bluuebunny/crossref_metadata_2025_split huggingface dataset:
Clinical Outcomes Using a Platelet Function-Guided Approach for Secondary Prevention in Patients With Ischemic Stroke or Transient Ischemic Attack
Authors: Depta Jeremiah P. , Fowler Jeffrey , Novak Eric , Katzan Irene , Bakdash Suzanne , Kottke-Marchant Kandice , Bhatt Deepak L. 
Published: June 2012

Background and Purpose—
Antiplatelet therapy nonresponse is associated with worse clinical outcomes. We studied the clinical outcomes associated with platelet function-guided modifications in antiplatelet therapy in patients with ischemic stroke or transient ischemic attack.

Methods—
From January 2005 to August 2007, 324 patients with ischemic stroke underwent platelet function testing using platelet aggregometry. Aspirin nonresponse was defined as a mean platelet aggregation ≥20% with 0.5 mg/mL arachidonic acid and/or ≥70% with 5 μmol/L adenosine diphosphate. Clopidogrel nonresponse was defined as a mean platelet aggregation ≥40% with 5 μmol/L adenosine diphosphate. A modification was any increase in antiplatelet therapy occurring after testing. Clinical outcomes were compared between patients with and without platelet function-guided antiplatelet therapy modifications using univariate and propensity score-adjusted analyses.

Results—

In patients with ischemic stroke or transient ischemic attack, 43% (n=128) and 35% (n=54) were nonresponders to aspirin and clopidogrel, respectively. After platelet function testing, antiplatelet therapy was increased in 23% of patients (n=73). After propensity score matching (n=61 in each group), antiplatelet therapy modification was associated with significantly increased rates of death, ischemic events, or bleeding (hazard ratio, 2.24; 95% CI, 1.12–4.47;
P
=0.02) compared with no modification in antiplatelet therapy and a trend toward increased bleeding (hazard ratio, 3.56; 95% CI, 0.98–12.95;
P
=0.05). No differences in ischemic events were observed.

Conclusions—
Platelet function-guided modification in antiplatelet therapy after an ischemic stroke or transient ischemic attack was associated with significantly higher rates of adverse clinical outcomes.
Space–Time Spectral Analysis of the Southern Hemisphere Daily 500-hPa Geopotential Height
Authors: Sun Cheng , Li Jianping 
Published: June 2012

AbstractIn this paper the authors use the NCEP–Department of Energy (DOE) Reanalysis 2 (NCEP2) data from 1979 to 2004 to expand the daily 500-hPa geopotential height in the Southern Hemisphere (SH, 90°–20°S) into a double Fourier series, and analyze the temporal frequency characteristics of the expansion coefficients over various spatial scales. For the daily series over the whole year, the coefficient series of the extratropical-mean height is characterized by a significant low-frequency (10–30 day) variation. For zonal waves with (k, l) = (1–5, 1), where k and l are the zonal and meridional wavenumbers, respectively, the low-frequency variability is most pronounced for zonal wavenumbers 3 and 4; while the short wave with zonal wavenumber 5 has significant high-frequency (4–8 day) variability. For meridional waves with (k, l) = (0, 2–6), the meridional dipole (l = 2) makes a major contribution to the low-frequency variability, consistent with the intraseasonal space–time features of the southern annular mode (SAM). The meridional tripole (l = 3) also exhibits low-frequency variability. For two-dimensional waves (k, l) = (1–5, 2–6), the dipole is a preferred meridional structure for intraseasonal modes with large zonal scales, indicating an out-of-phase relationship between low-frequency planetary-scale waves at mid- and high latitudes. The diagnostic results outlined above can be explained, to a certain extent, by the dispersion relation for Rossby waves. Theoretical analysis indicates that zonal wavenumber 3, zonally symmetric flow such as SAM, and planetary-scale waves with meridional dipole structures may be interpreted as low-frequency eigenmodes of the atmosphere.
Urinary Sodium to Creatinine Ratio in Healthy Infants
Authors: Mann Michelle , Waz Wayne , Poupoulos James , Kadle Rohini , Korn Ariella , Vaughan Russell , Borowitz Drucy 
Published: June 2012

Rationale Sodium is essential for adequate growth; the daily requirement in infants is 2 to 3 mmol/kg/d. Objectives The study aimed to establish a reference range for the ratio of urinary sodium (UNa) to creatinine (UCr) in healthy infants in a suburban setting in the United States. Methods UNa and UCr were measured in healthy infants and UNa:UCr was calculated. Daily sodium intake was estimated by parental report. Results Mean estimated sodium intake in the 71 infants was 1.34 mEq/kg/d (95% confidence interval = 1.23-1.44). The mean UNa:UCr was 11.73 (95% confidence interval = 10.24-13.23) and did not differ significantly in age-groups. There was no direct correlation between sodium intake and UNa:UCr in healthy infants. Conclusions The UNa:UCr was 11.73 in this population of healthy infants. This likely reflects the appropriate physiologic response to sodium intake in the study population, which was at the lower end of the usual estimated needs for infants.
Incidental Findings on Computed Tomography Scans in Children With Mild Head Trauma
Authors: Ortega Henry W. , Vander Velden Heidi , Reid Samuel 
Published: June 2012

Background Computed tomography (CT) scans are frequently used in managing traumatic brain injuries in children. Objective To assess incidental findings in children with head trauma undergoing CT scan and to describe any associated clinical ramifications. Materials and methods Retrospective review of 524 children treated in 2 emergency departments for closed head injury who received a CT scan. Results Overall, 137 (26.2%) patients had an incidental finding on CT scan. The most common incidental finding was sinus opacification with an air fluid level (115/137, 83.9%). Thirty-five interventions were reported in children with incidental findings. Children 2 years old or younger were more likely to receive a prescription for antibiotics (relative risk [RR] = 2.66, 95% confidence interval [CI] = 1.08-6.51) and be referred to a specialist (RR = 10.26, 95% CI = 3.56-29.56) than older children. Conclusion Incidental findings in minor head trauma are common. Clinicians should be prepared to address these findings if clinically indicated.
Fatigue in Women With Type 2 Diabetes
Authors: Fritschi Cynthia , Quinn Laurie , Hacker Eileen D. , Penckofer Sue M. , Wang Edward , Foreman Marquis , Ferrans Carol E. 
Published: June 2012

Purpose The purpose of this study was to explore the relationship between fatigue and physiological, psychological, and lifestyle phenomena in women with type 2 diabetes (T2DM) in order to establish the magnitude and correlates of fatigue in women with T2DM and explore the interrelationships between fatigue and specific diabetes-related factors that may be associated with increased levels of fatigue. These factors included physiological factors (glucose control, diabetes symptoms), psychological factors (diabetes emotional distress, depressive symptoms in general), and lifestyle factors (body mass index, physical activity). Methods A cross-sectional, descriptive design was used. Women who reported conditions known to cause fatigue were excluded. Physiological measures included fasting blood glucose (FBG), hemoglobin A1C (A1C), glucose variability, and body mass index (BMI). Women completed questionnaires about health, fatigue levels, diabetes symptoms, diabetes emotional distress, depressive symptoms, physical activity, and current diabetes self-care practices. A subset of the women wore a Medtronic Gold CGM sensor for 3 days for assessment of glucose variability. Results Eighty-three women aged 40 to 65 years with T2DM completed the study. Fatigue was significantly related to diabetes symptoms, diabetes emotional distress, depressive symptoms, higher BMI, and reduced physical activity. There was no relationship between fatigue and FBG or A1C. The strongest explanatory factors for fatigue were diabetes symptoms, depressive symptoms, and BMI, which accounted for 48% of the variance in fatigue scores. Glucose variability was not significantly associated with fatigue in these women. Conclusions Fatigue is a persistent clinical complaint among women with T2DM and may signal the presence of physiological, psychological, and lifestyle-related phenomena that could undermine diabetes health outcomes.
The role of the neurovascular scalp structures in migraine
Authors: Cianchetti Carlo 
Published: June 2012

Aim To review reports suggesting a role for neurovascular scalp structures in migraine. Main data reported (A) Scalp periarterial nervous fibres contain all the main peptides and receptors involved in pain. (B) It is possible to interrupt or alleviate migraine pain with a prolonged compression of the main scalp arteries, which decreases blood flow through the pain-sensitized vessels and probably induces a temporary conduction block of periarterial nociceptive fibres. (C) Painful points are present on the scalp arteries of a considerable percentage of migraine sufferers. (D) It is possible to stop or alleviate pain by intervening on nociceptive periarterial fibres, as for example with the injection of lidocaine or 3–5 ml saline, and with percutaneous application of a capsaicin cream. Conclusion The data reported suggest a role for neurovascular scalp structures in at least some patients with migraine. It would be of interest to find a clinical distinction between patients according to the prevalence of an intracranial or extracranial peripheral pain mechanism. This could lead to more efficacious treatments.
Prostaglandin E2 induces immediate migraine-like attack in migraine patients without aura
Authors: Antonova Maria , Wienecke Troels , Olesen Jes , Ashina Messoud 
Published: June 2012

Background: Prostaglandin E2 (PGE2) has been suggested to play an important role in the pathogenesis of migraine. In the present experiment we investigated if an intravenous infusion of PGE2 would induce migraine-like attacks in patients with migraine. Methods: Twelve patients with migraine without aura were randomly allocated to receive 0.4 µg/kg/min PGE2 (Prostin®E2, dinoprostone) or placebo over 25 minutes in a two-way, crossover study. Headache intensity was recorded on a verbal rating scale, middle cerebral artery blood flow velocity (VMCA) was measured by transcranial Doppler (TCD) and diameter of the superficial temporal artery (STA) was obtained by c-series scan (Dermascan C). Results: In total, nine migraine patients (75%) experienced migraine-like attacks after PGE2 compared to none after placebo ( p = 0.004). Seven out of 9 (58%) patients reported the migraine-like attacks during the immediate phase (0–90 min) ( p = 0.016). Only two patients experienced the delayed migraine-like attacks several hours after the PGE2 infusion stop ( p = 0.500). The VMCA decreased during the PGE2 infusion ( p = 0.005) but there was no significant dilatation of the STA ( p = 0.850). Conclusion: The migraine-like attacks during, and immediately after, the PGE2 infusion contrast with those found in previous provocation studies, in which the other pharmacological compounds triggered the delayed migraine-like attacks several hours after the infusion. We suggest that PGE2 may be one of the important final products involved in the generation of migraine attacks.
Effectiveness of the Reverse Camber Shoe in Postoperative Hallux Valgus Surgery
Authors: Sarmah Sasanka Sekhar , Hossain Fahad Siddique , Mishra Viren 
Published: June 2012

The reverse camber shoe (RCS) is commonly used for forefoot off-loading during mobilization after forefoot surgery. However, patient satisfaction and compliance may be affected because of the altered gait pattern that is conferred. The aim of this study was to investigate the patient-related factors associated with the compliance in the use of this device. The authors retrospectively reviewed a single surgeon series of 64 patients who underwent forefoot surgery and who were subsequently rehabilitated with early mobilization using the RCS. Data on patient age, arthritic comorbidities, adaptation to device, and symptoms during use were collected via a standardized postal questionnaire. In all, 39 patients complied with the use of the RCS for 8 weeks (group A), whereas 11 patients managed it for less than 6 weeks (group C). Also, 14 patients used the shoe for more than 6 weeks but less than 8 weeks (group B). The authors found that compliance in the use of the RCS is lower in older patients following forefoot surgery. This may be related to poor adaptation in the presence of preexisting arthritis. Level of Evidence: Therapeutic Level IV
Common Leg Injuries of Long-Distance Runners
Authors: Gallo Robert A. , Plakke Michael , Silvis Matthew L. 
Published: June 2012

Context Long-distance running (greater than 3000 m) is often recommended to maintain a healthy lifestyle. Running injury rates increase significantly when weekly mileage extends beyond 40 miles cumulatively. With the development of running analysis and other diagnostic tests, injuries to the leg secondary to bone, musculotendinous, and vascular causes can be diagnosed and successfully managed. Evidence Acquisition Searches used the terms running, injuries, lower extremity, leg, medial tibial stress syndrome, compartment syndrome, stress fractures, popliteal artery entrapment, gastrocnemius soleus tears, and Achilles tendinopathy. Sources included Medline, Google Scholar, and Ovid from 1970 through January 2012. Results Tibial stress fractures and medial tibial stress syndrome can sometimes be prevented and/or treated by correcting biomechanical abnormalities. Exertional compartment syndrome and popliteal artery entrapment syndrome are caused by anatomic abnormalities and are difficult to treat without surgical correction. Conclusion Leg pain due to bone, musculotendinous, and vascular causes is common among long-distance runners. Knowledge of the underlying biomechanical and/or anatomic abnormality is necessary to successfully treat these conditions.
Intravenous Fluid Use in Athletes
Authors: Givan Gordon V. , Diehl Jason J. 
Published: June 2012

Context: Time allowing, euhydration can be achieved in the vast majority of individuals by drinking and eating normal beverages and meals. Important to the competitive athlete is prevention and treatment of dehydration and exercise-associated muscle cramps, as they are linked to a decline in athletic performance. Intravenous (IV) prehydration and rehydration has been proposed as an ergogenic aid to achieve euhydration more effectively and efficiently. Evidence Acquisition: PubMed database was searched in November 2011 for all English-language articles related to IV utilization in sport using the keywords intravenous, fluid requirements, rehydration, hydration, athlete, sport, exercise, volume expansion, and performance. Results: Limited evidence exists for prehydration with IV fluids. Although anecdotal evidence does exist, at this time there are no high-level studies confirming that IV prehydration prevents dehydration or the onset of exercise-associated muscle cramps. Currently, there are no published studies describing IV fluid use during the course of an event, at intermission, or after the event as an ergogenic aid. Conclusion: The use of IV fluid may be beneficial for a subset of fluid-sensitive athletes; this should be reserved for high-level athletes with strong histories of symptoms in well-monitored settings. Volume expanders may also be beneficial for some athletes. IV fluids and plasma binders are not allowed in World Anti-Doping Agency–governed competitions. Routine IV therapy cannot be recommended as best practice for the majority of athletes.
Is There Evidence to Support a Forefoot Strike Pattern in Barefoot Runners? A Review
Authors: Lorenz Daniel S. , Pontillo Marisa 
Published: June 2012

Context: Barefoot running is a trend among running enthusiasts that is the subject of much controversy. At this time, benefits appear to be more speculative and anecdotal than evidence based. Additionally, the risk of injuries is not well established. Evidence acquisition: A PubMed search was undertaken for articles published in English from 1980 to 2011. Additional references were accrued from reference lists of research articles. Results: While minimal data exist that definitively support barefoot running, there are data lending support to the argument that runners should use a forefoot strike pattern in lieu of a heel strike pattern to reduce ground reaction forces, ground contact time, and step length. Conclusions: Whether there is a positive or negative effect on injury has yet to be determined. Unquestionably, more research is needed before definitive conclusions can be drawn.
Serum CTXii Correlates With Articular Cartilage Degeneration After Anterior Cruciate Ligament Transection or Arthrotomy Followed by Standardized Exercise
Authors: Coyle Christian H. , Henry Sarah E. , Haleem Amgad M. , O’Malley Michael J. , Chu Constance R. 
Published: June 2012

Background: Anterior cruciate ligament injury increases risk for accelerated development of osteoarthritis. The effect of exercise on articular cartilage following joint injury is not well understood. Biochemical biomarkers of collagen degradation and proteoglycan turnover are potential indicators for early articular cartilage degeneration. Hypothesis: This study tests the hypothesis that serum concentrations of CS846 and CTXii correlate with structural changes to articular cartilage following joint injury in exercised animals. Study Design: Controlled laboratory study. Methods: Twenty-four Sprague-Dawley rats underwent either arthrotomy alone (sham surgery) or anterior cruciate ligament transection (ACLT). Animals were recovered for 3 weeks and then exercised on a treadmill at 18 m per minute, 1 hour per day, 5 days per week, until sacrifice either 6 or 12 weeks later. Articular cartilage was assessed grossly, and histology was graded using modified Mankin, toluidine blue, and modified David-Vaudey scales. Serum collected preoperatively and at sacrifice was assayed by ELISA for CTXii and CS846. Results: At 6 weeks, gross grades ( P < 0.01), modified Mankin scores (P < 0.03), and toluidine blue scores (P < 0.04) were higher, reflecting increased degeneration in ACLT animals compared with sham surgery animals. Serum CS846 increased after 6 weeks in ACLT animals (P < 0.05). Serum CTXii levels strongly correlated with Mankin degenerative scores (coefficient = 0.81, P < 0.01) and David-Vaudey histology grades (coefficient = 0.73, P < 0.01) at 6 weeks. While gross grades remained higher at 12 weeks in ACLT animals (P < 0.04), no differences were seen in serum CS846 and CTXii. Histology scores also showed no differences between ACLT and sham due to increasing degeneration in the sham surgery group. Conclusion: The strong correlation between serum CTXii and microstructural changes to articular cartilage following joint injury demonstrates potential use of serum biomarkers for early detection of cartilage degeneration. Increasing cartilage degeneration in exercised sham-surgery animals suggests that early loading may have negative effects on articular cartilage due to either mechanical injury or hemarthrosis after arthrotomy. Clinical Relevance: Patients with anterior cruciate ligament injury are at increased risk for development of posttraumatic osteoarthritis. CTXii may be useful for early detection of joint degeneration. Further study on the effects of exercise after injury is important to postinjury and postoperative rehabilitation.
The (a)-Symptomatic Vertebral Fracture
Authors: de Klerk G. , Hegeman J. H. , Bronkhorst P. , van der Palen J. , van der Velde D. , Duis H. J. ten 
Published: June 2012

Objective. Description of the prevalence of vertebral fractures in a fracture and osteoporosis outpatient clinic (FO-Clinic) and evaluation of the value of spinal radiographs by screening on osteoporosis. Design. Retrospective data collection, description, and analysis. Methods. All patients admitted to the FO-Clinic during the period of December 2005 until October 2006 were enrolled in this study. At the FO-Clinic spinal radiographs were obtained and bone mineral density (BMD) was measured by Dual energy X-ray-Absorptiometry (DXA). Results. During the study period, a total of 176 patients were screened at our FO-Clinic. In 41.5% of these patients, a vertebral fracture was diagnosed. There appeared to be an indication for anti-osteoporotic medication in 95 of the 176 patients. Of these 95 patients, 77% could be identified by spinal radiographs. Moreover, only 36% of all patients with a vertebral fracture did suffer from osteoporosis. Conclusion. The prevalence of vertebral fractures in patients screened at an FO-Clinic is high and spinal radiographs can identify up to 77% of patients in which anti-osteoporotic medication should be considered. However, fracture risk is not only dependent on bone quality but also on bone density. Therefore, the preferred method of screening on osteoporosis is DXA with vertebral fracture assessment and, if necessary, spinal radiographs. If DXA is not available, spinal radiographs might be used as a first step in osteoporosis screening.
Ancient gene transfer from algae to animals: Mechanisms and evolutionary significance
Authors: Ni Ting , Yue Jipei , Sun Guiling , Zou Yong , Wen Jianfan , Huang Jinling 
Published: June 2012

Abstract

Background
Horizontal gene transfer (HGT) is traditionally considered to be rare in multicellular eukaryotes such as animals. Recently, many genes of miscellaneous algal origins were discovered in choanoflagellates. Considering that choanoflagellates are the existing closest relatives of animals, we speculated that ancient HGT might have occurred in the unicellular ancestor of animals and affected the long-term evolution of animals.

Results
Through genome screening, phylogenetic and domain analyses, we identified 14 gene families, including 92 genes, in the tunicate Ciona intestinalis that are likely derived from miscellaneous photosynthetic eukaryotes. Almost all of these gene families are distributed in diverse animals, suggesting that they were mostly acquired by the common ancestor of animals. Their miscellaneous origins also suggest that these genes are not derived from a particular algal endosymbiont. In addition, most genes identified in our analyses are functionally related to molecule transport, cellular regulation and methylation signaling, suggesting that the acquisition of these genes might have facilitated the intercellular communication in the ancestral animal.

Conclusions
Our findings provide additional evidence that algal genes in aplastidic eukaryotes are not exclusively derived from historical plastids and thus important for interpreting the evolution of eukaryotic photosynthesis. Most importantly, our data represent the first evidence that more anciently acquired genes might exist in animals and that ancient HGT events have played an important role in animal evolution.