bluuebunny/crossref_metadata_2025 huggingface dataset:
Hypoadiponectinemia and Proinflammatory State: Two Sides of the Same Coin?
Authors: Herder Christian , Hauner Hans , Haastert Burkhard , Röhrig Karin , Koenig Wolfgang , Kolb Hubert , Müller-Scholze Sylvia , Thorand Barbara , Holle Rolf , Rathmann Wolfgang
Published: June 2006

OBJECTIVE—Previous studies have yielded conflicting results on the association of adiponectin levels and inflammation. Low systemic concentrations of adiponectin, as well as elevated levels of immune mediators, represent risk factors for the development of type 2 diabetes and coronary artery disease. The major aim of this cross-sectional study was to investigate the interdependence of hypoadiponectinemia and low-grade systemic inflammation.

RESEARCH DESIGN AND METHODS—The study sample consisted of 606 participants aged 55–74 years (244 with normal glucose tolerance, 242 with impaired glucose tolerance, and 120 with newly diagnosed type 2 diabetes) of the population-based KORA S4 (Cooperative Health Research in the Region of Augsburg Survey 4; 1999–2001). Systemic concentrations of adiponectin and a wide range of anthropometric, metabolic, and inflammatory variables were available for analyses. The association of adiponectin with 15 immunological markers, including leukocyte count, acute-phase proteins, cytokines, cytokine receptors, and chemokines, was assessed using univariable and multivariable models.

RESULTS—No evidence for a significant correlation between adiponectin and all immunological parameters except eotaxin could be found after multivariable adjustments, whereas multiple strong correlations with obesity and metabolic factors were present.

CONCLUSIONS—From these data, we conclude that hypoadiponectinemia and a proinflammatory state are largely independent from each other.
A Systematic Review of Interventions to Improve Diabetes Care in Socially Disadvantaged Populations
Authors: Glazier Richard H. , Bajcar Jana , Kennie Natalie R. , Willson Kristie
Published: June 2006

OBJECTIVE—To identify and synthesize evidence about the effectiveness of patient, provider, and health system interventions to improve diabetes care among socially disadvantaged populations.

RESEARCH DESIGN AND METHODS—Studies that were included targeted interventions toward socially disadvantaged adults with type 1 or type 2 diabetes; were conducted in industrialized countries; were measured outcomes of self-management, provider management, or clinical outcomes; and were randomized controlled trials, controlled trials, or before-and-after studies with a contemporaneous control group. Seven databases were searched for articles published in any language between January 1986 and December 2004. Twenty-six intervention features were identified and analyzed in terms of their association with successful or unsuccessful interventions.

RESULTS—Eleven of 17 studies that met inclusion criteria had positive results. Features that appeared to have the most consistent positive effects included cultural tailoring of the intervention, community educators or lay people leading the intervention, one-on-one interventions with individualized assessment and reassessment, incorporating treatment algorithms, focusing on behavior-related tasks, providing feedback, and high-intensity interventions (>10 contact times) delivered over a long duration (≥6 months). Interventions that were consistently associated with the largest negative outcomes included those that used mainly didactic teaching or that focused only on diabetes knowledge.

CONCLUSIONS—This systematic review provides evidence for the effectiveness of interventions to improve diabetes care among socially disadvantaged populations and identifies key intervention features that may predict success. These types of interventions would require additional resources for needs assessment, leader training, community and family outreach, and follow-up.
Hypoadiponectinemia Is Associated With Progression Toward Type 2 Diabetes and Genetic Variation in the ADIPOQ Gene Promoter
Authors: Schwarz Peter E.H. , Towers Gordon W. , Fischer Sabine , Govindarajalu Suresh , Schulze Jan , Bornstein Stephan R. , Hanefeld Markolf , Vasseur Francis
Published: June 2006

OBJECTIVE—Adiponectin encoded by the ADIPOQ gene modulates insulin sensitivity and glucose homeostasis. The aim of the current study was to investigate whether ADIPOQ gene variants in the promoter region predict adiponectin levels and type 2 diabetes progression.

RESEARCH DESIGN AND METHODS—A total of 550 subjects with increased risk of type 2 diabetes were investigated; they underwent a 75-g oral glucose tolerance test, repeated after 3 years. Adiponectin levels were analyzed, and two ADIPOQ promoter variant single nucleotide polymorphisms, −11391G>A and −11377C>G, were genotyped.

RESULTS—Tertiles of the adjusted adiponectin levels were associated with single nucleotide polymorphism −11391G>A and −11377C>G haplotypes (P < 0.0001). Carriers of the intermediate/high-level haplotype combination showed a bisected diabetes risk at the 3-year follow-up and were characterized by a “regression” of glucose tolerance. Evolution of disease status correlates with preexisting low adiponectin levels at inclusion rather than with variation in adiponectin levels.

CONCLUSIONS—We present data that gene variants in the ADIPOQ promoter region are associated with variations in adiponectin levels and thus with future type 2 diabetes and disease progression.
The Prevalence, Severity, and Impact of Painful Diabetic Peripheral Neuropathy in Type 2 Diabetes
Authors: Davies Mark , Brophy Sinead , Williams Rhys , Taylor Ann
Published: June 2006

OBJECTIVE—To determine the prevalence of painful diabetic peripheral neuropathy (PDPN) in a population-based sample and to estimate its severity and impact.

RESEARCH DESIGN AND METHODS—A cross-sectional descriptive study consisting of two phases: phase 1, a postal survey to patients with type 2 diabetes (an initial screening questionnaire including one question about pain); phase 2, neurological history and examination using the Toronto Clinical Scoring System. Subjects with PDPN or mixed (PDPN and nonneuropathic) pain completed the Neuropathic Pain Scale and Neuroqol to assess severity and nature of the pain and impact on quality of life. Those without PDPN completed the Neuroqol only.

RESULTS—In phase 1, there was a 92.7% response (n = 326), with 208 (63.8%) subjects reporting pain. In phase 2, 269 (82.5%) subjects attended and 51 (19.0%) were found to have PDPN: 99 (36.8%) nonneuropathic pain, 20 (7.4%) mixed pain, and 99 (36.8%) no pain (PDPN prevalence 26.4%). Of those with PDPN, 80% stated that their pain was moderate or severe. Those affected had poorer quality of life than those with no pain (difference in mean scores 3.6 [95% CI 2.5–4.6%]) compared with those with nonneuropathic pain (1.7 [0.4–2.9%]). Both pain and neuropathy score were independently associated with quality of life, and subjects with PDPN had significantly higher neuropathy scores.

CONCLUSIONS—Our study showed a prevalence of PDPN of 26.4%. Having PDPN has a significant negative effect on quality of life, and increasing neuropathy is associated with an increasing risk of developing PDPN.
Continuous Glucose Monitoring–Guided Insulin Adjustment in Children and Adolescents on Near-Physiological Insulin Regimens
Authors: Yates Kylie , Hasnat Milton Abul , Dear Keith , Ambler Geoffrey
Published: June 2006

OBJECTIVE—This randomized controlled trial assesses the effect on glycemic control of continuous glucose monitoring system (CGMS)-guided insulin therapy adjustment in young people with type 1 diabetes on intensive diabetes treatment regimens with continuous subcutaneous insulin infusion (CSII) or glargine.

RESEARCH DESIGN AND METHODS—Pediatric subjects were recruited if they had an HbA1c (A1C) <10% and had been on CSII or glargine for at least 3 months. Thirty-six subjects were randomized to insulin adjustment on the basis of 72 h of CGMS every 3 weeks or intermittent self-monitoring of blood glucose (SMBG) for 3 months. A1C and fructosamine were measured at baseline and 6 and 12 weeks. Follow-up A1C was measured at 6 months. Mean baseline A1C was 8.2% (n = 19) in the CGMS group and 7.9% (n = 17) in the control group.

RESULTS—There was a significant improvement in A1C from baseline values in both groups, but there was no difference in the degree of improvement in A1C at 12 weeks between the CGMS (−0.4% [95% CI −0.7 to −0.1]) and the control group (−0.4% [−0.8 to 0.2]). In the CGMS group, improved A1C was at the cost of increased duration of hypoglycemia.

CONCLUSIONS—CGMS is no more useful than intermittent fingerstick SMBG and frequent review in improving diabetes control in reasonably well-controlled patients on near-physiological insulin regimens when used in an outpatient clinic setting.
Long-Term Clinical Effects of Epalrestat, an Aldose Reductase Inhibitor, on Diabetic Peripheral Neuropathy
Authors: Hotta Nigishi , Akanuma Yasuo , Kawamori Ryuzo , Matsuoka Kempei , Oka Yoshitomo , Shichiri Motoaki , Toyota Takayoshi , Nakashima Mitsuyoshi , Yoshimura Isao , Sakamoto Nobuo , Shigeta Yukio ,   the ADCT Study Group
Published: June 2006

OBJECTIVE—We sought to evaluate the long-term efficacy and safety of epalrestat, an aldose reductase inhibitor, on diabetic peripheral neuropathy.

RESEARCH DESIGN AND METHODS—Subjects with diabetic neuropathy, median motor nerve conduction velocity (MNCV) ≥40 m/s, and HbA1c ≤9% were enrolled in this open-label, multicenter study and randomized to 150 mg/day epalrestat or a control group. After excluding the withdrawals, 289 (epalrestat group) and 305 (control group) patients were included in the analyses. The primary end point was change from baseline in median MNCV at 3 years. Secondary end points included assessment of other somatic nerve function parameters (minimum F-wave latency [MFWL] of the median motor nerve and vibration perception threshold [VPT]), cardiovascular autonomic nerve function, and subjective symptoms.

RESULTS—Over the 3-year period, epalrestat prevented the deterioration of median MNCV, MFWL, and VPT seen in the control group. The between-group difference in change from baseline in median MNCV was 1.6 m/s (P < 0.001). Although a benefit with epalrestat was observed in cardiovascular autonomic nerve function variables, this did not reach statistical significance compared with the control group. Numbness of limbs, sensory abnormality, and cramping improved significantly with epalrestat versus the control group. The effects of epalrestat on median MNCV were most evident in subjects with better glycemic control and with no or mild microangiopathies.

CONCLUSIONS—Long-term treatment with epalrestat is well tolerated and can effectively delay the progression of diabetic neuropathy and ameliorate the associated symptoms of the disease, particularly in subjects with good glycemic control and limited microangiopathy.
Effect of Peroxisome Proliferator–Activated Receptor γ Agonist Treatment on Subclinical Atherosclerosis in Patients With Insulin-Requiring Type 2 Diabetes
Authors: Hodis Howard N. , Mack Wendy J. , Zheng Ling , Li Yanjie , Torres Mina , Sevilla Diego , Stewart Yolanda , Hollen Barbara , Garcia Karla , Alaupovic Petar , Buchanan Thomas A.
Published: June 2006

OBJECTIVE—To determine the effect of thiazolidinedione treatment on subclinical atherosclerosis progression in insulin-requiring patients with clinical characteristics suggesting type 2 diabetes.

RESEARCH DESIGN AND METHODS—Eligible participants (n = 299) were randomized within strata of baseline common carotid artery (CCA) intima-media thickness (IMT) (<0.8 mm, ≥0.8 mm) to 400 mg troglitazone daily or placebo for 2 years. A general linear mixed-effects model was used to compare the rate of change in CCA-IMT between treatment groups.

RESULTS—Overall, average rates of CCA-IMT change were not significantly different between troglitazone- and placebo-treated subjects (0.0030 ± 0.021 vs. 0.0066 ± 0.021 mm/year; P = 0.17). In the stratum of subjects with CCA-IMT ≥0.8 mm, troglitazone significantly reduced the progression of CCA-IMT relative to placebo (0.0013 ± 0.022 vs. 0.0084 ± 0.023 mm/year; P = 0.03). Fasting glucose, insulin, and HbA1c were significantly lower in troglitazone- versus placebo-treated subjects (P < 0.01). Whereas blood pressure significantly differed between treatment groups in the ≥0.8-mm stratum, there was no difference between treatment groups in the <0.8-mm stratum.

CONCLUSIONS—Insulin sensitization and reduction in blood pressure may be contributory mechanisms by which troglitazone reduced subclinical atherosclerosis progression in this cohort of well-controlled insulin-dependent patients with clinical characteristics suggesting type 2 diabetes.
Combined Treatment With Exercise Training and Acarbose Improves Metabolic Control and Cardiovascular Risk Factor Profile in Subjects With Mild Type 2 Diabetes
Authors: Wagner Henrik , Degerblad Marie , Thorell Anders , Nygren Jonas , Ståhle Agneta , Kuhl Jeanette , Brismar Torkel B. , Öhrvik John , Efendic Suad , Båvenholm Peter N.
Published: June 2006

OBJECTIVE—The effect of exercise training and acarbose on glycemic control, insulin sensitivity, and phenotype was investigated in mild type 2 diabetes.

RESEARCH DESIGN AND METHODS—Sixty-two men and women with type 2 diabetes were randomized to 12 weeks of structured exercise training with or without acarbose treatment or to acarbose alone. Glycemic control was determined by HbA1c (A1C), insulin sensitivity (M value) by euglycemic-hyperinsulinemic clamp, and regional fat distribution by computerized tomography and dual X-ray absorptiometry. Physical fitness was determined as maximal oxygen uptake (Vo2max). All investigations were performed before and after the intervention.

RESULTS—Forty-eight subjects completed the study. Exercise improved M value by 92% (P = 0.017) and decreased total and truncal fat (P = 0.002, 0.001) and systolic blood pressure (P = 0.01) but had no significant effect on Vo2max or A1C level. The combination of exercise and acarbose significantly decreased fasting plasma glucose, A1C, lipids, and diastolic blood pressure and increased Vo2max, whereas effects on M value and body composition were comparable with that of exercise alone. Acarbose alone had no significant effect on either M value or A1C but decreased systolic (P = 0.001) and diastolic blood pressure (P = 0.001) and fasting proinsulin level (P = 0.009). Multiple regression analysis showed that addition of acarbose to exercise improved glycemic control.

CONCLUSIONS—In subjects with mild type 2 diabetes, exercise training improved insulin sensitivity but had no effect on glycemic control. The addition of acarbose to exercise, however, was associated with significant improvement of glycemic control and possibly cardiovascular risk factors.
Use of HbA1c in Predicting Progression to Diabetes in French Men and Women
Authors: Droumaguet Celine , Balkau Beverley , Simon Dominique , Caces Emile , Tichet Jean , Charles Marie Aline , Eschwege Eveline ,   the DESIR Study Group
Published: June 2006

OBJECTIVE—Early identification of subjects at high risk for diabetes is essential, and random HbA1c (A1C) may be more practical than fasting plasma glucose (FPG). The predictive value of A1C, in comparison to FPG, is evaluated for 6-year incident diabetes.

RESEARCH DESIGN AND METHODS—From the French cohort study Data from an Epidemiological Study on the Insulin Resistance Syndrome (DESIR), 1,383 men and 1,437 women, aged 30–65 years, were volunteers for a routine health check-up. Incident diabetes was defined by FPG ≥7.0 mmol/l or treatment by antidiabetic drugs. Multivariate logistic regression models were used to predict diabetes at 6 years. Receiver operating characteristic curves compared the predictive values of A1C and FPG.

RESULTS—At 6 years, 30 women (2.1%) and 60 men (4.3%) had developed diabetes. Diabetes risk increased exponentially with A1C in both sexes (P < 0.001). After stratifying on FPG, A1C predicted diabetes only in subjects with impaired fasting glucose (IFG) (FPG ≥6.10 mmol/l): the odds ratio (95% CI) for a 1% increase in A1C was 7.20 (3.00–17.00). In these subjects, an A1C of 5.9% gave an optimal sensitivity of 64% and specificity of 77% to predict diabetes.

CONCLUSIONS—A1C predicted diabetes, even though the diagnosis of diabetes was based on FPG, but it was less sensitive and specific than FPG. It could be used as a test if fasting blood sampling was not available or in association with FPG. In subjects with IFG, A1C is better than glucose to evaluate diabetes risk, and it could be used to select subjects for intensive early intervention.
The Metabolic Syndrome Is Frequent in Klinefelter’s Syndrome and Is Associated With Abdominal Obesity and Hypogonadism
Authors: Bojesen Anders , Kristensen Kurt , Birkebaek Niels H. , Fedder Jens , Mosekilde Leif , Bennett Paul , Laurberg Peter , Frystyk Jan , Flyvbjerg Allan , Christiansen Jens S. , Gravholt Claus H.
Published: June 2006

OBJECTIVE—Klinefelter’s syndrome is associated with an increased prevalence of diabetes, but the pathogenesis is unknown. Accordingly, the aim of this study was to investigate measures of insulin sensitivity, the metabolic syndrome, and sex hormones in patients with Klinefelter’s syndrome and an age-matched control group.

RESEARCH DESIGN AN METHODS—In a cross-sectional study, we examined 71 patients with Klinefelter’s syndrome, of whom 35 received testosterone treatment, and 71 control subjects. Body composition was evaluated using dual-energy X-ray absorptiometry scans. Fasting blood samples were analyzed for sex hormones, plasma glucose, insulin, C-reactive protein (CRP), and adipocytokines. We analyzed differences between patients with untreated Klinefelter’s syndrome and control subjects and subsequently analyzed differences between testosterone-treated and untreated Klinefelter’s syndrome patients.

RESULTS—Of the patients with Klinefelter’s syndrome, 44% had metabolic syndrome (according to National Cholesterol Education Program/Adult Treatment Panel III criteria) compared with 10% of control subjects. Insulin sensitivity (assessed by homeostasis model assessment 2 modeling), androgen, and HDL cholesterol levels were significantly decreased, whereas total fat mass and LDL cholesterol, triglyceride, CRP, leptin, and fructosamine levels were significantly increased in untreated Klinefelter’s syndrome patients. In treated Klinefelter’s syndrome patients, LDL cholesterol and adiponectin were significantly decreased, whereas no difference in body composition was found in comparison with untreated Klinefelter’s syndrome patients. Multivariate analyses showed that truncal fat was the major determinant of metabolic syndrome and insulin sensitivity.

CONCLUSIONS—The prevalence of metabolic syndrome was greatly increased, whereas insulin sensitivity was decreased in Klinefelter’s syndrome. Both correlated with truncal obesity. Hypogonadism in Klinefelter’s syndrome may cause an unfavorable change in body composition, primarily through increased truncal fat and decreased muscle mass. Testosterone treatment in Klinefelter’s syndrome only partly corrected the unfavorable changes observed in untreated Klinefelter’s syndrome, perhaps due to insufficient testosterone doses.
Dietary Fibers and Glycemic Load, Obesity, and Plasma Adiponectin Levels in Women With Type 2 Diabetes
Authors: Qi Lu , Meigs James B. , Liu Simin , Manson JoAnn E. , Mantzoros Christos , Hu Frank B.
Published: June 2006

OBJECTIVE—The purpose of this study was to examine the associations of dietary fibers and glycemic load with plasma adiponectin in diabetic women and investigate the modification effect of obesity.

RESEARCH DESIGN AND METHODS—We conducted a cross-sectional analysis in 902 women with type 2 diabetes from the Nurses’ Health Study. Dietary information was obtained using semiquantitative food frequency questionnaires.

RESULTS—After adjustment for age, smoking, alcohol consumption, physical activity, aspirin use, HbA1c, history of hypertension and hypercholesterolemia, and postmenopausal hormone use, intakes of cereal fiber and fruit fiber (P for trend = 0.002 and 0.036, respectively) were significantly associated with an increasing trend of plasma adiponectin concentrations. Further adjustment for BMI did not appreciably change the associations for cereal fiber but attenuated the associations for fruit fiber. Adiponectin concentrations were 24% higher in the highest compared with the lowest quintile of cereal fiber. Dietary glycemic load and glycemic index were significantly associated with lower plasma adiponectin levels, after adjustment for BMI and other covariates (P for trend = 0.01 and 0.03, respectively). The percent differences in adiponectin concentration between the highest and the lowest quintiles of dietary glycemic load and glycemic index were 17 and 18%, respectively. The associations between dietary factors and plasma adiponectin were consistent across lean (BMI <25 kg/m2), overweight (25 ≤ BMI <30 kg/m2), and obese subjects (BMI ≥30 kg/m2).

CONCLUSIONS—Our data indicate that dietary cereal fiber and glycemic load/index are associated with the circulating adiponectin concentration. Such associations were not modified by obesity status.
A Prospective Study of Dairy Intake and the Risk of Type 2 Diabetes in Women
Authors: Liu Simin , Choi Hyon K. , Ford Earl , Song Yiqing , Klevak Anna , Buring Julie E. , Manson JoAnn E.
Published: June 2006

OBJECTIVE—Although studies have indicated that increased dairy intake may reduce risk of overweight and insulin resistance syndrome, data directly relating dairy intake to type 2 diabetes remain sparse.

RESEARCH DESIGN AND METHODS—We prospectively examined the associations between intake of dairy foods and calcium and incident type 2 diabetes in 37,183 women without a history of diabetes, cardiovascular disease, and/or cancer at baseline.

RESULTS—During an average of 10 years of follow-up, we documented 1,603 incident cases. After adjusting for potential confounders including BMI, smoking status, physical activity, family history of diabetes, alcohol consumption, history of hypertension, use of hormones, and high cholesterol, the relative risk for type 2 diabetes among women in the highest quintile of dairy intake was 0.79 (95% CI 0.67–0.94; P for trend = 0.007) compared with those in the lowest quintile. Each serving-per-day increase in dairy intake was associated with a 4% lower risk (0.96 [0.93–1.01]). The inverse association with type 2 diabetes appeared to be mainly attributed to low-fat dairy intake; the multivariate relative risks comparing the highest to the lowest quintiles was 0.79 (0.67–0.93; P for trend = 0.002) for low-fat dairy. The inverse relation between dairy intake and incident type 2 diabetes remained unchanged after further adjustment for dietary calcium, vitamin D, glycemic load, fat, fiber, and magnesium intake. These associations also did not vary significantly according to BMI.

CONCLUSIONS—A dietary pattern that incorporates higher low-fat dairy products may lower the risk of type 2 diabetes in middle-aged or older women.
Cerebral Blood Flow Velocity and Periventricular White Matter Hyperintensities in Type 2 Diabetes
Authors: Novak Vera , Last David , Alsop David C. , Abduljalil Amir M. , Hu Kun , Lepicovsky Lukas , Cavallerano Jerry , Lipsitz Lewis A.
Published: June 2006

OBJECTIVE—Diabetes increases the risk for cerebromicrovascular disease, possibly through its effects on blood flow regulation. The aim of this study was to assess the effects of type 2 diabetes on blood flow velocities (BFVs) in the middle cerebral arteries and to determine the relationship between white matter hyperintensities (WMHs) on magnetic resonance imaging (MRI) and BFVs.

RESEARCH DESIGN AND METHODS—We measured BFVs in 28 type 2 diabetic and 22 control subjects (aged 62.3 ± 7.2 years) using transcranial Doppler ultrasound during baseline, hyperventilation, and CO2 rebreathing. WMHs were graded, and their volume was quantified from fluid-attenuated inversion recovery images on a 3.0 Tesla MRI.

RESULTS—The diabetic group demonstrated decreased mean BFVs and increased cerebrovascular resistance during baseline, hypo- and hypercapnia (P < 0.0001), and impaired CO2 reactivity (P = 0.05). WMH volume was negatively correlated with baseline BFV (P < 0.0001). A regression model revealed that baseline BFVs were negatively associated with periventricular WMHs, HbA1c (A1C), and inflammatory markers and positively associated with systolic blood pressure (R2 = 0.86, P < 0.0001).

CONCLUSIONS—Microvascular disease in type 2 diabetes, which manifests as white matter abnormalities on MRI, is associated with reduced cerebral BFVs, increased resistance in middle cerebral arteries, and inflammation. These findings are clinically relevant as a potential mechanism for cerebrovascular disease in elderly with type 2 diabetes.
The Effect of Glucose Variability on the Risk of Microvascular Complications in Type 1 Diabetes
Authors: Kilpatrick Eric S. , Rigby Alan S. , Atkin Stephen L.
Published: June 2006

OBJECTIVE—It is not known whether glycemic instability may confer a risk of microvascular complications that is in addition to that predicted by the mean blood glucose (MBG) value alone. This study has analyzed data from the Diabetes Control and Complications Trial (DCCT) to assess the effect of glucose variability on the risk of retinopathy and nephropathy in patients with type 1 diabetes.

RESEARCH DESIGN AND METHODS—Pre- and postprandial seven-point glucose profiles were collected quarterly during the DCCT in 1,441 individuals. The mean area under the curve glucose and the SD of glucose variability within 24 h and between visits were compared with the risk of retinopathy and nephropathy, having adjusted for age, sex, disease duration, treatment group, prevention cohort, and phase of treatment.

RESULTS—Multivariate Cox regression showed that within-day and between-day variability in blood glucose around a patient’s mean value has no influence on the development or progression of either retinopathy (P = 0.18 and P = 0.72, respectively) or nephropathy (P = 0.32 and P = 0.57). Neither preprandial (P = 0.18) nor postprandial (P = 0.31) glucose concentrations preferentially contribute to the probability of retinopathy.

CONCLUSIONS—This study has shown that blood glucose variability does not appear to be an additional factor in the development of microvascular complications. Also, pre- and postprandial glucose values are equally predictive of the small-vessel complications of type 1 diabetes.
Hyperinsulinemic Hypoglycemia After Gastric Bypass Surgery Is Not Accompanied by Islet Hyperplasia or Increased β-Cell Turnover
Authors: Meier Juris J. , Butler Alexandra E. , Galasso Ryan , Butler Peter C.
Published: June 2006

OBJECTIVE—The purpose of this study was to establish whether hypoglycemia after gastric bypass surgery (GBS) for morbid obesity is due to increased fractional β-cell area or inappropriately increased insulin secretion.

RESEARCH DESIGN AND METHODS—We examined pancreata obtained at partial pancreatectomy from 6 patients with post-GBS hypoglycemia and compared these with 31 pancreata from obese subjects and 16 pancreata from lean control subjects obtained at autopsy. We addressed the following questions. In patients with post-GBS hypoglycemia, is β-cell area increased and is β-cell formation increased or β-cell apoptosis decreased?

RESULTS—We report that in patients with post-GBS hypoglycemia, β-cell area was not increased compared with that in obese or even lean control subjects. Consistent with this finding, there was no evidence of increased β-cell formation (islet neogenesis and β-cell replication) or decreased β-cell loss in patients with post-GBS hypoglycemia. In control subjects, mean β-cell nuclear diameter correlated with BMI (r2 = 0.79, P < 0.001). In patients with post-GBS hypoglycemia, β-cell nuclear diameter was increased (P < 0.001) compared with that for BMI in matched control subjects but was appropriate for BMI before surgery.

CONCLUSIONS—We conclude that post-GBS hypoglycemia is not due to increases in β-cell mass or formation. Rather, postprandial hypoglycemia after GBS is due to a combination of gastric dumping and inappropriately increased insulin secretion, either as a failure to adaptively decrease insulin secretion after GBS or as an acquired phenomenon.
Physical Activity, Cardiovascular Fitness, and Insulin Sensitivity Among U.S. Adolescents
Authors: Imperatore Giuseppina , Cheng Yiling J. , Williams Desmond E. , Fulton Janet , Gregg Edward W.
Published: June 2006

OBJECTIVE—The purpose of this study was to examine the association of physical activity and cardiovascular fitness (CVF) with insulin sensitivity in a nationally representative sample of U.S. youth.

RESEARCH DESIGN AND METHODS—The study included 1,783 U.S. adolescents (11% Mexican American, 14% non-Hispanic black, 63% non-Hispanic white, and 12% other) aged 12–19 years who were examined in the 1999–2002 National Health and Nutrition Examination Survey. Physical activity was assessed by questionnaire and expressed in units of MET hours per week. Predicted maximal oxygen uptake (Vo2max, expressed in milliliters per kilogram of body weight per minute), a measure of CVF, was determined by a submaximal multistage treadmill test. Insulin sensitivity was defined by the Quantitative Insulin Sensitivity Check Index.

RESULTS—Boys were more likely than girls to be highly active (≥30 MET h/week; 51 vs. 37%, P < 0.001) and had higher levels of CVF (mean Vo2max 47 vs. 39 ml · kg−1 · min−1, P < 0.001). Sex-specific multiple regression models controlled for age, race/ethnicity, and BMI showed that in boys, high levels of physical activity and high levels of CVF were significantly and positively associated with insulin sensitivity (β = 0.84, P < 0.001 and β = 0.82, P = 0.01, respectively). Among girls, insulin sensitivity was not significantly associated with physical activity or with CVF but was inversely and significantly associated with BMI.

CONCLUSIONS—Increasing physical activity and CVF may have an independent effect of improving insulin sensitivity among boys. For girls, the primary role of physical activity may be in weight maintenance.
A Strong Dose-Response Relation Between Serum Concentrations of Persistent Organic Pollutants and Diabetes
Authors: Lee Duk-Hee , Lee In-Kyu , Song Kyungeun , Steffes Michael , Toscano William , Baker Beth A. , Jacobs David R.
Published: June 2006

OBJECTIVE—Low-level exposure to some persistent organic pollutants (POPs) has recently become a focus because of their possible link with the risk of diabetes.

RESEARCH DESIGN AND METHODS—Cross-sectional associations of the serum concentrations of POPs with diabetes prevalence were investigated in 2,016 adult participants in the National Health and Nutrition Examination Survey 1999–2002. Six POPs (2,2′,4,4′,5,5′-hexachlorobiphenyl, 1,2,3,4,6,7,8-heptachlorodibenzo-p-dioxin, 1,2,3,4,6,7,8,9-octachlorodibenzo-p-dioxin, oxychlordane, p,p′-dichlorodiphenyltrichloroethane, and trans-nonachlor) were selected, because they were detectable in ≥80% of participants.

RESULTS—Compared with subjects with serum concentrations below the limit of detection, after adjustment for age, sex, race and ethnicity, poverty income ratio, BMI, and waist circumference, diabetes prevalence was strongly positively associated with lipid-adjusted serum concentrations of all six POPs. When the participants were classified according to the sum of category numbers of the six POPs, adjusted odds ratios were 1.0, 14.0, 14.7, 38.3, and 37.7 (P for trend < 0.001). The association was consistent in stratified analyses and stronger in younger participants, Mexican Americans, and obese individuals.

CONCLUSIONS—There were striking dose-response relations between serum concentrations of six selected POPs and the prevalence of diabetes. The strong graded association could offer a compelling challenge to future epidemiologic and toxicological research.
New Europe: place(s) without a sense of place?
Authors: Croci Valentina
Published: June 2006

The 10 new member states of Europe are united by no more than historic synchronicity ‐ a single point of entry into the EU in May 2004. Guest‐editor Valentina Croci introduces this title of AD by explaining both the circumstances that some of these countries share, particularly those of the ex‐Soviet bloc, but also the very different conditions the nations grapple with as separate entities. Despite the many disparities between countries, she finds an underlying consistency in the concerns voiced by the local contributors, as the respect for individual national identities and a sense of place emerge as paramount. Copyright © 2006 John Wiley & Sons, Ltd.
Slovenia: a new generation
Authors: Desman Miha
Published: June 2006

During the Soviet era, Slovenia was renowned as an architectural oasis for experimentation on the western borders of eastern European greyness. Miha Desman describes how this small but significant nation has maintained its taste for design innovation, despite the shifting economic and political conditions of the past two decades. He outlines what present‐day Slovenia has to offer a greater Europe and the special qualities of its contemporary architecture. Copyright © 2006 John Wiley & Sons, Ltd.
Berlin's empty heart
Authors: Watson Howard
Published: June 2006

In the early 1990s, all the energy and enthusiasm for the newly unified western and eastern Europe seemed to centre on Berlin, and the reconstruction of the city's Potsdamer Platz in particular. Now, well over a decade later, with the completion of the Beisheim Center, the final piece in the redevelopment of the Platz is in place. Howard Watson asks why, at a time when Berlin is being hailed as one of the most vibrant and artistic cities in Europe, there should be a vacuum at its very heart. Copyright © 2006 John Wiley & Sons, Ltd.
Contemporary architecture in China compiled
Authors: Denison Edward , Yu Ren Guang
Published: June 2006

Edward Denison and Guang Yu Ren, authors of Building Shanghai (Wiley‐Academy 2006), a narrative history of Shanghai's architectural development, review two new books on China that focus solely on its 21st‐century resurgence. Copyright © 2006 John Wiley & Sons, Ltd.
Top of the rock observatory
Authors: Merkel Jayne
Published: June 2006

Smack dab in the middle of the famous cluster of Manhattan towers, a new tri‐level, indoor‐outdoor observation deck on top of the tallest building in Rockefeller Center (the ge Building) brings visitors close to the surrounding pinnacles with overviews of the New York archipelago. One surprise, as Jayne Merkel explains, is that this sensational tourist site, with a glittery, spiralling, three‐storey entrance, was designed by Michael Gabellini, the New York architect known for pristine boutiques in elegant old buildings, such as the Jil Sander store in the former Royal Bank of Scotland on London's Saville Row. Copyright © 2006 John Wiley & Sons, Ltd.
Nile street: mixed‐tenure housing
Authors: Stewart Bruce
Published: June 2006

Bruce Stewart describes how Munkenbeck and Marshall, a practice whose work is more often associated with high‐end design, have, at a site in Hackney near the City of London, produced a complex scheme for Peabody that is considered in its treatment of mixed tenure. Copyright © 2006 John Wiley & Sons, Ltd.
Worker productivity and outpatient service use after the September 11th attacks: Results from the New York City Terrorism Outcome Study
Authors: Boscarino Joseph A. , Adams Richard E. , Figley Charles R.
Published: June 2006

Background

Research has shown that the terrorist attacks in New York City (NYC) on September 11, 2001 had an impact on the psychological status of area residents. Since a major goal of many terrorist attacks is to also adversely affect local socioeconomic activities, the long‐term impact of exposure to terrorist attacks on productivity and outpatient service utilization among workers in NYC is assessed.

Methods

The impact of the World Trade Center disaster (WTCD) among 1,167 workers in NYC is examined using a prospective cohort design. The study included measures of WTCD exposures, stressful life events, other traumatic events, post‐traumatic stress disorder (PTSD), and depression, assessed at 1 year and 2 years post‐disaster.

Results

Bivariate analyses suggest that exposure to WTCD events is associated with high productivity loss at baseline, but not consistently at follow‐up. Both PTSD and depression are associated with lower quality workdays at baseline and follow‐up, but depression is more consistently associated with high work loss and medical service use. In multivariate analyses, WTCD exposure is associated with productivity loss at baseline, but less consistently at follow‐up. At baseline, depression and history of traumatic events are associated with lower quality workdays and negative life events with greater workdays lost. Multivariate analyses at follow‐up indicated that experiencing negative life events is associated with higher workdays lost and lower quality workdays and that PTSD is associated with lower quality workdays. Similar regression models suggested that increased outpatient service use is associated with depression and lifetime traumatic events at baseline and with negative life events at follow‐up.

Conclusion

This study suggests that while the WTCD had an impact on worker productivity within the first year after the attack, this did not generally persist, especially after controlling for baseline status. Having PTSD or experiencing stressful life events at follow‐up, however, is associated with lower quality workdays, even after controlling for baseline status. Am. J. Ind. Med. 2006. © 2006 Wiley‐Liss, Inc.
Amyloid load and cerebral atrophy in Alzheimer's disease: An 11C‐PIB positron emission tomography study
Authors: Archer Hilary A. , Edison Paul , Brooks David J. , Barnes Jo , Frost Chris , Yeatman Tom , Fox Nick C. , Rossor Martin N.
Published: June 2006

To determine the relationship between cerebral amyloid plaque load and rates of cerebral atrophy in Alzheimer's disease. 11C‐PIB(11C‐6‐OH benzothiazole)PET (positron emission tomography) findings were correlated with volumetric magnetic resonance imaging (MRI) measurements in nine subjects with mild to moderate AD. Analysis revealed a positive correlation between rates of whole brain atrophy and whole brain (p = 0.019) and regional 11C‐PIB uptake. This provides support for the central role of amyloid deposition in the pathogenesis of AD. Ann Neurol 2006;60:145–147
Recovery from paralysis in adult rats using embryonic stem cells
Authors: Deshpande Deepa M. , Kim Yun‐Sook , Martinez Tara , Carmen Jessica , Dike Sonny , Shats Irina , Rubin Lee L. , Drummond Jennifer , Krishnan Chitra , Hoke Ahmet , Maragakis Nicholas , Shefner Jeremy , Rothstein Jeffrey D. , Kerr Douglas A.
Published: June 2006

Objective

We explored the potential of embryonic stem cell–derived motor neurons to functionally replace those cells destroyed in paralyzed adult rats.

Methods

We administered a phosphodiesterase type 4 inhibitor and dibutyryl cyclic adenosine monophosphate to overcome myelin‐mediated repulsion and provided glial cell–derived neurotrophic factor within the sciatic nerve to attract transplanted embryonic stem cell–derived axons toward skeletal muscle targets.

Results

We found that these strategies significantly increased the success of transplanted axons extending out of the spinal cord into ventral roots. Furthermore, transplant‐derived axons reached muscle, formed neuromuscular junctions, were physiologically active, and mediated partial recovery from paralysis.

Interpretation

We conclude that restoration of functional motor units by embryonic stem cells is possible and represents a potential therapeutic strategy for patients with paralysis. To our knowledge, this is the first report of the anatomical and functional replacement of a motor neuron circuit within the adult mammalian host. Ann Neurol 2006;60:32–44
Preliminary study on preparation of unsaturated polyester resin/natural rubber latex blends in the presence of dispersion aids
Authors: Pachpinyo P. , Lertprasertpong P. , Chuayjuljit S. , Sirisook R. , Pimpan V.
Published: June 2006

The objective of this research was to study the possibility of blending unsaturated polyester resin (UPE resin) with 5, 10, and 15 parts per hundred resin (phr) natural rubber latex (NRL) in the presence of dispersion aids in order to improve the impact resistance of UPE resin. Three types of dispersion aids, sodium lauryl sulfate (SLS), toluene, and ammonia, were used in this study in amounts of 10, 15, 20 and 25 wt % of the NRL. These blended mixtures were cured at room temperature using methyl ethyl ketone peroxide (MEKPO) as an initiator and cobalt octoate as an accelerator. It was found that, regardless of the type of dispersion aid, the impact strength of blended UPE samples was higher than that of the pure UPE samples, and at 20 wt % toluene in 15‐phr NRL, the sample had the highest impact strength. However, because of low elastic modulus, characteristic of NRL, the tensile strength and flexural strength of the blended samples decreased as the NRL content of the blends increased. © 2006 Wiley Periodicals, Inc. J Appl Polym Sci 101: 4238–4241, 2006
Diffusion coefficient of DMF in acrylic fiber formation
Authors: Hou Chen , Qu Rongjun , Wang Chunhua , Ying Liang
Published: June 2006

A H2O/dimethyl formamide (DMF) mixture was used as the coagulation bath of wet‐spun process for acrylic fibers. Diffusion coefficient of DMF in the protofibers prepared by acrylonitrile/acrylamide copolymers was determined. It has been found that diffusion coefficient of DMF outflow of the protofibers prepared by acrylonitrile/acrylamide copolymers synthesized by solution polymerization is highest compared with those of acrylonitrile/acrylamide copolymers synthesized by H2O/DMF mixture suspension polymerization and aqueous suspension polymerization. With an increase of copolymer concentration in the dope, diffusion coefficient of DMF decreases continuously. Diffusion coefficient of DMF increases along with the bath temperature, but the changes in diffusion coefficient values are less prominent as temperature goes beyond 55°C. When DMF concentration in the coagulation bath was 50%, the value of the diffusion coefficient of DMF was minimal. Diffusion coefficient of DMF increases along with jet stretch minus ratio increase. © 2006 Wiley Periodicals, Inc. J Appl Polym Sci 101: 3616–3619, 2006
Reactive blending approach to modify spin‐coated epoxy film: Part II. Crosslinking kinetics
Authors: Turunen Markus P. K. , Laurila Tomi , Kivilahti Jorma K.
Published: June 2006

Kinetics of the reactive blending of epoxy with a four‐armed ϵ‐caprolactone‐based carboxylic acid end‐functionalized oligomer was analyzed with a model‐free approach. The employment of a dual catalyst system ensured high density of crosslinking in the blends and minimized phase separation even when comparatively high concentration of the oligomer was incorporated. The two reactions were examined separately before analysis of the dual‐catalyzed system. The apparent activation energy of the single‐catalyzed reactions could be seen to fall into three regimes. It is proposed that regime I is due to reaction control, the middle part (II) to mass transport, and the high conversion tail (III) to structural control. The results of a thermal analysis carried out on the crosslinked samples corresponded well with the findings of the kinetic analysis. The combined kinetic and thermal results can be used in optimization of the crosslinking process. © 2006 Wiley Periodicals, Inc. J Appl Polym Sci 101: 3689–3696, 2006
Reactive blending approach to modify spin‐coated epoxy film: Part I. Synthesis and characterization of star‐shaped poly(ϵ‐caprolactone)
Authors: Turunen Markus P. K. , Laurila Tomi , Kivilahti Jorma K.
Published: June 2006

To effectively modify the properties of an epoxy, branched oligomers were synthesized from ϵ‐caprolactone (CL) and end‐functionalized to realize network precursors that can be reactively blended with the epoxy. The ring‐opening polymerization (ROP) of the CL in the presence of polyglycerol (PGL) initiator (3.9 and 9.1 mol %) and Sn(II) 2‐ethylhexanoate catalyst yielded oligomers with hydroxyl end‐groups, which were converted to carboxylic acid functionality by reaction with succinic anhydride. The functionalized oligomers had a four‐armed structure and the molecular weight of the oligomers could be controlled by the ratio of CL to PGL in the feed. To achieve an adequately crosslinked network in the reactive blending, a dual‐catalyzed reaction scheme was employed. First the oligomer was incorporated into the epoxy matrix in an imidazole‐catalyzed reaction and then the crosslinking was completed with an acid‐catalyzed ROP of the residual epoxies. Investigations showed that toughened coatings could be prepared from the inherently brittle epoxy through proper choice of the blending ratio of oligomer to epoxy. The blending increased surface hydrophobicity at high concentrations of functionalized oligomer, but did not have an adverse effect on the inherently advantageous endothelial cell spreading. © 2006 Wiley Periodicals, Inc. J Appl Polym Sci 101: 3677–3688, 2006
Preparation of poly(methyl methacrylate)/titanium oxide composite particles via in‐situ emulsion polymerization
Authors: Yang Mingjiao , Dan Yi
Published: June 2006

Poly(methyl methacrylate) (PMMA)/Titanium oxide (TiO2) composite particles were prepared via in‐situ emulsion polymerization of MMA in the presence of TiO2 particles. Before polymerization, the TiO2 particles was modified by the silane coupling agent, which is crucial to ensure that PMMA reacts with TiO2 via covalent bond bindings. The structure of the obtained PMMA/TiO2 composite particles was characterized using Fourier transform infrared spectra (FTIR) and thermogravimetric analysis (TGA). The results indicate that there are covalent bond bindings between PMMA macromolecules and TiO2 particles. Based on these facts, several factors affecting the resulting PMMA/TiO2 composite system, such as the type of coupling agents, the mass ratio of the MMA to the modified TiO2, the emulsifier concentration, and the initiator concentration, etc., were examined by the measurement of conversion of monomers, the gel content of polymers, the percentage of grafting, and the grafting efficiency, using gravity method or TGA method. As a result, the optimized recipe was achieved, and the percentage of grafting and the grafting efficiency could reach 216.86 and 96.64%, respectively. In addition, the obtained PMMA/TiO2 composite particles were found to a stable colloidal dispersion in good solvent for PMMA. © 2006 Wiley Periodicals, Inc. J Appl Polym Sci 101: 4056–4063, 2006