBJECTIVE
This study used qualitative interviews with black and Latino participants with diabetes to further understanding about types of foods eaten, food preparation, sources of foods and meals, communication with providers, and effects of race and ethnicity on eating in this population.

RESEARCH DESIGN AND METHODS
Researchers recruited black and Latino adults from East Harlem, New York, to participate in four English and Spanish focus groups. Discussions were transcribed, coded, and analyzed to uncover prevalent themes, which were interpreted with the Common Sense Model of Self-Regulation.

RESULTS
Thirty-seven adults with diabetes participated in four focus groups. The following four major themes emerged from the analyses: 1) The food environment limited participants’ access to healthy foods; 2) understanding of diabetes and communication with clinicians about healthy eating was limited and abstract; 3) the short-term, negative consequences of healthy eating outweighed the benefits; and 4) stress, in large part from poverty and discrimination, was seen as a causal factor for both poor eating and diabetes.

CONCLUSIONS
Participants’ responses indicated that using healthy eating to control diabetes does not provide immediate, tangible results. Thus, these participants followed their own common sense to guide their diabetes management and improve their health. Clinicians may be better able to help patients eat healthfully if they consider these factors during medical visits.
Categorical Analysis of the Impact of Aerobic and Resistance Exercise Training, Alone and in Combination, on Cardiorespiratory Fitness Levels in Patients With Type 2 Diabetes
Authors: Johannsen Neil M. , Swift Damon L. , Lavie Carl J. , Earnest Conrad P. , Blair Steven N. , Church Timothy S. 
Published: July 2013

OBJECTIVE
Low cardiorespiratory fitness (CRF) is an independent risk factor for cardiovascular disease (CVD), especially in individuals with type 2 diabetes. Age-predicted, sex-stratified, and maximal MET cut points have been developed to determine the risk of CVD events and mortality in low CRF categories. We examined the proportion of Health Benefits of Aerobic and Resistance Training in Individuals With Type 2 Diabetes (HART-D) participants above these cut points before and after 9 months of aerobic training (AT), resistance training (RT), or a combination of both (ATRT).

RESEARCH DESIGN AND METHODS
Participants from the HART-D study (n = 196) who were randomly assigned to exercise training (AT, RT, or ATRT) or to a nonexercise control group between April 2007 and August 2009 were used in this ancillary study. Cut points were previously established for age-predicted METs (&gt;100% and &gt;85%, mean and increased CVD risk, respectively), age- and sex-stratified METs (Aerobic Center Longitudinal Study), and clinically discernible METs (men &gt;8.0, women &gt;6.5).

RESULTS
Baseline prevalence of participants above these cut points was similar for all intervention groups (P &gt; 0.50) and ranged from 11.9% (&gt;100% age predicted) to 55.1% (&gt;85% age predicted). Baseline prevalence and age-, sex-, and race/ethnic group–adjusted percentage of participants above each cut point increased significantly after AT and ATRT (P &lt; 0.05 for all).

CONCLUSIONS
Structured exercise training, especially the AT component, was associated with a greater number of participants moving above established cut points indicative of low CRF. These results have public health and clinical implications for the growing number of patients with type 2 diabetes at high risk for CVD.
HbA1c and the Risks for All-Cause and Cardiovascular Mortality in the General Japanese Population
Authors: Sakurai Masaru , Saitoh Shigeyuki , Miura Katsuyuki , Nakagawa Hideaki , Ohnishi Hirofumi , Akasaka Hiroshi , Kadota Aya , Kita Yoshikuni , Hayakawa Takehito , Ohkubo Takayoshi , Okayama Akira , Okamura Tomonori , Ueshima Hirotsugu ,   for the NIPPON DATA90 Research Group
Published: July 2013

OBJECTIVE
Associations between HbA1c and cardiovascular diseases (CVD) have been reported mainly in Western countries. It is not clear whether HbA1c measurements are useful for assessing CVD mortality risk in East Asian populations.

RESEARCH DESIGN AND METHODS
The risk for cardiovascular death was evaluated in a large cohort of participants selected randomly from the overall Japanese population. A total of 7,120 participants (2,962 men and 4,158 women; mean age 52.3 years) free of previous CVD were followed for 15 years. Adjusted hazard ratios (HRs) and 95% CIs among categories of HbA1c (&lt;5.0%, 5.0–5.4%, 5.5–5.9%, 6.0–6.4%, and ≥6.5%) for participants without treatment for diabetes and HRs for participants with diabetes were calculated using a Cox proportional hazards model.

RESULTS
During the study, there were 1,104 deaths, including 304 from CVD, 61 from coronary heart disease, and 127 from stroke (78 from cerebral infarction, 25 from cerebral hemorrhage, and 24 from unclassified stroke). Relations to HbA1c with all-cause mortality and CVD death were graded and continuous, and multivariate-adjusted HRs for CVD death in participants with HbA1c 6.0–6.4% and ≥6.5% were 2.18 (95% CI 1.22–3.87) and 2.75 (1.43–5.28), respectively, compared with participants with HbA1c &lt;5.0%. Similar associations were observed between HbA1c and death from coronary heart disease and death from cerebral infarction.

CONCLUSIONS
High HbA1c levels were associated with increased risk for all-cause mortality and death from CVD, coronary heart disease, and cerebral infarction in general East Asian populations, as in Western populations.
New-Onset Diabetes in Elderly Subjects
Authors: Twito Orit , Ahron Ella , Jaffe Anat , Afek Shani , Cohen Efrat , Granek-Catarivas Martine , Klein Pinchas , Hermoni Doron 
Published: July 2013

OBJECTIVE
New-onset diabetes mellitus (DM) in elderly patients is associated with increased risk of diabetes complications and mortality. It is unknown whether glycemic control in this population influences the mortality risk.

RESEARCH DESIGN AND METHODS
The current study was conducted using the computerized database of the Sharon-Shomron District of Clalit Health Services in Israel. Included in the study were subjects 65 years of age and above with new-onset DM. The primary outcome measures were all-cause mortality and coronary revascularization procedures with either percutaneous coronary intervention or coronary artery bypass grafting.

RESULTS
Participants (n = 2,994) were stratified into four groups according to their mean HbA1c levels during the follow-up period (&lt;6.5% [48 mmol/mol], 6.5–6.99% [48–52 mmol/mol], 7–7.49% [53–57 mmol/mol], and ≥7.5% [58 mmol/mol]). During a mean follow-up of 5.54 ± 2.1 years, 1,173 (39.17%) participants died and 285 (9.51%) underwent coronary revascularization. An HbA1c level &gt;7.5% (58 mmol/mol) was associated with a significantly increased all-cause mortality rate (hazard ratio [HR] 1.74 [95% CI 1.2–1.8], P &lt; 0.0001). This difference remained statistically significant after a multivariate model adjusted for the conventional cardiovascular risk factors and for the use of hypoglycemic agents and statins. Kaplan-Meier survival plots revealed lower survival rates in this group of patients. Coronary revascularization rates were highest among subjects with HbA1c 6.5–6.99% (48–52 mmol/mol) (HR 1.6 [1.01–2.4], P &lt; 0.05) and lowest in patients with HbA1c ≥7.5% (58 mmol/mol).

CONCLUSIONS
An HbA1c level &gt;7.5% (58 mmol/mol) is associated with increased risk for all-cause mortality and with a lower revascularization rate in elderly patients with new-onset DM.
Impact of Specific Glucose-Control Strategies on Microvascular and Macrovascular Outcomes in 58,000 Adults With Type 2 Diabetes
Authors: Neugebauer Romain , Fireman Bruce , Roy Jason A. , O’Connor Patrick J. 
Published: July 2013

OBJECTIVE
Comparative effectiveness research methods are used to compare the effect of four distinct glucose-control strategies on subsequent myocardial infarction and nephropathy in type 2 diabetes.

RESEARCH DESIGN AND METHODS
A total of 58,000 adults with type 2 diabetes and A1C &lt;7% (53 mmol/mol) while taking two or more oral agents or basal insulin had subsequent A1C ≥7% (53 mmol/mol) to 8.5% (69 mmol/mol). Follow-up started on date of first A1C ≥7% and ended on date of a specific clinical event, death, disenrollment, or study end. Glucose-control strategies were defined as first intensification of glucose-lowering therapy at A1C ≥7, ≥7.5, ≥8, or ≥8.5% with subsequent control for treatment adherence. Logistic marginal structural models were fitted to assess the discrete-time hazards for each dynamic glucose-control strategy, adjusting for baseline and time-dependent confounding and selection bias through inverse probability weighting.

RESULTS
After adjustment for age, sex, race/ethnicity, comorbidities, blood pressure, lipids, BMI, and other covariates, progressively more aggressive glucose-control strategies were associated with reduced onset or progression of albuminuria but not associated with significant reduction in occurrence of myocardial infarction or preserved renal function based on estimated glomerular filtration rate over 4 years of follow-up.

CONCLUSIONS
In a large representative cohort of adults with type 2 diabetes, more aggressive glucose-control strategies have mixed short-term effects on microvascular complications and do not reduce the myocardial infarction rate over 4 years of follow-up. These findings are consistent with the results of recent clinical trials, but confirmation over longer periods of observation is needed.
Risk of a Recurrent Cardiovascular Event in Individuals With Type 2 Diabetes or Intermediate Hyperglycemia
Authors: van der Heijden Amber A.W.A. , van’t Riet Esther , Bot Sandra D.M. , Cannegieter Suzanne C. , Stehouwer Coen D.A. , Baan Caroline A. , Dekker Jacqueline M. , Nijpels Giel 
Published: July 2013

OBJECTIVE
To investigate risk of a recurrent cardiovascular event and its predictors in a population-based cohort.

RESEARCH DESIGN AND METHODS
Participants of the Hoorn Study who had experienced a first cardiovascular event after baseline (n = 336) were followed with respect to a recurrent event. Absolute risk of a recurrent event was calculated for individuals with normal glucose metabolism, intermediate hyperglycemia, and type 2 diabetes. Cox regression models were used to investigate which variables, measured before the first vascular event, predicted a recurrent event using the stepwise backward procedure.

RESULTS
During a median follow-up of 4.1 years, 44% (n = 148) of the population developed a recurrent vascular event. The rate of recurrent events per 100 person-years was 7.2 (95% CI 5.8–8.7) in individuals with normal glucose metabolism, compared with 9.8 (6.6–14.0) in individuals with intermediate hyperglycemia and 12.5 (8.5–17.6) in individuals with type 2 diabetes. Higher age (hazard ratio 1.02 [95% CI 1.00–1.04]), male sex (1.56 [1.08–2.25]), waist circumference (1.02 [1.02–1.03]), higher systolic blood pressure (1.01 [1.01–1.02]), higher HbA1c (%, 1.13 [0.97–1.31]/ mmol/mol, 1.01 [1.00–1.03]), and family history of myocardial infarction (1.38 [0.96–2.00]) predicted a recurrent cardiovascular event.

CONCLUSIONS
Individuals with type 2 diabetes, but not individuals with intermediate hyperglycemia, are at increased risk for a recurrent vascular event compared with individuals with normal glucose metabolism. In people with a history of cardiovascular disease, people at increased risk of a recurrent event can be identified based on the patient’s risk profile before the first event.
Matrix Gla Protein Species and Risk of Cardiovascular Events in Type 2 Diabetic Patients
Authors: Dalmeijer Geertje W. , van der Schouw Yvonne T. , Magdeleyns Elke J. , Vermeer Cees , Verschuren W.M. Monique , Boer Jolanda M.A. , Beulens Joline W.J. 
Published: July 2013

OBJECTIVE
To investigate the relationship of circulating matrix Gla protein (MGP) species with incident cardiovascular disease (CVD) or coronary heart disease (CHD) in type 2 diabetic patients.

RESEARCH DESIGN AND METHODS
EPIC-NL is a prospective cohort study among 40,011 Dutch men and women. At baseline (1993–1997), 518 participants were known to have type 2 diabetes. MGP levels were measured by ELISA techniques in baseline plasma samples. The incidence of fatal and nonfatal CVD and CVD subtypes—CHD, peripheral arterial disease (PAD), heart failure, and stroke—were obtained by linkage to national registers. Cox proportional hazard models were used to calculate hazard ratios (HRs), adjusted for sex, waist-to-hip ratio, physical activity, and history of CVD.

RESULTS
During a median 11.2 years of follow-up, 160 cases of CVD were documented. Higher circulating desphospho-uncarboxylated MGP (dp-ucMGP) levels were significantly associated with higher risk of CVD, with an HR per SD (HRSD) of 1.21 (95% CI 1.06–1.38), PAD (HRSD 1.32 [95% CI 1.07–1.65]), and heart failure (HRSD 1.75 [95% CI 1.42–2.17]) after adjustment. Higher circulating dp-ucMGP levels were not related to risk of CHD (HRSD 1.12 [95% CI 0.94–1.34]) or stroke (HRSD 1.05 [95% CI 0.73–1.49]). Circulating desphospho-carboxylated MGP and circulating total-uncarboxylated MGP levels were not associated with CVD or CVD subtypes.

CONCLUSIONS
High dp-ucMGP levels were associated with increased CVD risk among type 2 diabetic patients, especially with the subtypes PAD and heart failure, while other MGP species were not related to CVD risk. These results suggest that a poor vitamin K status is associated with increased CVD risk.
Subarachnoid Hemorrhage in Type 1 Diabetes
Authors: Korja Miikka , Thorn Lena M. , Hägg Stefanie , Putaala Jukka , Liebkind Ron , Harjutsalo Valma , Forsblom Carol M. , Gordin Daniel , Tatlisumak Turgut , Groop Per-Henrik ,   on behalf of the FinnDiane Study Group
Published: July 2013

OBJECTIVE
To estimate for the first time the incidence of subarachnoid hemorrhage (SAH) in type 1 diabetes.

RESEARCH DESIGN AND METHODS
Using the nationwide Finnish Diabetic Nephropathy (FinnDiane) Study cohort of 4,083 patients with type 1 diabetes (mean age of 37.4 ± 11.8 years at enrollment), we analyzed the incidence of first-ever SAH events.

RESULTS
During the follow-up time of 36,680 person-years (median 9.4 years), 15 patients with type 1 diabetes experienced an aneurysmal or nonaneurysmal SAH, and thus the crude incidence of SAH was 40.9 (95% CI 22.9–67.4) per 100,000 person-years. One patient had a verified aneurysmal SAH, and four patients died suddenly of an SAH, which was most likely caused by an aneurysm. SAHs in 10 out of 15 patients were classified as nonaneurysmal SAH, and thus the crude incidence of nonaneurysmal SAH was 27.3 (13.1–50.1) per 100,000 person-years. None of the nonaneurysmal SAHs were fatal. In univariate analysis, current smokers had a hazard ratio of 4.82 (95% CI 1.31–17.81) for nonaneurysmal SAH.

CONCLUSIONS
The incidence of nonaneurysmal SAH is high among patients with type 1 diabetes. Our findings suggest that nonaneurysmal SAH is a distinct new microvascular complication in type 1 diabetes.
Cancer Incidence Among Those Initiating Insulin Therapy With Glargine Versus Human NPH Insulin
Authors: Stürmer Til , Marquis M. Alison , Zhou Haibo , Meigs James B. , Lim Soo , Blonde Lawrence , MacDonald Eileen , Wang Ray , LaVange Lisa M. , Pate Virginia , Buse John B. 
Published: July 2013

OBJECTIVE
To add to the evidence on comparative long-term effects of insulin analog glargine versus human NPH insulin on the risk for cancer.

RESEARCH DESIGN AND METHODS
We identified cohorts of initiators of glargine and human NPH without an insulin prescription during the prior 19 months among patients covered by the Inovalon Medical Outcomes Research for Effectiveness and Economics Registry (MORE2 Registry) between January 2003 and December 2010. Patients were required to have a second prescription of the same insulin within 180 days and to be free of cancer. We balanced cohorts on risk factors for cancer outcomes based on comorbidities, comedication, and health care use during the prior 12 months using inverse probability of treatment weighting. Incident cancer was defined as having two claims for cancer (any cancer) or the same cancer (breast, prostate, colon) within 2 months. We estimated adjusted hazard ratios (HRs) and their 95% CI using weighted Cox models censoring for stopping, switching, or augmenting insulin treatment, end of enrollment, and mortality.

RESULTS
More patients initiated glargine (43,306) than NPH (9,147). Initiators of glargine (NPH) were followed for 1.2 (1.1) years and 50,548 (10,011) person-years; 993 (178) developed cancer. The overall HR was 1.12 (95% CI 0.95–1.32). Results were consistent for breast cancer, prostate cancer, and colon cancer; various durations of treatment; and sensitivity analyses.

CONCLUSIONS
Patients initiating insulin glargine rather than NPH do not seem to be at an increased risk for cancer. While our study contributes significantly to our evidence base for long-term effects, this evidence is very limited mainly based on actual dynamics in insulin prescribing.
Safety and Efficacy of Sitagliptin Therapy for the Inpatient Management of General Medicine and Surgery Patients With Type 2 Diabetes
Authors: Umpierrez Guillermo E. , Gianchandani Roma , Smiley Dawn , Jacobs Sol , Wesorick David H. , Newton Christopher , Farrokhi Farnoosh , Peng Limin , Reyes David , Lathkar-Pradhan Sangeeta , Pasquel Francisco 
Published: July 2013

OBJECTIVE
This study investigated the safety and efficacy of sitagliptin (Januvia) for the inpatient management of type 2 diabetes (T2D) in general medicine and surgery patients.

RESEARCH DESIGN AND METHODS
In this pilot, multicenter, open-label, randomized study, patients (n = 90) with a known history of T2D treated with diet, oral antidiabetic agents, or low total daily dose of insulin (≤0.4 units/kg/day) were randomized to receive sitagliptin alone or in combination with glargine insulin (glargine) or to a basal bolus insulin regimen (glargine and lispro) plus supplemental (correction) doses of lispro. Major study outcomes included differences in daily blood glucose (BG), frequency of treatment failures (defined as three or more consecutive BG &gt;240 mg/dL or a mean daily BG &gt;240 mg/dL), and hypoglycemia between groups.

RESULTS
Glycemic control improved similarly in all treatment groups. There were no differences in the mean daily BG after the 1st day of treatment (P = 0.23), number of readings within a BG target of 70 and 140 mg/dL (P = 0.53), number of BG readings &gt;200 mg/dL (P = 0.23), and number of treatment failures (P &gt; 0.99). The total daily insulin dose and number of insulin injections were significantly less in the sitagliptin groups compared with the basal bolus group (both P &lt; 0.001). There were no differences in length of hospital stay (P = 0.78) or in the number of hypoglycemic events between groups (P = 0.86).

CONCLUSIONS
Results of this pilot indicate that treatment with sitagliptin alone or in combination with basal insulin is safe and effective for the management of hyperglycemia in general medicine and surgery patients with T2D.