bluuebunny/crossref_metadata_2025 huggingface dataset:
Soil Total Mercury Concentrations across the Greater Everglades
Authors: Cohen Matthew J. , Lamsal Sanjay , Osborne Todd Z. , Bonzongo Jean Claude J. , Newman Susan , Reddy K. Ramesh
Published: February 2009

Elevated Hg concentrations in the Everglades pose ecological and human health risks. We mapped soil total Hg concentrations per mass (THgM) and area (THgA) across the Everglades, and investigated relationships with soil properties (total P [TP] and organic matter content), community type, and hydrologic compartmentalization. Samples (n= 600) from surface soils (0–10 cm) were selected from a population of 1405 sites spanning the Everglades. Overall, 168 sites had THgMlevels >0.2 mg kg−1; interpolation suggests that 23% of the Greater Everglades exceeds this threshold. Hot spots (>0.4 mg kg−1) were observed in eastern Water Conservation Area (WCA) 1 and west‐central WCA3A; parts of WCA2A, WCA3AN, and WCA3B were locally high. Despite significant global differences in THgMamong plant communities, differences evaluated using paired proximate sites were not significant, suggesting that large spatial scale depositional gradients govern ecosystem storage. Median THgAwas 1.89 mg m−2(range 0.07–12.05 mg m−2), representing approximately 100 yr of atmospheric deposition at contemporary rates (∼19 μg m−2yr−1). Correlation between TP and THgMwas positive in unimpacted areas (TP < 500 mg kg−1,r= 0.69), but negative in impacted areas (TP > 500 mg kg−1,r= ‐0.47), probably due to accelerated peat accretion rates in P‐enriched areas. Moreover, while reverse correlation with distance from a canal for THgM(0.70) and TP (−0.77) supports Hg enrichment via atmospheric deposition, THgMhotspots in WCA3AS, WCA1, and the Holeyland and Rotenberger tracts are suggestive of local enrichment mechanisms. Finally, despite dramatic regional emissions declines, the estimated mass of Hg in surface soils across the Everglades has increased ∼20% (11,000 vs. 13,100 kg) since 1996; while the statistical significance of this change is unknown, it provides a useful benchmark for future surveys.
Calibration of Hydra Impedance Probes using Electric Circuit Theory
Authors: Kelleners T. J. , Ferre-Pikal E. S. , Schaap M. G. , Paige G. B.
Published: February 2009

Impedance probes are an attractive electromagnetic technique to measure water content and bulk electrical conductivity (EC) in the same volume of soil. In this study, we developed an electric circuit model for Hydra probes that explains how the output voltages can be related to the soil real and imaginary permittivity. Internal probe transmission line sections were modeled using either a distributed approach or a lumped approach. The distributed approach resulted in seven circuit model parameters, while the lumped approach resulted in six parameters. Optimization of all the parameters using probe readings in air, ethanol, methanol, deionized water, and saline water solutions did not result in physically realistic parameter values. In contrast, fixing four parameters (distributed approach) and two parameters (lumped approach), while optimizing others, did yield realistic parameter values. Both the parameter optimization method and the default probe algorithm performed well during model verification. The parameter optimization method resulted in improved real permittivity measurements when nonsaline fluids at different temperatures were used in the optimization process.
An Automated Tool for Three Types of Saturated Hydraulic Conductivity Laboratory Measurements
Authors: Wietsma T.W. , Oostrom M. , Covert M.A. , Queen T.E. , Fayer M.J.
Published: February 2009

Acquisition of porous media saturated hydraulic conductivity data in the laboratory is usually time consuming and costly because of the manual labor associated with the currently available techniques. Lately, there has been increased interest in automating hydraulic conductivity laboratory techniques to reduce analysis time and improve data consistency. A new apparatus was developed that is able to measure hydraulic conductivity values with the constant‐flux, constant‐head, and falling‐head methods in a fully automated fashion. The apparatus can be used for both packed columns and undisturbed field cores. The column design is such that water is forced to flow in a nominally one‐dimensional manner through the porous medium. An analysis is initiated with a “smart search,” yielding an estimate of the saturated hydraulic conductivity. The operator can use this estimated value to obtain conductivity values using one, two, or all three methods. Besides installing and removing the columns, no manual efforts are required. Hydraulic conductivity data for standard laboratory sands showed that application of the three methods resulted in similar results, indicating that external flow resistance was small. A comparison with literature data for the same sands, obtained with a constant‐flux method, showed differences <9%.
In Situ Monitoring of Soil Solution Nitrate: Proof of Concept
Authors: Tuli Atac , Wei Jing-Bin , Shaw Benjamin D. , Hopmans Jan W.
Published: February 2009

A lack of in situ instrumentation limits continuous monitoring of contaminants and plant nutrients in soil solution to evaluate environmental and agricultural management practices. We developed a prototype soil solution monitoring technique to measure long‐term in situ NO3−–N concentration, consisting of an in situ stainless steel (SS) porous cup, with real time concentration measurements using an ion selective electrode and an ultraviolet fiber‐optic sensor. The measurement technique does not require soil solution extraction, but is based on in situ soil solution equilibration by diffusion between the porous cup and the surrounding medium. The technique was tested on a NO3−–N solution with two different SS collection cups. Analytical solutions evaluated solute diffusion coefficients, as controlled by a variety of experimental conditions. The principles of operation were developed for diffusion in a liquid solution and a saturated sand, illustrating the potential application in a soil environment.
Evaluation of Automotive Varnish as a Coating for Density Measurements of Soil Clods
Authors: de Almeida B. G. , da Silva A. P. , Raine S.R. , Figueiredo G.C.
Published: February 2009

Saran F‐310 resin (Dow Chemical Co, Midland, MI) has been widely used to coat soil clods for density and size measurements; however, the manufacturer has recently stopped producing this resin and supplies are difficult to obtain. Hence, we evaluated the feasibility of using Lazzudur 7502 (Sherwin‐Williams, Cleveland, OH) automotive varnish to coat soil clods for density measurement. Preliminary evaluations showed that immersion of clods in the varnish did not affect clod cohesion and that a single immersion in Lazzudur with 30 min of post‐immersion drying produced density results not significantly (P< 0.05) different to those obtained using saran. This technique was tested across seven soils and no significant (P< 0.05) difference was found in the density of the clods measured using the two coating methods. This work suggests that automotive varnish can be used as an alternative to saran resin for clod density measurements.
Do Binucleate Cardiomyocytes Have A Role in Myocardial Repair? Insights Using Isolated Rodent Myocytes and Cell Culture
Authors: Stephen Michael J , Poindexter Brian J , Moolman Johan A , Sheikh-Hamad David , Bick Roger J
Published: February 2009

Neonatal and adult cardiomyocytes were isolated from rat hearts. Some of the adult myocytes were cultured to allow for cell dedifferentiation, a phenomenon thought to mimic cell changes that occur in stressed myocardium, with myocytes regressing to a fetal pattern of metabolism and stellate neonatal shape.

Using fluorescence deconvolution microscopy, cells were probed with fluorescent markers and scanned for a number of proteins associated with ion control, calcium movements and cardiac function. Image analysis of deconvoluted image stacks and sequential real-time image recordings of calcium transients of cells were made.

All three myocyte groups were predominantly comprised of binucleate cells. Clustering of proteins to a single nucleus was a common observation, suggesting that one nucleus is active in protein synthesis pathways, while the other nucleus assumes a ‘dormant’ or different role and that cardiomyocytes might be mitotically active even in late development, or specific protein syntheses could be targeted and regulated for reintroduction into the cell cycle.

Such possibilities would extend cardiac disease associated stem cell research and therapy options, while producing valuable insights into developmental and death pathways of binucleate cardiomyocytes (word count 183).
Letter: Comment on Glaeser and Gyourko
Authors: Ho Lok Sang
Published: February 2009

Lok Sang Ho of Lingnan University takes issue with Edward Glaeser and Joseph Gyourko for their free-market views of housing, and argues that a price floor could be cheaper than you might think.
Dynamic Changes in Pancreatic Endocrine Cell Abundance, Distribution, and Function in Antigen-Induced and Spontaneous Autoimmune Diabetes
Authors: Pechhold Klaus , Zhu Xiaolong , Harrison Victor S. , Lee Janet , Chakrabarty Sagarika , Koczwara Kerstin , Gavrilova Oksana , Harlan David M.
Published: February 2009

OBJECTIVE

Insulin deficiency in type 1 diabetes and in rodent autoimmune diabetes models is caused by β-cell–specific killing by autoreactive T-cells. Less is known about β-cell numbers and phenotype remaining at diabetes onset and the fate of other pancreatic endocrine cellular constituents.

RESEARCH DESIGN AND METHODS

We applied multicolor flow cytometry, confocal microscopy, and immunohistochemistry, supported by quantitative RT-PCR, to simultaneously track pancreatic endocrine cell frequencies and phenotypes during a T-cell–mediated β-cell–destructive process using two independent autoimmune diabetes models, an inducible autoantigen-specific model and the spontaneously diabetic NOD mouse.

RESULTS

The proportion of pancreatic insulin-positive β-cells to glucagon-positive α-cells was about 4:1 in nondiabetic mice. Islets isolated from newly diabetic mice exhibited the expected severe β-cell depletion accompanied by phenotypic β-cell changes (i.e., hypertrophy and degranulation), but they also revealed a substantial loss of α-cells, which was further confirmed by quantitative immunohistochemisty. While maintaining normal randomly timed serum glucagon levels, newly diabetic mice displayed an impaired glucagon secretory response to non–insulin-induced hypoglycemia.

CONCLUSIONS

Systematically applying multicolor flow cytometry and immunohistochemistry to track declining β-cell numbers in recently diabetic mice revealed an altered endocrine cell composition that is consistent with a prominent and unexpected islet α-cell loss. These alterations were observed in induced and spontaneous autoimmune diabetes models, became apparent at diabetes onset, and differed markedly within islets compared with sub–islet-sized endocrine cell clusters and among pancreatic lobes. We propose that these changes are adaptive in nature, possibly fueled by worsening glycemia and regenerative processes.
Age-Dependent Decline in β-Cell Proliferation Restricts the Capacity of β-Cell Regeneration in Mice
Authors: Tschen Shuen-Ing , Dhawan Sangeeta , Gurlo Tatyana , Bhushan Anil
Published: February 2009

OBJECTIVE

The aim of this study was to elucidate whether age plays a role in the expansion or regeneration of β-cell mass.

RESEARCH DESIGN AND METHODS

We analyzed the capacity of β-cell expansion in 1.5- and 8-month-old mice in response to a high-fat diet, after short-term treatment with the glucagon-like peptide 1 (GLP-1) analog exendin-4, or after streptozotocin (STZ) administration.

RESULTS

Young mice responded to high-fat diet by increasing β-cell mass and β-cell proliferation and maintaining normoglycemia. Old mice, by contrast, did not display any increases in β-cell mass or β-cell proliferation in response to high-fat diet and became diabetic. To further assess the plasticity of β-cell mass with respect to age, young and old mice were injected with a single dose of STZ, and β-cell proliferation was analyzed to assess the regeneration of β-cells. We observed a fourfold increase in β-cell proliferation in young mice after STZ administration, whereas no changes in β-cell proliferation were observed in older mice. The capacity to expand β-cell mass in response to short-term treatment with the GLP-1 analog exendin-4 also declined with age. The ability of β-cell mass to expand was correlated with higher levels of Bmi1, a polycomb group protein that is known to regulate the Ink4a locus, and decreased levels of p16Ink4aexpression in the β-cells. Young Bmi1−/− mice that prematurely upregulate p16Ink4afailed to expand β-cell mass in response to exendin-4, indicating that p16Ink4alevels are a critical determinant of β-cell mass expansion.

CONCLUSIONS

β-Cell proliferation and the capacity of β-cells to regenerate declines with age and is regulated by the Bmi1/p16Ink4apathway.
Type 2 Diabetes Risk Alleles Are Associated With Reduced Size at Birth
Authors: Freathy Rachel M. , Bennett Amanda J. , Ring Susan M. , Shields Beverley , Groves Christopher J. , Timpson Nicholas J. , Weedon Michael N. , Zeggini Eleftheria , Lindgren Cecilia M. , Lango Hana , Perry John R.B. , Pouta Anneli , Ruokonen Aimo , Hyppönen Elina , Power Chris , Elliott Paul , Strachan David P. , Järvelin Marjo-Riitta , Smith George Davey , McCarthy Mark I. , Frayling Timothy M. , Hattersley Andrew T.
Published: February 2009

OBJECTIVE

Low birth weight is associated with an increased risk of type 2 diabetes. The mechanisms underlying this association are unknown and may represent intrauterine programming or two phenotypes of one genotype. The fetal insulin hypothesis proposes that common genetic variants that reduce insulin secretion or action may predispose to type 2 diabetes and also reduce birth weight, since insulin is a key fetal growth factor. We tested whether common genetic variants that predispose to type 2 diabetes also reduce birth weight.

RESEARCH DESIGN AND METHODS

We genotyped single-nucleotide polymorphisms (SNPs) at five recently identified type 2 diabetes loci (CDKAL1, CDKN2A/B, HHEX-IDE, IGF2BP2, and SLC30A8) in 7,986 mothers and 19,200 offspring from four studies of white Europeans. We tested the association between maternal or fetal genotype at each locus and birth weight of the offspring.

RESULTS

We found that type 2 diabetes risk alleles at the CDKAL1 and HHEX-IDE loci were associated with reduced birth weight when inherited by the fetus (21 g [95% CI 11–31], P = 2 × 10−5, and 14 g [4–23], P = 0.004, lower birth weight per risk allele, respectively). The 4% of offspring carrying four risk alleles at these two loci were 80 g (95% CI 39–120) lighter at birth than the 8% carrying none (Ptrend = 5 × 10−7). There were no associations between birth weight and fetal genotypes at the three other loci or maternal genotypes at any locus.

CONCLUSIONS

Our results are in keeping with the fetal insulin hypothesis and provide robust evidence that common disease-associated variants can alter size at birth directly through the fetal genotype.
Association Between Increased Platelet P-Selectin Expression and Obesity in Patients With Type 2 Diabetes
Authors: Schneider David J. , Hardison Regina M. , Lopes Neuza , Sobel Burton E. , Brooks Maria Mori ,   the Pro-Thrombosis Ancillary Study Group
Published: February 2009

OBJECTIVE

To determine whether obesity increases platelet reactivity and thrombin activity in patients with type 2 diabetes plus stable coronary artery disease.

RESEARCH DESIGN AND METHODS

We assessed platelet reactivity and markers of thrombin generation and activity in 193 patients from nine clinical sites of the Bypass Angioplasty Revascularization Investigation 2 Diabetes (BARI 2D). Blood taken at the time of enrollment was used for assay of the concentration of prothrombin fragment 1.2 (PT1.2, released when prothrombin is activated) and fibrinopeptide A (FPA, released when fibrinogen is cleaved). Platelet activation was identified with the use of flow cytometry in response to 0, 0.2, and 1 μmol/l adenosine diphosphate (ADP).

RESULTS

Concentrations of FPA, PT1.2, and platelet activation in the absence of agonist were low. Greater BMI was associated with higher platelet reactivity in response to 1 μm ADP as assessed by surface expression of P-selectin (r = 0.29, P < 0.0001) but not reflected by the binding of fibrinogen to activated glycoprotein IIb-IIIa. BMI was not associated with concentrations of FPA or PT1.2. Platelet reactivity correlated negatively with A1C (P < 0.04), was not related to the concentration of triglycerides in blood, and did not correlate with the concentration of C-reactive peptide.

CONCLUSIONS

Among patients enrolled in this substudy of BARI 2D, a greater BMI was associated with higher platelet reactivity at the time of enrollment. Our results suggest that obesity and insulin resistance that accompanies obesity may influence platelet reactivity in patients with type 2 diabetes.
Coenzyme Q10 Improves Endothelial Dysfunction in Statin-Treated Type 2 Diabetic Patients
Authors: Hamilton Sandra J. , Chew Gerard T. , Watts Gerald F.
Published: February 2009

OBJECTIVE

The vascular benefits of statins might be attenuated by inhibition of coenzyme Q10 (CoQ10) synthesis. We investigated whether oral CoQ10 supplementation improves endothelial dysfunction in statin-treated type 2 diabetic patients.

RESEARCH DESIGN AND METHODS

In a double-blind crossover study, 23 statin-treated type 2 diabetic patients with LDL cholesterol <2.5mmol/l and endothelial dysfunction (brachial artery flow-mediated dilatation [FMD] <5.5%) were randomized to oral CoQ10 (200 mg/day) or placebo for 12 weeks. We measured brachial artery FMD and nitrate-mediated dilatation (NMD) by ultrasonography. Plasma F2-isoprostane and 24-h urinary 20-hydroxyeicosatetraenoic acid (HETE) levels were measured as systemic oxidative stress markers.

RESULTS

Compared with placebo, CoQ10 supplementation increased brachial artery FMD by 1.0 ± 0.5% (P = 0.04), but did not alter NMD (P = 0.66). CoQ10 supplementation also did not alter plasma F2-isoprostane (P = 0.58) or urinary 20-HETE levels (P = 0.28).

CONCLUSIONS

CoQ10 supplementation improved endothelial dysfunction in statin-treated type 2 diabetic patients, possibly by altering local vascular oxidative stress.
Cerebrovascular Reactivity, Intima-Media Thickness, and Nephropathy Presence in Patients With Type 1 Diabetes
Authors: Kozera Grzegorz M. , Wolnik Bogumił , Kunicka Katarzyna B. , Szczyrba Sebastian , Wojczal Joanna , Schminke Ulf , Nyka Walenty M. , Bieniaszewski Leszek
Published: February 2009

OBJECTIVE

Cerebrovascular reactivity impairment was reported as a marker of cerebral microangiopathy in long-term type 1 diabetes. Intima-media complex thickening reflects early stages of macroangiopathy in type 1 diabetes. The analysis of the relationship between these variables and other microangiopathic complications might serve as a beneficial indicator for early prophylaxis in these patients.

RESEARCH DESIGN AND METHODS

Vasomotor reactivity reserve (VMRr) and breath-holding index (BHI) of the middle cerebral artery were measured with transcranial Doppler in 59 patients (median age 32.0 years, range 20–51, 36 females) with type 1 diabetes, without history of cerebrovascular events, and 30 healthy control subjects (median age 31.5 years, range 25–39, 15 females). The relationships between the presence of selected vascular complications of type 1 diabetes and biochemical parameters, intima-media thickness (IMT), and VMRr and BHI in patients were analyzed.

RESULTS

VMRr and BHI were lower in patients with type 1 diabetes when compared with healthy subjects (81.5 vs. 100%, P < 0.01, and 1.6 vs. 2.2, P = 0.04, respectively), whereas IMT was significantly higher in patients then in healthy control subjects (0.36 vs. 0.30 mm, P = 0.001). However, no association of IMT with VMRr was found. We found a significant reduction of VMRr and BHI in patients with diabetic nephropathy.

CONCLUSIONS

The presence of diabetic nephropathy, but not IMT, can be regarded as an indicator of cerebral microangiopathy severity in patients with type 1 diabetes.
Childhood Predictors of Adult Acute Insulin Response and Insulin Action
Authors: Thearle Marie S. , Bunt Joy C. , Knowler William C. , Krakoff Jonathan
Published: February 2009

OBJECTIVE

Because declines in acute insulin response (AIR) and insulin action (M) predict development of type 2 diabetes, we sought to determine childhood factors that predict insulin action and AIR using longitudinal data from young Pima Indian adults with normal glucose regulation.

RESEARCH DESIGN AND METHODS

Predictors of adult M, measured by the euglycemic-hyperinsulinemic clamp, and AIR, measured after a 25-g glucose bolus, were assessed in 76 individuals from a set of childhood data (BMI, systolic blood pressure [sBP] and diastolic blood pressure, cholesterol, fasting and 2-h insulin, and glucose levels during an oral glucose tolerance test).

RESULTS

After adjustment for sex, adult percent body fat, adult and childhood age, childhood BMI, and sBP were negative and independent predictors of adult M. A 5 kg/m2 increase in childhood BMI was associated with a 7.4% decrease in adult insulin action (95% CI −12.7 to −1.8%, P = 0.01) and a 10-mmHg increase in childhood sBP with a 5.0% decrease in adult M (95% CI −8.4 to −1.4%, P = 0.007). After a similar adjustment with M as an additional covariate, childhood 2-h insulin was a positive predictor of adult AIR such that a 25% increase predicted a 7.3% increase in adult AIR (95% CI 1.5–13.5%, P = 0.014).

CONCLUSIONS

Childhood insulin response during an oral glucose challenge predicts adult AIR, indicating that β-cell capacity may be set early in life. Childhood measures related to adiposity predict adult insulin action, which may reflect common underlying mechanisms that may be amenable to modification through programs targeting prevention or treatment of childhood obesity.
Relation of Abdominal Fat Depots to Systemic Markers of Inflammation in Type 2 Diabetes
Authors: Sam Susan , Haffner Steven , Davidson Michael H. , D'Agostino Ralph B. , Feinstein Steven , Kondos George , Perez Alfonso , Mazzone Theodore
Published: February 2009

OBJECTIVE

Both visceral adipose tissue (VAT) and subcutaneous adipose tissue (SAT) have been linked to systemic inflammation in nondiabetic cohorts. We examined the relationships between VAT and SAT and systemic inflammatory markers in a large well-characterized cohort of subjects with type 2 diabetes.

RESEARCH DESIGN AND METHODS

Three hundred eighty-two subjects with type 2 diabetes in the CHICAGO (Carotid Intima-Media Thickness in Atherosclerosis Using Pioglitazone) study cohort underwent abdominal computed tomography to determine SAT and VAT distribution. Fasting blood was obtained for measurement of inflammatory markers. The relationships between inflammatory markers and BMI, SAT, and VAT were examined using regression models adjusted for age, sex, diabetes treatment, duration of diabetes, smoking, statin use, and A1C.

RESULTS

VAT was positively related to CRP, monocyte chemoattractant protein (MCP), intracellular adhesion molecule (ICAM)-1, and plasminogen activator inhibitor type 1 (PAI-1) antigen before adjustment for BMI. After adjustment for BMI, the relationship to CRP was lost but positive associations with MCP (P < 0.01), PAI-1 (P < 0.0001), ICAM-1 (P < 0.01), and vascular cell adhesion molecule (P = 0.01) were evident. BMI was positively related to CRP (P < 0.0001) and IL-6 (P < 0.01) even after adjustment for VAT and SAT. SAT was not related to any inflammatory marker after adjustment for BMI.

CONCLUSIONS

In this large group of subjects with type 2 diabetes, BMI was most strongly associated with CRP and IL-6 levels. SAT was not associated with markers of systemic inflammation. The size of the VAT depot provided information additional to that provided by BMI regarding inflammatory markers that are strongly related to vascular wall remodeling and coagulation. Our findings suggest that adipose tissue distribution remains an important determinant of systemic inflammation in type 2 diabetes.
Predictors and Impact of Intensification of Antihyperglycemic Therapy in Type 2 Diabetes
Authors: McEwen Laura N. , Bilik Dori , Johnson Susan L. , Halter Jeffrey B. , Karter Andrew J. , Mangione Carol M. , Subramanian Usha , Waitzfelder Beth , Crosson Jesse C. , Herman William H.
Published: February 2009

OBJECTIVE

The purpose of this study was to examine the predictors of intensification of antihyperglycemic therapy in patients with type 2 diabetes; its impact on A1C, body weight, symptoms of anxiety/depression, and health status; and patient characteristics associated with improvement in A1C.

RESEARCH DESIGN AND METHODS

We analyzed survey, medical record, and health plan administrative data collected in Translating Research into Action for Diabetes (TRIAD). We examined patients who were using diet/exercise or oral antihyperglycemic medications at baseline, had A1C >7.2%, and stayed with the same therapy or intensified therapy (initiated or increased the number of classes of oral antihyperglycemic medications or began insulin) over 18 months.

RESULTS

Of 1,093 patients, 520 intensified therapy with oral medications or insulin. Patients intensifying therapy were aged 58 ± 12 years, had diabetes duration of 11 ± 9 years, and had A1C of 9.1 ± 1.5%. Younger age and higher A1C were associated with therapy intensification. Compared with patients who did not intensify therapy, those who intensified therapy experienced a 0.49% reduction in A1C (P < 0.0001), a 3-pound increase in weight (P = 0.003), and no change in anxiety/depression (P = 0.5) or health status (P = 0.2). Among those who intensified therapy, improvement in A1C was associated with higher baseline A1C, older age, black race/ethnicity, lower income, and more physician visits.

CONCLUSIONS

Treatment intensification improved glycemic control with no worsening of anxiety/depression or health status, especially in elderly, lower-income, and minority patients with type 2 diabetes. Interventions are needed to overcome clinical inertia when patients might benefit from treatment intensification and improved glycemic control.
Predictors of Overweight During Childhood in Offspring of Parents With Type 1 Diabetes
Authors: Hummel Sandra , Pflüger Maren , Kreichauf Susanne , Hummel Michael , Ziegler Anette-G.
Published: February 2009

OBJECTIVE

To study which perinatal factors affect the risk of childhood overweight in offspring with a first-degree relative (FDR) with type 1 diabetes and to determine whether maternal diabetes is an independent contributor to overweight risk.

RESEARCH DESIGN AND METHODS

Data on a child's weight and height were collected at age 2, 5, and 8 years from 1,214 children participating in the prospective BABYDIAB study. All children had an FDR with type 1 diabetes, including 783 whose mothers had type 1 diabetes. Overweight was defined as BMI percentile ≥90. Data on birth size, breast-feeding, maternal age, and smoking during pregnancy were collected by questionnaires. Risk estimates were calculated by logistic regression analyses.

RESULTS

Breastfeeding duration and birth size both contributed significantly to overweight risk at all age intervals. Full breast-feeding >4 months or any breast-feeding >6 months reduced risk of overweight (aged 8 years: odds ratio 0.3 [95% CI 0.2–0.7], P = 0.004; and 0.3 [0.1–0.6], P = 0.001). Large-for-gestational-age status increased risk of overweight (aged 8 years: 2.4 [1.4–4.3], P = 0.002). Importantly, no evidence was found for an independent contribution of maternal type 1 diabetes to childhood overweight.

CONCLUSIONS

Our findings indicate that maternal type 1 diabetes is not an independent risk factor for overweight during childhood in offspring of type 1 diabetic mothers but that factors associated with maternal type 1 diabetes, such as short breast-feeding duration and high birth size, predispose children to overweight during childhood.
Cardiovascular Risk Attributable to Diabetes in Southern Brazil
Authors: Moreira Leila B. , Fuchs Sandra C. , Wiehe Mário , Neyeloff Jeruza L. , Picon Rafael V. , Moreira Marina B. , Gus Miguel , Fuchs Flávio D.
Published: February 2009

OBJECTIVE

To analyze the effect of diabetes on general and cardiovascular disease (CVD) mortality and morbidity in southern Brazil.

RESEARCH DESIGN AND METHODS

A population-based cohort study of 1,091 individuals was conducted. Diabetes was ascertained by medical history. The vital status of 982 individuals and the incidence of events were ascertained during another visit and through hospital records, death certificates, and verbal necropsy with relatives.

RESULTS

The mean ± SD age of participants was 43.1 ± 17 years, and 55.7% were women. The prevalence of diabetes was 4.2%, and the mean follow-up time was 5.3 ± 0.07 years. Mortality was 36.3% and 6.6% in participants with or without diabetes, respectively; the incidence of CVD was 20.8% and 3.0%, with an adjusted hazard ratio of 4.4 (95% CI 2.4–7.9). Diabetic population-attributable risk (PAR) for CVD mortality was 10.1% and 13.1% for total CVD.

CONCLUSIONS

Diabetes is responsible for a large PAR for overall mortality and cardiovascular events in Brazil.
Continuity and Change in Glycemic Control Trajectories From Adolescence to Emerging Adulthood
Authors: Luyckx Koen , Seiffge-Krenke Inge
Published: February 2009

OBJECTIVE

To determine developmental classes of glycemic control in young people with type 1 diabetes throughout adolescence and emerging adulthood and assess relationships with general family climate and self-concept.

RESEARCH DESIGN AND METHODS

In an eight-wave longitudinal study, 72 individuals (37 females) completed questionnaires assessing family climate (at times 1–4) and self-concept (at times 1–4 and 6). Times 1–4 covered adolescence (mean ages were 14–17 years, respectively); times 5–8 covered emerging adulthood (mean ages were 21–25 years, respectively). At each time point, patients visited their physicians to determine A1C values, and questionnaires were sent to the physicians to obtain these values. Latent class growth analysis was used to identify developmental classes of glycemic control.

RESULTS

Latent class growth analysis favored a three-class solution, consisting of optimal control (n = 10), moderate control (n = 51), and deteriorating control (n = 11). From time 3 on and especially during emerging adulthood, mean A1C levels were substantially different among the classes. Additional ANOVAs indicated that at times 1, 2, and 4, the optimal control class was characterized by the most optimal family climate, whereas at times 3, 4, and 6, the deteriorating control class was characterized by the lowest score on positive self-concept.

CONCLUSIONS

From late adolescence on, a multiformity of glycemic control trajectories emerged, which became more diversified throughout emerging adulthood. Family climate and self-concept in mid-to-late adolescence served as psychosocial markers of these developmental classes.
Delaying Mobility Disability in People With Parkinson Disease Using a Sensorimotor Agility Exercise Program
Authors: King Laurie A , Horak Fay B
Published: February 2009

This article introduces a new framework for therapists to develop an exercise program to delay mobility disability in people with Parkinson disease (PD). Mobility, or the ability to efficiently navigate and function in a variety of environments, requires balance, agility, and flexibility, all of which are affected by PD. This article summarizes recent research identifying how constraints on mobility specific to PD, such as rigidity, bradykinesia, freezing, poor sensory integration, inflexible program selection, and impaired cognitive processing, limit mobility in people with PD. Based on these constraints, a conceptual framework for exercises to maintain and improve mobility is presented. An example of a constraint-focused agility exercise program, incorporating movement principles from tai chi, kayaking, boxing, lunges, agility training, and Pilates exercises, is presented. This new constraint-focused agility exercise program is based on a strong scientific framework and includes progressive levels of sensorimotor, resistance, and coordination challenges that can be customized for each patient while maintaining fidelity. Principles for improving mobility presented here can be incorporated into an ongoing or long-term exercise program for people with PD.
Influence of weekend versus weekday hospital admission on mortality following subarachnoid hemorrhage
Authors: Crowley R. Webster , Yeoh Hian K. , Stukenborg George J. , Ionescu Adina A. , Kassell Neal F. , Dumont Aaron S.
Published: February 2009

Object

Several studies have indicated that short-term mortality risk is higher among patients who are admitted on the weekends. This “weekend effect” has been observed among patients admitted with a variety of diagnoses, including myocardial infarction, pulmonary embolism, ruptured abdominal aortic aneurysm, and stroke. This study examines the relationship between short-term mortality risk and weekend admission among patients hospitalized following subarachnoid hemorrhage (SAH).

Methods

This retrospective cohort study examines mortality outcomes among patients included in the Nationwide Inpatient Sample (NIS) for 2004. Patients included in the cohort were identified using the International Classification of Diseases, 9th revision, Clinical Modification (ICD-9-CM) code for SAH. Multivariable logistic regression analyses and Cox proportional hazard regression analyses are used to measure the association of weekend admission on mortality for patients with SAH, adjusted for differences in patient characteristics that also contribute to mortality risk.

Results

Weekend admissions occurred among 27.5% of the 5667 patients with SAH in the NIS database. Weekend admission was not a statistically significant independent predictor of death in the SAH study population at 7 days (OR 1.07, 95% CI 0.91–1.25), 14 days (OR 1.01, 95% CI 0.87–1.17), or 30 days (OR 1.03, 95% CI 0.89–1.19).

Conclusions

Weekend admission is not associated with significantly increased short-term mortality risk among patients hospitalized with SAH.
Multispectral molecular imaging of capillary endothelium to facilitate preoperative endovascular brain mapping
Authors: Manning H. Charles , Shay Sheila D. , Mericle Robert A.
Published: February 2009

Object

Brain mapping aims to localize neurological function to specific regions of the human brain. Preoperative endovascular brain mapping (PEBM) is a novel approach that allows clear visualization of nonfunctional (silent) brain parenchyma in real time during a resection. It has potential to improve neurosurgical guidance because brain shift does not alter the maps, and the map is visualized directly on the brain in situ rather than on a nearby image. Therefore, the risk of a new neurological deficit should be reduced. The authors report the first PEBM approach that combines selective molecular targeting of brain endothelium with multispectral (optical) imaging in preclinical animal models.

Methods

Sprague-Dawley rats and New Zealand white rabbits were selectively catheterized, and a fluorescein isothiocyanate–derivatized tomato lectin–based imaging probe was administered into the carotid artery or posterior cerebral artery, measuring < 500 μm in diameter. After binding/uptake of the imaging probe, and removal of unbound probe, a craniotomy was performed to directly visualize the “brain map.”

Results

Selective localization of the imaging probe to the right hemisphere in rats or right posterior cerebral artery in rabbits was clearly visualized after craniotomy. Cross-sections of stained capillaries demonstrated that the imaging probe did not cause vascular occlusion. Gross regional selectivity of the imaging probe was documented by multispectral molecular imaging of intact brains, with discrete localization and endothelium-directed targeting validated by histological examination.

Conclusions

The authors have demonstrated the first molecular endothelium-targeted approach to PEBM that does not require manipulation of the intact blood-brain barrier or result in vascular occlusion. Furthermore, the presented multispectral molecular imaging technique appears to be a suitable methodology for the generation of region-selective brain maps of vascularized brain parenchyma. Further refinement of the PEBM approach, as well as the development of improved imaging probes, may result in clinical advancement of PEBM where direct visual discrimination of nonfunctional silent brain parenchyma at the time of resection could significantly improve neurosurgical outcomes.
Hemodynamic instability during carotid artery stenting: the relative contribution of stent deployment versus balloon dilation
Authors: Bussière Miguel , Lownie Stephen P. , Lee Donald , Gulka Irene , Leung Andrew , Pelz David M.
Published: February 2009

Object

Hemodynamic instability may complicate carotid angioplasty and stenting in up to 40% of patients. The authors have previously demonstrated that primary self-expanding stent placement alone can gradually dilate severely stenosed carotid arteries without the use of balloons. The authors hypothesized that eliminating the balloon would reduce carotid baroreceptor stimulation, thereby decreasing the incidence of hemodynamic instability.

Methods

Ninety-seven high surgical risk patients with symptomatic, severely stenosed carotid arteries were treated with the intention of using a self-expanding stent alone. Seventy-seven arteries (79%) were treated with stenting alone, and 20 required angioplasty (21%).

Results

Intraprocedural bradycardia (heart rate < 60 bpm) developed in 29 patients (38%) and hypotension (systolic blood pressure < 90 mm Hg) occurred in 1 patient (1%) treated with stenting alone. Fourteen patients (70%) who underwent angioplasty and stenting had bradycardia, and hypotension developed in 4 (20%). Atropine, glycopyrrolate, or vasopressors were required in 8% of patients who received stenting alone, compared to 30% of patients who underwent angioplasty. In the first 24 hours after treatment, hypotension or bradycardia developed in 25 patients (32%) who had undergone stent placement alone, and in 15 patients (75%) after stent placement and balloon angioplasty. There was no difference in the occurrence of intra- or postprocedural hypertension (systolic blood pressure > 160 mm Hg) between patients treated with stenting alone or stenting and balloons. Factors independently associated with hemodynamic depression included baseline heart rate and balloon use.

Conclusions

Hemodynamic instability during and after carotid artery stenting was observed more frequently when balloon angioplasty was required than when stent placement was performed without concurrent balloon angioplasty.
A Study on the job Analysis for New Nurse
Authors: Kim Moon Sil , Song Ji Ho , Kim Bun Han , Lee Seung Hee
Published: February 2009

This study is empirical and descriptive one for analysing the nurse's job. This study used the methods of making the job descriptions and survey research about the nurses' perception of importance in their job and the frequency of job performance. The results were in following: the research divided the job of new nurse into 11 duties. And duties include the 65 tasks and 446 task elements. According to the survey research on the nurses' perception of importance and the frequency of job performance, the elements graded higher than 2.5 point in importance perception, were 47 elements(10.5%). And the elements from 2.0 to 2.5 were 93 elements(18.8%). Regarding the frequency of job performance, the 56 elements were graded higher than 2.5 point on average(12.6%), and 84 elements were from 2.0 to 2.5(18.8%). Especially, the elements which grade higher than 2.5 point in both two items, were 31 elements(7.0%). Based on these results, the elements graded higher than 2.0 point were grouped to the core competencies for registered nurse, these could be core concepts to develop the questions for national examination for nurse's registration.
A Study on the Standard of Optician National Licensing Examination by Job Analysis
Authors: Lee Won Jin , Won Chan Hee , Mah Ki Choong , Sung Duk Yong , Kang Sung Soo , Youk Do Jin , Park Hae Jong
Published: February 2009

This study shows the optician's job analysis, some questionaire and their analysis. Job description drafed, the standard of questionaire was fixed. Job description is establised on the results of the job analysis by DACUM(Developing A Curriculum Method). The job description formed above 2.15 referred to the results of survey of the importance and perfomance frequency of the job. These elements made a draft of drawing up standard of the Optician National Licensing Examination by Job Analysis.
A Pychometric Approach to Setting a Passing Score on Korean National Medical Licensing Examination
Authors: Lee Guemin
Published: February 2009

National Health Personnel Licensing Examination Board (hereafter NHPLEB) has used 60% correct responses of overall tests and 40% correct responses of each subject area test as a criterion to give physician licenses to satisfactory candidates. The 60%-40% criterion seems reasonable to laypersons without pychometric or measurement knowledge, but it may causes several severe problems on pychometrician's perspective. This paper pointed out several problematic cases that can be encountered by using the 60%-40% criterion, and provided several pychometric alternatives that could overcome these problems. A fairly new approach, named Bookmark standard setting method, was introduced and explained in detail as an example. This paper concluded with five considerations when the NHPLEB decides to adopt a pychometric standard setting approach to set a cutscore for a licensure test like medical licensing examination.
A Study on Certifying Systems for Clinical Laboratory Scientists
Authors: Cho Kyung Jin , Lee Chang Kyou , Lee Seung Gwan , Chung So Woong , Kim Tae Un , Moon Hee Joo , Kim Tae Jeon , Bae Hyung Joon , Choi Seung Gu , Kim Shin Moo , Kim Chong Ho , Jin Bok Hee
Published: February 2009

Reviewing and comparing the certifying systems for clinical laboratory scientists in some developed countries would be meaningful for us in the renovation of our current systems. Through the homepages of relevant organizations in five countries we got the information on education and certifying systems for clinical laboratory scientists. And we also e-mailed or made phone calls directly to the chairpersons for more additional data. The ladders systems in both educational and certifying were well developed in the United States compared to other countries. ln Japan and Korea, it seemed that too many competencies are required for the entry-level medical technologist requiring even competencies in the fields of histo-pathology, cytology, clinical physiology in the current medical technologist's job descriptions. Now we have to evaluate the applicants' competencies at the entry-level and establish the content outlines as a guideline for the applicants. For more reliable and efficient evaluations we might consider adopting the computerized testing like CBT or CAT.
Comparison of item analysis results of Korean Medical Licensing Examination according to classical test theory and item response theory
Authors: Lim Eun Young , Park Jang Hee , Kwon ll , Song Gue Lim , Huh Sun
Published: February 2009

The results of the 64th and 65th Korean Medical Licensing Examination were analyzed according to the classical test theory and item response theory in order to know the possibility of applying item response theory to item analys and to suggest its applicability to computerized adaptive test. The correlation coefficiency of difficulty index, discriminating index and ability parameter between two kinds of analysis were got using computer programs such as Analyst 4.0, Bilog and Xcalibre. Correlation coefficiencies of difficulty index were equal to or more than 0.75; those of discriminating index were between - 0.023 and 0.753; those of ability parameter were equal to or more than 0.90. Those results suggested that the item analysis according to item response theory showed the comparable results with that according to classical test theory except discriminating index. Since the ability parameter is most widely used in the criteria-reference test, the high correlation between ability parameter and total score can provide the validity of computerized adaptive test utilizing item response theory.
A study on the satisfaction of medical licensing examination and the present condition of skill test in medical schools
Authors: Park Jang Hee , Kim Un Mook , Lee Won Chul , Lee Yoon Seong
Published: February 2009

lt has been an issue whether the current medical examination system can evaluate medical students' competencies efficiently. This study was performed to survey on the satisfaction for the current medical examination system and present situation for clinical skill test in medical schools. We conducted a survey for this research and the subjects of this study were deans, medical professors, resident and medical students. We met with interesting results. First, most respondents answered the current medical examination system couldn't evaluate the medical students' competencies efficiently. Second, many residents thought preparing for paper-pencil test was not helpful for training, while experiencing clinical skill test was helpful for it. Third, the current contents and methods to evaluate clinical skill in the medical schools were variable and desirable. We concluded it was high time to change our medical examination system for evaluating the clinical skill performance of medical students.
Correlations between the scores of computerized adaptive testing, paper and pencil tests, and the Korean Medical Licensing Examination
Authors: Kim Mee Young , Lee Yoon Hwan , Huh Sun
Published: February 2009

To evaluate the usefulness of computerized adaptive testing (CAT) in medical school, the General Examination for senior medical students was administered as a paper and pencil test (P&P) and using CAT. The General Examination is a graduate examination, which is also a preliminary examination for the Korean Medical Licensing Examination (KMLE). The correlations between the results of the CAT and P&P and KMLE were analyzed. The correlation between the CAT and P&P was 0.8013 (p=0.000); that between the CAT and P&P was 0.7861 (p=0.000); and that between the CAT and KMLE was 0.6436 (p=0.000). Six out of 12 students with an ability estimate below 0.52 failed the KMLE. The results showed that CAT could replace P&P in medical school. The ability of CAT to predict whether students would pass the KMLE was 0.5 when the criterion of the theta value was set at -0.52 that was chosen arbitrarily for the prediction of pass or failure.