bluuebunny/crossref_metadata_2025 huggingface dataset:
Loss of inhibitory semaphorin 3A (SEMA3A) autocrine loops in bone marrow endothelial cells of patients with multiple myeloma
Authors: Vacca Angelo , Scavelli Claudio , Serini Guido , Di Pietro Giulia , Cirulli Teresa , Merchionne Francesca , Ribatti Domenico , Bussolino Federico , Guidolin Diego , Piaggio Giovanna , Bacigalupo Andrea , Dammacco Franco
Published: May 2006

Vascular endothelial growth factor165 (VEGF165) and semaphorin3A (SEMA3A) elicit pro- and antiangiogenic signals respectively in endothelial cells (ECs) by binding to their receptors VEGFR-2, neuropilin-1 (NRP1), and plexin-A1. Here we show that the VEGF165-driven angiogenic potential of multiple myeloma (MM) ECs is significantly higher than that of monoclonal gammopathy of undetermined significance (MGUS) ECs (MGECs) and human umbilical vein (HUV) ECs. This is probably due to a constitutive imbalance of endogenous VEGF165/SEMA3A ratio, which leans on VEGF165 in MMECs but on SEMA3A in MGECs and HUVECs. Exogenous VEGF165 induces SEMA3A expression in MGECs and HUVECs, but not in MMECs. Moreover, by counteracting VEGF165 activity as efficiently as an anti-VEGFR-2 antibody, exogenous SEMA3A restrains the over-angiogenic potential of MMECs. Our data indicate that loss of endothelial SEMA3A in favor of VEGF165 could be responsible for the angiogenic switch from MGUS to MM.
The effect of engineered disulfide bonds on the stability of Drosophila melanogaster acetylcholinesterase
Authors: Siadat Omid Ranaei , Lougarre Andrée , Lamouroux Lucille , Ladurantie Caroline , Fournier Didier
Published: May 2006

Background

Acetylcholinesterase is irreversibly inhibited by organophosphate and carbamate insecticides allowing its use in biosensors for detection of these insecticides. Drosophila acetylcholinesterase is the most sensitive enzyme known and has been improved by in vitro mutagenesis. However, its stability has to be improved for extensive utilization.

Results

To create a disulfide bond that could increase the stability of the Drosophila melanogaster acetylcholinesterase, we selected seven positions taking into account first the distance between Cβ of two residues, in which newly introduced cysteines will form the new disulfide bond and second the conservation of the residues in the cholinesterase family. Most disulfide bonds tested did not increase and even decreased the stability of the protein. However, one engineered disulfide bridge, I327C/D375C showed significant stability increase toward denaturation by temperature (170 fold at 50°C), urea, organic solvent and provided resistance to protease degradation. The new disulfide bridge links the N-terminal domain (first 356 aa) to the C-terminal domain. The quantities produced by this mutant were the same as in wild-type flies.

Conclusion

Addition of a disulfide bridge may either stabilize or unstabilize proteins. One bond out of the 7 tested provided significant stabilisation.
The feminization of the medical work force, implications for Scottish primary care: a survey of Scottish general practitioners
Authors: McKinstry Brian , Colthart Iain , Elliott Katy , Hunter Colin
Published: May 2006

Background

The number of women working in general practice internationally has been steadily rising. In Scotland there have been concerns that such a change may lead to increased part-time working and subsequently to a fall in available general practice manpower despite an apparently rising overall number of general practitioners. However, there is very little information on the actual hours worked by men and women general practitioners or on the types of work they are undertaking.

Methods

Anonymous workload questionnaires of all Scottish general practitioner principals and non-principals

Results

Response rates for general practice principals and non-principals were 67.2% and 65.2% respectively. Male principals spent on average 18% more time on general medical services (GMS) and 50% more time on non-GMS activities (such as teaching, specialist sessions, administration and research) than women (both p <0.01). This difference was similar for non-principals. In no age group did the hours worked by women doctors approach that of male doctors.

Conclusion

Women doctors in primary care in Scotland work fewer hours in all age groups than their male counterparts. The rapidly increasing proportion of women in general practice may lead to an increasing shortfall of medical availability in the future if current work patterns are maintained. Further longitudinal research is required to establish this and man-power planning is required now to address this. More worryingly auxiliary activities such as teaching and administrative duties are not being taken up by women. This may have serious implications for the future development of the specialty in Scotland.
The Australian experiment: the use of evidence based medicine for the reimbursement of surgical and diagnostic procedures (1998–2004)
Authors: O'Malley Sue P
Published: May 2006

Background

In 1998 a formal process using the criteria of safety, effectiveness and cost-effectiveness (evidence based medicine) on the introduction and use of new medical procedures was implemented in Australia. As part of this process an expert panel, the Medical Services Advisory Committee (MSAC) was set up. This paper examines the effectiveness of this process based on the original criteria, that is, evidence based medicine.

Method

The data for this analysis was sourced primarily from that made available in the public domain. The MSAC web site provided Minutes from MSAC meetings; Annual Reports; Assessment and Review reports; Progress status; and Archived material.

Results

The total number of applications submitted to the MSAC has been relatively low averaging approximately only fourteen per year. Additionally, the source of applications has quickly shifted to the medical devices, equipment and diagnostic industry as being the major source of applications. An overall average time for the processing of an application is eighteen months. Negative recommendations were in most cases based on insufficient clinical evidence rather than clinical evidence that clearly demonstrated a lack of clinical effectiveness. It was rare for a recommendation, either positive or negative, to be based on cost-effectiveness.

Conclusion

New medical procedures are often the result of a process of experimentation rather than formally conducted research. Affordability and the question of who should pay for the generation, collection and analysis of the clinical evidence is perhaps the most difficult to answer. This is especially the case where the new procedure is the result of a process of experimentation with an old procedure. A cost-effective way needs to be found to collect acceptable levels of evidence proving the clinical effectiveness of these new procedures, otherwise the formal processes of evaluation such as that used by the Australian MSAC since 1998 will continue to run the risk of committing Type II errors, that is, denying access to medical procedures that are beneficial and efficient.
Facile Synthesis of Group 4–6 Transition Metal Phenoxides and X-Ray Structures of TiCl2[O-2,6-(CH3)2C6H3]2(THF)2 and NbCl3[O-2,6-(CH3)2C6H3]2(THF)
Authors: Kanehisa Nobuko , Kai Yasushi , Kasai Nobutami , Yasuda Hajime , Nakayama Yuushou , Takei Kazuo , Nakamura Akira
Published: May 2006

Reactions of Group 4–6 metal halides with 2,6-dimethylphenoxy(trimethyl)silane in THF afford pure compounds of type MX1[O-2,6-(CH3)2C6H3]m(THF)n(M = Ti, Zr, Hf with l = 3, m = 1, n = 2 or l = 2, m = 2, n = 2; M = Nb, l = 4, m = 1, n = 1 or l = 3, m = 2, n = 1; M = W, l = 5, m = 1, n = 0 or l = 4, m = 2, n = 0) in >75% yields. Geometries of TiCl2[O-2,6-(CH3)2C6H3]2(THF)2 and NbCl3[O-2,6-(CH3)2C6H3]2(THF) were determined by the X-Ray diffraction method.
A Convenient and Versatile Route for the Stereoselective Synthesis of Monosaccharides via Key Chiral Synthons Prepared from Achiral Sources
Authors: Mukaiyama Teruaki , Shiina Isamu , Kobayashi Shu
Published: May 2006

Three types of sugars, 6-deoxy-L-tallose,4-C-methyl-D-ribose, and D-ribose were synthesized from both achiral starting materials, α,β-unsaturated aldehydes and silyl enol ethers of α-benzyloxy thioesters, by successive asymmetric aldol and vicinal dihydroxylation reactions.
Enantioselective Inclusion Behavior of Monosubstituted Cyclodextrins with Guest-Induced Substituent Movement
Authors: Takahashi Keiko , Ohtsuka Yutaka , Hattori Kenjiro
Published: May 2006

6N(N′-formyl-D- and L-phenylalanyl)-deoxyamino-β-cyclodextrins(I and II) indicate reversed enantiomeric selectivity when they include D- and L-dansylphenylalanine.
Human Progress — And Collapse?
Authors: Kasper Wolfgang E.
Published: May 2006

Against the human experience of long-term stagnation and misery, the record of growing prosperity over the past two centuries, and in particular the last fifty years, is astounding. Economic growth owes much to the mobilisation of resources and structural flexibility, but this depends on the ‘software of economic development’ – institutions, which change slowly. Now, old fears and growth-impeding policies are being justified on environmental grounds. One example is Jared Diamond's recent book ‘Collapse’, which discusses the possibility of a swift descent of the world into social disintegration. To anyone familiar with long-term economic history and the theory of growth, the book is pure millennial pessimism. It could become self-fulfilling if environmentalist doomsayers win the political argument with the doers — the engineers, entrepreneurs and economists.
From Genocide to Ecocide: The Rape of Rapa Nui
Authors: Peiser Benny
Published: May 2006

The ‘decline and fall’ of Easter Island and its alleged self-destruction has become the poster child of a new environmentalist historiography, a school of thought that goes hand-in-hand with predictions of environmental disaster. Why did this exceptional civilisation crumble? What drove its population to extinction? These are some of the key questions Jared Diamond endeavours to answer in his new book Collapse: How Societies Choose to Fail or Survive. According to Diamond, the people of Easter Island destroyed their forest, degraded the island's topsoil, wiped out their plants and drove their animals to extinction. As a result of this self-inflicted environmental devastation, its complex society collapsed, descending into civil war, cannibalism and self-destruction. While his theory of ecocide has become almost paradigmatic in environmental circles, a dark and gory secret hangs over the premise of Easter Island's self-destruction: An actual genocide terminated Rapa Nui's indigenous populace and its culture. Diamond, however, ignores and fails to address the true reasons behind Rapa Nui's collapse. Why has he turned the victims of cultural and physical extermination into the perpetrators of their own demise? This paper is a first attempt to address this disquieting quandary. It describes the foundation of Diamond's environmental revisionism and explains why it does not hold up to scientific scrutiny.
A Climate Policy for the Short and Medium Term: Stabilization or Adaptation?
Authors: Goklany Indur M.
Published: May 2006

An evaluation of analyses sponsored by the predecessor to the U.K. Department for Environment, Food and Rural Affairs (DEFRA) of the global impacts of climate change under various mitigation scenarios (including CO2. stabilization at 550 and 750 ppm) coupled with an examination of the relative costs associated with different schemes to either mitigate climate change or reduce vulnerability to various climate-sensitive hazards (namely, malaria, hunger, water shortage, coastal flooding, and losses of global forests and coastal wetlands) indicates that, at least for the next few decades, risks and/or threats associated with these hazards would be lowered much more effectively and economically by reducing current and future vulnerability to those hazards rather than through stabilization. Accordingly, over the next few decades the focus of climate policy should be to: (a) broadly advance sustainable development (particularly in developing countries since that would generally enhance their adaptive capacity to cope with numerous problems that currently beset them, including climate-sensitive problems), (b) reduce vulnerabilities to climate-sensitive problems that are urgent today and might be exacerbated by future climate change, and (c) implement “no-regret” emission reduction measures while at the same time striving to expand the universe of such measures through research and development of cleaner and more affordable technologies. Such a policy would help solve current urgent problems facing humanity while preparing it to face future problems that might be caused by climate change.
Improvement of Glycemic Control, Triglycerides, and HDL Cholesterol Levels With Muraglitazar, a Dual (α/γ) Peroxisome Proliferator–Activated Receptor Activator, in Patients With Type 2 Diabetes Inadequately Controlled With Metformin Monotherapy
Authors: Kendall David M. , Rubin Cindy J. , Mohideen Pharis , Ledeine Jean-Marie , Belder Rene , Gross Jorge , Norwood Paul , O’Mahony Michael , Sall Kenneth , Sloan Greg , Roberts Anthony , Fiedorek Fred T. , DeFronzo Ralph A.
Published: May 2006

OBJECTIVE—We sought to evaluate the effects of muraglitazar, a dual (α/γ) peroxisome proliferator–activated receptor (PPAR) activator within the new glitazar class, on hyperglycemia and lipid abnormalities.

RESEARCH DESIGN AND METHODS—A double-blind, randomized, controlled trial was performed in 1,159 patients with type 2 diabetes inadequately controlled with metformin. Patients received once-daily doses of either 5 mg muraglitazar or 30 mg pioglitazone for a total of 24 weeks in addition to open-label metformin. Patients were continued in a double-blind fashion for an additional 26 weeks.

RESULTS—Analyses were conducted at week 24 for HbA1c (A1C) and at week 12 for lipid parameters. Mean A1C at baseline was 8.12 and 8.13% in muraglitazar and pioglitazone groups, respectively. At week 24, muraglitazar reduced mean A1C to 6.98% (−1.14% from baseline), and pioglitazone reduced mean A1C to 7.28% (−0.85% from baseline; P < 0.0001, muraglitazar vs. pioglitazone). At week 12, muraglitazar and pioglitazone reduced mean plasma triglyceride (−28 vs. −14%), apolipoprotein B (−12 vs. −6%), and non-HDL cholesterol (−6 vs. −1%) and increased HDL cholesterol (19 vs. 14%), respectively (P < 0.0001 vs. pioglitazone for all comparisons). At week 24, weight gain (1.4 and 0.6 kg, respectively) and edema (9.2 and 7.2%, respectively) were observed in the muraglitazar and pioglitazone groups; at week 50, weight gain and edema were 2.5 and 1.5 kg, respectively, and 11.8 and 8.9%, respectively. At week 50, heart failure was reported in seven patients (five with muraglitazar and two with pioglitazone), and seven deaths occurred: three from sudden death, two from cerebrovascular accident, and one from pancreatic cancer in the muraglitazar group and one from perforated duodenal ulcer in the pioglitazone group.

CONCLUSIONS—We found that 5 mg muraglitazar resulted in greater improvements in A1C and lipid parameters than a submaximal dose of 30 mg pioglitazone when added to metformin. Weight gain and edema were more common when muraglitazar was compared with a submaximal dose of pioglitazone.
The Effects of the Pro12Ala Polymorphism of the Peroxisome Proliferator–Activated Receptor-γ2 Gene on Glucose/Insulin Metabolism Interact With Prenatal Exposure to Famine
Authors: de Rooij Susanne R. , Painter Rebecca C. , Phillips David I.W. , Osmond Clive , Tanck Michael W.T. , Defesche Joep C. , Bossuyt Patrick M.M. , Michels Robert P.J. , Bleker Otto P. , Roseboom Tessa J.
Published: May 2006

OBJECTIVE—An adverse fetal environment may permanently modify the effects of specific genes on glucose tolerance, insulin secretion, and insulin sensitivity. In the present study, we assessed a possible interaction of the peroxisome proliferator–activated receptor (PPAR)-γ2 Pro12Ala polymorphism with prenatal exposure to famine on glucose and insulin metabolism.

RESEARCH DESIGN AND METHODS—We measured plasma glucose and insulin concentrations after an oral glucose tolerance test and determined the PPAR-γ2 genotype among 675 term singletons born around the time of the 1944–1945 Dutch famine.

RESULTS—A significant interaction effect between exposure to famine during midgestation and the PPAR-γ2 Pro12Ala polymorphism was found on the prevalence of impaired glucose tolerance and type 2 diabetes. The Ala allele of the PPAR-γ2 gene was associated with a higher prevalence of impaired glucose tolerance and type 2 diabetes but only in participants who had been prenatally exposed to famine during midgestation. Similar interactions were found for area under the curve for insulin and insulin increment ratio, which were lower for Ala carriers exposed to famine during midgestation.

CONCLUSIONS—The effects of the PPAR-γ2 Pro12Ala polymorphism on glucose and insulin metabolism may be modified by prenatal exposure to famine during midgestation. This is possibly due to a combined deficit in insulin secretion, as conferred by pancreatic β-cell maldevelopment and carrier type of the Ala allele in the PPAR-γ2 gene.
Burden of Infection and Insulin Resistance in Healthy Middle-Aged Men
Authors: Fernández-Real José-Manuel , López-Bermejo Abel , Vendrell Joan , Ferri Maria-José , Recasens Mónica , Ricart Wifredo
Published: May 2006

OBJECTIVE—We hypothesized that burden of infection could be associated with chronic low-grade inflammation, resulting in insulin resistance. We aimed to study the effect of exposure to four infections on insulin sensitivity in apparently healthy middle-aged men (n = 124).

RESEARCH DESIGN AND METHODS—By inclusion criteria, all subjects were hepatitis C virus antibody seronegative. Each study subject’s serum was tested for specific IgG class antibodies against herpes simplex virus (HSV)-1, HSV-2, enteroviruses, and Chlamydia pneumoniae through the use of quantitative in vitro enzyme-linked immunosorbent assays. Insulin sensitivity was evaluated using minimal model analysis.

RESULTS—The HSV-2 titer was negatively associated with insulin sensitivity even after controlling for BMI, age, and C-reactive protein (CRP). The associations were stronger when considering the infection burden. In particular, in those subjects who were seropositive for C. pneumoniae, the relationship between the quantitative seropositivity index (a measure of the exposure to various pathogens) and insulin sensitivity was strengthened (r = −0.50, P < 0.0001). We also observed decreasing mean insulin sensitivity index with increasing seropositivity score in subjects positive for enteroviruses. In the latter, the relationship between insulin sensitivity and seropositivity was especially significant (r = −0.71, P < 0.0001). In a multivariate regression analysis, both BMI and quantitative seropositivity index (7%) independently predicted insulin sensitivity variance in subjects with C. pneumoniae seropositivity. When controlling for CRP, this association was no longer significant.

CONCLUSIONS—Pathogen burden showed the strongest association with insulin resistance, especially with enteroviruses and C. pneumoniae seropositivity. We hypothesize that exposure to multiple pathogens could cause a chronic low-grade inflammation, resulting in insulin resistance.
Monitoring Kidney Function in Type 2 Diabetic Patients With Incipient and Overt Diabetic Nephropathy
Authors: Rossing Peter , Rossing Kasper , Gæde Peter , Pedersen Oluf , Parving Hans-Henrik
Published: May 2006

OBJECTIVE—The purpose of this study was to assess agreement between glomerular filtration rate (GFR) and the decline in GFR estimated with the Modification of Diet in Renal Disease (MDRD) Study Group equation or the Cockcroft-Gault formula and measured by the plasma clearance of 51Cr-EDTA.

RESEARCH DESIGN AND METHODS—We followed a cohort of 156 microalbuminuric type 2 diabetic patients for 8 years with four measurements of GFR and another cohort of 227 type 2 diabetic patients with overt diabetic nephropathy for 6.5 (range 3–17) years with seven (3–22) measurements of GFR.

RESULTS—For patients with microalbuminuria, mean ± SD baseline GFR was 117 ± 24 measured, 92 ± 20 estimated (MDRD equation), or 103 ± 24 ml · min−1 per 1.73 m2 estimated (Cockcroft-Gault formula) (both P < 0.001); 95% limits of agreement were −66.1 to 20.3 (MDRD equation) and −58.7 to 30.7 (Cockcroft-Gault formula). The rate of decline in GFR was 4.1 ± 4.2 measured, 2.9 ± 2.8 estimated (MDRD equation), or 3.4 ± 3.2 ml · min−1 per 1.73 m2 estimated (Cockcroft-Gault formula) (both P < 0.001). For patients with overt nephropathy, baseline GFR was 84 ± 30 measured, 73 ± 24 estimated (MDRD equation), or 81 ± 28 ml · min−1 per 1.73 m2 estimated (Cockcroft-Gault formula) (both P < 0.001) with 95% limits of agreement −47 to 25 (MDRD equation) and −39 to 33 (Cockcroft-Gault formula). The rate of decline in GFR was 5.2 ± 4.1 measured, 4.2 ± 3.8 estimated (MDRD equation), and 4.6 ± 4.1 ml · min−1 per 1.73 m2 estimated (Cockcroft-Gault formula) (both P < 0.001).

CONCLUSIONS—Particularly in microalbuminuric (hyperfiltering) patients, GFR is significantly underestimated with wide limits of agreement by the MDRD equation as well as by the Cockcroft-Gault formula. The rate of decline in GFR is also significantly underestimated with both equations. This makes GFR estimations based upon these equations unacceptable for monitoring kidney function in type 2 diabetic patients with incipient and overt diabetic nephropathy.
Antihypertensive Medications and the Risk of Incident Type 2 Diabetes
Authors: Taylor Eric N. , Hu Frank B. , Curhan Gary C.
Published: May 2006

OBJECTIVE—The purpose of this study was to examine the association between the use of different classes of antihypertensive medications and the risk of incident type 2 diabetes.

RESEARCH DESIGN AND METHODS—We conducted a prospective study of three cohorts: the Nurses’ Health Study (NHS) I and II and the Health Professionals Follow-up Study (HPFS). Antihypertensive medication use was ascertained by biennial questionnaires. After excluding participants who reported a history of diabetes at baseline, 41,193 older women (NHS I), 14,151 younger women (NHS II), and 19,472 men (HPFS), all with hypertension, were followed for 8, 10, and 16 years, respectively.

RESULTS—We documented 3,589 incident cases of diabetes. After adjustment for age, BMI, physical activity, the use of other antihypertensive medications, and other risk factors, the multivariate relative risk (RR) of incident diabetes in participants taking a thiazide diuretic compared with those not taking a thiazide was 1.20 (95% CI 1.08–1.33) in older women, 1.45 (1.17–1.79) in younger women, and 1.36 (1.17–1.58) in men. The multivariate RR in participants taking a β-blocker compared with those not taking a β-blocker was 1.32 (1.20–1.46) in older women and 1.20 (1.05–1.38) in men. ACE inhibitors and calcium channel blockers were not associated with risk.

CONCLUSIONS—Thiazide diuretic and β-blocker use were independently associated with a higher risk of incident diabetes. Increased surveillance for diabetes in patients treated with these medications may be warranted.
Association of Elevated Serum Ferritin Levels and the Risk of Gestational Diabetes Mellitus in Pregnant Women
Authors: Chen Xinhua , Scholl Theresa O. , Stein T. Peter
Published: May 2006

OBJECTIVE— We examined the influence of a moderately elevated serum ferritin level at entry to care on the risk of gestational diabetes mellitus (GDM) and a possible mechanism (increased iron stores versus inflammation).

RESEARCH DESIGN AND METHODS— In a prospective observational study with 1,456 healthy pregnant women in Camden, New Jersey, serum ferritin and anthropometric measurements were determined. Serum C-reactive protein (CRP) concentration was measured in a nested case-control study of 172 subjects.

RESULTS— Women who developed GDM had a higher concentration of serum ferritin than women who did not develop GDM (P < 0.001). Elevated serum ferritin level (highest quintile) was significantly and positively correlated with prepregnant BMI and skinfold measurements. Women in the highest quintile of serum ferritin had a twofold increased risk of developing GDM adjusted for several known risk factors (adjusted odds ratio, 2.02 [95% CI 1.04–3.92], P < 0.05). Similar results were obtained with a nested case-control study, in which women in the highest tertile of serum ferritin (2.35 [1.06–5.22], P < 0.05) or CRP (2.67 [1.16–6.17], P < 0.001) had a greater than twofold increased risk of GDM. However, these effects were modified and became nonstatistically significant after additional adjustment for prepregnant BMI.

CONCLUSIONS— Elevated serum ferritin concentrations early in gestation are associated with an increased risk of GDM. The association, at least in part, is mediated by the maternal fat mass and obesity. These data suggest a possible link between elevated serum ferritin and low-grade inflammation.
Coronary Heart Disease Risk Equivalence in Diabetes Depends on Concomitant Risk Factors
Authors: Howard Barbara V. , Best Lyle G. , Galloway James M. , Howard William James , Jones Kristina , Lee Elisa T. , Ratner Robert E. , Resnick Helaine E. , Devereux Richard B.
Published: May 2006

OBJECTIVE—Diabetes has been defined as a coronary heart disease (CHD) risk equivalent, and more aggressive treatment goals have been proposed for diabetic patients.

RESEARCH DESIGN AND METHODS—We studied the influence of single and multiple risk factors on the 10-year cumulative incidence of fatal and nonfatal CHD and cardiovascular disease (CVD) in diabetic and nondiabetic men and women, with and without baseline CHD or CVD, in a population (n = 4,549) with a high prevalence of diabetes.

RESULTS—In both sexes, diabetes increased the risk for CHD (hazard ratio 1.99 and 2.93 for men and women, respectively). Diabetic men and women had a 10-year cumulative incidence of CHD of 25.9 and 19.1%, respectively, compared with 57.4 and 58.4% for nondiabetic men and women with previous CHD. The pattern was similar when only fatal events were considered. Diabetic individuals with one or two risk factors had a 10-year cumulative incidence of CHD that was only 1.4 times higher than that of nondiabetic individuals (14%). However, the 10-year incidence of CHD in diabetic subjects with multiple risk factors was >40%, and the incidence of fatal CHD was higher in these subjects than in nondiabetic subjects with previous CHD. Data for CVD showed similar patterns, as did separate analyses by sex.

CONCLUSIONS—Our results and comparisons with other available data show wide variation in the rate of CHD in diabetes, depending on the population and existing risk factors. Most individuals had a 10-year cumulative incidence >20%, but only those with multiple risk factors had a 10-year cumulative incidence that was equivalent to that of patients with CHD. Until more data are available, it may be prudent to consider targets based on the entire risk factor profile rather than just the presence of diabetes.
Coffee, Caffeine, and Risk of Type 2 Diabetes
Authors: van Dam Rob M. , Willett Walter C. , Manson JoAnn E. , Hu Frank B.
Published: May 2006

OBJECTIVE—High habitual coffee consumption has been associated with a lower risk of type 2 diabetes, but data on lower levels of consumption and on different types of coffee are sparse.

RESEARCH DESIGN AND METHODS—This is a prospective cohort study including 88,259 U.S. women of the Nurses’ Health Study II aged 26–46 years without history of diabetes at baseline. Consumption of coffee and other caffeine-containing foods and drinks was assessed in 1991, 1995, and 1999. We documented 1,263 incident cases of confirmed type 2 diabetes between 1991 and 2001.

RESULTS—After adjustment for potential confounders, the relative risk of type 2 diabetes was 0.87 (95% CI 0.73–1.03) for one cup per day, 0.58 (0.49–0.68) for two to three cups per day, and 0.53 (0.41–0.68) for four or more cups per day compared with nondrinkers (P for trend <0.0001). Associations were similar for caffeinated (0.87 [0.83–0.91] for a one-cup increment per day) and decaffeinated (0.81 [0.73–0.90]) coffee and for filtered (0.86 [0.82–0.90]) and instant (0.83 [0.74–0.93]) coffee. Tea consumption was not substantially associated with risk of type 2 diabetes (0.88 [0.64–1.23] for four or more versus no cups per day; P for trend = 0.81).

CONCLUSIONS—These results suggest that moderate consumption of both caffeinated and decaffeinated coffee may lower risk of type 2 diabetes in younger and middle-aged women. Coffee constituents other than caffeine may affect the development of type 2 diabetes.
Gestational Diabetes Identifies Women at Risk for Permanent Type 1 and Type 2 Diabetes in Fertile Age
Authors: Järvelä Ilkka Y. , Juutinen Jaana , Koskela Pentti , Hartikainen Anna-Liisa , Kulmala Petri , Knip Mikael , Tapanainen Juha S.
Published: May 2006

OBJECTIVE—Our aim was to evaluate the predictive value of gestational diabetes mellitus (GDM), diabetes-associated autoantibodies, and other factors for development of clinical diabetes later in life.

RESEARCH DESIGN AND METHODS—In this case-control study the presence of autoantibodies was studied in 435 women with GDM and in healthy matched control subjects. The need for exogenous insulin during GDM was recorded. In the GDM group, the mean follow-up period was 5.7 years and in the control group 6.1 years.

RESULTS—Among the subjects with GDM, 20 (4.6%) developed type 1 diabetes and 23 (5.3%) developed type 2 diabetes, whereas none of the control subjects became diabetic. Two-thirds of those who developed type 1 diabetes tested positive initially for islet cell antibodies (ICAs), whereas 56% of them had autoantibodies to GAD (GADAs) and 38% to the protein tyrosine phosphatase–related IA-2 molecule. Only 2 of the 23 women who presented later with type 2 diabetes tested positive for autoantibodies. According to multivariate analysis, initial age ≤30 years, the need for insulin treatment for GDM, and antibody positivity for ICAs and GADAs were associated with increased risk for clinical type 1 diabetes.

CONCLUSIONS—Pregnancy seems to identify women who are at risk of developing diabetes later in life. About 10% of Finnish women with GDM will develop diabetes over the next 6 years; nearly half of them develop type 1 diabetes and the other half type 2 diabetes. Age ≤30 years, the need for insulin treatment during pregnancy, and positivity for ICAs and GADAs confer a high risk of subsequent progression to type 1 diabetes in women affected by GDM.
Is Self-Efficacy Associated With Diabetes Self-Management Across Race/Ethnicity and Health Literacy?
Authors: Sarkar Urmimala , Fisher Lawrence , Schillinger Dean
Published: May 2006

OBJECTIVE—Although prior research demonstrated that improving diabetes self-efficacy can improve self-management behavior, little is known about the applicability of this research across race/ethnicity and health literacy levels. We examined the relationship between diabetes self-efficacy and self-management behavior in an urban, diverse, low-income population with a high prevalence of limited health literacy.

RESEARCH DESIGN AND METHODS—We administered an oral questionnaire in Spanish and English to patients with type 2 diabetes at two primary care clinics at a public hospital. We measured self-efficacy, health literacy, and self-management behaviors using established instruments. We performed multivariate regressions to explore the associations between self-efficacy and self-management, adjusting for clinical and demographic factors. We tested for interactions between self-efficacy, race/ethnicity, and health literacy on self-management.

RESULTS—The study participants were ethnically diverse (18% Asian/Pacific Islander, 25% African American, 42% Latino/a, and 15% white), and 52% had limited health literacy (short version of the Test of Functional Health Literacy in Adults score <23). Diabetes self-efficacy was associated with four of the five self-management domains (P < 0.01). After adjustment, with each 10% increase in self-efficacy score, patients were more likely to report optimal diet (0.14 day more per week), exercise (0.09 day more per week), self-monitoring of blood glucose (odds ratio 1.16), and foot care (1.22), but not medication adherence (1.10, P = 0.40). The associations between self-efficacy and self-management were consistent across race/ethnicity and health literacy levels.

CONCLUSIONS—Self-efficacy was associated with self-management behaviors in this vulnerable population, across both race/ethnicity and health literacy levels. However, the magnitude of the associations suggests that, among diverse populations, further study of the determinants of and barriers to self-management is warranted. Policy efforts should be focused on expanding the reach of self-management interventions to include ethnically diverse populations across the spectrum of health literacy.
Choice of Antibody Immunotherapy Influences Cytomegalovirus Viremia in Simultaneous Pancreas-Kidney Transplant Recipients
Authors: Huurman Volkert A.L. , Kalpoe Jayant S. , van de Linde Pieter , Vaessen Norbert , Ringers Jan , Kroes Aloys C.M. , Roep Bart O. , De Fijter Johan W.
Published: May 2006

OBJECTIVE—Simultaneous pancreas-kidney (SPK) transplantation in type 1 diabetic patients requires immunotherapy against allo- and autoreactive T-cells. Cytomegalovirus (CMV) infection is a major cause for morbidity after transplantation and is possibly related to recurrent autoimmunity. In this study, we assessed the pattern of CMV viremia in SPK transplant recipients receiving either antithymocyte globulin (ATG) or anti-CD25 (daclizumab) immunosuppressive induction therapy.

RESEARCH DESIGN AND METHODS—We evaluated 36 SPK transplant recipients from a randomized cohort that received either ATG or daclizumab as induction therapy. Patients at risk for CMV infection received oral prophylactic ganciclovir therapy. The CMV DNA level in plasma was measured for at least 180 days using a quantitative real-time PCR. Recipient peripheral blood mononuclear cells were cross-sectionally HLA tetramer-stained for CMV-specific CD8+ T-cells.

RESULTS—Positive CMV serostatus in donors was correlated with a higher incidence of CMV viremia than negative serostatus. In patients at risk, daclizumab induction therapy significantly prolonged CMV-free survival. CMV viremia occurred earlier and was more severe in patients with rejection episodes than in patients without rejection episodes. CMV-specific CD8+ T-cell counts were significantly lower in patients developing CMV viremia than in those who did not.

CONCLUSIONS—Despite their comparable immunosuppressive potential, daclizumab is safer than ATG regarding CMV infection risk in SPK transplantation. ATG-treated rejection episodes are associated with earlier and more severe infection. Furthermore, high CMV-specific tetramer counts reflect antiviral immunity rather than concurrent viremia because they imply low viremic activity. These findings may prove valuable in the discussion on both safety of induction therapy and recurrent autoimmunity in SPK and islet transplantation.
The Real Impact of the Alabama Supreme Court Decision in LePage v Center for Reproductive Medicine
Authors: Bayefsky Michelle J. , Caplan Arthur L. , Quinn Gwendolyn P.
Published: March 2024

This Viewpoint breaks down the myriad ways the Alabama Supreme Court decision to declare frozen embryos as legal equivalents to children harms the health of mothers and fetuses, limits reproductive decision-making based on genetics and out-of-reach costs, and impedes research.
Clinical Outcomes of Rapid Respiratory Virus Testing in Emergency Departments
Authors: Schober Tilmann , Wong Kimberly , DeLisle Gaëlle , Caya Chelsea , Brendish Nathan J. , Clark Tristan W. , Dendukuri Nandini , Doan Quynh , Fontela Patricia S. , Gore Genevieve C. , Li Patricia , McGeer Allison J. , Noël Kim Chloe , Robinson Joan L. , Suarthana Eva , Papenburg Jesse
Published: March 2024

Importance

Rapid tests for respiratory viruses, including multiplex panels, are increasingly available in emergency departments (EDs). Their association with patient outcomes remains unclear.

Objective

To determine if ED rapid respiratory virus testing in patients with suspected acute respiratory infection (ARI) was associated with decreased antibiotic use, ancillary tests, ED length of stay, and ED return visits and hospitalization and increased influenza antiviral treatment.

Data Sources

Ovid MEDLINE, Embase (Ovid), Scopus, and Web of Science from 1985 to November 14, 2022.

Study Selection

Randomized clinical trials of patients of any age with ARI in an ED. The primary intervention was rapid viral testing.

Data Extraction and Synthesis

Preferred Reporting Items for Systematic Reviews and Meta-Analyses reporting guidelines were followed. Two independent reviewers (T.S. and K.W.) extracted data and assessed risk of bias using the Cochrane Risk of Bias, version 2.0. Estimates were pooled using random-effects models. Quality of evidence was assessed using the Grading of Recommendations, Assessment, Development, and Evaluations framework.

Main Outcomes and Measures

Antibiotic use and secondary outcomes were pooled separately as risk ratios (RRs) and risk difference estimates with 95% CIs.

Results

Of 7157 studies identified, 11 (0.2%; n = 6068 patients) were included in pooled analyses. Routine rapid viral testing was not associated with antibiotic use (RR, 0.99; 95% CI, 0.93-1.05; high certainty) but was associated with higher use of influenza antivirals (RR, 1.33; 95% CI, 1.02-1.75; moderate certainty) and lower use of chest radiography (RR, 0.88; 95% CI, 0.79-0.98; moderate certainty) and blood tests (RR, 0.81; 95% CI, 0.69-0.97; moderate certainty). There was no association with urine testing (RR, 0.95; 95% CI, 0.77-1.17; low certainty), ED length of stay (0 hours; 95% CI, −0.17 to 0.16; moderate certainty), return visits (RR, 0.93; 95%, CI 0.79-1.08; moderate certainty) or hospitalization (RR, 1.01; 95% CI, 0.95-1.08; high certainty). Adults represented 963 participants (16%). There was no association of viral testing with antibiotic use in any prespecified subgroup by age, test method, publication date, number of viral targets, risk of bias, or industry funding.

Conclusions and Relevance

The results of this systematic review and meta-analysis suggest that there are limited benefits of routine viral testing in EDs for patients with ARI. Further studies in adults, especially those with high-risk conditions, are warranted.
Use of SGLT2 Inhibitors vs GLP-1 RAs and Anemia in Patients With Diabetes and CKD
Authors: Hu Jia-Chian , Shao Shih-Chieh , Tsai Daniel Hsiang-Te , Chuang Albert Tzu-Ming , Liu Kuan-Hung , Lai Edward Chia-Cheng
Published: March 2024

Importance

Sodium-glucose cotransporter 2 (SGLT2) inhibitors are associated with lower anemia risk, based on findings from post hoc analyses of the CREDENCE and DAPA-CKD trials; however, the effectiveness of SGLT2 inhibitors in a more generalizable type 2 diabetes (T2D) and chronic kidney disease (CKD) population, with active comparisons pertinent to current practice, is unknown.

Objective

To evaluate and compare anemia incidence between SGLT2 inhibitors and glucagon-like peptide-1 receptor agonists (GLP-1 RAs) among patients with T2D and CKD stages 1 to 3.

Design, Setting, and Participants

This retrospective cohort study used target trial emulation of an expanded CREDENCE and DAPA-CKD study framework. The study was conducted among adults with T2D and CKD initiating SGLT2 inhibitors or GLP-1 RAs between January 1, 2016, and December 31, 2021, with follow-up until December 31, 2022. The study was conducted at the Chang Gung Medical Foundation, the largest multi-institutional hospital system in Taiwan.

Exposures

Initiation of SGLT2 inhibitors or GLP-1 RAs.

Main Outcomes and Measures

The primary outcome was a composite of anemia outcomes, including anemia event occurrence (hemoglobin level <12-13 g/dL or International Statistical Classification of Diseases, Tenth Revision, Clinical Modification diagnosis codes) or anemia treatment initiation. Changes in hematological parameters, including hemoglobin level, hematocrit level, and red blood cell count, were evaluated during the follow-up period for as long as 3 years.

Results

The cohort included a total of 13 799 patients with T2D and CKD, initiating SGLT2 inhibitors (12 331 patients; mean [SD] age, 62.4 [12.3] years; 7548 [61.2%] male) or GLP-1 RAs (1468 patients; mean [SD] age, 61.5 [13.3] years; 900 [61.3%] male). After the median follow-up period of 2.5 years, patients receiving SGLT2 inhibitors had lower incidence of composite anemia outcomes (hazard ratio [HR], 0.81; 95% CI, 0.73-0.90) compared with those receiving GLP-1 RAs. SGLT2 inhibitors were associated with a lower incidence of anemia events (HR, 0.79; 95% CI, 0.71-0.87) but not with a lower rate of anemia treatment initiation (HR, 0.99; 95% CI, 0.83-1.19). Changes in hematological parameters for SGLT2 inhibitors and GLP-1 RAs throughout the 3-year follow-up period supported the primary analyses.

Conclusions and Relevance

In this multi-institutional cohort study with target trial emulation, SGLT2 inhibitors were associated with a decreased risk of composite anemia outcomes, especially anemia event occurrences. SGLT2 inhibitors may be considered as an adjunct therapy to reduce anemia incidence in patients with T2D and CKD.
Hydrophilic‐Zincophobic Separator Enabling by Crystal Structure Regulation toward Stabilized Zn Metal Anode
Authors: Lv Shujun , Su Mingyu , Li Zhuo , Mao Yiyang , Yin Jinling , cao Dianxue , Wang Guiling , Yi Jin , Ning Fanghua , Zhu Kai
Published: March 2024

Aqueous zinc‐ion batteries (ZIBs) hold significant promise for large‐scale energy storage. While considerable strides have been made in modifying separators, the challenge of developing dendrite‐free, corrosion‐resistant, and cost‐effective separators for achieving extended cycling performance of Zn anodes persists. In light of this, a TiO2 coating separator to mitigate interfacial corrosion and passivation reactions, thereby facilitating high‐performance ZIBs is designed. This study delves into the influence of the loading amount and crystal phase of the TiO2 coating layers on separator modification. Zn symmetric cells employing the anatase TiO2‐modified glass fiber (A‐TiO2@GF) separator demonstrate superior Zn2+ ion transport kinetics in a mild ZnSO4 electrolyte, ensuring sustained long‐term stability and uniform Zn deposition. Furthermore, the reduced hydrogen evolution reaction (HER) activity of A‐TiO2 coatings curbs H+ ion migration, minimizing interfacial corrosion and HER. Consequently, the assembled Zn||CaV8O20 zinc‐ion full cells demonstrate outstanding long‐term durability and impressive specific capacity, boasting a discharge capacity of 142 mAh g−1 after 1000 cycles. This work introduces a straightforward interface engineering strategy for creating efficient separators in zinc‐ion batteries, promoting uniform Zn deposition.
Time‐Dependent Information Encryption in Liquid Crystalline Polymer with Programmable Glass Transition Temperature
Authors: Zhang Jianying , Song Chenjie , Zhang Shuoning , Qin Shengyu , Ren Yunxiao , Zhang Lanying , Xiao Jiumei , Li Kexuan , Hu Wei , Yang Huai
Published: March 2024

Time‐dependent dynamic information encryption technology is a promising approach to enhancing the security and complexity of information transmission. Herein, a time‐dependent information encryption model from a liquid crystalline polymer (LCP) film with a programmable glass transition temperature (Tg) and gradually adjustable fluorescence is demonstrated. The programmable Tg is achieved by adjusting the degree of order of the LC molecules via a configuration interconversion of spiropyran‐based materials (SPBMs), which can convert between a V‐shaped colorless spiro (SP) and a rodlike dark‐colored merocyanine (MC) form. An LCP film obtained by visible light polymerization exhibits a lower Tg than UV light, because the SPBM molecules keep different configurations in the two films. By adjusting the ratio of two isomerization forms of SPBM molecules during the polymerization process, the Tg values of LCP films can change from 11.6 °C to 31.1 °C. Based on the isomerization rate of SPBM in the LCP films with different Tg, time‐dependent information encryption is successfully achieved.
Copper(I)‐Arsine Clusters with a Near‐Unity Phosphorescence Quantum Yield for X‐Ray Scintillation and LED Applications
Authors: Demyanov Yan V. , Ma Zihao , Jia Zhenglin , Rakhmanova Marianna I. , Carignan Gia M. , Bagryanskaya Irina Yu. , Sulyaeva Veronika S. , Globa Anastasiya A. , Brel Valery K. , Meng Lingqiang , Meng Hong , Lin Qianqian , Li Jing , Artemev Alexander V.
Published: March 2024

Rare‐earth element‐free materials that exhibit strong room temperature phosphorescence (RTP) and X‐ray scintillation properties are gaining global interest incessantly in the recent years. This work reports a series of easily synthesizable cubane Cu4I4‐triarsenic clusters [Cu4I4(R3As)3L] (L = none or nitrile), that exhibit a strong yellow‐green RTP with quantum efficiencies up to 100% and short decay times (4.4–4.9 µs). The title cluster complexes display X‐ray scintillation properties with a record ultralow detection limit (18.1 nGy s−1) and a perfectly linear dose rate response within a remarkably wide dose rate window (0–640 µGyair s−1). The cluster [Cu4I4(Ph3As)3] is highlighted as an efficient phosphor for UV‐pumped white and yellow LED devices, demonstrating an excellent white spectrum with a CIE index of (0.32,0.33) and bright yellow emission, respectively. These results may stimulate the future efforts in designing highly efficient arsenic‐based RTP materials and enriching the Cu4I4 cluster family.
Review on high‐performance polymeric bipolar membrane design and novel electrochemical applications
Authors: Yan Junying , Yu Weisheng , Wang Zihao , Wu Liang , Wang Yaoming , Xu Tongwen
Published: March 2024

Electrochemical devices allow the conversion and storage of renewable energy into high‐value chemicals to mitigate carbon emissions, such as hydrogen production by water electrolysis, carbon dioxide reduction, and the electrochemical synthesis of ammonia. Independent regulation of the electrode pH environment is essential for optimizing the electrode reaction kinetics and enriching the catalyst species. The in situ water dissociation (WD, ) in bipolar membranes (BPMs) offers the possibility of realizing this pH adjustment. Here, the design principles of high‐performance polymeric BPMs in electrochemical device applications are presented by analyzing and connecting WD principles and current–voltage curves. The structure–transport property relationships and membrane durability, including the chemical and mechanical stability of the anion‐ and cation‐exchange layers as well as the integrality of the interfacial junction, are systematically discussed. The advantages of BPMs in new electrochemical devices and major challenges to break through are also highlighted. The improved ion and water transport in the membrane layer and the minimized WD overpotential and ohmic loss at high current densities are expected to facilitate the promotion of BPMs from conventional chemical production to novel electrochemical applications.