bluuebunny/crossref_metadata_2025_split huggingface dataset:
Organizational Factors Associated With Self-management Behaviors in Diabetes Primary Care Clinics
Authors: Kaissi Amer A. , Parchman Michael 
Published: September 2009

Purpose The purpose of this article is to examine the relationship between organizational characteristics as measured by the Chronic Care Model (CCM) and patient self-management behaviors among patients with type 2 diabetes. Methods The study design was cross-sectional. The study setting included 20 primary care clinics from South Texas. The sample included approximately 30 consecutive patients that were enrolled from each clinic for a sample of 617 patients. For the data collection procedures, the CCM survey was completed by caregivers in the clinic. Self-management behaviors were obtained from patient exit surveys. For measures, the CCM consisted of 6 structural dimensions: (1) organization support, (2) community linkages, (3) self-management support, (4) decision support system, (5) delivery system design, and (6) clinical information systems. Patient self-management behavior included whether the patient reported always doing all 4 of the following behaviors as they were instructed: (1) checking blood sugars, (2) following diabetes diet, (3) exercising, and (4) taking medications. For data analyses, to account for clustering of patients within clinics, hierarchical logistic regression models were used. Results Self-management support was positively associated with medication adherence, while decision support system was positively associated with exercise and all 4 self-management behaviors. Surprisingly, community linkages were negatively associated with medication adherence, while clinical information system was negatively associated with diet and all 4 behaviors. A total score, including all dimensions, was positively associated with only exercise. Conclusions Health care providers and diabetes educators in primary care clinics should consider how organizational characteristics of the clinic might influence self-management behaviors of patients. The focus should be on better access to evidence-based information at the point of care and self-management needs and activities.
Assessing the Value of Diabetes Education
Authors: Duncan Ian , Birkmeyer Christian , Coughlin Sheryl , Li Qijuan , Sherr Dawn , Boren Sue 
Published: September 2009

Purpose The purpose of this study was to evaluate the impact of diabetes self-management education/training (DSME/T) on financial outcomes (cost of patient care). Methods Commercial and Medicare claims payer-derived datasets were used to assess whether patients who participate in diabetes education are more likely to follow recommendations for care than similar patients who do not participate in diabetes education, and if claims of patients who participate in diabetes education are lower than those of similar patients who do not. Results Patients using diabetes education have lower average costs than patients who do not use diabetes education. Physicians exhibit high variation in their referral rates to diabetes education. Conclusions The collaboration between diabetes educators and physicians yields positive clinical quality and cost savings. The analysis indicates that quality can be improved, and cost reduced, by increasing referral rates to diabetes education among low-referring physicians, specifically among men and people in disadvantaged areas. More needs to be done to inform physicians about ways to increase access to diabetes education for underserved populations.
A Prospective Investigation of Biomechanical Risk Factors for Patellofemoral Pain Syndrome
Authors: Boling Michelle C. , Padua Darin A. , Marshall Stephen W. , Guskiewicz Kevin , Pyne Scott , Beutler Anthony 
Published: September 2009

Background Patellofemoral pain syndrome is one of the most common chronic knee injuries; however, little research has been done to determine the risk factors for this injury. Hypothesis Altered lower extremity kinematics and kinetics, decreased strength, and altered postural measurements will be risk factors. Study Design Cohort study (prognosis); Level of evidence, 2. Methods A total of 1597 participants were enrolled in this investigation and prospectively followed from the date of their enrollment (July 2005, July 2006, or July 2007) through January 2008, a maximum of 2.5 years of follow-up. Each participant underwent baseline data collection during their pre-freshman summer at the United States Naval Academy. Baseline data collection included 3-dimensional motion analysis during a jump-landing task, 6 lower extremity isometric strength tests, and postural alignment measurements (navicular drop and Q angle). Results Risk factors for the development of patellofemoral pain syndrome included decreased knee flexion angle, decreased vertical ground-reaction force, and increased hip internal rotation angle during the jump-landing task. Additionally, decreased quadriceps and hamstring strength, increased hip external rotator strength, and increased navicular drop were risk factors for the development of patellofemoral pain syndrome. Conclusion Multiple modifiable risk factors for patellofemoral pain syndrome pain have been identified in this investigation. To decrease the incidence of this chronic injury, the risk factors for patellofemoral pain syndrome need to be targeted in injury prevention programs. Clinical Relevance Prevention programs should focus on increasing strength of the lower extremity musculature along with instructing proper mechanics during dynamic movements to decrease the incidence of patellofemoral pain syndrome.
Biomechanical Evaluation of 2 Arthroscopic Biceps Tenodeses
Authors: Lopez-Vidriero Emilio , Costic Ryan S. , Fu Freddie H. , Rodosky Mark W. 
Published: September 2009

Background Recently, there is increasing interest in different arthroscopic biceps tenodesis techniques. However, little data have been published about the biomechanical properties of soft tissue tenodesis. Purpose This study was undertaken to evaluate the biomechanical properties of 2 different arthroscopic biceps tenodeses: the percutaneous intra-articular transtendon (PITT) technique and the suture-anchor technique. Study Design Controlled laboratory study. Methods Fifteen fresh-frozen cadaveric specimens were randomly allocated to the 2 different biceps tenodesis techniques. The humerus with biceps tenodesis was mounted on a materials testing machine to perform a load to failure test. The structural properties including ultimate load (N) and stiffness (N/mm) were derived from the load-displacement curve. The mode of failure was also recorded. Ultimate load and stiffness were compared with the parametric Student t test. Results Both repairs showed typical load-displacement curves followed by a constant increase in load and displacement until failure occurred. Suture-anchor and PITT techniques had ultimate loads of 175.4 ± 40.4 N and 142.7 ± 30.9 N (P = .10) and stiffness of 15.9 ± 8.4 N/mm and 13.3 ± 3 N/mm (P = .36), respectively, with no significant differences between them. All of the surgical constructs failed in the tendon site by pulling out with the sutures through the substance of the tendon. Conclusion The suture-anchor and PITT techniques exhibited satisfactory initial strength with no statistical difference between the 2 groups. These findings, along with the consistent pullout of the suture through the tendon during failure, suggest that the most important factor for initial strength is not the attachment site but the quality of the biceps tendon. Clinical Relevance The quality of the tendon should be taken into account when deciding the surgical technique and the rehabilitation program. The PITT technique has the benefit of avoiding hardware complications and cost.
Instrumentation-Specific Infection After Anterior Cruciate Ligament Reconstruction
Authors: Parada Stephen A. , Grassbaugh Jason A. , DeVine John G. , Arrington Edward D. 
Published: September 2009

Background: Anterior cruciate ligament (ACL) reconstruction is uncommonly complicated by postoperative infections, the causes of which are rarely identified. Hypothesis/Purpose: The goal of this study was to characterize the relationship between methodological sterilization failure and ACL reconstruction infection at an army medical center. Study Design: Case series. Methods: Demographic, clinical, and laboratory data were collected on 5 postoperative infections during a 14-week period in 2003. All ACL reconstructions completed within the past 6 years at the institution were reviewed to establish a baseline infection rate. Results: There was a 14-week period in which 5 cases of infection occurred postoperatively, an infection rate of 12.2%. Previous and subsequent to the identified period, the established rate of infection after ACL reconstruction was 0.3%. There were no violations of sterile technique noted in any of the identified cases. All cases utilized hamstring autograft. All cases also used the DePuy Mitek Intrafix system for tibial fixation of the graft. Two of these cases had positive cultures. Conclusions: An isolated series of increased infection rate led to an investigation into the sterile technique. This revealed gross biomaterial remaining inside instrumentation common to all the cases, the DePuy Mitek Intrafix system. The modular cannulated hex driver, made to fit over a small caliber wire, had no wire brushes of a small-enough diameter for the cleaning and sterilization procedure. After recognition of infection, all patients were treated with surgical irrigation and debridement of the affected knee, as well as individualized antibiotic therapy. Patients were followed postoperatively and no patients required revision ACL reconstruction or radical debridement of the graft.
Selectin-mediated activation of endothelial cells induces expression of CCL5 and promotes metastasis through recruitment of monocytes
Authors: Läubli Heinz , Spanaus Katharina-Susanne , Borsig Lubor 
Published: September 2009

AbstractHematogenous metastasis is promoted by interactions of tumor cells with leukocytes, platelets, and the endothelium in the local intravascular microenvironment. Here we show that the activation of the microvascular endothelium results in recruitment of monocytes to metastatic tumor cells and promotes the establishment of the metastatic microenvironment. This inflammatory-like endothelial response was observed in microvascular endothelial cells only. Microarray analysis of microvascular endothelial cells cocultured with tumor cells in the presence of leukocytes and platelets revealed a specific gene expression profile. Selectin-mediated interactions of tumor cells with platelets and leukocytes activated endothelial cells and induced production of C-C chemokine ligand 5 (CCL5). Inhibition of CCL5-dependent monocyte recruitment during the early phase of metastasis by a CCL5 receptor antagonist strongly reduced tumor cell survival and attenuated metastasis. Collectively, these findings demonstrate that the endothelial expression of CCL5 contributes to the formation of a permissive metastatic microenvironment.
Dasatinib treatment of chronic-phase chronic myeloid leukemia: analysis of responses according to preexisting BCR-ABL mutations
Authors: Müller Martin C. , Cortes Jorge E. , Kim Dong-Wook , Druker Brian J. , Erben Philipp , Pasquini Ricardo , Branford Susan , Hughes Timothy P. , Radich Jerald P. , Ploughman Lynn , Mukhopadhyay Jaydip , Hochhaus Andreas 
Published: September 2009

Abstract
Dasatinib is a BCR-ABL inhibitor with 325-fold higher potency than imatinib against unmutated BCR-ABL in vitro. Imatinib failure is commonly caused by BCR-ABL mutations. Here, dasatinib efficacy was analyzed in patients recruited to phase 2/3 trials with chronic-phase chronic myeloid leukemia with or without BCR-ABL mutations after prior imatinib. Among 1043 patients, 39% had a preexisting BCR-ABL mutation, including 48% of 805 patients with imatinib resistance or suboptimal response. Sixty-threedifferent BCR-ABL mutations affecting 49 amino acids were detected at baseline, with G250, M351, M244, and F359 most frequently affected. After 2 years of follow-up, dasatinib treatment of imatinib-resistant patients with or without a mutation resulted in notable response rates (complete cytogenetic response: 43% vs 47%) and durable progression-free survival (70% vs 80%). High response rates were achieved with different mutations except T315I, including highly imatinib-resistant mutations in the P-loop region. Impaired responses were observed with some mutations with a dasatinib median inhibitory concentration (IC50) greater than 3nM; among patients with mutations with lower or unknown IC50, efficacy was comparable with those with no mutation. Overall, dasatinib has durable efficacy in patients with or without BCR-ABL mutations. All trials were registered at http://www.clinicaltrials.gov as NCT00123474, NCT00101660, and NCT00103844.
Differential gene expression and cytokine production from neutrophils in asthma phenotypes
Authors: Baines K. J. , Simpson J. L. , Bowden N. A. , Scott R. J. , Gibson P. G. 
Published: September 2009

Asthma is characterised into eosinophilic and non-eosinophilic phenotypes based on inflammatory cell patterns in airway secretions. Neutrophils are important in innate immunity, and are increased in the airways in non-eosinophilic asthma. The present study investigated the activity of neutrophils in asthma phenotypes.Participants with eosinophilic (n = 8) and non-eosinophilic asthma (n = 9) and healthy controls (n = 11) underwent sputum induction and blood collection. Neutrophils were isolated and cultured with or without lipopolysaccharide. Cytokines were measured by ELISA, and gene expression was analysed using a gene expression microarray and quantitative PCR.In non-eosinophilic asthma, blood neutrophils released significantly higher levels of interleukin-8 at rest. Cytokine gene expression and sputum neutrophil protein production did not differ between asthma subtypes. Microarrays demonstrated closely related expression profiles from participants with non-eosinophilic asthma that were significantly distinct from those in eosinophilic asthma. A total of 317 genes were significantly altered in resting neutrophils from participants with non-eosinophilic asthmaversuseosinophilic asthma, including genes related to cell motility and regulation of apoptosis.Non-eosinophilic and eosinophilic asthma are associated with specific gene expression profiles, providing further evidence that these phenotypes of asthma involve different molecular mechanisms of disease pathogenesis at the systemic level. The mechanisms of non-eosinophilic asthma may involve enhancement of blood neutrophil chemotaxis and survival.
Health-related quality of life and unmet needs in patients with primary ciliary dyskinesia
Authors: Pifferi M. , Bush A. , Di Cicco M. , Pradal U. , Ragazzo V. , Macchia P. , Boner A. L. 
Published: September 2009

Few studies have evaluated the quality of life of patients with primary ciliary dyskinesia (PCD). We sought to determine the health impact of the disease as well as the unmet needs in a large group of patients.Questionnaires were either posted or e-mailed to known patients with PCD and published online. Questionnaires included the St George's Respiratory Questionnaire, the Medical Outcomes Study Short Form-36 and a questionnaire that we produced to obtain information on age of diagnosis, symptoms and likely PCD-specific problems of these patients.78 subjects (96% of those invited) answered all the questionnaires. Patients were diagnosed at a mean age of 9.4 yrs. Progressive worsening of the disease was observed and adherence to physiotherapy was found to be poor, particularly in adolescents and adults. Patients with the highest treatment burden had a worse quality of life. Over time patients become progressively less interested in treating their disease and adherence to treatment modalities decreases.PCD is associated with a progressive and continuous impact on the physical and mental health of the patients. Earlier identification of the patients and better strategies aimed at improving compliance with care are urgently needed.
Novel strategy to identify genetic risk factors for COPD severity: a genetic isolate
Authors: van Diemen C. C. , Postma D. S. , Aulchenko Y. S. , Snijders P. J. L. M. , Oostra B. A. , van Duijn C. M. , Boezen H. M. 
Published: September 2009

Studies using genetic isolates with limited genetic variation may be useful in chronic obstructive pulmonary disease (COPD) genetics, but are thus far lacking. The associations between single nucleotide polymorphisms (SNPs) in candidate genes and lung function in COPD were studied in a genetic isolate.In 91 subjects with Global Initiative for Chronic Obstructive Lung Disease (GOLD) stage ≥1 COPD, who were members of an extended pedigree including 6,175 people from the Genetic Research in Isolated Populations study, 32 SNPs were analysed in 13 candidate genes: a disintegrin and metalloprotease domain 33 gene (ADAM33), transforming growth factor-β1 gene (TGFB1), matrix metalloprotease-1 gene (MMP1),MMP2,MMP9,MMP12, tissue inhibitor of metalloprotease-1 gene (TIMP1), surfactant protein A1 gene (SFTPA1),SFTPA2,SFTPB,SFTPD, glutathione S-transferase P1 gene (GSTP1), and haem oxygenase 1 gene (HMOX1). Their relation to forced expiratory volume in 1 s (FEV1), inspiratory vital capacity (IVC) and FEV1/IVC were studied using restricted maximum likelihood linear mixed modelling, accounting for pedigree structure. Significant associations were replicated in the general Vlagtwedde/Vlaardingen study.Six SNPs inTGFB1,SFTPA1,SFTPA2andSFTPDwere significantly associated with FEV1/IVC in subjects with GOLD stage ≥1 COPD. Two SNPs inTGFB1(C to T substitution at nucleotide -509 and substitution of leucine 10 with proline (Leu10Pro)), Leu50Val inSFTPA1and Ala160Thr inSFTPDshowed evidence suggestive of association with FEV1/IVC in subjects with GOLD stage ≥2 COPD. TheTGFB1associations were replicated in GOLD stage ≥2 patients from the Vlagtwedde/Vlaardingen population, with similar effect sizes.It was shown that a genetic isolate can be used to determine the genetics of lung function, which can be replicated in COPD patients from an independent population.
The effect of surgery on lung volume and conventional monitoring parameters in ventilated newborn infants
Authors: Proquitté H. , Freiberger O. , Yilmaz S. , Bamberg C. , Degenhardt P. , Roehr C. C. , Wauer R. R. , Schmalisch G. 
Published: September 2009

In newborn infants, thoraco-abdominal surgery is a serious intervention with respect to gas exchange and lung mechanics. This prospective clinical study compared surgery-induced changes in functional residual capacity (FRC) and ventilation inhomogeneity (VI) indices with changes in conventional monitoring parameters.Of 29 ventilated newborns (mean weight 2,770±864 g at surgery), 13, nine and seven underwent thoracic, abdominal or congenital diaphragmatic hernia (CDH) surgery, respectively. The multiple breath washout (MBWO) technique using heptafluoropropane as tracer gas (Babylog® 8000; Dräger, Lübeck, Germany) was performed <6 h before surgery, 22–24 h after surgery and <6 h before extubation. Gas exchange, respiratory mechanics, FRC and VI index data were recorded.Thoraco-abdominal surgery resulted in changes to FRC and VI indices in a procedure-specific manner; however, these changes were not reflected in conventional mechanical or ventilatory monitoring parameters. FRC decreased in non-CDH infants, while FRC increased and VI indices decreased in CDH infants. Despite improvements, the differences in FRC and VI between CDH and non-CDH infants indicated persistent impaired lung function in CHD infants.MBWO can be advantageously used to measure the effect of surgery on the lung. While FRC and VI indices changed following surgery, conventional monitoring parameters did not.
Nasopharyngoscopic evaluation of oral appliance therapy for obstructive sleep apnoea
Authors: Chan A. S. L. , Lee R. W. W. , Srinivasan V. K. , Darendeliler M. A. , Grunstein R. R. , Cistulli P. A. 
Published: September 2009

This study aimed to explore the effect of mandibular advancement splints (MAS) on upper airway anatomy during wakefulness in obstructive sleep apnoea (OSA).Patients commencing treatment for OSA with MAS were recruited. Response to treatment was defined by a ≥50% reduction in the apnoea/hypopnoea index. Nasopharyngoscopy was performed in the supine position.Nasopharyngoscopy was performed in 18 responders and 17 nonresponders. Mandibular advancement caused an increase in the calibre of the velopharynx (mean±sem+40±10%), with relatively minor changes occurring in the oropharynx and hypopharynx. An increase in cross-sectional area of the velopharynx with mandibular advancement occurred to a greater extent in responders than nonresponders (+56±16%versus+22±13%; p<0.05). Upper airway collapse during the Müller manoeuvre, relative to the baseline cross-sectional area, was greater in nonresponders than responders in the velopharynx (-94±4%versus-69±9%; p<0.01) and oropharynx (-37±6%versus-16±3%; p<0.01). When the Müller manoeuvre was performed with mandibular advancement, airway collapse was greater in nonresponders than responders in the velopharynx (-80±11%versus+9±37%; p<0.001), oropharynx (-36±6%versus-20±5%; p<0.05) and hypopharynx (-64±6%versus-42±6%; p<0.05).These results indicate that velopharyngeal calibre is modified by MAS treatment and this may be useful for predicting treatment response.
Phosphoinositide 3-kinase γ required for lipopolysaccharide-induced transepithelial neutrophil trafficking in the lung
Authors: Reutershan J. , Saprito M. S. , Wu D. , Rückle T. , Ley K. 
Published: September 2009

Phosphoinositide 3-kinase γ(PI3Kγ) is a critical mediator of directional cell movement. Here, we sought to characterise the role ofPI3Kγin mediating the different steps of polymorphonuclear leukocyte (PMN) trafficking in the lung.In a murine model of lipopolysaccharide (LPS)-induced lung injury, PMN migration into the different lung compartments was determined inPI3Kγgene-deficient (PI3Kγ-/-) and wild-type mice. Bone marrow chimeras were created to characterise the role ofPI3Kγon haematopoieticversusnonhaematopoietic cells. A small-moleculePI3Kγinhibitor was testedin vitroandin vivo.PMN adhesion to the pulmonary endothelium and transendothelial migration into the lung interstitium was enhanced inPI3Kγ-/-mice. However, transepithelial migration into the alveolar space was reduced in these mice. When irradiatedPI3Kγ-/-mice were reconstituted with bone marrow from wild-type mice, migratory activity into the alveolar space was restored partially. A small-moleculePI3Kγinhibitor reduced chemokine-induced PMN migrationin vitrowhen PMNs or epithelial cells, but not when endothelial cells, were treated. The inhibitor also reduced LPS-induced PMN migrationin vivo.We conclude thatPI3Kγis required for transepithelial but not for transendothelial migration in LPS-induced lung injury. Inhibition ofPI3Kγactivity may be effective at curbing excessive PMN infiltration in lung injury.