bluuebunny/crossref_metadata_2025 huggingface dataset:
Estimativas de insegurança alimentar grave nos municípios Brasileiros
Authors: Gubert Muriel Bauermann , Benício Maria Helena D'Aquino , Santos Leonor Maria Pacheco dos
Published: August 2010

Estimou-se a prevalência de insegurança alimentar grave para os municípios brasileiros, com base na Pesquisa Nacional por Amostra de Domicílios (PNAD) 2004. Inicialmente, foi gerado e testado um modelo por regressão logística multivariada com base nesse banco de dados. O modelo foi aplicado à amostra do Censo Demográfico de 2000, gerando estimativas de prevalências de insegurança alimentar grave para os municípios brasileiros, que foram analisadas de acordo com o percentual de famílias em condição de insegurança alimentar grave. Essa insegurança alimentar está mais concentrada nas regiões Norte e Nordeste, onde 46,1% e 65,3% dos municípios, respectivamente, apresentam altas prevalências de insegurança alimentar grave. Predominam nas regiões Sudeste e Sul municípios com baixa exposição à insegurança alimentar grave. No Centro-oeste a maior parte dos municípios mostra estimativas de insegurança alimentar grave classificadas como médias. Verificou-se grande variação intra-regional na ocorrência da insegurança alimentar, sendo a Região Sul a mais uniforme. Conclui-se que o Brasil apresenta grandes variações inter e intra-regionais na ocorrência da insegurança alimentar, sendo importante realçá-las e analisá-las, no intuito de subsidiar políticas públicas.
Sintomáticos respiratórios nas unidades de atenção primária no Município de Vitória, Espírito Santo, Brasil
Authors: Moreira Claudia Maria Marques , Zandonade Eliana , Lacerda Thamy , Maciel Ethel Leonor Noia
Published: August 2010

O objetivo do estudo foi estimar a proporção de sintomáticos respiratórios na população que busca atendimento nas unidades de atenção primária do Município de Vitória, Espírito Santo. Foi realizado um estudo transversal do qual participaram 603 indivíduos que responderam a um questionário referente a dados sócio-demográficos e questão sobre tosse há mais de três semanas. Foi calculada a razão de prevalência com nível de significância de 5%. A proporção de sintomáticos respiratórios encontrada no município foi de 4%, variando de 1,6 a 11,7% entre as regiões. A maioria (71%) não referiu a tosse como motivo de procura do serviço. As variáveis significativamente associadas à condição de sintomático respiratório foram: falta de ar (RP = 6,29; IC95%: 2,22-21,81) e falta de apetite (RP = 2,75; IC95%: 1,08-6,82). Entre os sintomáticos respiratórios, a tosse foi o principal motivo de consulta. Observou-se associação dessa condição com somente duas variáveis, demonstrando a necessidade de adoção de diferentes estratégias para busca e identificação desses indivíduos na demanda diária das unidades de atenção primária.
Early Consonant Production in Swedish Infants with and without Unilateral Cleft Lip and Palate and Two-Stage Palatal Repair
Authors: Lohmander Anette , Olsson Maria , Flynn Traci
Published: September 2010

Objective

To investigate consonant production at 12 and 18 months of age following early soft palate repair in infants with unilateral cleft lip and palate (UCLP), and to compare it with typically developing children without clefts.

Design

Randomized study with comparison group.

Participants

Twenty Swedish infants born with UCLP and 21 without clefts (COMP) were included in a randomized trial of palatal surgery (Scandcleft project). Soft palate closure was completed at age 5 months; hard palate closure was performed in 11 of the infants with UCLP at 1 year of age (HPC) and was left open in nine (HPO).

Method

Audio recordings at 12 months (UCLP = 9, COMP = 21) and at 18 months (UCLP = 18, COMP = 21) were phonetically transcribed. Consonant inventory, frequency of manner and place of articulation, true canonical babbling (TCB), and impact of hearing status were analyzed.

Results

At 12 months of age, all children had reached the stage of TCB. Mild hearing impairment was significantly correlated with fewer consonant types. A lower frequency of dentals and oral stops was found in the UCLP group than in the COMP group. However, the number of oral stops was high compared with what has been previously reported.

Conclusions

Early soft palate closure seems to give a relatively high number of oral stops even with the hard palate unrepaired, although with significantly fewer dentals/alveolars than are seen in peers without clefts. Differences in consonant inventory were correlated with hearing function.
CRISPLD2 Variants Including a C471T Silent Mutation May Contribute to Nonsyndromic Cleft Lip with or without Cleft Palate
Authors: Letra Ariadne , Menezes Renato , Cooper Margaret E. , Fonseca Renata F. , Tropp Stephen , Govil Manika , Granjeiro Jose M. , Imoehl Sandra R. , Mansilla M. Adela , Murray Jeffrey C. , Castilla Eduardo E. , Orioli Iêda M. , Czeizel Andrew E. , Ma Lian , Chiquet Brett T. , Hecht Jacqueline T. , Vieira Alexandre R. , Marazita Mary L.
Published: September 2010

Objective

To assess the association between nonsyndromic (NS) cleft lip with or without cleft palate (CL(P)) and single-nucleotide polymorphisms (SNPs) within the CRISPLD2 gene (cysteine-rich secretory protein LCCL domain containing 2).

Design

Four SNPs within the CRISPLD2 gene domain (rs1546124, rs8061351, rs2326398, rs4783099) were genotyped to test for association via family-based association methods.

Participants

A total of 5826 individuals from 1331 families in which one or more family member is affected with CL(P).

Results

Evidence of association was seen for SNP rs1546124 in U.S. ( p = .02) and Brazilian ( p = .04) Caucasian cohorts. We also found association of SNP rs1546124 with cleft palate alone (CP) in South Americans (Guatemala and ECLAMC) and combined Hispanics (Guatemala, ECLAMC, and Texas Hispanics; p = .03 for both comparisons) and with both cleft lip with cleft palate (CLP; p = .04) and CL(P) ( p = .02) in North Americans. Strong evidence of association was found for SNP rs2326398 with CP in Asian populations ( p = .003) and with CL(P) in Hispanics ( p = .03) and also with bilateral CL(P) in Brazilians ( p = .004). In Brazilians, SNP rs8061351 showed association with cleft subgroups incomplete CL(P) ( p = .004) and unilateral incomplete CL(P) ( p = .003). Prediction of SNP functionality revealed that the C allele in the C471T silent mutation (overrepresented in cases with CL(P) presents two putative exonic splicing enhancer motifs and creates a binding site AP-2 alpha, a transcription factor involved in craniofacial development.

Conclusions

Our results support the hypothesis that variants in the CRISPLD2 gene may be involved in the etiology of NS CL(P).
Prosthetic Rehabilitation of a Patient with Bilateral Cleft Lip and Palate Using Osseointegrated Implants and Extracoronal Resilient Attachments: A Case Report
Authors: Murat Sema , Gurbuz Ayhan , Genc Fikret
Published: September 2010

This case study reports on the prosthetic rehabilitation of a patient with an unrepaired bilateral cleft lip and palate using osseointegrated implants, extracoronal resilient attachments, a combination of metal-ceramic cement-retained fixed partial restorations, and removable prosthesis. Preoperative clinical examination of a 32-year-old woman with bilateral cleft lip and palate revealed a large oronasal communication, hyperplastic soft tissue surrounding the hard palate defect, and a severely resorbed alveolar ridge. A maxillary obturator prosthesis supported by implants and retained with an extracoronal resilient attachment was designed to cover the oronasal communication in the hard palate and fulfill the patient's functional and aesthetic requirements. The patient has been wearing the prosthesis for 1 year. Her speech quality has greatly improved, and her aesthetic and functional expectations have been met.
Oral Synechia with Epithelial Cyst in Neonate with Cleft Palate: A Case Report
Authors: German Michael , Wong Hausin
Published: September 2010

Cleft palate with oral synechia is a rare congenital deformity that is represented in the literature by only a handful of cases. Midline synechia is less common than lateral. Failure to recognize and appropriately treat this condition has serious implications for neonatal airway management and feeding. We present a case of cleft palate with midline subglossopalatal synechia that was transferred from an outside institution after a prolonged period of nonsurgical management in which the patient ultimately required intubation for respiratory distress. Release of the synechia was performed without complications. We review the current literature and discuss diagnosis and surgical management of this rare condition.
Derivation of a Variable Rate Nitrogen Application Model for In‐Season Fertilization of Corn
Authors: Holland K. H. , Schepers J. S.
Published: September 2010

Nitrogen fertilizers used in crop production contribute to pollution of groundwater by nitrate and occurrence of hypoxia in the Gulf of Mexico. Economic and environmental pressures are forcing producers to improve N use efficiency. The objective of this study was to develop a production‐based in‐season N recommendation model for use with crop canopy sensors and remote sensing data. The approach is based on the general shape of an N fertilizer response function (sensor index vs. N rate) and the relationship between N rate and in‐season crop vegetation index data. Transformation and substitution techniques were used to generate a simple function that offers an N fertilizer recommendation based on spatially variable in‐season remote sensing data and established local crop production information such as the economic optimum N rate or producer defined optimum N rate. The model accommodates management zones, preplant N applications, manure mineralization, legume credits, nitrate in irrigation water, and crop growth stage. Estimates of potential yield are not needed. Instead the method relies on production information provided by the user and the generalized shape of the fertilizer N response function. Testing the model with SPAD chlorophyll meter data from irrigated corn showed that the recommended fertilizer N rate plus preplant N rate totaled 184, 164, 186, 188, and 200 kg ha−1 for preplant N rates of 0, 50,100, 150, and 200 kg N ha−1 when averaged across growth stages for 3 yr.
Prospects for Monitoring Cotton Crop Maturity with Normalized Difference Vegetation Index
Authors: Gwathmey C. Owen , Tyler Donald D. , Yin X.
Published: September 2010

Cotton (Gossypium hirsutum L.) producers monitor crop maturity during the season to determine when to terminate inputs and to defoliate. COTMAN monitors crop maturity based on time for plants to reach five nodes above white flower (NAWF = 5). Normalized difference vegetation index (NDVI) estimates crop biomass and condition from canopy reflectance of near‐infrared and visible radiation. We conducted a 4‐yr study at Jackson, TN to evaluate the suitability of NDVI for monitoring cotton crop maturity, relative to COTMAN. Maturity was altered by combinations of winter cover crop and N fertilization. Flowering was monitored to determine the date of NAWF = 5 for COTMAN, which predicted later maturity with higher N rates. Relative to zero N, boll opening was delayed by 100 kg N ha−1 in 3 yr. Cover crop effects on NAWF = 5 and maturity were inconsistent. Canopy NDVI data were collected weekly after mid‐bloom with a hand‐held GreenSeeker red/near‐infrared sensor. Significant date × treatment interactions for NDVI indicated the potential to detect maturity differences with NDVI. However, dissimilar time courses of NDVI were obtained in different years, complicating efforts to develop an empirical model of NDVI attenuation with crop maturity. Late‐season NDVI was correlated with degree‐days to open boll in 3 yr, but differences in NDVI corresponding to crop maturity differences occurred later in the season than NAWF = 5 used by COTMAN. Relationships between changes in NDVI and crop maturity did not provide a simple basis for predicting readiness for defoliation similar to COTMAN. Improved multispectral sensors are needed for monitoring row crop condition and maturity.
Impact of Varying Planting Dates and Irrigation Regimes on Cotton Growth and Lint Yield Production
Authors: Pettigrew William T.
Published: September 2010

Yield enhancements can be obtained in the Mississippi Delta by planting irrigated cotton (Gossypium hirsutum L.) during the first week of April rather than the first week of May. Because some late season drought stress is avoided, early planting might also work for dryland production. Objectives were to compare the performance of early and normal planted cotton while grown under both irrigated and dryland conditions. Six cotton cultivars were planted in the field at Stoneville, MS during either the first week of April (Early) or the first week of May (Normal) in 2005 to 2008. Half the plots were irrigated and half were dryland. Dry matter partitioning, light interception, flowering, lint yield, yield components, and fiber quality data were collected. With the exception of the hurricane‐plagued season of 2005, irrigation increased lint yield regardless of planting date. In 2006 and 2007, early planting increased lint yield by 13% under irrigated conditions, but not dryland conditions. Early planting decreased dryland lint yield by 35% in 2008 but not under irrigated conditions. Fiber from normal planted cotton was 5% stronger than from those early planted. Both early planting and dryland conditions had a propensity to increase the short fiber content. Based on the 4 yr of this research, early planting appears to need irrigation to achieve its yield benefits, which implies that dryland Mississippi Delta cotton producers should not adopt an early planting production strategy.
Endogenous Internet Structure and Bargaining Power in Interconnection Agreements
Authors: Jun Tackseung , Kim Jeong-Yoo , Kim Hee-Su
Published: August 2010

We consider a model of Internet interconnection. We characterize the Myerson value as the bargaining outcome in interconnection agreements in given networks and provide its interpretation in terms of "betweenness centrality." Then, in an extended network formation model, we characterize the structures of the efficient network and the stable network and confirm the disparity between them. We also identify the condition for the disparity to disappear under bill-and-keep agreements. The possibility of multi-homing and secondary peering is briefly discussed.
Preliminary analysis of arsenic and other metallic elements in PM10 sampled near a copper smelter Bor (Serbia)
Authors: Kovacevic Renata , Jovasevic-Stojanovic Milena , Tasic Visa , Milosevic Novica , Petrovic Nevenka , Stankovic Suzana , Matic-Besarabic Snezana
Published: August 2010

In this paper, there are presented levels of twenty one elements (Ag, Al, As,
B, Ba, Ca, Cd, Cr, Cu, Fe, K, Mg, Mn, Mo, Na, Ni, Pb, S, Se, Sr, and Zn) in
PM10 and SO2 concentration measured at the sampling site in an urban area of
the town of Bor (40000 inhabitants) in eastern Serbia. Sampling site was
located in densely populated city center about 0.65 km far from one of the
largest copper mine and cooper smelter in Europe. For the first time PM10 was
collected using Europen standard sampler, during preliminar campaing in
duration of 7 days in early spring 2009. PM10 were sampled on PTFE memebrane
filters and element concentrations quantified by GF AAS and ICP AES. A
concentration level and correlations within trace elements, PM10 and SO2
indicated that industrial activates underpinned with metrological conditions
of slow wind speed (calm), are the main factors that influence air pollution
in densely populated area. It was evident that both, PM10 mass concentration
and SO2 concentration once exceeded daily limit values during measuring
period of seven days. Strong relationship was found between PM10 and Mn, Mg,
Ca and B daily average concentrations. On the other side, SO2 correlated
strongly with As, Pb, Cd, Cu and S daily average concentrations. These
results confirm relationship between emissions of SO2 from the Copper Smelter
Bor, calm meteorological conditions (wind speed less than 0.5 m/sec) with
concentration level of carcinogenic substances of arsenic, lead and cadmium
in ambient air.
Auditing Operational Compliance: The Case of Employee Long Distance Piracy
Authors: Watson Marcia Weidenmier , Dow Kevin E.
Published: August 2010

ABSTRACT: This case provides an active-learning opportunity for students to assume the role of an internal auditor conducting a compliance audit. Specifically, we provide students with the actual telephone records of a firm with a policy prohibiting employees from using company phones for personal long distance calls. The case exposes students to (1) using generalized audit software, (2) validating data (for potential anomalies) before performing analysis, (3) analyzing nonfinancial information, (4) converting nonfinancial information into financial impact (i.e., the cost of the nonbusiness long distance phone calls), and (5) writing a business letter outlining the findings of the compliance audit and recommendations. Students must understand the data, analyze it, interpret the results, and develop recommendations. Given that most shareholder value is lost due to strategic, operational, and business risks, rather than financial risks, audit committees and senior management are now putting pressure on internal auditing to shift its focus from financial compliance auditing to nonfinancial concerns. This case helps students gain the necessary skills to conduct these non-SOX audits.
Preparing Graphical Representations of Business Processes and Making Inferences from Them
Authors: Borthick A. Faye , Schneider Gary P. , Vance Anthony O.
Published: August 2010

ABSTRACT: In this case, students (1) listen to (or read a transcript of) conversations among managers of a convenience store company about current and contemplated supply chain processes, (2) prepare a system flowchart and a business process diagram (BPD) to represent the processes, and (3) use these graphical representations to make inferences about system effectiveness. The case contrasts the emerging practice of business process modeling with the more traditional practice of system flowcharting. Instructors can use the case to help students develop advanced skills in documenting business processes and to assess their ability to represent business processes and make inferences about process effectiveness. The case is appropriate for accounting information systems and business courses in which business process modeling skills are developed or applied. Students should have a general knowledge of sales, order entry, and purchasing processes and be able to prepare simple flowcharts and BPDs.
Integrating AIS and Accounting for Income Taxes: From Calculation to Disclosure
Authors: Loraas Tina M. , Key Kimberly Galligan
Published: August 2010

ABSTRACT: TK Foods, Inc. is a leading online retailer of whole and organic foods, and while this company is doing well, management is struggling with accounting for income taxes. The case requires you to take the role of a consultant who has been hired to calculate the provision of income taxes and to create a template for the footnote disclosure using spreadsheet and word processing tools. Further, TK requires documentation regarding both the process and internal controls surrounding this calculation. This case will further your understanding of accounting for income taxes, expose you to a significant internal control problem faced by many corporations, and develop your spreadsheet skills from both computational and control standpoints.
A Novel Clinically Relevant Strategy to Abrogate Autoimmunity and Regulate Alloimmunity in NOD Mice
Authors: Vergani Andrea , D'Addio Francesca , Jurewicz Mollie , Petrelli Alessandra , Watanabe Toshihiko , Liu Kaifeng , Law Kenneth , Schuetz Christian , Carvello Michele , Orsenigo Elena , Deng Shaoping , Rodig Scott J. , Ansari Javeed M. , Staudacher Carlo , Abdi Reza , Williams John , Markmann James , Atkinson Mark , Sayegh Mohamed H. , Fiorina Paolo
Published: August 2010

OBJECTIVE

To investigate a new clinically relevant immunoregulatory strategy based on treatment with murine Thymoglobulin mATG Genzyme and CTLA4-Ig in NOD mice to prevent allo- and autoimmune activation using a stringent model of islet transplantation and diabetes reversal.

RESEARCH DESIGN AND METHODS

Using allogeneic islet transplantation models as well as NOD mice with recent onset type 1 diabetes, we addressed the therapeutic efficacy and immunomodulatory mechanisms associated with a new immunoregulatory protocol based on prolonged low-dose mATG plus CTLA4-Ig.

RESULTS

BALB/c islets transplanted into hyperglycemic NOD mice under prolonged mATG+CTLA4-Ig treatment showed a pronounced delay in allograft rejection compared with untreated mice (mean survival time: 54 vs. 8 days, P < 0.0001). Immunologic analysis of mice receiving transplants revealed a complete abrogation of autoimmune responses and severe downregulation of alloimmunity in response to treatment. The striking effect on autoimmunity was confirmed by 100% diabetes reversal in newly hyperglycemic NOD mice and 100% indefinite survival of syngeneic islet transplantation (NOD.SCID into NOD mice).

CONCLUSIONS

The capacity to regulate alloimmunity and to abrogate the autoimmune response in NOD mice in different settings confirmed that prolonged mATG+CTLA4-Ig treatment is a clinically relevant strategy to translate to humans with type 1 diabetes.
Latent Autoimmune Diabetes in Adults Differs Genetically From Classical Type 1 Diabetes Diagnosed After the Age of 35 Years
Authors: Andersen Mette K. , Lundgren Virve , Turunen Joni A. , Forsblom Carol , Isomaa Bo , Groop Per-Henrik , Groop Leif , Tuomi Tiinamaija
Published: August 2010

OBJECTIVE

We studied differences between patients with latent autoimmune diabetes in adults (LADA), type 2 diabetes, and classical type 1 diabetes diagnosed after age 35 years.

RESEARCH DESIGN AND METHODS

Polymorphisms in HLA-DQB1, INS, PTPN22, and CTLA4 were genotyped in patients with LADA (n = 213), type 1 diabetes diagnosed at >35 years of age (T1D>35y; n = 257) or <20 years of age (T1D<20y; n = 158), and type 2 diabetes.

RESULTS

Although patients with LADA had an increased frequency of HLA-DQB1 and PTPN22 risk genotypes and alleles compared with type 2 diabetic subjects, the frequency was significantly lower compared with T1D>35y patients. Genotype frequencies, measures of insulin secretion, and metabolic traits within LADA differed according to GAD antibody (GADA) quartiles, but even the highest quartile differed from type 1 diabetes. Having two or more risk genotypes was associated with lower C-peptide concentrations in LADA.

CONCLUSIONS

LADA patients differed genetically and phenotypically from both T1D>35y and type 2 diabetic patients in a manner dependent on GADA levels.
Disposition Index, Glucose Effectiveness, and Conversion to Type 2 Diabetes
Authors: Lorenzo Carlos , Wagenknecht Lynne E. , Rewers Marian J. , Karter Andrew J. , Bergman Richard N. , Hanley Anthony J.G. , Haffner Steven M.
Published: August 2010

OBJECTIVE

Disposition index (DI) and glucose effectiveness (SG) are risk factors for diabetes. However, the effect of DI and SG on future diabetes has not been examined in large epidemiological studies using direct measures.

RESEARCH DESIGN AND METHODS

Insulin sensitivity index (SI), acute insulin response (AIR), and SG were measured in 826 participants (aged 40–69 years) in the Insulin Resistance Atherosclerosis Study (IRAS) by the frequently sampled intravenous glucose tolerance test. DI was expressed as SI × AIR. At the 5-year follow-up examination, 128 individuals (15.5%) had developed diabetes.

RESULTS

The area under the receiver operating characteristic curve of a model with SI and AIR was similar to that of DI (0.767 vs. 0.774, P = 0.543). In a multivariate logistic regression model that included both DI and SG, conversion to diabetes was predicted by both SG (odds ratio × 1 SD, 0.61 [0.47–0.80]) and DI (0.68 [0.54–0.85]) after adjusting for demographic variables, fasting and 2-h glucose concentrations, family history of diabetes, and measures of obesity. Age, sex, race/ethnicity, glucose tolerance status, obesity, and family history of diabetes did not have a significant modifying impact on the relation of SG and DI to incident diabetes.

CONCLUSIONS

The predictive power of DI is comparable to that of its components, SI and AIR. SG and DI independently predict conversion to diabetes similarly across race/ethnic groups, varying states of glucose tolerance, family history of diabetes, and obesity.
Common Genetic Variation in GLP1R and Insulin Secretion in Response to Exogenous GLP-1 in Nondiabetic Subjects
Authors: Sathananthan Airani , Man Chiara Dalla , Micheletto Francesco , Zinsmeister Alan R. , Camilleri Michael , Giesler Paula D. , Laugen Jeanette M. , Toffolo Gianna , Rizza Robert A. , Cobelli Claudio , Vella Adrian
Published: August 2010

OBJECTIVE

Glucagon-like peptide (GLP)-1 receptor is encoded by GLP1R. The effect of genetic variation at this locus on the response to GLP-1 is unknown. This study assessed the effect of GLP1R polymorphisms on insulin secretion in response to hyperglycemia and to infused GLP-1 in nondiabetic subjects.

RESEARCH DESIGN AND METHODS

Eighty-eight healthy individuals (aged 26.3 ± 0.6 years, fasting glucose 4.83 ± 0.04 mmol/l) were studied using a hyperglycemic clamp. GLP-1 was infused for the last 2 h of the study (0.75 pmol/kg/min over 121–180 min, 1.5 pmol/kg/min over 181–240 min). β-Cell responsivity (ΦTotal) was measured using a C-peptide minimal model. The effect of 21 tag single nucleotide polymorphisms (SNPs) in GLP1R on ΦTotal was examined.

RESULTS

Two SNPs (rs6923761 and rs3765467) were nominally associated with altered β-cell responsivity in response to GLP-1 infusion.

CONCLUSIONS

Variation in GLP1R may alter insulin secretion in response to exogenous GLP-1. Future studies will determine whether such variation accounts for interindividual differences in response to GLP-1–based therapy.
Disparate Effects of Atorvastatin Compared With Simvastatin on C-Reactive Protein Concentrations in Patients With Type 2 Diabetes
Authors: Sathyapalan Thozhukat , Atkin Stephen L. , Kilpatrick Eric S.
Published: August 2010

OBJECTIVE

Reduction in LDL and high sensitivity (hs) C-reactive protein (CRP) are independent indicators of successful cardiovascular risk reduction with statins. This study compared the effect of equivalent LDL-lowering doses of simvastatin and atorvastatin on hsCRP in type 2 diabetic patients.

RESEARCH DESIGN AND METHODS

A crossover study of 26 patients with type 2 diabetes taking either 40 mg simvastatin or 10 mg atorvastatin was undertaken. After 3 months on one statin, lipids and hsCRP were measured on 10 occasions over a 5-week period. The same procedure was then followed taking the other statin.

RESULTS

LDL was comparable on either treatment: atorvastatin 2.2 ± 0.2 vs. 2.1 ± 0.3 mmol/l (mean ± SD; P = 0.19). CRP of individuals taking atorvastatin was significantly lower than when they were taking simvastatin (median 1.08 vs. 1.47 mg/l, P = 0.0002) and was less variable (median SD of logCRP 0.0036 vs. 0.178, P = 0.0001).

CONCLUSIONS

Compared with simvastatin, atorvastatin reduced hsCRP and its variability in type 2 diabetic patients. This enhanced anti-inflammatory effect may prove beneficial if lower CRP is associated with improved cardiovascular risk.
Cost-Effectiveness of Bariatric Surgery for Severely Obese Adults With Diabetes
Authors: Hoerger Thomas J. , Zhang Ping , Segel Joel E. , Kahn Henry S. , Barker Lawrence E. , Couper Steven
Published: August 2010

OBJECTIVE

To analyze the cost-effectiveness of bariatric surgery in severely obese (BMI ≥35 kg/m2) adults who have diabetes, using a validated diabetes cost-effectiveness model.

RESEARCH DESIGN AND METHODS

We expanded the Centers for Disease Control and Prevention–RTI Diabetes Cost-Effectiveness Model to incorporate bariatric surgery. In this simulation model, bariatric surgery may lead to diabetes remission and reductions in other risk factors, which then lead to fewer diabetes complications and increased quality of life (QoL). Surgery is also associated with perioperative mortality and subsequent complications, and patients in remission may relapse to diabetes. We separately estimate the costs, quality-adjusted life-years (QALYs), and cost-effectiveness of gastric bypass surgery relative to usual diabetes care and of gastric banding surgery relative to usual diabetes care. We examine the cost-effectiveness of each type of surgery for severely obese individuals who are newly diagnosed with diabetes and for severely obese individuals with established diabetes.

RESULTS

In all analyses, bariatric surgery increased QALYs and increased costs. Bypass surgery had cost-effectiveness ratios of $7,000/QALY and $12,000/QALY for severely obese patients with newly diagnosed and established diabetes, respectively. Banding surgery had cost-effectiveness ratios of $11,000/QALY and $13,000/QALY for the respective groups. In sensitivity analyses, the cost-effectiveness ratios were most affected by assumptions about the direct gain in QoL from BMI loss following surgery.

CONCLUSIONS

Our analysis indicates that gastric bypass and gastric banding are cost-effective methods of reducing mortality and diabetes complications in severely obese adults with diabetes.
Cognitive Function in Type 1 Diabetic Adults With Early Exposure to Severe Hypoglycemia
Authors: Åsvold Bjørn O. , Sand Trond , Hestad Knut , Bjørgaas Marit R.
Published: August 2010

OBJECTIVE

We assessed adulthood cognition in relation to early exposure to severe hypoglycemia (SH).

RESEARCH DESIGN AND METHODS

Sixteen years subsequent to a study of cognitive function in 28 diabetic children and 28 matched control subjects, we reexamined the same subjects with a 96% participation rate. Diabetic subjects were classified as with (n = 9) or without (n = 18) early (≤10 years of age) SH, which was defined as convulsions or loss of consciousness.

RESULTS

Overall, cognitive scores were 0.9 SDs lower in subjects with early SH compared with subjects without early SH (P = 0.003). The two diabetic groups particularly differed with respect to problem solving, verbal function, and psychomotor efficiency. Earlier age at first incident of SH was associated with poorer cognition (P for trend = 0.001).

CONCLUSIONS

The findings suggest that early exposure to SH may have lasting and clinically relevant effects on cognition.
No Protective Effect of Calcitriol on β-Cell Function in Recent-Onset Type 1 Diabetes
Authors: Bizzarri Carla , Pitocco Dario , Napoli Nicola , Di Stasio Enrico , Maggi Daria , Manfrini Silvia , Suraci Concetta , Cavallo Maria Gisella , Cappa Marco , Ghirlanda Giovanni , Pozzilli Paolo ,   the IMDIAB Group
Published: August 2010

OBJECTIVE

We investigated whether supplementation of the active form of vitamin D (calcitriol) in recent-onset type 1 diabetes can protect β-cell function evaluated by C-peptide and improve glycemic control assessed by A1C and insulin requirement.

RESEARCH DESIGN AND METHODS

Thirty-four subjects (aged 11–35 years, median 18 years) with recent-onset type 1 diabetes and high basal C-peptide >0.25 nmol/l were randomized in a double-blind trial to 0.25 μg/day calcitriol or placebo and followed-up for 2 years.

RESULTS

At 6, 12, and 24 months follow-up, A1C and insulin requirement in the calcitriol group did not differ from the placebo group. C-peptide dropped significantly (P < 0.001) but similarly in both groups, with no significant differences at each time point.

CONCLUSIONS

At the doses used, calcitriol is ineffective in protecting β-cell function in subjects (including children) with recent-onset type 1 diabetes and high C-peptide at diagnosis.
Microleakage of Posterior Composite Restorations Lined with Self-adhesive Resin Cements
Authors: Al-Saleh M. , El-Mowafy O. , Tam L. , Fenton A.
Published: September 2010

Clinical Relevance

Two self-adhesive resin cements resulted in minimal microleakage scores when used as liners in Class II composite restorations.
Removal of Enamel Caries with an Air Abrasion Powder
Authors: Neuhaus K. W. , Ciucchi P. , Donnet M. , Lussi A.
Published: September 2010

Clinical Relevance

The results of the current study indicate that air abrasion with a powder for selective preparation of carious enamel saves healthy tooth substance. It also has a diagnostic potential for operative intervention in patients with high caries risk, because only carious enamel with underlying dentin caries is abraded. Furthermore, this powder could be used in cavitated lesions for selective enamel removal.
Korovkin-type convergence results for non-positive operators
Authors: Nowak Oliver
Published: September 2010

Korovkin-type approximation theory usually deals with convergence analysis for sequences of positive operators. In this work we present qualitative Korovkin-type convergence results for a class of sequences of non-positive operators, more precisely regular operators with vanishing negative parts under a limiting process. Sequences of that type are called sequences of almost positive linear operators and have not been studied before in the context of Korovkin-type approximation theory. As an example we show that operators related to the multivariate scattered data interpolation technique moving least squares interpolation originally due to Lancaster and Šalkauskas [Surfaces generated by moving least squares methods, Math. Comp., 1981, 37, 141–158] give rise to such sequences. This work also generalizes Korovkin-type results regarding Shepard interpolation [Korovkin-type convergence results for multivariate Shepard formulae, Rev. Anal. Numér. Théor. Approx., 2009, 38, 170–176] due to the author. Moreover, this work establishes connections and differences between the concepts of sequences of almost positive linear operators and sequences of quasi-positive or convexity-monotone linear operators introduced and studied by Campiti in [Convexity-monotone operators in Korovkin theory, Rend. Circ. Mat. Palermo (2) Suppl., 1993, 33, 229–238].
Influence of lead dioxide electrodes morphology on kinetics and current efficiency of oxygen-ozone evolution reactions
Authors: Rufino Élen , Santana Mario , Faria Luiz , Silva Leonardo
Published: September 2010

Influence of electrode morphology on electrochemical properties of lead dioxide electrodes (β-PbO2) for oxygen-ozone evolution reactions in acid medium was investigated using scanning electronic microscopy (SEM), cyclic voltammetry (CV), polarization curves (PC), and determination of the current efficiency (Φ). Experimental findings revealed that application of high electrodeposition current densities furnishes more rough β-PbO2 films. Surface characteristics were verified by SEM images and the analysis of interfacial pseudo-capacitances and morphology factor (φ). Kinetic study of the overall electrode process (O2 + O3) based on the analysis of the Tafel slope revealed that the electrode morphology and electrolyte composition considerably affect the electrode kinetics. In most cases, the existence of two Tafel slopes distributed in the low and high overpotential domains was observed. Abnormal Tafel slopes (b ≠ 120 mV) obtained for the primary water discharge step during water electrolysis were interpreted considering the apparent charge transfer coefficient (α apa). Optimum conditions for the ozone production were obtained for the less rough β-PbO2 electrode immersed in a sulfuric acid solution (1.0 mol dm−3) containing KPF6 (30 × 10−3 mol dm−3), where the current efficiency of 15 mass % for the ozone production was obtained.
Oxidative polymerization of anilinium 5-sulfosalicylate with peroxydisulfate in water
Authors: Marjanović Budimir , Juranić Ivan , Mentus Slavko , Ćirić-Marjanović Gordana , Holler Petr
Published: September 2010

Anilinium 5-sulfosalicylate was prepared and characterized by elemental analysis, and FTIR and NMR spectroscopies. It was polymerized in an aqueous solution using ammonium peroxydisulfate as an oxidant. The precipitated polyaniline 5-sulfosalicylate exhibited high thermal stability and conductivity of 0.13 S cm−1. Its mass-average molar mass and polydispersity index were determined by gel-permeation chromatography as 22,900 g mol−1 and 2.7, respectively. Elemental analysis and FTIR spectroscopy study of polyaniline 5-sulfosalicylate revealed the doping level and the oxidation state between emeraldine and protoemeraldine salt while corresponding studies of the polyaniline base indicate a small extent of the covalent bonding of 5-sulfosalicylate anions to polyaniline chains.
Modification of poly(vinyl alcohol) membrane via blending with poly(γ-benzyl l-glutamate)-block-poly(ethylene glycol) copolymer
Authors: Zhu Guo-Quan , Gao Qiao-Chun , Li Zhi-He , Wang Fa-Gang , Zhang Hua
Published: September 2010

A series of poly(vinyl alcohol) (PVA)/poly(γ-benzyl l-glutamate)-block-poly(ethylene glycol) (PBLG-b-PEG) blend membranes with different PVA/PBLG-b-PEG mole ratios were prepared by pervaporation. Structure and morphologies of PVA/PBLG-b-PEG blend membranes were investigated using Fourier transformation infrared spectroscopy (FTIR), and atomic force microscopy (AFM). Mechanical and chemical properties of PVA/PBLG-b-PEG blend membrane were studied by tensile testing and other physical methods. It was revealed that the introduction of PBLG-b-PEG copolymer has significant effect on the properties of a PVA membrane.
Tibial Spine Avulsion Fracture
Authors: Matheson Heather , Lentz Trevor A.
Published: August 2010

The patient was a 32-year-old male who sustained a noncontact left knee injury during a quick pivot on a planted left foot, while playing flag football.He felt a pop in his knee, noted immediate swelling, and was unable to bear weight. He subsequently presented to the emergency department for evaluation.

Radiographs of the left knee revealed findings consistent with a tibial spine avulsion fracture, while magnetic resonance imaging confirmed a medial tibial spine avulsion fracture. Bone marrow edema was noted in a pivot shift injury pattern involving the lateral femoral condyle and the lateral tibial plateau, and there was also a fracture of the posterior lateral tibial cortex at the site of the bone marrow edema. To determine the best course of treatment, a computed tomography scan was ordered to better visualize the extent of the avulsion fracture. The computed tomography scan demonstrated a comminuted fracture through the tibial spine. J Orthop Sports Phys Ther 2010;40(9):595. doi:10.2519/jospt.2010.0414
Foot and Ankle Pain in a Young Female Athlete
Authors: Loudon Janice K. , Diehl Nancy E.
Published: August 2010

The patient was a 14-year-old female with a 4-year history of left anterolateral foot and ankle pain of insidious onset that was first noticed while playing soccer. After a lack of progress with conservative measures for her left foot and ankle pain, the patient was evaluated by an orthopaedic surgeon. While conventional radiographs of the foot and ankle were normal, magnetic resonance imaging revealed generalized bone marrow edema in the navicular bone with irregularity along the lateral margin of the navicular bone and adjacent anterior margin of the anterior process of the calcaneus. These findings suggested possible sequelae of osteonecrosis or a partial coalition between the lateral margin of the navicular bone and anterior process of the calcaneus. Computed tomography scanning revealed focal osteochondral bone changes along the lateral margin of the navicular bone and anterior process of the calcaneus. Surgery was performed 3 months later, which involved excision of a fibrous calcaneonavicular tarsal coalition. J Orthop Sports Phys Ther 2010;40(9):596. doi:10.2519/jospt.2010.0415
Plasma levels of apolipoprotein M in normal and complicated pregnancy
Authors: Ahnström Josefin , Lindqvist Pelle G. , Walle Ursula , Dahlbäck Björn
Published: August 2010

Apolipoprotein M (apoM) is mainly associated with high‐density lipoprotein in human plasma. Despite several studies suggesting apoM as an anti‐atherogenic, its function is not yet fully understood. Plasma apoM was measured in normal pregnancies at four different gestational ages and in the postpartum period to investigate whether the concentration of apoM changes during pregnancy. In addition, apoM was measured at 13 weeks in women who subsequently developed preeclampsia, gestational diabetes, recurrent miscarriage, or small‐for‐gestational age babies, and in women with uncomplicated pregnancies. The plasma concentrations of apoM increased during pregnancy to reach highest levels in the postpartum period. Thus, plasma apoM in non‐pregnant women was around 0.77 μmol/l, 0.88 μmol/l at 40 gestational weeks, and 1.05 μmol/l in the postpartum period (p < 0.0001). No differences in plasma concentrations of apoM were found among the studied pregnancy complications.
Conservative approach in heavy postpartum hemorrhage associated with coagulopathy
Authors: Palacios‐Jaraquemada Jose , Fiorillo Angel
Published: August 2010

The application of external uterine elastic bandage is a new approach to control serious postpartum hemorrhage. This was applied in 10 consecutive patients with severe postpartum hemorrhage. After circulatory stabilization by external aortic compression, laparotomy and identification of the source of bleeding, compression sutures were applied and intrauterine fibrin glue was administered. Immediately thereafter, external uterine elastic bandage was wrapped around the uterus to compress it and stop the bleeding. After hemostasis had persisted for some time, the bandage was removed, and uterus and abdomen were then closed. Application of external uterine elastic bandage resulted in hemostasis within 45 minutes after aortic compression. Hysteroscopy 6 months after the procedure showed no signs of uterine ischemia or endometrial adhesions. In conclusion, external elastic uterine bandage is a simple tool that seems to improve hemostasis and prevent hysterectomy in heavy postpartum hemorrhage.
Origin of multiple pregnancies in a subfertile population
Authors: Brandes Monique , Hamilton Carl J.C.M. , Bergevoet Kim A.Y.J. , de Bruin Jan Peter , Nelen Willianne L.D.M. , Kremer Jan A.M.
Published: August 2010

Objective. To evaluate the contribution of different subfertility treatments to the number of multiple pregnancies in a subfertile population. Design. A prospective cohort study between January 2002 and December 2006. Setting. A subfertility clinic in a large regional training hospital in the Netherlands. Population. A total of 1,001 continuing pregnancies, of which 63 (6.3%) were multiple. Methods. Of all pregnancies, mode of conception, outcome and type of pregnancy (singleton or multiple) were documented. Main outcome measures. Proportions of continuing and multiple pregnancies caused by the different modes of conception. Results. Of all subfertility related continuing pregnancies, 46% were conceived spontaneously, 16% were induced by clomiphene citrate (CC), 2.4% by follicle stimulating hormone (FSH) and 14% by intra‐uterine insemination combined with controlled hyperstimulation (IUI/(COH)). In vitro fertilization (IVF) and its related techniques resulted in about a fifth of all continuing pregnancies (n = 212), but were responsible for more than half (n = 36) of the multiple pregnancies. Furthermore, 18% of the multiple pregnancies were induced by IUI/(COH), 3% by FSH, 11% by CC, whereas about 11% were conceived spontaneously. Conclusions. IVF and intra‐cytoplasmic sperm injection (ICSI) were responsible for the majority of the multiple pregnancies in a subfertile population. Therefore, twin prevention should be focused on further promoting elective single embryo transfer (eSET). Fertility treatment and particular IVF should not be started as long as the spontaneous pregnancy prognosis is good.
Continuous glucose monitoring‐enabled insulin‐pump therapy in diabetic pregnancy
Authors: Secher Anna L. , Schmidt Signe , Nørgaard Kirsten , Mathiesen Elisabeth R.
Published: August 2010

We describe the feasibility of continuous glucose monitoring (CGM)‐enabled insulin‐pump therapy during pregnancy in a woman with type 1 diabetes, who was treated with CGM‐enabled insulin‐pump therapy in her third pregnancy. During her first pregnancy, the woman was treated with multiple daily injections and baseline HbA1c was 8.9%. Due to pre‐eclampsia, the child was born preterm, and had neonatal hypoglycemia. In the planning of the second pregnancy, insulin‐pump therapy was initiated, resulting in an HbA1c of 6.8% in early pregnancy. Due to pre‐eclampsia, the second child was born preterm, but without neonatal morbidity. Before her third pregnancy, CGM‐enabled insulin‐pump therapy was introduced, and HbA1c was 6.4% in early pregnancy. The patient was satisfied with this therapy, pre‐eclampsia did not occur, and the child was born at term without neonatal morbidity. CGM‐enabled insulin‐pump therapy appears feasible in diabetic pregnancies.
Validity of self‐reported birthweight among middle‐aged and elderly women in the Danish Nurse Cohort Study
Authors: Wodskou Pernille M. , Hundrup Yrsa A. , Obel Erik B. , Jørgensen Torben
Published: August 2010

Objective. To investigate the validity of self‐reported birthweight among middle‐aged and elderly women and to identify possible determinants of reporting accuracy. Setting and design. The Danish Nurse Cohort Study (DNCS), a prospective risk factor and hormone therapy study. Population. Participants in the 1999 DNCS. Methods. Self‐reported exact and categorical birthweight data from the DNCS was compared with data from the Copenhagen School Health Records Register (CSHRR), which contains birthweight data. Main outcome measures. Accuracy of self‐reported birthweight expressed as mean difference with limits of agreement, sensitivity, specificity, and positive and negative predictive values (PPV and NPV). Results. Exact birthweight was available for 441 participants. The correlation coefficient was 0.83. The mean difference was −21 g and limits of agreement were −843 to 818 g. A total of 74% answered correctly within 250 g while 7% were more than 500 g in error. Categorical birthweight was available for 925 participants. A total of 87% reported the correct birthweight. Sensitivity and PPV were high for normal birthweight, whereas specificity and NPV were better for high and low birthweight (HBW and LBW). Multiple logistic regression analyses showed that HBW, LBW and being the daughter of a young mother decreased the accuracy of self‐reported birthweight. Conclusions. Self‐reported birthweight is a valid measure of actual birthweight among middle‐aged and elderly women. Due to the lower accuracy of HBW and LBW, studies of the association between birthweight and chronic disease may underestimate the true effect of these weights.
Evaluation of the introduction of a new treatment for the termination of pregnancy in The Netherlands
Authors: Brouns Joseph F.G.M. , Burger Matthe P.M. , van Wijngaarden Wim J.
Published: August 2010

All hospital‐based gynecologists in The Netherlands were sent a questionnaire on the termination of pregnancy with off‐label drugs in the absence of treatment protocols. Response was received from 93.2% of the teaching hospitals and 87.9% of the non‐teaching hospitals, thus representing practice of nearly all gynecologists working in The Netherlands. More than 40 different regimens were used for five different indications. Gynecologists embarked on a large number of different regimens of which a distressing number do not have any merits to be found in studies or guidelines illustrating that, without clear protocols or guidelines, the implementation of new medical treatments is potential haphazard and based on personal preference. Suboptimal treatment regimens will frustrate patients and doctors and deprive future patients from the most efficacious and patient friendly treatment regimes available.