bluuebunny/crossref_metadata_2025_split huggingface dataset:
Possibility of oral feeding after induction of percutaneous endoscopic gastrostomy
Authors: Yokohama Shiro , Aoshima Masaru , Koyama Satoshi , Hayashi Keisuke , Shindo Junya , Maruyama Junichi 
Published: November 2009

AbstractBackground and Aim:  Although percutaneous endoscopic gastrostomy (PEG) has become established as a useful enteral nutrition technique, the associated risks must always be kept in mind. Recently, we experienced several patients who could orally ingest after PEG. To avoid unnecessary PEG, we investigated patients who could orally ingest after PEG, and analyzed predictive factors of postoperative oral feeding.Methods:  We retrospectively analyzed data of 302 patients who underwent PEG at our hospital. After all patients were divided according to postoperative oral feeding status, we assessed factors of patients' backgrounds. In patients who could orally ingest after PEG, we investigated the course of oral feeding status. We attempted to identify predictive factors for postoperative oral feeding using logistic regression analysis.Results:  Mean age was high in both groups, and overall condition was markedly poor. Forty‐four patients (15%) were able to ingest orally after PEG. Enteral nutrition could be avoided during our observation period in 15 cases, because sufficient oral intake was achieved. Conversely, oral feeding was reduced or discontinued in 14 cases. Multivariate analysis identified the following independent predictive factors for postoperative oral feeding: (i) absence of dysphagia or aphagia; (ii) younger age; (iii) favorable performance status; (iv) presence of post‐traumatic encephalopathy; and (v) preoperative swallowing training.Conclusions:  A total of 15% of PEG cases were able to ingest orally after PEG. In patients showing positive predictive factors, indications for PEG should be carefully considered.
Is bedtime supper necessary for older children with diabetes using glargine insulin in multiple daily injection regimens?
Authors: Barton A. L. , Gilbertson H. R. , Donath S. M. , Cameron F. J. 
Published: November 2009

Diabet. Med. 27, 238–241 (2010)AbstractAims  Current guidelines for dietary management of Type 1 diabetes in children recommend a carbohydrate supper before bed. However, with the introduction of insulin analogues such as glargine (with a basal insulin profile), supper may be unnecessary. The purpose of this study was to investigate whether supper is required to prevent nocturnal hypoglycaemia when using multiple daily injections, with glargine as the basal insulin and rapid‐acting insulin pre‐meals, in older children with Type 1 diabetes.Methods  Thirty‐five children aged 10–18 years with Type 1 diabetes were recruited to a randomized cross‐over trial (supper vs. no supper). Each phase consisted of three consecutive days of wearing a continuous glucose‐monitoring system (CGMS) to record nocturnal blood glucose levels in the home setting. The supper phase included one 15‐g carbohydrate dairy snack consumed before bed. The evening meals were standardized. Activity was restricted.Results  Valid CGMS data were obtained for 163 nights (85 supper, 78 no supper). Nocturnal hypoglycaemia rates were similar in the supper and no‐supper groups (32.9% vs. 33.3% of nights; P = 0.96).Conclusions  This study suggests that supper is not necessary for all children to prevent nocturnal hypoglycaemia when using glargine insulin. The recommendation for inclusion of supper should be individually tailored and not mandatory.
Anti‐CD3 monoclonal antibody treatment in newly diagnosed Type 1 diabetes patients: a hypothetical modelling analysis
Authors: Smith‐Palmer J. , Curtis B. H. , Boye K. S. , Goodall G. , Pillemer S. R. 
Published: November 2009

Diabet. Med. 27, 189–196 (2010)AbstractAims  Although limited clinical data exist for anti‐CD3 monoclonal antibody therapies, it is believed that they may influence glycaemic control, endogenous insulin secretion and hypoglycaemic event rates in individuals newly diagnosed with Type 1 diabetes. In the absence of suitable empirical evidence, the objective of this study was to estimate the potential long‐term clinical outcomes associated with treatment via a hypothetical modelling analysis.Methods  Analyses were performed using a published and validated computer simulation model of diabetes in a hypothetical US cohort based on published literature and expert opinion. The efficacy of anti‐CD3 monoclonal antibody treatment was estimated from clinical data and expert opinion and simulations were performed over a 60‐year time horizon. The impact on quality of life associated with treatment was also captured via published utility values.Results  Assuming that a treatment course of an anti‐CD3 monoclonal antibody produced an initial reduction in glycated haemoglobin of −0.8%, and that the effects persisted for up to 5 years, treatment was projected to lead to an increase in undiscounted life expectancy of 0.43 years and an increase in quality‐adjusted life expectancy of 0.36 quality‐adjusted life years compared with conventional exogenous insulin.Conclusions  A course of a hypothetical anti‐CD3 monoclonal antibody treatment associated with improved glycaemic control and, potentially, the preservation of pancreatic β‐cell function was estimated to lead to improved life expectancy and quality‐adjusted life expectancy compared with conventional treatment in patients with newly diagnosed Type 1 diabetes.
Prevalence of comorbid depression is high in out‐patients with Type 1 or Type 2 diabetes mellitus. Results from three out‐patient clinics in the Netherlands
Authors: Pouwer F. , Geelhoed‐Duijvestijn P. H. L. M. , Tack C. J. , Bazelmans E. , Beekman A.‐J. , Heine R. J. , Snoek F. J. 
Published: November 2009

Diabet. Med. 27, 217–224 (2010)AbstractAims  Depression is common in diabetes, but the scope of the problem and associated correlates are not well established in specialist diabetes care. We aimed to determine the prevalence of depression among adult outpatients with Type 1 (T1DM) or Type 2 diabetes (T2DM) using both self‐report measures and a diagnostic interview, and to establish demographic and clinical characteristics associated with depressive affect.Methods  A random sample of 2055 diabetes out‐patients from three diabetes clinics was invited to participate. Depressive affect was assessed using the World Health Organization‐5 Well Being Index (WHO‐5), the Centre for Epidemiologic Studies‐Depression scale (CESD) using predefined cut‐off scores, and depressive disorder with the Composite International Diagnostic Interview (CIDI). Associations between depression and patient characteristics were explored using regression analyses.Results  Seven hundred and seventy‐two patients completed the depression questionnaires. About one‐third of T1DM patients and 37–43% of T2DM patients reported depressive affect (WHO‐5). The prevalence of depressive affect (CESD) was 25% and 30% for men and women with T1DM, and 35% and 38% for men and women with T2DM, respectively. Based on the CIDI, 8% of T1DM patients (no gender difference) and 2% of men and 21% of women with T2DM suffered from a depressive disorder. Depressive affect was associated with poor glycaemic control and proliferative retinopathy in T1DM, while non‐Dutch descent, obesity and neuropathy were correlates in T2DM.Conclusions  Depressive symptoms and major depressive disorder constitute a common comorbid problem among Dutch out‐patients with T1DM or T2DM and appear particularly common in migrants and women with T2DM.
Barriers in initiating insulin therapy in a South Asian Muslim community
Authors: Ahmed U. S. , Junaidi B. , Ali A. W. , Akhter O. , Salahuddin M. , Akhter J. 
Published: November 2009

Diabet. Med. 27, 169–174 (2010)AbstractAims  Insulin therapy is often required for optimal glycaemic control. Pakistani patients display reluctance to use insulin. We aimed to determine the reasons for this and to assess impressions after initiation of insulin in our patients.Methods  Patients with Type 2 diabetes attending Aga Khan Hospital were surveyed using a questionnaire detailing opinions on insulin use. This was a cross‐sectional study of two groups, one with no experience with insulin use and the other who were insulin users.Results  Three hundred and seventeen patients were interviewed, 55.8% male, mean age 53.6 years. Of 210 patients who had never used insulin, 72.9% felt insulin was a measure of last resort and 45.2% thought that tolerance developed to insulin. Only 45.7% felt insulin would reduce complications, while 24% thought that insulin use would interfere with religious obligations. Thirty‐four percent thought that it was difficult or very difficult to learn insulin administration, 41% felt that they could not self‐inject even if absolutely necessary and 25% stated they would not use insulin in any circumstances. There was an association of lack of education with negative image of insulin usage. Among 107 patients using insulin, 52.3% were hesitant before initiation. However, 78.5% noted an improvement in glucose control and 86% said they would recommend insulin to others.Conclusions  Reluctance to use insulin prior to initiation is high, but views improve considerably after insulin initiation. Further awareness of the benefits of insulin use needs to be highlighted and the concerns of our population addressed.
Prevalence of undiagnosed diabetes and impaired glucose regulation in 35–59‐year‐old individuals in Southern Germany: the KORA F4 Study
Authors: Meisinger C. , Strassburger K. , Heier M. , Thorand B. , Baumeister S. E. , Giani G. , Rathmann W. 
Published: November 2009

Diabet. Med. 27, 360–362 (2010)AbstractAims  Limited data are available for European populations regarding the prevalence of diabetes and disturbed glucose metabolism in younger individuals. Our aim was to estimate the prevalence of diagnosed and undiagnosed diabetes, isolated impaired fasting glucose (i‐IFG), isolated impaired glucose tolerance (i‐IGT) and combined IFG/IGT in a population‐based sample (n = 1653) from Southern Germany aged 35–59 years.Methods  Oral glucose tolerance tests were carried out in all non‐diabetic participants of the KORA F4 Study (2006–2008). Diabetes, IGT and IFG were defined according to the 1999 World Health Organization diagnostic criteria. The original IFG criteria (6.1–6.9 mmol/l) were used as recommended by the European Diabetes Epidemiology Group.Results  The age‐standardized prevalence was 2.2% for known diabetes, 2.0% for newly detected diabetes, 2.9% for i‐IFG, 6.3% for i‐IGT and 1.1% for combined IFG/IGT. About half of the cases with overt diabetes were undiagnosed in all age groups. The prevalence of i‐IGT was approximately twice as high as that of i‐IFG. The proportion of i‐IGT varied between 3.2% (age group 35–44 years) and 11.8% (age group 55–59 years); the corresponding numbers for i‐IFG were 1.1% and 5.9%. IFG/IGT was present in 1.2% of the total sample, and was most frequently found in the age group 55–59 years (2.4%). Overall, 16% of the study population had either diabetes or abnormalities of glucose metabolism.Conclusions  The study reveals for the first time a high prevalence of impaired glucose regulation in the younger and middle‐aged German population. The detection of disturbed glucose metabolism or diabetes needs to be improved.
Striving for the impossible dream: a community‐based multi‐practice collaborative model of diabetes management
Authors: Distiller L. A. , Brown M. A. , Joffe B. I. , Kramer B. D. 
Published: November 2009

Diabet. Med. 27, 197–202 (2010)AbstractAims  In 1994 the Centre for Diabetes and Endocrinology (CDE) based in Johannesburg, South Africa established a novel community‐based capitation and risk‐sharing model for diabetes management. We here describe the model and present a recent survey of the performance/outcomes of this unique diabetes care programme.Methods  Data on 17 043 patients managed by the CDE Diabetes Management Programme at its Centre and its 262 affiliated Centres were analysed from its national database. From this total cohort, 1520 Type 1 and 8026 Type 2 diabetes patients have been in the Programme for > 5 years. The 5‐year outcome data on hospital admission rates, glycaemic control (HbA1c), and microvascular complication rates were assessed in this subgroup of patients.Results  Major reductions in hospital admission rates for both acute metabolic emergencies and all causes (40% overall) were achieved in patients enrolled onto the Diabetes Management Programme. The mean HBA1c on enrolment was 9.2% for subjects with Type 1 and 8.8% for those with Type 2 diabetes. After 1 year, mean HbA1c fell to 7.6% and 7.3% for the Type 1 and Type 2 subjects, respectively. At 5 years the HbA1c remained similar at 7.7% for the Type 1 subjects and 7.4% for the Type 2 subjects, demonstrating sustained improvement. Progression of microvascular complications appears to have been delayed.Conclusions  This managed care model of diabetes care in the context of the South African Private Health Care System achieved long‐term improvement in glycaemic control and all‐cause hospital admission rates. This may be due to the cost‐containment being in the hands of the treating doctor, supported by an annual training programme. This programme is based on an individualized and holistic approach encompassing intensive patient education to facilitate self‐empowerment and including prompting for the management of risk factors.
Does accounting conservatism pay?
Authors: Iyengar Raghavan J. , Zampelli Ernest M. 
Published: November 2009

AbstractWe investigate whether or not there is a link between conservative accounting practices and the sensitivity of executive pay to accounting performance. Using several accrual‐based measures of accounting conservatism as well as alternative measures of accounting performance, we estimate an econometric model of CEO compensation that incorporates the interaction of accounting conservatism and accounting performance. Consistent with optimal contracting theory, we find that the sensitivity of executive pay to accounting performance is higher for firms that report conservative accounting earnings. These results support the hypothesis that accounting conservatism, by limiting earnings management opportunities and improving the reliability of accounting performance measures, allows firms to formulate contracts that tie executive compensation more closely to accounting performance.
Profile or group discriminative techniques? Generating reliable species distribution models using pseudo‐absences and target‐group absences from natural history collections
Authors: Mateo Rubén G. , Croat Thomas B. , Felicísimo Ángel M. , Muñoz Jesús 
Published: November 2009

AbstractAim  The presence‐only data stored in natural history collections is the most important source of information available regarding the distribution of organisms. These data and profile techniques can be used to generate species distribution models (SDMs), but pseudo‐absences must be generated to use group discriminative techniques. In this study, we evaluated whether the SDMs generated with pseudo‐absences are reliable and also if there are differences in the results obtained with profile and group discriminative techniques.Location  Ecuador, South America.Methods  The SDMs were generated with a training data set for each of the five species of Anthurium and six different methods: two profile techniques (BIOCLIM and Gower’s distance index), three group discriminative techniques [logistic multiple regression (LMR), multivariate adaptative regression splines (MARS) and Maxent] and a mixed modelling approach genetic algorithm for rule‐set production (GARP), which employs a combination of profile and group discriminative techniques and generates its own pseudo‐absences. For LMR, MARS and Maxent, three types of absences were generated: (1) random pseudo‐absences in equal number to presences and excluding a buffer area around presences (except for Maxent, which assumes that this background sample includes presences), (2) a large number (10,000) of random pseudo‐absences, also excluding a buffer area around each presence and (3) ‘target‐group absences’ (TGA), consisting of sites where other species of the group have been collected by the specialist, but not the species being modelled. To compare the predictive performance of the SDMs, the area under the curve statistic was calculated using an independent testing data set for each species.Results  MARS, Maxent and LMR produce better results than the profile techniques. The models created with TGA are generally more accurate than those generated with pseudo‐absences.Main conclusions  The advantages and disadvantages of different options for using pseudo‐absences and TGA with profile and group discriminative modelling techniques are explained and recommendations are made for the future.
The Devolution of Peru’s Sendero Luminoso: From Hybrid Maoists to Narco‐Traffickers?
Authors: Masterson Daniel M. 
Published: November 2009

AbstractThis History Compass article examines the ideological transformation of Peru’s Sendero Luminoso insurgency from its immediate origins in the 1960s in the remote province of Ayacucho to its devolution to small armed bands of drug traffickers in the nation’s remote central Andean regions. Originally, Sendero claimed allegiance to the peasant‐based Marxism of José Carlos Mariátegui, the founder of Peru’s Socialist Party. In reality, however, much of its ideology and revolutionary strategy was based on Maoist theory. As, Sendero’s Maoism was largely based on its leader’s experience in China in the mid‐1960s, the party felt compelled to rabidly defend ‘orthodox’ Maoism as China moved away this ideology in the late 1970s. Maoism with a Peruvian radical stamp, nevertheless, failed to win over the peasantry in the 1980s. Sendero’s leadership then violated basic Maoist strategy and began an urban terror campaign which exposed its leadership to eventual capture in late 1992. Since then, Sendero has survived only as a force fortified by drug revenues and isolated by rugged mountain terrain. We can only speculate about its future. But an estimated 66,000 deaths caused by its insurgency are stark evidence of its destructive potential.
Temporal Changes in Brain Volume and Cognition in a Randomized Treatment Trial of Vascular Dementia
Authors: Broderick Joseph P. , Gaskill Mary , Dhawan Atam , Khoury Jane C. 
Published: November 2009

ABSTRACT Objective. To measure changes in brain and ischemic volume over time by magnetic resonance imaging (MRI) as part of a randomized treatment trial of vascular dementia. Methods. Participants who met criteria for vascular dementia underwent comprehensive neurological and neuropsychological testing on entrance, during, and at completion of the 1‐year study. For those centers who had easily available MRI, MRI of the brain was to be performed on entry and completion of the study. Image analysis was performed on all balanced and T2‐weighted MR films to determine ventricular, sulcal, ischemic, and hemispheric brain volumes. Results. Of the 105 patients who met the criteria for vascular dementia, 40 had a baseline MRI study that met protocol requirements and was of excellent image quality. The baseline ventricular volume in these 40 patients with high‐quality MR correlated with most measures of cognitive and behavioral function, including the total Alzheimer's Disease Assessment Score (ADAS) (r= 0.51, P= .0024), as well as activities of daily living (r= 0.61, P= .0002). The baseline ischemic brain volume correlated well only with the gait and postural stability scale (r= 0.74, P= .009). Of the 40 participants, 25 had MRI studies at baseline and at completion of the study that were comparable and of excellent image quality. For these 25 patients, the mean ventricular volumes increased by 9% over the study year (P= .001) and the mean ischemic brain volume increased by 18% (P= .01). Temporal changes in the sulcal and nonischemic brain volume did not reach significance. None of the 14 clinical score measures changed significantly between baseline and completion of the study in these 25 patients. Conclusion. In summary, ventricular volume correlated well with cognitive measures in patients with vascular dementia and was a more sensitive marker for change during the study year than the clinical scales used in this study. This study also points out the practical limitations of brain imaging as a surrogate measure of clinical outcome in multicenter randomized treatment trials of brain disease.
Modeling of Receptor Ligand Data in PET and SPECT Imaging: A Review of Major Approaches
Authors: Meyer Jeffrey H. , Ichise Masanori 
Published: November 2009

ABSTRACTOver the past decade, a number of new kinetic modeling techniques have been developed for PET and SPECT ligands. This article will review commonly used modeling solutions for reversible positron‐emission tomography (PET) and single photon emission computed tomography (SPECT) radioligands, with an emphasis on noninvasive methods. All of the modeling approaches in PET and SPECT assume a compartmental system and derive parameters that describe the compartmental system. These parameters will be defined, and their relationship to analogous parameters in pharmacology will be discussed. Then the major approaches are presented under the categories of graphical or mathematical as well as invasive or noninvasive.
Anticoagulation and Microembolus Detection in a Case of Internal Carotid Artery Dissection
Authors: Koch Sebastian , Romano Jose G. , Bustillo Iszet Campo , Concha Mauricio , Forteza Alejandro M. 
Published: November 2009

ABSTRACT Background. Microembolic signals (MES) have been demonstrated by transcranial Doppler (TCD) in cases of internal carotid artery dissection. The influence of treatment on MES in arterial dissection is uncertain. The authors here present a case of internal carotid artery dissection in which we detected a reduction of MES after the initiation of intravenous heparin. Methods. A 37‐year‐old woman developed a right temporal headache 10 days prior to admission. This was followed by episodes of left arm numbness and weakness. Magnetic resonance imaging (MRI) showed a right frontal and deep subcortical ischemic infarct. Catheter angiography confirmed a right internal carotid artery dissection with intracranial extension. She was then monitored with TCD for MES before and after intravenous heparin was started. Results. The first TCD, performed 12 days after symptom onset, showed 39 MES during 60 minutes of insonation of the right middle cerebral artery. Treatment with intravenous heparin resulted in a decline in MES by 50% after 96 hours. This decline continued and no further MES were detected after 11 days of anticoagulation. Conclusion. The authors were able to demonstrate a decline of MES with heparin anticoagulation in a case of internal carotid artery dissection.
A Pilot Study of Microembolic Signals in Patients With Middle Cerebral Artery Stenosis
Authors: Wong K. S. , Gao S. , Lam W.W.M. , Chan Y. L. , Kay R. 
Published: November 2009

ABSTRACT Objective. There has been limited data on the frequency of microembolic signals in patients with middle cerebral artery (MCA) stenosis, especially during the acute phase of stroke. Using transcranial Doppler, the authors prospectively monitored the MCA segments distal to stenosis in 4 groups of patients for 30 minutes: (1) symptomatic patients with acute ischemic stroke and MCA stenosis, (2) asymptomatic group patients with asymptomatic MCA stenosis, (3) control patients with acute ischemic stroke of undetermined etiology, and (4) normal people. A total of 60 patients completed the study. There were no microembolic signals in the asymptomatic, control, and normal groups. Among 20 patients in the symptomatic group, microembolic signals were detected in 3 patients (15%). The number of emboli ranged from 1 to 6 per 30 minutes. This is the first report of the presence of microembolic signals in acute stroke patients with MCA stenosis.