bluuebunny/crossref_metadata_2025 huggingface dataset:
Relative Satisfaction and Welfare Maximizing Wealth Distribution
Authors: Coram Alex , Noakes Lyle
Published: November 2009

Suppose individuals get utilities from the total amount of wealth they hold and from their wealth relative to those above and below them in a near neighbourhood. This paper studies the distribution of wealth that maximizes an additive welfare function made up of these utilities. It shows that the optimal distribution mostly requires an egalitarian solution if the concern is with those above. If the concern is with those below it has some unexpected properties.
Trab determination in newly detected patients with hyperthyroidism and their prognostic importance
Authors: Nikolic Aleksandra , Micic Dragan , Nikolic Dejan , Stanimirovic Violeta
Published: November 2009

Introduction. In more than 50 years since the first demonstration of the immune basis for thyroiditis was done, the autoimmune disease has been identified as a major cause of disfunction of all endocrine organs. Identification of the antithyroid with the radio-receptor assay is widespread in clinical use for differential diagnosis of other thyroid disorders manifesting with the hyperthyroidism. Material and methods. Our study included 44 patients with new onset Graves disease which was primarily verified according to the objective status of the patients (signs of hyperthyroidism), biochemical parameters (which included thyroid hormones) and detection of the TRAb (TSAb-thyreotropin-stimulanting antibodies) at the beginning of diagnosis and in the first, second and after the third month since the introduction of antithyroid therapy (propiltiouracil). RESULTS. On the basis of the TSAb concentration level, we found that the response to the therapy was positive in 65.9% ('responders') of the patients and negative in 22.7% ('non responders') of the patients and without therapeutic effect were 11.4% of the patients. During the therapy (after the first month), in the group of non responders we found increased values of the TSAb (p<0.05) and in the group of responders we found reduction of the TSAb levels (p<0.05). Conclusion. Our study demonstrated that the therapy with propiltiouracil, after the first month divide patients with positive and negative response, which could change the therapeutic, options in the future.
Therapeutic approach in patients undergoing percutaneous coronary interventions
Authors: Mijailovic Zdravko , Stajic Zoran , Jevtic Miodrag , Aleksandric Srdjan , Matunovic Radomir , Tavciovski Dragan
Published: November 2009

While the performance of percutaneous coronary interventions remains the domain of interventional cardiologists, the management of these patients before, during, and after the procedure is in the domain of general cardiologists, internists and primary care physicians. Therefore, for optimal patient care it is crucial that all engaged physicians should understand the procedural risks, complications and optimal treatment strategy before, during and after the procedure. Before a percutaenous coronary intervention, patients with known allergies to iodinated contrast dye should be pretreated with oral corticosteroids and H1-receptor blockers. Diabetic patients as well as patients with renal failure need special care. Hydration is crucial for patients with renal insufficiency in order to minimise the risk of contrast nephropathy. Metformin therapy should be discontinued before the procedure in patients with renal failure in order to avoid lactic acidosis, and it should be reinstituted after the procedure only when normal serum creatine level is confirmed. Double antiplatelet therapy (aspirin plus clopidogrel) should be initiated at least six hours before the procedure. While aspirin therapy after the procedure is life long, the duration of clopidogrel therapy depends on the type of implanted stent (in patients with bare stents implanted clopidogrel should be taken at least 3 - 4 weeks post procedural, and in patients with drug-eluting stents implanted clopidogrel should be taken at least 6 - 12 months after the procedure due to in-stent restenosis prevention). Patients who experience typical anginal pain in a period of one to eight month after percutaneous coronary revascularization are likely to have restenosis, and they should be reevaluated with stress echocardiography and/or repeated coronary angiography.
Ultrasound detection of endometrial fluid in postmenopausal women
Authors: Curcic Aleksandar , Djurdjevic Srdjan , Mihaldzic-Tubic Slobodana , Mladenovic-Segedi Ljiljana , Maksimovic Marko
Published: November 2009

Introduction. The aim of this prospective study was to estimate whether the presence of endometrial fluid detected by transvaginal ultrasound investigation was a marker for the pathological changes of the endometrium in postmenopausal women. Material and methods. 128 postmenopausal women with uterine bleeding and 29 asymptomatic postmenopausal women underwent transvaginal ultrasound investigation, curettage and histopathological investigation of the curettage specimens. Results. There were significantly more asymptomatic women with endometrial fluid collection was found (41,4%) than those with uterine bleeding (7,8%) (p<0,001). We found 4 cases of carcinoma of the endometrium, 4 with hyperplasia and 1 with polyp of the endometrium in women with uterine bleeding and endometrial fluid collection. In the asymptomatic group of women we found 1 case with polyp and 1 with carcinoma of the endometrium. In the presence of endometrial fluid collection the least thickness of the endometrium measured by transvaginal ultrasound was 12 mm in postmenopausal women with carcinoma of the endometrium, 7 mm in women with hyperplasia and 5 mm with polyp. No pathological changes were found below the above values. Conclusion. The presence of endometrial fluid detected by transvaginal ultrasonography is a good marker for pathological changes of the endometrium in postmenopausal women if the endometrial thickness is greater than 4 mm. If the endometrial thickness is 4 mm or less, the presence of endometrial fluid is not an indication for further invasive investigation of endometrial cavity, but we must eliminate possible presence of ednexal or cervical malignant disease in some patients.
Treatment of pregnancy related venous thromboembolism
Authors: Mitic Gorana , Povazan Ljubica , Lucic Aleksandar
Published: November 2009

Introduction. Prevention and treatment of venous thromboembolism during pregnancy are complicated since the use of antithrombotic drugs carries a certain risk to the mother, the fetus or both. Coumarins cross the placental barrier and may be responsible for bleeding, teratogenicity and central nervous system abnormalities. The risk of embriopathy is particularly high between 6 and 12 weeks of gestation. Treatement. Heparin is the treatment of choice for thrombosis during pregnancy because it is entirely safe for the fetus, unlike oral anticoagulants. The frequency of heparin-induced thrombocytopenia and osteoporosis is significantly lower if LMWH is applied, so this heparin type is preferable to UFH during pregnancy. Treatment of women with VTE during pregnancy, especially those with thrombophilia, requires individualized dosing and duration of antithrombotic thrapy. Peripartal management. In order to avoid the peripartum anticoagulant heparin effect and possible bleeding, heparin should be discontinued prior to the delivery and reintroduced after the parturition. PROPHYLACTIC REGIMEn. Prophylactic antithrombotic regimen during subsequent pregnancies should also be individualized. The use of low molecular weight heparins is becoming more widespread. They have reliable pharmacokinetics, require less frequent injections than unfractionated heparin and carry a lower risk of treatment complications. LMW heparins are safe and effective and they are replacing UFH as the anticoagulant of choice during pregnancy. Both UFH and LMWH are not secreted into breast milk and can be safely given to nursing mothers. Warfarin does not induce an anticoagulant effect in the breast-fed infant, so it can be safely used in women who require postpartum anticoagulant therapy.
An analytical and experimental study of performance on jatropha biodiesel engine
Authors: Ganapathy Thirunavukkarasu , Gakkhar Parkash , Murugesan Krishnan
Published: November 2009

Biodiesel plays a major role as one of the alternative fuel options in direct injection diesel engines for more than a decade. Though many feed stocks are employed for making biodiesel worldwide, biodiesel derived from domestically available non-edible feed stocks such as Jatropha curcas L. is the most promising alternative engine fuel option especially in developing countries. Since experimental analysis of the engine is pricey as well as more time consuming and laborious, a theoretical thermodynamic model is necessary to analyze the performance characteristics of jatropha biodiesel fueled diesel engine. There were many experimental studies of jatropha biodiesel fueled diesel engine reported in the literature, yet theoretical study of this biodiesel run diesel engine is scarce. This work presents a theoretical thermodynamic study of single cylinder four stroke direct injection diesel engine fueled with biodiesel derived from jatropha oil. The two zone thermodynamic model developed in the present study computes the in-cylinder pressure and temperature histories in addition to various performance parameters. The results of the model are validated with experimental values for a reasonable agreement. The variation of cylinder pressure with crank angle for various models are also compared and presented. The effects of injection timing, relative air fuel ratio and compression ratio on the engine performance characteristics for diesel and jatropha biodiesel fuels are then investigated and presented in the paper.
Studies on a CI engine using orange skin powder diesel solution with different fuel nozzle opening pressure
Authors: Purushothaman Krishnan , Nagarajan Govindan
Published: November 2009

Experiments have been conducted to study the effect of nozzle opening pressure on the combustion process and exhaust emissions of a direct injection diesel engine fueled with orange skin powder diesel solution (OSPDS). Earlier investigation by the authors revealed that 30% OSPDS was optimum for better performance and reduced emissions. In the present investigation the nozzle opening pressure was varied with 30% OSPDS and the combustion, performance, and emissions characteristics were studied and compared with those of diesel fuel. The different nozzle opening pressures studied were 215 bar, 235 bar, and 255 bar. The results showed that the cylinder pressure with 30% OSPDS at 235 bar fuel nozzle opening pressure, was higher than that of diesel fuel as well as at other nozzle opening pressures. Similarly, the ignition delay was longer with shorter combustion duration in case of 30% OSPDS at 235 bar nozzle opening pressure. The brake thermal efficiency was higher at 235 bar than that of other fuel nozzle opening pressures with OSPDS and lower than that of diesel fuel. The NOx emission was higher and HC and CO emissions were lower with 30% OSPDS at 235 bar. The smoke emission was marginally lower at 235 bar and marginally higher at 215 bar than diesel fuel. The performance of the engine at 235 bar nozzle opening pressure was better with reduction in emissions except NOx than other nozzle opening pressures.
Evaluation of reduced chemical kinetic mechanisms used for modeling mild combustion for natural gas
Authors: Hamdi Mohamed , Benticha Hmaeid , Sassi Mohamed
Published: November 2009

A numerical and parametric study was performed to evaluate the potential of reduced chemistry mechanisms to model natural gas chemistry including NOx chemistry under mild combustion mode. Two reduced mechanisms, 5-step and 9-step, were tested against the GRI-Mech3.0 by comparing key species, such as NOx, CO2 and CO, and gas temperature predictions in idealized reactors codes under mild combustion conditions. It is thus concluded that the 9-step mechanism appears to be a promising reduced mechanism that can be used in multi-dimensional codes for modeling mild combustion of natural gas.
Potentials and limitations of alternative fuels for diesel engine
Authors: Gligorijevic Radinko , Jevtic Jeremija , Borak Djuro , Petrovic Velimir
Published: November 2009

The primary energy consumption in the world has increased continuously. The most important primary energy source is oil. The supply of automotive fuels today is based almost entirely on oil, and the demand for liquid transportation fuels worldwide will rise significantly in the next fifty years. Growing energy consumption and decreasing fossil resources are reasons for increasing prices of fossil fuel. Besides limited availability, contribution to greenhouse effect and pollutant emission represent another problem of fossil fuel. Both of these problems can be overcome by increased application of renewable biofuels. Therefore, great effort is made to supplement the primary energy sources by including renewable energies. There are alternative fuels 1st and 2nd generation. Some of them show high potential for reduction of engine out emission. But there are economical and technical barriers when such fuels are applied. This paper shows both advantage and disadvantage of alternative fuels, especially when used for diesel engines.
Mixtures of bioethanol and gasoline as a fuel for SI engines
Authors: Stojiljkovic Dragoslava , Nestorovic Dusan , Jovanovic Vladimir , Manic Nebojsa
Published: November 2009

The importance of alternative fuels, especially bioethanol and biodiesel, rises due to the limited oil sources, secure supply, prices changes, and environment pollution. Bioethanol is an alternative fuel which will be important in future, as a fuel produced from different crops and lignocelluloses materials. The quality of bioethanol has significant influence on the characteristics of mixtures with gasoline and engine performance. The investigations were performed with the bioethanol obtained as by-product from sugar industry, which is not denaturated and produced according the requests prescribed by standards for ethanol used in mixtures with gasoline. Main target was to examine the possibility of utilisation of bioethanol obtained as by-product and without additional technologies for purification and additional costs. The results of standard and non-standard investigations and engine tests of bioethanol and gasoline mixtures are presented.
Application of transport demand modeling in pollution estimation of a street network
Authors: Jovic Jadranka , Djoric Vladimir
Published: November 2009

The importance of transportation modeling, especially personal car flow modeling, is well recognized in transportation planning. Modern software tools give the possibility of generating many development scenarios of transport system, which can be tested quickly. Transportation models represent a good (and necessary) basis in the procedure of environmental traffic impacts and energy emission estimation. Research in this paper deals with the possibility of using transportation modeling as a tool for estimation of some air pollution and global warming indicators on street network, produced by personal cars with internal combustion engines. These indicators could be the basis for defining planning and management solutions for transport system with respect to their environmental impacts. All the analyses are based on several years of research experience in Belgrade. According to the emissions of gases from the model, the values of other green house gases can be estimated using the known relations between the pollutants. There is a possibility that all these data can be used to calculate the transportation systems impact on temperature increase in urban areas.
The Effect of System Characteristics, Stage of Adoption, and Experience on Institutional Explanations for ERP Systems Choice
Authors: Ugrin Joseph C.
Published: November 2009

SYNOPSIS: Existing studies have found a linkage between institutional factors and systems adoption, but the literature has overlooked an important question: When is the decision to implement a system influenced by institutional factors? In this paper, the author argues that decisions to adopt systems are not influenced equally by institutional factors, and examines how system characteristics moderate the effects of institutional factors on adoption decisions, specifically decisions to adopt enterprise resource planning (hereafter, ERP) systems. The results of the study reveal that institutional factors, such as mimicry of peers, compliance with industry norms, and coercion from powerful entities influence ERP adoption decisions. The results also show that the effects of institutional factors on adoption decisions are amplified when participants have not already adopted an ERP system, the benefits of the system are difficult to quantify, and the system enhances organizational interaction throughout the supply chain. Through this paper, the author contributes to the institutional theory literature by exploring conditions that enhance the salience of institutional factors and contributes to accounting information systems literature by investigating the boundaries of the influence of institutional factors on ERP adoption.
Engineered Zinc Finger Protein–Mediated VEGF-A Activation Restores Deficient VEGF-A in Sensory Neurons in Experimental Diabetes
Authors: Pawson Elizabeth J. , Duran-Jimenez Beatriz , Surosky Richard , Brooke Heather E. , Spratt S. Kaye , Tomlinson David R. , Gardiner Natalie J.
Published: November 2009

OBJECTIVE

The objectives of the study were to evaluate retrograde axonal transport of vascular endothelial growth factor A (VEGF-A) protein to sensory neurons after intramuscular administration of an engineered zinc finger protein activator of endogenous VEGF-A (VZ+434) in an experimental model of diabetes, and to characterize the VEGF-A target neurons.

RESEARCH DESIGN AND METHODS

We compared the expression of VEGF-A in lumbar (L)4/5 dorsal root ganglia (DRG) of control rats and VZ+434-treated and untreated streptozotocin (STZ)-induced diabetic rats. In addition, axonal transport of VEGF-A, activation of signal transduction pathways in the DRG, and mechanical sensitivity were assessed.

RESULTS

VEGF-A immunoreactivity (IR) was detected in small- to medium-diameter neurons in DRG of control rats. Fewer VEGF-A-IR neurons were observed in DRG from STZ-induced diabetic rats; this decrease was confirmed and quantified by Western blotting. VZ+434 administration resulted in a significant increase in VEGF-A protein expression in ipsilateral DRG, 24 h after injection. VEGF-A was axonally transported to the DRG via the sciatic nerve. VZ+434 administration resulted in significant activation of AKT in the ipsilateral DRG by 48 h that was sustained for 1 week after injection. VZ+434 protected against mechanical allodynia 8 weeks after STZ injection.

CONCLUSIONS

Intramuscular administration of VZ+434 increases VEGF-A protein levels in L4/5 DRG, correcting the deficit observed after induction of diabetes, and protects against mechanical allodynia. Elevated VEGF-A levels result from retrograde axonal transport and are associated with altered signal transduction, via the phosphatidylinositol 3′-kinase pathway. These data support a neuroprotective role for VEGF-A in the therapeutic actions of VZ+434 and suggest a mechanism by which VEGF-A exerts this activity.
Depletion of Liver Kupffer Cells Prevents the Development of Diet-Induced Hepatic Steatosis and Insulin Resistance
Authors: Huang Wan , Metlakunta Anantha , Dedousis Nikolaos , Zhang Pili , Sipula Ian , Dube John J. , Scott Donald K. , O'Doherty Robert M.
Published: November 2009

OBJECTIVE

Increased activity of the innate immune system has been implicated in the pathogenesis of the dyslipidemia and insulin resistance associated with obesity and type 2 diabetes. In this study, we addressed the potential role of Kupffer cells (liver-specific macrophages, KCs) in these metabolic abnormalities.

RESEARCH DESIGN AND METHODS

Rats were depleted of KCs by administration of gadolinium chloride, after which all animals were exposed to a 2-week high-fat or high-sucrose diet. Subsequently, the effects of these interventions on the development of hepatic insulin resistance and steatosis were assessed. In further studies, the effects of M1-polarized KCs on hepatocyte lipid metabolism and insulin sensitivity were addressed.

RESULTS

As expected, a high-fat or high-sucrose diet induced steatosis and hepatic insulin resistance. However, these metabolic abnormalities were prevented when liver was depleted of KCs. In vitro, KCs recapitulated the in vivo effects of diet by increasing hepatocyte triglyceride accumulation and fatty acid esterification, and decreasing fatty acid oxidation and insulin responsiveness. To address the mechanisms(s) of KC action, we inhibited a panel of cytokines using neutralizing antibodies. Only neutralizing antibodies against tumor necrosis factor-α (TNFα) attenuated KC-induced alterations in hepatocyte fatty acid oxidation, triglyceride accumulation, and insulin responsiveness. Importantly, KC TNFα levels were increased by diet in vivo and in isolated M1-polarized KCs in vitro.

CONCLUSIONS

These data demonstrate a role for liver macrophages in diet-induced alterations in hepatic lipid metabolism and insulin sensitivity, and suggest a role for these cells in the etiology of the metabolic abnormalities of obesity/type 2 diabetes.
Cellular Production of n-3 PUFAs and Reduction of n-6–to–n-3 Ratios in the Pancreatic β-Cells and Islets Enhance Insulin Secretion and Confer Protection Against Cytokine-Induced Cell Death
Authors: Wei Dong , Li Jie , Shen Miaoda , Jia Wei , Chen Nuoqi , Chen Tao , Su Dongming , Tian Haoming , Zheng Shusen , Dai Yifan , Zhao Allan
Published: November 2009

OBJECTIVE

To evaluate the direct impact of n-3 polyunsaturated fatty acids (n-3 PUFAs) on the functions and viability of pancreatic β-cells.

RESEARCH DESIGN AND METHODS

We developed an mfat-1 transgenic mouse model in which endogenous production of n-3 PUFAs was achieved through overexpressing a C. elegans n-3 fatty acid desaturase gene, mfat-1. The islets and INS-1 cells expressing mfat-1 were analyzed for insulin secretion and viability in response to cytokine treatment.

RESULTS

The transgenic islets contained much higher levels of n-3 PUFAs and lower levels of n-6 PUFAs than the wild type. Insulin secretion stimulated by glucose, amino acids, and glucagon-like peptide-1 (GLP-1) was significantly elevated in the transgenic islets. When challenged with tumor necrosis factor-α (TNF-α), interleukin-1β (IL-1β), and γ-interferon (IFN-γ), the transgenic islets completely resisted cytokine-induced cell death. Adenoviral transduction of mfat-1 gene in wild-type islets and in INS-1 cells led to acute changes in the cellular levels of n-3- and n-6 PUFAs and recapitulated the results in the transgenic islets. The expression of mfat-1 led to decreased production of prostaglandin E2 (PGE2), which in turn contributed to the elevation of insulin secretion. We further found that cytokine-induced activation of NF-κB and extracellular signal–related kinase 1/2 (ERK1/2) was significantly attenuated and that the expression of pancreatic duodenal hemeobox-1 (PDX-1), glucokinase, and insulin-1 was increased as a result of n-3 PUFA production.

CONCLUSIONS

Stable cellular production of n-3 PUFAs via mfat-1 can enhance insulin secretion and confers strong resistance to cytokine-induced β-cell destruction. The utility of mfat-1 gene in deterring type 1 diabetes should be further explored in vivo.
Antigen-Specific Dependence of Tr1-Cell Therapy in Preclinical Models of Islet Transplant
Authors: Gagliani Nicola , Jofra Tatiana , Stabilini Angela , Valle Andrea , Atkinson Mark , Roncarolo Maria-Grazia , Battaglia Manuela
Published: November 2009

OBJECTIVE

In type 1 diabetes, allogeneic pancreatic islet transplant restores insulin production, but life-threatening immunosuppression is required to avoid graft rejection. Induction of antigen (Ag)–specific tolerance by cell therapy with regulatory T-cells (Tregs) represents an attractive alternative approach but its therapeutic efficacy in islet transplant remains to be determined. Among the different subsets of CD4+ Tregs, the T inducible regulatory type 1 (Tr1) cells can be generated from naive T-cells in the presence of interleukin-10 (IL-10) and represent one promising therapeutic choice. This study was designed to define the efficacy of Tr1-cell therapy in preclinical models of islet transplant.

RESEARCH DESIGN AND METHODS

Non–Ag-specific polyclonal Tr1 cells and donor Ag-specific Tr1 cells were transferred, in the absence of any pharmacological treatment, in two distinct mouse models of islet transplant. The two models differed in their therapeutic stringency, based on the mean rejection time of untreated mice that underwent a transplant.

RESULTS

Transfer of polyclonal Tr1 cells engendered graft tolerance only in the nonstringent mouse model. Conversely, cell therapy with Ag-specific Tr1 cells induced an IL-10–dependent tolerance in the stringent mouse model of islet transplant. The therapeutic advantage of Ag-specific Tr1 cells over polyclonal Tr1 cells was due to their donor Ag specificity.

CONCLUSIONS

These results demonstrate that Tr1-cell therapy leads to tolerance in settings of islet transplant and that its therapeutic efficacy is highly dependent on the antigen specificity of these cells.
Prokineticin 2 Is a Hypothalamic Neuropeptide That Potently Inhibits Food Intake
Authors: Gardiner James V. , Bataveljic Attia , Patel Neekhil A. , Bewick Gavin A. , Roy Debabrata , Campbell Daniel , Greenwood Hannah C. , Murphy Kevin G. , Hameed Saira , Jethwa Preeti H. , Ebling Francis J.P. , Vickers Steven P. , Cheetham Sharon , Ghatei Mohammad A. , Bloom Stephen R. , Dhillo Waljit S.
Published: November 2009

OBJECTIVE

Prokineticin 2 (PK2) is a hypothalamic neuropeptide expressed in central nervous system areas known to be involved in food intake. We therefore hypothesized that PK2 plays a role in energy homeostasis.

RESEARCH DESIGN AND METHODS

We investigated the effect of nutritional status on hypothalamic PK2 expression and effects of PK2 on the regulation of food intake by intracerebroventricular (ICV) injection of PK2 and anti-PK2 antibody. Subsequently, we investigated the potential mechanism of action by determining sites of neuronal activation after ICV injection of PK2, the hypothalamic site of action of PK2, and interaction between PK2 and other hypothalamic neuropeptides regulating energy homeostasis. To investigate PK2's potential as a therapeutic target, we investigated the effect of chronic administration in lean and obese mice.

RESULTS

Hypothalamic PK2 expression was reduced by fasting. ICV administration of PK2 to rats potently inhibited food intake, whereas anti-PK2 antibody increased food intake, suggesting that PK2 is an anorectic neuropeptide. ICV administration of PK2 increased c-fos expression in proopiomelanocortin neurons of the arcuate nucleus (ARC) of the hypothalamus. In keeping with this, PK2 administration into the ARC reduced food intake and PK2 increased the release of α-melanocyte–stimulating hormone (α-MSH) from ex vivo hypothalamic explants. In addition, ICV coadministration of the α-MSH antagonist agouti-related peptide blocked the anorexigenic effects of PK2. Chronic peripheral administration of PK2 reduced food and body weight in lean and obese mice.

CONCLUSIONS

This is the first report showing that PK2 has a role in appetite regulation and its anorectic effect is mediated partly via the melanocortin system.
Cost-Effectiveness of the Diabetes Care Protocol, a Multifaceted Computerized Decision Support Diabetes Management Intervention That Reduces Cardiovascular Risk
Authors: Cleveringa Frits G.W. , Welsing Paco M.J. , van den Donk Maureen , Gorter Kees J. , Niessen Louis W. , Rutten Guy E.H.M. , Redekop William K.
Published: November 2009

OBJECTIVE

The Diabetes Care Protocol (DCP), a multifaceted computerized decision support diabetes management intervention, reduces cardiovascular risk of type 2 diabetic patients. We performed a cost-effectiveness analysis of DCP from a Dutch health care perspective.

RESEARCH DESIGN AND METHODS

A cluster randomized trial provided data of DCP versus usual care. The 1-year follow-up patient data were extrapolated using a modified Dutch microsimulation diabetes model, computing individual lifetime health-related costs, and health effects. Incremental costs and effectiveness (quality-adjusted life-years [QALYs]) were estimated using multivariate generalized estimating equations to correct for practice-level clustering and confounding. Incremental cost-effectiveness ratios (ICERs) were calculated and cost-effectiveness acceptability curves were created. Stroke costs were calculated separately. Subgroup analyses examined patients with and without cardiovascular disease (CVD+ or CVD− patients, respectively).

RESULTS

Excluding stroke, DCP patients lived longer (0.14 life-years, P = NS), experienced more QALYs (0.037, P = NS), and incurred higher total costs (€1,415, P = NS), resulting in an ICER of €38,243 per QALY gained. The likelihood of cost-effectiveness given a willingness-to-pay threshold of €20,000 per QALY gained is 30%. DCP had a more favorable effect on CVD+ patients (ICER = €14,814) than for CVD− patients (ICER = €121,285). Coronary heart disease costs were reduced (€−587, P < 0.05).

CONCLUSIONS

DCP reduces cardiovascular risk, resulting in only a slight improvement in QALYs, lower CVD costs, but higher total costs, with a high cost-effectiveness ratio. Cost-effective care can be achieved by focusing on cardiovascular risk factors in type 2 diabetic patients with a history of CVD.
Evaluation of Serum 1,5 Anhydroglucitol Levels as a Clinical Test to Differentiate Subtypes of Diabetes
Authors: Pal Aparna , Farmer Andrew J. , Dudley Christina , Selwood Mary P. , Barrow Beryl A. , Klyne Rhiannon , Grew Jilly P. , McCarthy Mark I. , Gloyn Anna L. , Owen Katharine R.
Published: November 2009

OBJECTIVE

Assignment of the correct molecular diagnosis in diabetes is necessary for informed decisions regarding treatment and prognosis. Better clinical markers would facilitate discrimination and prioritization for genetic testing between diabetes subtypes. Serum 1,5 anhydroglucitol (1,5AG) levels were reported to differentiate maturity-onset diabetes of the young due to HNF1A mutations (HNF1A-MODY) from type 2 diabetes, but this requires further validation. We evaluated serum 1,5AG in a range of diabetes subtypes as an adjunct for defining diabetes etiology.

RESEARCH DESIGN AND METHODS

1,5AG was measured in U.K. subjects with: HNF1A-MODY (n = 23), MODY due to glucokinase mutations (GCK-MODY, n = 23), type 1 diabetes (n = 29), latent autoimmune diabetes in adults (LADA, n = 42), and type 2 diabetes (n = 206). Receiver operating characteristic curve analysis was performed to assess discriminative accuracy of 1,5AG for diabetes etiology.

RESULTS

Mean (SD range) 1,5AG levels were: GCK-MODY 13.06 μg/ml (5.74–29.74), HNF1A-MODY 4.23 μg/ml (2.12–8.44), type 1 diabetes 3.09 μg/ml (1.45–6.57), LADA 3.46 μg/ml (1.42–8.45), and type 2 diabetes 5.43 (2.12–13.23). Levels in GCK-MODY were higher than in other groups (P < 10−4 vs. each group). HNF1A-MODY subjects showed no difference in unadjusted 1,5AG levels from type 2 diabetes, type 1 diabetes, and LADA. Adjusting for A1C revealed a difference between HNF1A-MODY and type 2 diabetes (P = 0.001). The discriminative accuracy of unadjusted 1,5AG levels was 0.79 for GCK-MODY versus type 2 diabetes and 0.86 for GCK-MODY versus HNF1A-MODY but was only 0.60 for HNF1A-MODY versus type 2 diabetes.

CONCLUSIONS

In our dataset, serum 1,5AG performed well in discriminating GCK-MODY from other diabetes subtypes, particularly HNF1A-MODY. Measurement of 1,5AG levels could inform decisions regarding MODY diagnostic testing.
Accumulation of Gene Polymorphisms Related to Plaque Disruption and Thrombosis Is Associated With Cerebral Infarction in Subjects With Type 2 Diabetes
Authors: Katakami Naoto , Takahara Mitsuyoshi , Kaneto Hideaki , Shimizu Ikki , Ohno Keizo , Ishibashi Fukashi , Osonoi Takeshi , Kashiwagi Atsunori , Kawamori Ryuzo , Shimomura Iichiro , Matsuhisa Munehide , Yamasaki Yoshimitsu
Published: November 2009

OBJECTIVE

It is believed that disruption of vulnerable atherosclerotic plaque and subsequent thrombus formation play critical roles in the pathogenesis of cerebral infarction. We simultaneously determined four relatively common genetic variants related to plaque rupture or subsequent local thrombus formation and evaluated the combined effect on cerebral infarction.

RESEARCH DESIGN AND METHODS

We enrolled 3,094 Japanese type 2 diabetic subjects (62.7% male; aged 61.5 ± 8.4 years) and determined their genotypes regarding matrix metalloproteinase 9 C-1562T, coagulation factor XII (F12) C46T, von Willebrand factor (VWF) G-1051A, and plasminogen activator inhibitor (PAI-1) 675 4G/5G polymorphisms. The diagnosis of cerebral infarction was performed based on history, physical examination, and neuroimaging.

RESULTS

The single association analysis revealed that there were no statistically significant associations between each polymorphism and the prevalence of cerebral infarction. Interestingly, the prevalence of cerebral infarction was higher with the increase of the total number of four concomitant unfavorable proatherothrombotic alleles in each subject (P value for linear trend = 0.004). Furthermore, a multiple logistic regression analysis showed that the number of proatherothrombotic alleles was a risk factor for cerebral infarction independently of conventional risk factors (odds ratio for one-point increase in the number of proatherothrombotic allele 1.15 [95% CI 1.05–1.26], P = 0.004).

CONCLUSIONS

Accumulation of gene polymorphisms related to plaque rupture and thrombus formation is likely associated with the prevalence of cerebral infarction in type 2 diabetic patients, suggesting that the combined information about these variants is useful to assess the risk of cerebral infarction.
Anti-DR5 mAb Ameliorate Adjuvant Arthritis Rats Through Inducing Synovial Cells Apoptosis
Authors: Li Wenzhu , Liu Zhongchen , Zhuang Guohong , Yin Ping , Tao Huiran , Qiu Jinghua , Hu Qingzhong , Zhang Jiakai
Published: November 2009

Objective: Study the therapeutic effects and immunoregulatory mechanisms of anti-DR5 mAb on adjuvant arthritis (AA) rats.

Methods: AA rats induced by CFA, were treated with anti-DR5 mAb through mainline administration. Effect on the synovial membranes of the tissues was detected by H&E staining. Flow cytometry and MTT assay were used for detecting the induced apoptosis in an in vitro system and TUNEL assay was used for analysis in an in vivo system. The involvement of the apoptotic pathway was further proved by a caspase inhibition assay.

Results: Anti-DR5 mAb could induce synovial cell apoptosis in an in vitro system, which was related with the mRNA expression of DR5 on the cell surface. The mRNA expressions of c-myc and bcl-2 were decreased in synovial cells and those of p21, p53, and bax were increased. The protein expressions of caspase-8/3/9, RANKL, JNK2, and c-Jun were raised and that of bcl-2 was decreased. When the caspase inhibitor was added to the synovial cells treated with anti-DR5 mAb, it showed a dose-dependence inhibition effect, indicating that anti-DR5 mAb inducing apoptosis might be through the caspase pathway.

Conclusion: This study shows that anti-DR5 mAb can ameliorate arthritic symptoms. The mechanisms of the treatment are related to the increase in synovial cell apoptosis by regulating the mRNA expression of DR5 and apoptosis-related genes, prolonging the duration of the cell cycle by modulation of the mRNA expression of cell cycle-related genes, and the protein expression of the molecules in the caspase pathway and RANKL, JNK2, and c-Jun.
Gestational and Postnatal Low Protein Diet Alters Insulin Sensitivity in Female Rats
Authors: Berleze Kally J. , Müller Alexandre P. , Schweigert Ingrid D. , Longoni Aline , Sordi Fernanda , de Assis Adriano M. , Rotta Liane N. , de Souza Diogo O. G. , Perry Marcos L. S.
Published: November 2009

Nutrition during pregnancy and lactation can program an offspring’s metabolism with regard to glucose and lipid homeostasis. A suboptimal environment during fetal, neonatal and infant development is associated with impaired glucose tolerance, type 2 diabetes and insulin resistance in later adult life. However, studies on the effects of a low protein diet imposed from the beginning of gestation until adulthood are scarce. This study’s objective was to investigate the effects of a low protein diet imposed from the gestational period until 4 months of age on the parameters of glucose tolerance and insulin responsiveness in Wistar rats. The rats were divided into a low protein diet group and a control group and received a diet with either 7% or 25% protein, respectively. After birth, the rats received the same diet as their mothers, until 4 months of age. In the low protein diet group it was observed that: (i) the hepatic glycogen concentration and hepatic glycogen synthesis from glycerol were significantly greater than in the control group; (ii) the disposal of 2-deoxyglucose in soleum skeletal muscle slices was 29.8% higher than in the control group; (iii) there was both a higher glucose tolerance in the glucose tolerance test; and (iv) a higher insulin responsiveness in than in the control group. The results suggest that the low protein diet animals show higher glucose tolerance and insulin responsiveness relative to normally nourished rats. These findings were supported by the higher hepatic glycogen synthesis and the higher disposal of 2-deoxyglucose in soleum skeletal muscle found in the low protein diet rats.
Impact of Stimulatory Pathways on Adipogenesis and HIV-Therapy Associated Lipoatrophy
Authors: Stankov Metodi V. , Schmidt Reinhold E. , Behrens Georg M. N.
Published: November 2009

Objective: Current understanding of adipogenesis derives mainly from studies with in vitro cell culture systems with divergent experimental requirements. We aimed to investigate the discrepancy between the anti-adipogenic effects of the HIV protease-inhibitor indinavir (IDV) in vitro and the lack of evidence that IDV inhibits adipogenesis in humans. Design and Methods: We studied cell viability and adipogenesis in murine 3T3-F442A, 3T3-L1 and primary human subcutaneous preadipocytes (phsPA). Differentiation was studied after activation of the established four signalling pathways in different combinations. We analyzed CCAAT/enhancer-binding protein (C/EBP) α and peroxisome proliferator-activated receptor (PPAR) γ expression and triacylglyceride accumulation. Cells were exposed to IDV at concentrations around therapeutic Cmaxlevels and higher (10 μM and 20 μM) for up to 30 days. Results: Under insulin and fetal calf serum (FCS) input, IDV inhibited 3T3-F442A differentiation, an effect that was partially rescued by the addition of 3-isobutyl-1-methylxanthine (IBMX) stimulation. Combined stimulation with FCS, insulin, dexamethasone (DEX) and IBMX led to normal 3T3-L1 differentiation even in the presence of IDV. However, omission of IBMX rendered this cell line sensitive to IDV’s anti-adipogenic effects. Differentiation of phsPA requiring complete adipogenic stimulation was not affected by IDV presence. Conclusions: Our data suggest that the potency of IDV to impair differentiation under partial stimulation disappears when all of the differentiation pathways are activated. Such compensatory mechanisms might be responsible for the inability of the drug to affect adipogenesis in vivo.
Cak numerals
Authors: Keisuke Huziwara
Published: November 2009

Cak is a Luish language of the Tibeto-Burman language family and it is spoken mainly in the Naikhyongchari subdistrict of Bandarban district, Chittagong Hill Tracts (henceforth, CHT),Bangladesh. In this paper, I briefly describe the Cak numeral system. Numerals in Cak are basically nouns. Cak has two series of cardinal numerals: one is the native Cak numerals and the other is borrowed from Marma. The difference between these two types of numerals is reflected in the classifiers that they take: Cak numerals take native Cak classifiers whereas the numerals borrowed from Marma take classifiers of Marma origin. The native Cak numeral for ‘one' is unique in two respects. First, it changes form according to its phonological environment. Second, it appears after classifiers, while the other numerals precede classifiers. Finally, I show that all the ordinal numerals are borrowed from Pali through Marma. Key words: Cak, Marma, numerals, numeral classifiers, Tibeto-Burman languagesDOI: 10.3329/dujl.v1i2.3714 The Dhaka University Journal of Linguistics: Vol. 1 No.2 August, 2008 Page: 1-10
Colour terms in Bengali: A linguistic analisis
Authors: Ansary Shakhawat , Baktiyara Farida
Published: November 2009

A large number of colour terms is used both in oral and written form of all the languages of the present world. It is equally applicable for the Bangla language also. Since colour terms occupy an excessive place and play an important role in every language, innumerable researches have been conducted focusing their various aspects. It is doubtlessly sorrowful that research of this kind is void in Bangla. This paper is an attempt to make a list of colour terms used in Bangla, to point out their etymology, to analyze their structures and meanings and to find out their nature of social reflection and semiotic aspects.DOI: 10.3329/dujl.v1i2.3715 The Dhaka University Journal of Linguistics: Vol. 1 No.2 August, 2008 Page: 11-44
Gemination in Bangla: An optimality Theoretic Analysis
Authors: Kar Somdev
Published: November 2009

This paper attempts to identify and analyze different types of gemination processes in Bangla. The focus is mainly on the phonological representation of sound combinations which forms a set of valid geminates in this language. I argue for three major types of gemination processes present in modern Bangla and a stratification strategy for the relavant lexical items based on their origin (SB, NB and OB, depending on the native vs. two type of borrowings). An analysis of these gemination processes are given in the framework of optimality theory (OT). Therefore, the constraint-based analysis of OT is organized in a threefold argument structure for each stratum. The conclusion is drawn towards an understanding of gemination processes of Bangla for different categories of lexical items and their phonological formuations.DOI: 10.3329/dujl.v1i2.3718 The Dhaka University Journal of Linguistics: Vol. 1 No.2 August, 2008 Page: 87-114
A socio-linguistics view of the resent mixed form used in Bengali
Authors: Nasrin Salma
Published: November 2009

As a social phenomenon, language is frequently influenced by different social codes, orders, and customs of society. Apart from the structural variety of language, many social dimensions of languages, develop over the time, occur. Nowadays Bengali- a rich language of south Asia- is encountering such social dimensional changes, as it interacts with its complex socio-cultural components. More elaborately, Bengali exhibits frequently different sociolinguistic characteristics such as code switching and code mixing, bilingualism and multilingualism, social dialect and dialectal free variation, language maintenance and language shift. This paper provides a brief description of sociolinguistic terms mentioned above from the point of view of the recent changes in Bengali. Key words: speech community, sociolect, code switching code mixing, code shifting, language shiftDOI: 10.3329/dujl.v1i2.3719 The Dhaka University Jaurnal of Linguistics: Vol. 1 No.2 Augus, 2008 Page: 115-124
A Cognitive Psychological Explanation of Difficulties in Learning Katakana
Authors: Hossain Muhammad Salim , Uddin Muhammad Kamal
Published: November 2009

Japanese is one of the difficult languages for the non-natives. Every year many Bangladeshi students enrolled in language schools to learn Japanese. However, many of them eventually fail to continue the course owing to the difficulties in learning Japanese. The present paper investigated which script of Japanese seems difficult for the learners. The findings indicated that Katakana seems to be difficult for the learners than the Hiragana. Two cognitive psychological explanations of the difficulties associated with in learning Japanese specially Katakana is offered and concludes by suggesting ways to reduce drops-out. Key words: Distinctive features, Hiragana, Katakana, Serial position effectDOI: 10.3329/dujl.v1i2.3721 The Dhaka University Journal of Linguistics: Vol. 1 No. 2 August, 2008 Page: 147-156
Reusable Framework for Remote Monitoring and Maintenance of Manufacturing Systems
Authors: Fayolle Jacques , Gravier Christophe , Ates Mia
Published: November 2009

The aim of this paper is to address the problem of remote control of manufacturing systems for maintenance, object conception and production purposes.

We present a global approach of this problem according to two research axis: the genericity of the platform according to the underlying device, and the security of the data and information systems. The primary goal of this paper is to describe the framework that allows the remote control, and especially its independence to the devices. We propose a special study on the security issues in such architecture by explaining why we have made the choice of adopting identity federation technologies as a mean to reach remote devices hosted in different Information Systems. We also describe how this kind of systems can be used in a collaborative way in order to build a real extended entreprise for e-manufacturing systems.
Networking Online Labs within the ISA Framework
Authors: Garbi Zutin Danilo
Published: November 2009

The proposed paper focuses in outlining the implementation of online laboratories within the framework of the iLab Shared Architecture (ISA) in order to facilitate sharing those labs among several institutions and managing laboratory users. The laboratories are compliant with the ISA batched architecture, which is based on Web services to mediate the communication between Lab Servers and Lab Clients. The first laboratory presented is a Hybrid Lab that allows for the realization of real experiments as well as simulations with an analog programmable device.
An Auto-Adjustment Video Mechanism for Steadily Monitoring of Remote Laboratory
Authors: Lin Jian-Wei
Published: November 2009

This work presents an auto-adaptable video streaming Web-based system, enabling on-line simultaneously monitoring of multiple instruments of remote experiment. The system is capability of not only handling multiple concurrent stream processes, but also automatically tuning encoding parameters of the running video streaming processes once overload so that the whole system can always keep in a smooth and steady circumstance.