bluuebunny/crossref_metadata_2025_split huggingface dataset:
Incidence of Diabetes and Prediabetes and Predictors of Progression Among Asian Indians: 10-Year Follow-up of the Chennai Urban Rural Epidemiology Study (CURES)
Authors: Anjana Ranjit Mohan , Shanthi Rani Coimbatore Subramanian , Deepa Mohan , Pradeepa Rajendra , Sudha Vasudevan , Divya Nair Haridas , Lakshmipriya Nagarajan , Subhashini Sivasankaran , Binu Valsalakumari Sreekumarannair , Unnikrishnan Ranjit , Mohan Viswanathan 
Published: April 2015

OBJECTIVE
There are few data on the incidence rates of diabetes and prediabetes (dysglycemia) in Asian Indians. This article presents the incidence of diabetes and prediabetes and the predictors of progression in a population-based Asian Indian cohort.

RESEARCH DESIGN AND METHODS
Data on progression to diabetes and prediabetes from 1,376 individuals, a subset of 2,207 of the Chennai Urban Rural Epidemiology Study (CURES) cohort (phase 3) with normal glucose tolerance (NGT) or prediabetes at baseline, who were followed for a median of 9.1 years (11,629 person-years), are presented. During follow-up, 534 died and 1,077 with NGT and 299 with prediabetes at baseline were reinvestigated in a 10-year follow-up study. Diabetes and prediabetes were diagnosed based on the American Diabetes Association criteria. Incidence rates were calculated and predictors of progression to prediabetes and/or diabetes were estimated using the Cox proportional hazards model.

RESULTS
The incidence rates of diabetes, prediabetes, and “any dysglycemia” were 22.2, 29.5, and 51.7 per 1,000 person-years, respectively. Among those with NGT, 19.4% converted to diabetes and 25.7% to prediabetes, giving an overall conversion rate to dysglycemia of 45.1%. Among those with prediabetes, 58.9% converted to diabetes. Predictors of progression to dysglycemia were advancing age, family history of diabetes, 2-h plasma glucose, glycated hemoglobin (HbA1c), low HDL cholesterol, and physical inactivity.

CONCLUSIONS
Asian Indians have one of the highest incidence rates of diabetes, with rapid conversion from normoglycemia to dysglycemia. Public health interventions should target modifiable risk factors to slow down the diabetes epidemic in this population.
Impact of polymethylmethacrylate additives on methicillin-resistant Staphylococcus pseudintermedius biofilm formation in vitro
Authors: Morrison Shauna , Singh Ameet , Rousseau Joyce , Walker Meagan , Nazarali Alim , Crawford Evan , Brisson Brigitte , Sears William C. , Weese J. Scott 
Published: April 2015

Abstract
OBJECTIVE To evaluate the impact of gentamicin, silver, or both additives in polymethylmethacrylate (PMMA) beads on methicillin-resistant Staphylococcus pseudintermedius (MRSP) biofilm formation in vitro.
SAMPLE 4 preparations of PMMA beads (formed with no additive [control], gentamicin, silver, and gentamicin and silver).
PROCEDURES Beads from each group were exposed to 10 MRSP isolates known to be strong biofilm formers. Following incubation, the beads were rinsed to remove planktonic bacteria, then sonicated to dislodge biofilm-associated bacteria. Resulting suspensions were serially diluted, plated on blood agar, and incubated overnight; CFUs were counted. Variance of mean CFU counts following log10 transformation was analyzed among PMMA groups.
RESULTS None of the PMMA additives tested completely inhibited MRSP biofilm formation. There was a significant effect of gentamicin and gentamicin plus silver on this variable, compared with controls, but not of silver alone. There was no difference between gentamicin and gentamicin plus silver. When only isolates not susceptible to gentamicin were evaluated, there were no significant differences among PMMA additive groups. Within gentamicin-susceptible isolates, there was an impact of gentamicin and gentamicin plus silver, but no impact of silver alone and no difference between gentamicin and gentamicin plus silver.
CONCLUSIONS AND CLINICAL RELEVANCE Gentamicin-impregnated PMMA was effective at reducing biofilm formation of gentamicin-susceptible MRSP isolates but had no effect on isolates not susceptible to gentamicin. Silver-impregnated PMMA had no effect on MRSP biofilm formation. Results suggested that gentamicin-impregnated PMMA may not be effective in vivo against MRSP isolates not susceptible to gentamicin. Antibacterial efficacy of silver should not be assumed without proper testing of the target bacteria and specific silver compound.
Therapist-Designed Adaptive Riding in Children With Cerebral Palsy: Results of a Feasibility Study
Authors: Angsupaisal Mattana , Visser Baudina , Alkema Anne , Meinsma-van der Tuin Marja , Maathuis Carel G.B. , Reinders-Messelink Heleen , Hadders-Algra Mijna 
Published: April 2015

BackgroundIt is debatable whether adaptive riding (AR) in children with cerebral palsy (CP) improves postural control and gross motor development.ObjectiveThe study aim was to explore the feasibility of an extensive assessment protocol for a randomized controlled trial of therapist-designed adaptive riding (TDAR) in children with CP, with the goals of assessing the effect on child outcomes and evaluating working mechanisms of sitting postural control.DesignA pretest-posttest group design with 2 baseline measurements was used.MethodsSix children (1 girl, 5 boys; age range=6–12 years, median age=8 years 9 months) with bilateral spastic CP (Gross Motor Function Classification System level III) participated. Outcomes were evaluated 3 times (T0, T1, and T2) at 6-week intervals. T0 and T1 were baseline measurements; between T1 and T2, a TDAR intervention including an integrated program of postural challenge exercises (2 times per week for 1 hour) was applied. The complex protocol included the 88-item Gross Motor Function Measure (GMFM-88) and electromyographic (EMG) recording of postural muscle activity during reaching while sitting (EMG recording at T1 and T2 only).ResultsThe protocol was feasible. Median GMFM-88 scores changed from 64.4 at T0 to 66.7 at T1 and from 66.7 at T1 to 73.2 at T2. The change scores for all children exceeded the minimal clinically important difference of the GMFM-88. Five of 6 children showed a decrease in stereotyped top-down recruitment between T1 and T2.LimitationsStudy limitations included the lack of a control group, small sample size, and potential assessor bias for all but the EMG parameters.ConclusionsThe feasibility of the complex protocol was established. The data suggested that a 6-week TDAR intervention may improve gross motor function and may reduce stereotyped postural adjustments in children with CP. The limited results warrant replication in a well-powered randomized controlled trial.
Risk Adjustment for Lumbar Dysfunction: Comparison of Linear Mixed Models With and Without Inclusion of Between-Clinic Variation as a Random Effect
Authors: Yen Sheng-Che , Corkery Marie B. , Chui Kevin K. , Manjourides Justin , Wang Ying-Chih , Resnik Linda J. 
Published: April 2015

BackgroundValid comparison of patient outcomes of physical therapy care requires risk adjustment for patient characteristics using statistical models. Because patients are clustered within clinics, results of risk adjustment models are likely to be biased by random, unobserved between-clinic differences. Such bias could lead to inaccurate prediction and interpretation of outcomes.PurposeThe purpose of this study was to determine if including between-clinic variation as a random effect would improve the performance of a risk adjustment model for patient outcomes following physical therapy for low back dysfunction.DesignThis was a secondary analysis of data from a longitudinal cohort of 147,623 patients with lumbar dysfunction receiving physical therapy in 1,470 clinics in 48 states of the United States.MethodsThree linear mixed models predicting patients' functional status (FS) at discharge, controlling for FS at intake, age, sex, number of comorbidities, surgical history, and health care payer, were developed. Models were: (1) a fixed-effect model, (2) a random-intercept model that allowed clinics to have different intercepts, and (3) a random-slope model that allowed different intercepts and slopes for each clinic. Goodness of fit, residual error, and coefficient estimates were compared across the models.ResultsThe random-effect model fit the data better and explained an additional 11% to 12% of the between-patient differences compared with the fixed-effect model. Effects of payer, acuity, and number of comorbidities were confounded by random clinic effects.LimitationsModels may not have included some variables associated with FS at discharge. The clinics studied may not be representative of all US physical therapy clinics.ConclusionsRisk adjustment models for functional outcome of patients with lumbar dysfunction that control for between-clinic variation performed better than a model that does not.
Experimental investigation of thermal mixing phenomena in a tee pipe
Authors: Chen Mei-Shiue , Hsieh Huai-En , Zhang Zhi-Yu , Pei Bau-Shi 
Published: April 2015

Abstract
T-pipe designs have been widely used in the industry. Among them, mixing of hot and cold water is a common application. In the mixing process, cold and hot fluids are respectively injected through main and branch pipes, and are mixed in the downstream area of T-tube. High temperature hot water flows through the main pipe for a long time; hence, the pipe wall is at high temperatures. The fluid injected into the branch pipe is a cooling fluid. After mixing, the wall of the main pipe is under high thermal fluctuations causing strong thermal stresses, which will eventually lead to pipe damage and water loss. Through flow rate adjustments of the branch and main pipes, when the branch/main velocity ratio was greater than 7.8, showing that cold water hit the bottom of the main pipe and created a reverse flow. This reverse flow created large thermal stresses on the wall. Hence, the branch/main velocity ratio and the hot-water-mixing phenomenon are the focus of this study.
An analytical approach for a nodal formulation of a two-dimensional fixed-source neutron transport problem in heterogeneous medium
Authors: Barichello L. B. , da Cunha R. D. , Picoloto C. B. , Tres A. 
Published: April 2015

Abstract
A nodal formulation of a fixed-source two-dimensional neutron transport problem, in Cartesian geometry, defined in a heterogeneous medium, is solved by an analytical approach. Explicit expressions, in terms of the spatial variables, are derived for averaged fluxes in each region in which the domain is subdivided. The procedure is an extension of an analytical discrete ordinates method, the ADO method, for the solution of the two-dimensional homogeneous medium case. The scheme is developed from the discrete ordinates version of the two-dimensional transport equation along with the level symmetric quadrature scheme. As usual for nodal schemes, relations between the averaged fluxes and the unknown angular fluxes at the contours are introduced as auxiliary equations. Numerical results are in agreement with results available in the literature.
Flow impinging effect of critical heat flux and nucleation boiling heat transfer on a downward facing heating surface
Authors: Hsieh Huai-En , Chen Mei-Shiue , Chen Jyun-Wei , Lin Wei-Keng , Pei Bau-Shei 
Published: April 2015

Abstract
Boiling heat transfer has a high heat removal capability in convective cooling. However, the heat removal capability of downward-facing boiling is significantly worse than that of upward-facing cases because of the confined buoyancy effect. This study was inspired by the conception of external reactor vessel cooling (ERVC) condition relevant to the in-vessel retention (IVR) design of Westinghouse AP1000 plant. In the present study, a small-scale test facility had been established to investigate the local phenomena of boiling heat transfer under a downward-facing horizontal heated surface with impinging coolant flow. In this study, the surface temperature, heat flux information and several specific scenes of bubbles are taken down throughout the boiling processes for detailed investigation. It is observed that bubbles are confined under the downward-facing heated surface, which causes a worse heat transfer rate and a lower critical heat flux (CHF) limit than upward-facing boiling. Nevertheless, the impinging coolant flow is found to disturb the thermal boundary layer formed by the heated surface, so the CHF increases with an increase of coolant flow rate. In addition, during nucleate boiling, it is discovered that the growth, combination and dissipation of bubbles induce turbulent wakes and therefore enhance the heat transfer capability.
Operating experience feedback from safety significant events at research reactors
Authors: Shokr A. M. , Rao D. 
Published: April 2015

Abstract
Operating experience feedback is an effective mechanism to provide lessons learned from the events and the associated corrective actions to prevent recurrence of events, resulting in improving safety in the nuclear installations. This paper analyzes the events of safety significance that have been occurred at research reactors and discusses the root causes and lessons learned from these events. Insights from literature on events at research reactors and feedback from events at nuclear power plants that are relevant to research reactors are also presented along with discussions. The results of the analysis showed the importance of communication of safety information and exchange of operating experience are vital to prevent reoccurrences of events. The analysis showed also the need for continued attention to human factors and training of operating personnel, and the need for establishing systematic ageing management programmes of reactor facilities, and programmes for safety management of handling of nuclear fuel, core components, and experimental devices.
Nonmelanoma cutaneous cancers involving the skull base: outcomes of aggressive multimodal management
Authors: Raza Shaan M. , Ramakrishna Rohan , Weber Randal S. , Kupferman Michael E. , Gidley Paul W. , Hanna Ehab Y. , DeMonte Franco 
Published: April 2015

OBJECT
A relative paucity of information exists regarding outcomes from craniofacial resection for advanced nonmelanoma skin cancers involving the skull base. In light of advances in surgical technique and adjuvant therapy protocols, the authors reviewed their surgical experience to determine disease control rates, overall survival (OS), morbidity, and mortality.

METHODS
A retrospective review of 24 patients with nonmelanoma cutaneous cancers with skull base involvement treated with craniofacial resection at The University of Texas MD Anderson Cancer Center from 1994 to 2012 was performed. Of these patients, 19 (79%) had squamous cell carcinoma (SCC), 4 (17%) had basosquamous carcinoma (BSCC), and 1 patient (4%) had adenocarcinoma. Factors as assessed were prior treatment, TNM staging, tumor involvement, extent of intracranial extension, margin status, postoperative complications, recurrence, disease status at last follow-up, and long-term survival. The majority of tumors were T4 (67%) according to the TNM classification; perineural extension was noted in 58%, cavernous sinus involvement in 25%, and dural involvement in 29%.

RESULTS
Postoperative complications occurred in 4 patients (17%) including 1 death. Kaplan-Meier estimates were calculated for OS and progression-free survival (PFS). Median OS was 43.2 months with an 82% 1-year OS and 37% 5-year OS; the median PFS was 91.2 months. Margin status was positively associated with median OS in SCC (91 months [for negative margins] vs 57 months, p = 0.8) and in BSCC (23.7 vs 3.2 months, p < 0.05). Postoperative radiotherapy was associated with improved median OS (43.2 vs 22 months, p = 0.6). Brain involvement was uniformly fatal after 1 year, while cavernous sinus involvement (31 vs 43 months, p = 0.82), perineural disease (31 vs 54 months, p = 0.30), and T4 stage (22 vs 91.2 months, p = 0.09) were associated with worsened OS. Similar associations were found with median PFS.

CONCLUSIONS
Aggressive multimodality management with surgery and postoperative radiotherapy can positively impact locoregional control and OS. With improvements in technique and adjuvant therapy protocols, treatment can still be considered in situations of perineural disease and cavernous sinus involvement and as a salvage option for patients in whom prior treatment has failed. As patients with advanced NMSCs often have few options, craniofacial resection, as part of a coordinated multimodal management plan, is justified if it can be performed safely.
A quantitative analysis of adverse radiation effects following Gamma Knife radiosurgery for arteriovenous malformations
Authors: Cohen-Inbar Or , Lee Cheng-Chia , Xu Zhiyuan , Schlesinger David , Sheehan Jason P. 
Published: April 2015

OBJECT
The authors review outcomes following Gamma Knife radiosurgery (GKRS) of cerebral arteriovenous malformations (AVMs) and their correlation to postradiosurgery adverse radiation effects (AREs).

METHODS
From a prospective institutional review board–approved database, the authors identified patients with a minimum of 2 years of follow-up and thin-slice T2-weighted MRI sequences for volumetric analysis. A total of 105 AVM patients were included. The authors analyzed the incidence and quantitative changes in AREs as a function of time after GKRS. Statistical analysis was performed to identify factors related to ARE development and changes in the ARE index.

RESULTS
The median clinical follow-up was 53.8 months (range 24–212.4 months), and the median MRI follow-up was 36.8 months (range 24–212.4 months). 47.6% of patients had an AVM with a Spetzler-Martin grade ≥ III. The median administered margin and maximum doses were 22 and 40 Gy, respectively. The overall obliteration rate was 70.5%. Of patients who showed complete obliteration, 74.4% developed AREs within 4–6 months after GKRS. Late-onset AREs (i.e., > 12 months) correlated to a failure to obliterate the nidus. 58.1% of patients who developed appreciable AREs (defined as ARE index > 8) proceeded to have a complete nidus obliteration. Appreciable AREs were found to be influenced by AVM nidus volume > 3 ml, lobar location, number of draining veins and feeding arteries, prior embolization, and higher margin dose. On the other hand, a minimum ARE index > 8 predicted obliteration (p = 0.043).

CONCLUSIONS
ARE development after radiosurgery follows a temporal pattern peaking at 7–12 months after stereotactic radiosurgery. The ARE index serves as an important adjunct tool in patient follow-up and outcome prediction.
Sagittal balance of the cervical spine: an analysis of occipitocervical and spinopelvic interdependence, with C-7 slope as a marker of cervical and spinopelvic alignment
Authors: Núñez-Pereira Susan , Hitzl Wolfgang , Bullmann Viola , Meier Oliver , Koller Heiko 
Published: April 2015

OBJECT
Sagittal malalignment of the cervical spine has been associated with worsened postsurgical outcomes. For better operative planning of fusion and alignment restoration, improved knowledge of ideal fusion angles and interdependences between upper and lower cervical spine alignment is needed. Because spinal and spinopelvic parameters might play a role in cervical sagittal alignment, their associations should be studied in depth.

METHODS
The authors retrospectively analyzed digital lateral standing cervical radiographs of 145 patients (34 asymptomatic, 74 symptomatic; 37 surgically treated), including full-standing radiographs obtained in 45 of these patients. Sagittal measurements were as follows: C2–7, occiput (Oc)–C2, C1–2 Cobb angles, and C-7 slope (the angle between the horizontal line and the superior endplate of C-7), as well as T4–12 and L1–S1 Cobb angles, sacral slope, pelvic incidence, and C-7 sagittal vertical axis (SVA). A correlation analysis was performed, and linear regression models were developed.

RESULTS
Statistical analyses revealed significant correlations between C2–7 and Oc–C2 (r = −0.4, p < 0.01), Oc–C2 (r = −0.3, p < 0.01), and C1–2 angle (r = −0.3, p < 0.01). C-7 slope was significantly correlated with C2–7 (r = −0.5, p < 0.01) and with Oc–C2 angle (r = 0.2, p = 0.02). Total cervical (Oc–C7) lordosis was 30.2° and did not differ significantly among asymptomatic, symptomatic, and surgically treated patients. Correlations between C2–7 and Oc–C2 alignment were stronger in asymptomatic patients (r = –0.5, p < 0.01) and surgically treated patients (r = –0.5, p < 0.01) than in symptomatic patients (r = –0.3, p = 0.01), but the between-group difference was not significant (p > 0.1). Comparing cervical and spinopelvic alignment revealed a significant correlation between sacral slope and C-7 slope (r = –0.3, p = 0.04) and C2–7 (r = 0.4, p < 0.01). The C-7 SVA correlated significantly with the C-7 slope (r = –0.4, p < 0.01). The interdependences were stronger within the occipitocervical parameters than between the cervical and remaining spinal parameters.

CONCLUSIONS
Significant correlations between the upper and lower cervical spine exist, confirming the existence of inherent compensatory mechanisms to maintain overall balance; no significant differences were found among asymptomatic, symptomatic, and surgically treated patients. The C-7 slope is a useful marker of overall sagittal alignment, acting as a link between the occipitocervical and thoracolumbar spine.
A single-stage posterior approach with open reduction and pedicle screw fixation in subaxial cervical facet dislocations
Authors: Park Jin Hoon , Roh Sung Woo , Rhim Seung Chul 
Published: April 2015

OBJECT
The optimal treatment for cervical facet dislocations is controversial, but the generally accepted process recommends an initial closed reduction with the next step determined according to the success of the closed reduction and the presence of traumatic disc herniation. This study aimed to show the efficacy of a posterior approach performed with an open reduction and pedicle screw fixation with removal of disc particles, if required, in the management of subaxial cervical dislocations.

METHODS
Between March 2012 and September 2013, 21 consecutive patients with cervical facet dislocations were enrolled. The affected levels were as follows: 4 at C3–4; 2 at C4–5; 5 at C5–6; and 10 at the C6–7 level. Seven patients had traumatic disc herniations. Closed reduction was not attempted; a prompt posterior cervical surgery was performed instead. After open reduction, pedicle screw fixation was performed. In cases with traumatic disc herniation, herniated disc fragments were excised via a posterolateral approach and successful decompressions were determined by postoperative MRI studies. Clinical outcomes were assessed using the American Spinal Injury Association (ASIA) grading system. Radiological outcomes were assessed by comparing the degree of subluxation and the angle of segmental lordosis between pre- and postoperative CT scans.

RESULTS
All patients improved neurologically. The mean segmental angles improved from 7.3° ± 8.68° to −5.9° ± 4.85°. The mean subluxation improved from 23.4% ± 16.52% to 2.6% ± 7.19%. Disc fragments were successfully removed from the 7 patients with herniated discs, as shown on MRI.

CONCLUSIONS
Open reduction followed by pedicle screw fixation or posterolateral removal of herniated disc fragments is a good treatment option for cervical facet dislocations.