bluuebunny/crossref_metadata_2025_split huggingface dataset:
Prevalence of Diabetic Neuropathy in Patients Undergoing Foot and Ankle Surgery
Authors: Suder Natalie C. , Wukich Dane K. 
Published: February 2012

Introduction: The aim of this prospective study was to determine the prevalence of neuropathy in diabetic patients undergoing foot and ankle surgery. It was hypothesized that the prevalence of diabetic neuropathy is higher among patients who undergo foot and ankle surgery compared with historical rates of neuropathy in diabetic patients in general. Methods: During a consecutive 42-month period, patient data were prospectively entered for 1859 consecutive patients undergoing foot and ankle surgery. Among the subjects, 394 had been previously diagnosed with diabetes mellitus (DM), and the remaining 1465 did not have DM. Results: The prevalence of neuropathy in patients with and without DM was 77.2% (304 of 394 patients) and 11.7% (172 of 1465 patients), respectively. Patients with diabetic neuropathy were older, had poorer glycemic control, had higher serum creatinine levels, and reported more significant tobacco use than diabetic patients without neuropathy. Conclusion: Nearly 80% of diabetic patients undergoing foot and ankle surgery at a large academic medical center had diabetic neuropathy. Preoperative recognition of this morbid complication of DM is important to appropriately stratify those diabetic patients into a high-risk category. Level of Evidence: Prognostic, Level IV
Arthroscopic Reduction and Fibula Nailing in High-Risk Diabetic Ankle Fractures
Authors: Thevendran Gowreeson , Younger Alastair 
Published: February 2012

The management of diabetic ankle fractures is difficult given the associated wound and bone healing complications. Even with meticulous soft tissue handling and a stable construct, the fixation sometimes fails because of the poor biological environment. This study reports on 2 cases of Weber type B ankle fractures in patients with diabetes mellitus where the authors elected to treat with arthroscopy-assisted fracture reduction and percutaneous fibula nailing to reduce the risk of wound complications. Levels of Evidence: Therapeutic, Level V
A novel pre-authentication scheme based on fast channel switching in IEEE 802.11 WLANs
Authors: Baek JaeJong , Seo SungHoon , Shi Fei , Song JooSeok 
Published: February 2012

Abstract
In the case of a 3G-WLAN interworking architecture, handoff latency is mainly caused by the delays incurred when a mobile station (STA) transfers a current security context to the target access network or establishes connectivity to a new access point (AP). Existing handoff optimization schemes have mostly focused on reducing the scanning time which is to discover nearby access points. Even though the time taken by a mobile STA to authenticate the target APs contributes to the total handoff delay, the schemes to optimize the authentication time have not yet been fully investigated for providing seamless connectivity to mobile users performing handoff in WLANs. As a solution, pre-authentication, a technique performing the authentication of target APs before the completion of the handoff procedure, has attracted considerable attention to reduce the overall delay related with a handoff, which is performed within inter-subnet and/or inter-administrative domain levels. Therefore, in this article, we propose a novel pre-authentication scheme to minimize the handoff delay in 3G-WLAN interworking architecture. The proposed scheme pre-authenticates a new AP directly through a switched channel in a short period of time. Our evaluation shows that the proposed scheme outperforms the existing authentication schemes defined in the IEEE 802.11 standards in terms of authentication delay, signaling cost, and mobility rate. The proposed mechanism offers an additional advantage in that it is easy to implement and deploy by simply modifying the device driver modules of clients' WLAN interfaces.
Evaluation of heterogeneity dose distributions for Stereotactic Radiotherapy (SRT): comparison of commercially available Monte Carlo dose calculation with other algorithms
Authors: Takahashi Wataru , Yamashita Hideomi , Saotome Naoya , Iwai Yoshio , Sakumi Akira , Haga Akihiro , Nakagawa Keiichi 
Published: February 2012

Abstract

Background
The purpose of this study was to compare dose distributions from three different algorithms with the x-ray Voxel Monte Carlo (XVMC) calculations, in actual computed tomography (CT) scans for use in stereotactic radiotherapy (SRT) of small lung cancers.

Methods
Slow CT scan of 20 patients was performed and the internal target volume (ITV) was delineated on Pinnacle3. All plans were first calculated with a scatter homogeneous mode (SHM) which is compatible with Clarkson algorithm using Pinnacle3 treatment planning system (TPS). The planned dose was 48 Gy in 4 fractions. In a second step, the CT images, structures and beam data were exported to other treatment planning systems (TPSs). Collapsed cone convolution (CCC) from Pinnacle3, superposition (SP) from XiO, and XVMC from Monaco were used for recalculating. The dose distributions and the Dose Volume Histograms (DVHs) were compared with each other.

Results
The phantom test revealed that all algorithms could reproduce the measured data within 1% except for the SHM with inhomogeneous phantom. For the patient study, the SHM greatly overestimated the isocenter (IC) doses and the minimal dose received by 95% of the PTV (PTV95) compared to XVMC. The differences in mean doses were 2.96 Gy (6.17%) for IC and 5.02 Gy (11.18%) for PTV95. The DVH's and dose distributions with CCC and SP were in agreement with those obtained by XVMC. The average differences in IC doses between CCC and XVMC, and SP and XVMC were -1.14% (p = 0.17), and -2.67% (p = 0.0036), respectively.

Conclusions
Our work clearly confirms that the actual practice of relying solely on a Clarkson algorithm may be inappropriate for SRT planning. Meanwhile, CCC and SP were close to XVMC simulations and actual dose distributions obtained in lung SRT.
Functional, cognitive and psychological outcomes, and recurrent vascular events in Pakistani stroke survivors: a cross sectional study
Authors: Khan Maria , Ahmed Bilal , Ahmed Maryam , Najeeb Myda , Raza Emmon , Khan Farid , Moin Anoosh , Shujaat Dania , Arshad Ahmed , Kamal Ayeesha Kamran 
Published: February 2012

Abstract

Background
There is little direct data describing the outcomes and recurrent vascular morbidity and mortality of stroke survivors from low and middle income countries like Pakistan. This study describes functional, cognitive and vascular morbidity and mortality of Pakistani stroke survivors discharged from a dedicated stroke center within a nonprofit tertiary care hospital based in a multiethnic city with a population of more than 20 million.

Methods
Patients with stroke, aged > 18 years, discharged alive from a tertiary care centre were contacted via telephone and a cross sectional study was conducted. All the discharges were contacted. Patients or their legal surrogate were interviewed regarding functional, cognitive and psychological outcomes and recurrent vascular events using standardized, pretested and translated scales. A verbal autopsy was carried out for patients who had died after discharge. Stroke subtype and risk factors data was collected from the medical records. Subdural hemorrhages, traumatic ICH, subarachnoid hemorrhage, iatrogenic stroke within hospital and all other diagnoses that presented like stroke but were subsequently found not to have stroke were also excluded. Composites were created for functional outcome variable and depression. Data were analyzed using logistic regression.

Results
309 subjects were interviewed at a median of 5.5 months post discharge. 12.3% of the patients had died, mostly from recurrent vascular events or stroke complications. Poor functional outcome defined as Modified Rankin Score (mRS) of > 2 and a Barthel Index (BI) score of < 90 was seen in 51%. Older age (Adj-OR-2.1, p = 0.01), moderate to severe dementia (Adj-OR-19.1, p < 0.001), Diabetes (Adj-OR-2.1, p = 0.02) and multiple post stroke complications (Adj-OR-3.6, p = 0.02) were independent predictors of poor functional outcome. Cognitive outcomes were poor in 42% and predictors of moderate to severe dementia were depression (Adj-OR-6.86, p < 0.001), multiple post stroke complications (Adj-OR-4.58, p = 0.01), presence of bed sores (Adj-OR-17.13, p = 0.01) and history of atrial fibrillation (Adj-OR-5.12, p < 0.001).

Conclusions
Pakistani stroke survivors have poor outcomes in the community, mostly from preventable complications. Despite advanced disability, the principal caretakers were family rarely supported by health care personnel, highlighting the need to develop robust home care support for caregivers in these challenging resource poor settings.
HLA molecules and nasal carriage of Staphylococcus aureus isolated from dialysis and kidney transplant patients at a hospital in Southern Brazil
Authors: Giarola Luciana Borges , dos Santos Rosiane Ribeiro , Bedendo João , da Silva Júnior Waldir Veríssimo , Borelli Sueli Donizete 
Published: February 2012

Abstract

Background
Healthy individuals can host Staphylococcus aureus in the nasopharynx, body surface and vagina. Most invasive infections by this bacterium are endogenous, caused by strains spread from the nasopharynx of carriers. S. aureus is a pathogen involved in the etiology of hospital- and community-acquired infections. Transplant and dialysis patients are at risk of colonization or infection by multi-resistant S. aureus. Infection is directly linked to individual immunity, and the major histocompatibility complex (MHC) plays a crucial role in determining susceptibility to diseases. Different MHC specificities have been shown to be more frequent in individuals suffering from certain diseases. This study aimed to investigate the association between HLA class I (HLA-A and -B) and class II (HLA-DRB1) molecules and nasal carriage of S. aureus in dialysis and kidney transplant patients at a hospital in Southern Brazil.

Results
The sample consisted of 70 dialysis and 46 kidney transplant patients, totaling 116 patients. All subjects were typed for HLA molecules using LABType® SSO (One Lambda). Nasal swab samples of S. aureus were isolated from the nasal cavity (both nostrils) of patients undergoing dialysis or kidney transplantation.
In renal dialysis patients, HLA-A*02 was the most frequent allele in both carriers (25.5%) and non-carriers (21.2%) of S. aureus. Allele A*68 was not observed in the carrier group, but the allele was observed six times in the non-carrier group (p = 0.0097). Regarding HLA-B and HLA-DRB1, no allele was shown to be involved in protection against or susceptibility to carriage of S. aureus. In kidney transplant patients, allele A*03 was more frequent in the non-carrier (20.83%) than in the carrier (5.88%) group (p = 0.0486). HLA-B*15 was present in carriers (5.88%) and non-carriers (25%) (p = 0.0179). Regarding class II alleles, DRB1*03 appeared to be related to susceptibility to carriage of S. aureus (p = 0.0319).

Conclusions
Our findings suggest that HLA-DRB1*03 may be involved in susceptibility to nasal carriage of S. aureus in transplant patients. In addition, HLA-A*68 (dialysis patients) and HLA-A*03 and HLA-B*15 (transplant patients) appear to be associated with increased resistance to S. aureus nasal carriage.
Computational prediction of MicroRNAs targeting GABA receptors and experimental verification of miR-181, miR-216 and miR-203 targets in GABA-A receptor
Authors: Zhao Chunling , Huang Chaoqun , Weng Tingting , Xiao Xiao , Ma Hong , Liu Lin 
Published: February 2012

Abstract

Background
GABA receptors are well known as the inhibitory receptors in the central nervous system and are also found in peripheral tissues. We have previously shown that GABA receptors are involved in lung development and fluid homeostasis. However, the microRNAs that regulate GABA receptors have not yet been identified.

Results
In this study, we used the online software, TargetScan and miRanda, to query the microRNAs that directly target GABA receptors and then selected some of them to verify experimentally using 3'-UTR reporter assays. Computational approaches predict many microRNA binding sites on the 3'-UTR of GABAA receptors, but not on GABAC receptors. 3'-UTR reporter assays only verified miR-181, miR-216, and miR-203 as the microRNAs that target GABA receptor α1-subunit among 10 microRNAs tested.

Conclusions
Our studies reinforce that microRNA target prediction needs to be verified experimentally. The identification of microRNAs that target GABA receptors provides a basis for further studies of post-transcriptional regulation of GABA receptors.
Serum 24,25-Dihydroxyvitamin D Concentrations in Osteogenesis Imperfecta: Relationship to Bone Parameters
Authors: Edouard Thomas , Husseini Abdallah , Glorieux Francis H. , Rauch Frank 
Published: February 2012

Background:Several studies suggest that 24,25-dihydroxyvitamin D [24,25(OH)2D] may have an effect on bone mass and metabolism.Objective:We evaluated the relationship between serum 24,25(OH)2D levels and bone density and bone metabolism in children with a primary bone disorder—osteogenesis imperfecta (OI).Materials and Methods:The study included 132 patients (age, 1.1 to 17.9 yr; 67 girls) with OI types I, III, or IV who had not received bisphosphonate treatment at the time of analysis.Results:Serum 24,25(OH)2D levels were significantly higher in OI type III than in OI type I or IV. Serum 24,25(OH)2D concentrations were positively correlated with serum 25-hydroxyvitamin D (25OHD) levels and negatively correlated with serum PTH levels, and were not correlated with serum 1α,25-dihydroxyvitamin D [1,25(OH)2D]. The ratio between serum 24,25(OH)2D and 25OHD was negatively correlated with age and was independent of serum 25OHD concentrations. Regression analysis revealed that OI severity (P = 0.04), serum 25OHD levels (P &lt; 0.001), and serum PTH concentrations (P = 0.045), but not age, gender, or serum 1,25(OH)2D, were independent predictors of serum 24,25(OH)2D levels. No correlation was found between serum 24,25(OH)2D levels or the ratio between serum 24,25(OH)2D and 25OHD and lumbar spine bone mineral density z-scores or bone marker levels (serum osteocalcin and urinary collagen type I N-telopeptide) after adjusting for OI type, age, and gender.Conclusion:Patients with more severe OI type had higher 24,25(OH)2D serum levels and higher serum 24,25(OH)2D to 25OHD ratios, suggesting an increased 25OHD-24-hydroxylase activity.
Assessment of global left ventricular function with dual-source computed tomography in patients with valvular heart disease
Authors: Bak So Hyeon , Ko Sung Min , Jeon Hae Jeong , Yang Hyun Suk , Hwang Hweung Kon , Song Meong Gun 
Published: February 2012

Background Left ventricular (LV) function is a vital parameter for prognosis, therapy guidance, and follow-up of cardiovascular disease. Dual-source computed tomography (DSCT) provides an accurate analysis of global LV function. Purpose To assess the performance of DSCT in the determination of global LV functional parameters in comparison with cardiovascular magnetic resonance (CMR) and two-dimensional transthoracic echocardiography (2D-TTE) in patients with valvular heart disease (VHD). Material and Methods A total of 111 patients (58 men, mean age 49.9 years) with known VHD and who underwent DSCT, 2D-TTE, and CMR a period of 2 weeks before undergoing valve surgery were included in this study. LV end-systolic volume (ESV), end-diastolic volume (EDV), stroke volume (SV), and ejection fraction (EF) were calculated by DSCT using the threshold-based technique, by 2D-TTE using a modified Simpson's method, and by CMR using Simpson's method. Agreement for parameters of LV global function was determined with the Pearson's correlation coefficient ( r) and Bland-Altman analysis. All the DSCT and CMR data-sets were assessed independently by two readers. Results Fifty of the total 111 patients had aortic VHD, 29 patients had mitral VHD, and 32 patients had mixed aortic and mitral VHD. An excellent inter-observer agreement was seen for the assessment of global LV function using DSCT ( r = 0.910–0.983) and CMR ( r = 0.854–0.965). An excellent or good correlation ( r = 0.93, 0.95, 0.87, and 0.71, respectively, P < 0.001) was noted between the DSCT and 2D-TTE values for EDV, ESV, SV, and EF. EDV (33.7 mL, P < 0.001), ESV (12.1 mL, P < 0.001), SV (21.2 mL, P < 0.001), and EF (1.6%, P = 0.019) were significantly overestimated by DSCT when compared with 2D-TTE. An excellent correlation ( r = 0.96, 0.97, 0.91, and 0.94, respectively, P < 0.001) between DSCT and CMR was seen in the evaluation of EDV, ESV, SV, and EF. EDV (15.9 mL, P < 0.001), ESV (7.3 mL, P < 0.001), and SV (8.5 mL, P < 0.001) were significantly underestimated, but EF (1.1%, P = 0.002) was significantly overestimated by DSCT when compared with CMR. Conclusion Our study showed that DSCT measurements of global LV function using the threshold-based technique were highly reproducible and compared more favorably with CMR measurements using Simpson's method than those of 2D-TTE using the modified Simpson's method. DSCT enables accurate quantification of global LV function in patients with VHD.
Impact of Increased Patient Choice of Providers in Sweden: Cataract Surgery
Authors: Hanning Marianne , ÅHs Annika , Winblad Ulrika , LundströM Mats 
Published: February 2012

Objectives Choice of provider was introduced in Sweden in 2001. Our aim was to describe the scope and character of patient flows and to analyze any differences between patients who chose to move outside of their home county (movers) and those who did not (non-movers) with regard to age, sex, waiting time and level of need. Methods Use of cataract operations between 2005 and 2008 based on data from the National Cataract Register. Data were analysed using descriptive statistics, odds ratios and multivariate regression analysis to compare movers and non-movers. Information on contracting between county councils and providers in other counties was obtained from a survey. Results Only 4% of cataract patients were treated by a provider outside their home county. Patient flows were mainly determined by contracts between county councils and providers, and only 1% were considered to be ‘true’ movers (i.e. patients who were not part of any special contracting agreement). Movers differed from non-movers in that they were on average younger, had less serious visual problems and had shorter waiting times. Conclusion Though patient flows are minor in scope, the possibility of changing provider has probably been important in tackling long waits in some counties. However, the reform may threaten the equity of health care use.
Designing Messages to Motivate Parents To Get Their Preteenage Sons Vaccinated Against Human Papillomavirus
Authors: Cates Joan R. , Ortiz Rebecca , Shafer Autumn , Romocki LaHoma Smith , Coyne‐Beasley Tamera 
Published: February 2012

CONTEXT:
Human papillomavirus (HPV) vaccine, licensed for use in 9‐–26‐year‐olds, is most effective when given before sexual activity begins. HPV causes genital warts, is associated with several cancers and disproportionately affects racial and ethnic minorities. Parents are typically unaware of male HPV vaccine; messages that might motivate them to get their preteenage sons vaccinated are unexplored.
METHODS:
Messages promoting vaccination of preteenage boys were designed and tested in 2009 and 2010. Five focus groups were conducted with 29 black parents of 11–12‐year‐old boys, recruited through three churches and a middle school in North Carolina, and a racially diverse sample of 100 parents of 9–13‐year‐old boys in a university‐based adolescent health clinic was interviewed. A constant comparison method was used to code transcripts and interpret themes. Chi‐square and t tests or analyses of variance were used to assess differences in quantitative data.
RESULTS:
Focus group parents knew little about HPV in males. Although concerned about safety and cost, parents supported vaccination for their sons. They wanted to see racial diversity and both parents in motivational materials. In interviews, 89% of parents reported never having heard of male HPV vaccine. The largest proportion said that a message stressing the prevalence and possible consequences of HPV infection was the most motivating (32%); the design favored by the largest proportion (43%) showed two parents.
CONCLUSIONS:
Messages that may most motivate parents to get preteenage boys vaccinated against HPV focus on infection risk and include images of parents with their sons.
Spuriously High Prevalence of Prediabetes Diagnosed by HbA1c in Young Indians Partly Explained by Hematological Factors and Iron Deficiency Anemia
Authors: Hardikar Pallavi S. , Joshi Suyog M. , Bhat Dattatray S. , Raut Deepa A. , Katre Prachi A. , Lubree Himangi G. , Jere Abhay , Pandit Anand N. , Fall Caroline H.D. , Yajnik Chittaranjan S. 
Published: February 2012

OBJECTIVE
To examine the influence of glycemic and nonglycemic parameters on HbA1c concentrations in young adults, the majority of whom had normal glucose tolerance.

RESEARCH DESIGN AND METHODS
We compared the diagnosis of normal glucose tolerance, prediabetes, and diabetes between a standard oral glucose tolerance test (OGTT; World Health Organization 2006 criteria) and HbA1c concentrations (American Diabetes Association [ADA] 2009 criteria) in 116 young adults (average age 21.6 years) from the Pune Children’s Study. We also studied the contribution of glycemic and nonglycemic determinants to HbA1c concentrations.

RESULTS
The OGTT showed that 7.8% of participants were prediabetic and 2.6% were diabetic. By ADA HbA1c criteria, 23.3% were prediabetic and 2.6% were diabetic. The negative predictive value of HbA1c was 93% and the positive predictive value was 20% (only 20% had prediabetes or diabetes according to the OGTT; this figure was 7% in anemic participants). Of participants, 34% were anemic, 37% were iron deficient (ferritin &lt;15 ng/mL), 40% were vitamin B12 deficient (&lt;150 pmol/L), and 22% were folate deficient (&lt;7 nmol/L). On multiple linear regression analysis, HbA1c was predicted by higher 2-h glucose (R2 = 25.6%) and lower hemoglobin (R2 = 7.7%). When hematological parameters were replaced by ferritin, vitamin B12, and folate, HbA1c was predicted by higher glycemia (R2 = 25.6%) and lower ferritin (R2 = 4.3%).

CONCLUSIONS
The use of HbA1c to diagnose prediabetes and diabetes in iron-deficient populations may lead to a spuriously exaggerated prevalence. Further investigation is required before using HbA1c as a screening tool in nutritionally compromised populations.
Absence of Disparities in the Quality of Primary Diabetes Care for South Asians and Chinese in an Urban Canadian Setting
Authors: Shah Baiju R. , Cauch-Dudek Karen , Anand Sonia S. , Austin Peter C. , Manuel Douglas G. , Hux Janet E. 
Published: February 2012

OBJECTIVE
To examine whether quality of diabetes care is equitable for South Asian and Chinese patients in an urban Canadian setting.

RESEARCH DESIGN AND METHODS
Process and intermediate measures of quality of care were compared between 246 South Asians, 170 Chinese, and 431 patients from the general population with type 2 diabetes selected from 45 family physicians’ practices.

RESULTS
A total of 61% of Chinese achieved A1C ≤7.0% versus 45% of South Asians and 49% of the general population (P &lt; 0.05). They were also more likely to achieve LDL cholesterol ≤2.0 mmol/L, while South Asians were more likely to achieve blood pressure ≤130/80. There was only one significant process of care deficiency: fewer foot examinations among South Asians (34 vs. 49% for the general population, P &lt; 0.01).

CONCLUSIONS
Quality of diabetes care in a Canadian urban setting was equitable, with ethnic minorities somewhat more likely to achieve recommended targets than the general population.