bluuebunny/crossref_metadata_2025 huggingface dataset:
Introduction
Authors: Kasper Gabriele
Published: October 2006

This Special Issue contributes to current conceptualizations of politeness as a discursive phenomenon. Although earlier theories of politeness differ in some important respects, the most influential proposals, those of Brown and Levinson (1987) and Leech (1983), rest on one or more of the following assumptions. 1. Politeness is grounded either in a set of social maxims or the social psychological construct of face. Either way, the theories adopt a rational actor model of politeness, focusing on speakers' goals and social motivations. 2. Social acts are understood as endowed with inherent relational properties and hence categorized as ‘face threatening’ and ‘face supportive’, or as ‘competitive’, ‘convivial’, ‘conflictive’, and ‘collaborative’, in abstractu, outside of activities in natural settings. 3. Likewise, the linguistic resources serving to ‘encode’ politeness are seen as having fixed relational values. Nonverbal and nonvocal resources are not examined for their possible politeness-implicative functions. 4. Social context, viewed as configurations of discourse-external social variables, is the determining force in speakers' selection of politeness strategies. 5. Context factors assumed to have a bearing on politeness are understood as prespecified and static. Typically such factors are confined to power relations, social distance, and the culturally variable degree of ‘imposition’ inherent in a social act. 6. Politeness results from an actor's internal assessment of context variables in relation to the social act she or he is planning to perform. In other words, politeness as a form of linguistic behavior is conceptualized as a dependent variable, determined by the values of the context factors as independent variables.
Japanese politeness as an interactional achievement: Academic consultation sessions in Japanese universities
Authors: Cook Haruko Minegishi
Published: October 2006

From a social constructionist perspective, this paper examines speech-style shifts in academic consultation sessions between professors and students in Japanese universities and demonstrates that politeness is an interactional achievement. It has been argued that politeness in Japanese society is predominantly ‘discernment (wakimae)’, which differs from ‘volition (i. e., strategic politeness based on face needs)’ as proposed by Brown and Levinson (1978, 1987). This paper attempts to demonstrate that the dichotomy between the two types of politeness – ‘discernment’ and ‘volition’ – is irrelevant. It reanalyzes what was previously described as a display of ‘discernment’ as an active co-construction in which the grammatical structures and the sequential organization of talk serve as resources for the participants to construct their identities in the moment-by-moment unfolding of interaction.
Negotiation of face in web chats
Authors: Golato Andrea , Taleghani-Nikazm Carmen
Published: October 2006

Using conversation analytic methodology, this paper investigates how ‘politeness’ and ‘face’ are negotiated in web chats. Following previous conversation analytic research (Heritage 1984), we first tie the concepts face and social solidarity to the conversation analytic concept of preference organization. We then proceed to describe the system of communication of chats, delineating some technological constraints of the medium that have an impact on the resources available for participants for indicating preferred and dispreferred turns. Specifically, we indicate that some resources available in ordinary talk-in-interaction are not available in web chats, while web chats also allow for certain resources not available in ordinary talk-in-interaction. By analyzing requests (i. e., first pair parts) and second assessments (i. e., second pair parts), we demonstrate how participants adapt their interaction to the specific environment of web chats when negotiating issues of social solidarity.
When once is not enough: Politeness of multiple requests in oral proficiency interviews
Authors: Kasper Gabriele
Published: October 2006

The paper takes a conversation-analytic approach to examine the politeness of multiple requests in Oral Proficiency Interviews (OPI). In this assessment activity, interviewers regularly reissue a first request in environments of increased task demands or in response to candidates' difficulties with the first directive. In such multiple request sequences, two kinds of structurally parallel operations of mitigation and conventionally indirect request frames are observed. For the most part, interviewers treat mitigational material and conventionally indirect request frames as dispensable in the subsequent version, a pattern seen in multiple requests in same-turn as well as in other-initiated and third position repair. When local contingencies increase the risk that the interviewer's request may not generate the projected action, subsequent versions tend to be prefaced by the marker please. Furthermore, in environments of topic introduction or change, presequences also play a politeness-implicative role. The paper closes by considering some implications of the analysis for an interaction-based theory of politeness.
Effects of Increased Feeding Frequency on Growth of Hybrid Bluegill in Ponds
Authors: Sager Clifton R , Winkelman Dana L
Published: October 2006

Increased feeding frequency has been used in aquaculture to increase growth and food conversion efficiency, and recent laboratory studies have indicated that feeding frequency could be used to reduce the size variation within groups of hybrid bluegills (F1: Male bluegill Lepomis macrochirus × female green sunfish L. cyanellus). Our experiment evaluated the growth of pond-reared hybrid bluegills fed equal amounts of food either once or four times per day. We were particularly interested in reducing the size variation and increasing the percentage of harvestable-size fish (≥110 g). After 194 d, there was no significant effect of feeding frequency on growth, food conversion efficiency, size variation, or percentage of harvestable-size fish.
Using Portable Lactate and Glucose Meters for Catfish Research: Acceptable Alternatives to Established Laboratory Methods?
Authors: Beecham Rachel Venn , Small Brian C , Minchew C Douglas
Published: October 2006

Simple and portable methods for assessing the physiological state of channel catfish Ictalurus punctatus would be valuable tools in field situations where problems with blood storage and transportation occur. This study compared the use of handheld lactate and glucose meters with established laboratory methods in stressed (fatigued) and unstressed (control) channel catfish fingerlings. The results obtained from the Accutrend (Roche Diagnostics Corp.) lactate meter and the Accu-Chek Advantage (Roche Diagnostics) glucose meter were consistently lower (P < 0.05) than those obtained with the laboratory reference method. However, significant differences (P < 0.0001) were found between the control and fatigued fish for both lactate and glucose, regardless of the method of analysis. Both handheld meters were found to be reliable and suitable for use in field or laboratory situations where relative measurements are acceptable. The costs associated with using the handheld meters were higher than those associated with accepted laboratory methods; however, the initial capital investment was lower for the handheld meters. Ease of use, portability, and rapidity of sample analysis make the handheld meters attractive alternatives to traditional laboratory methods.
Developing Methods for Harvesting Rosy Red Fathead Minnow Eggs
Authors: Masson Ignacio , Stone Nathan , Lee Yong-Woo
Published: October 2006

We evaluated the effectiveness of different types of spawning substrates in retaining the eggs of rosy red fathead minnow Pimephales promelas, the potential substrate preference of the fish, and the effectiveness of different concentrations of sodium sulfite for detaching eggs from substrates without affecting egg survival. Egg adherence was determined by placing replicate sections of four types of conveyor belt material of varying roughness into a pool stocked with fathead minnow. A screened tray was suspended below each substrate to catch the eggs that did not adhere. Substrate preference was evaluated by following a similar protocol, but only three males were stocked (equal to the number of replicates of each substrate). To test the efficacy of sodium sulfite in removing eggs, substrates with eggs were placed in 0.0, 1.5, and 3.0% solutions and uniformly agitated. The effect of exposure time and egg age was tested by exposing eggs to a 1.5% solution of sodium sulfite for 0 (control), 5, 10, 15, 20, 25, and 30 min. The two rougher substrates retained a significantly greater percentage of eggs than the two smoother ones (72–77% versus 34–39%). Nest locations near the water inlet and air stones were preferred regardless of substrate type. The 1.5% sodium sulfite solution was as effective as the 3.0% solution in removing eggs from substrates. There were no significant differences in hatching rate or percentage of atypical fry resulting from exposure of eggs to 1.5% sodium sulfite for up to 30 min. An egg harvesting system consisting of placing a rough or textured substrate in well-aerated locations and subsequent egg removal with sodium sulfite appears to be feasible, although economic questions remain.
Metabolic Syndrome
Authors: Ravaglia Giovanni , Forti Paola , Maioli Fabiola , Bastagli Luciana , Chiappelli Martina , Montesi Fausta , Bolondi Luigi , Patterson Christopher
Published: October 2006

OBJECTIVE—Little is known about the prevalence of the metabolic syndrome among elderly people in Italy, its association with all-cause mortality, and whether measurement of serum C-reactive protein (CRP) and interleukin (IL)-6 affects this association.

RESEARCH DESIGN AND METHODS—The baseline prevalence of metabolic syndrome, diagnosed according to the National Cholesterol Education Program (NCEP) criteria, and all-cause mortality at 4 years were recorded in an Italian population-based cohort (981 subjects, 55% women, aged 65–97 years). A Cox model adjusted for sociodemographic, lifestyle, and medical variables was used to investigate 1) whether metabolic syndrome was a predictor of mortality and 2) how the association was affected by baseline high CRP (>3 mg/l) and IL-6 (>1.33 pg/ml).

RESULTS—Overall, metabolic syndrome prevalence was 27.2% [95% CI 24.0–30.5] and higher in women (33.3% [28.7–38.0]) than in men (19.6% [15.5–24.2]). During follow-up, 137 deaths occurred. Using the no metabolic syndrome/no high IL-6 group as the reference, mortality was not associated with the metabolic syndrome alone (multivariable-adjusted hazard ratio 1.24 [0.60–2.59]), only weakly associated with high IL-6 alone (1.66 [1.04–2.63]), but strongly associated with the concurrent presence of metabolic syndrome and high IL-6 (3.26 [2.00–5.33]). High CRP was not a mortality predictor (0.83 [0.58–1.20]) nor did it affect the association of the other variables with mortality.

CONCLUSIONS—Metabolic syndrome by NCEP criteria is highly prevalent in the Italian elderly population. It is not itself associated with mortality but may improve the usefulness of IL-6 as a mortality predictor in older age.
Sustained Virological Response Correlates With Reduction in the Incidence of Glucose Abnormalities in Patients With Chronic Hepatitis C Virus Infection
Authors: Simó Rafael , Lecube Albert , Genescà Joan , Esteban Joan Ignaci , Hernández Cristina
Published: October 2006

OBJECTIVE—There is evidence to suggest that hepatitis C virus (HCV) infection is a high-risk condition for developing type 2 diabetes. However, there are no interventional studies that confirm that HCV infection causes diabetes. The main aim of this study was to compare the incidence of glucose abnormalities (diabetes plus impaired fasting glucose) between HCV-infected patients with or without sustained virological response (SVR) after antiviral therapy.

RESEARCH DESIGN AND METHODS—Patients with normal fasting glucose (<100 mg/dl) with biopsy-proven chronic hepatitis C without cirrhosis and with at least 3 years of follow-up after finishing antiviral therapy were included in the study (n = 234). Patients received interferon α-2b (alone or with ribavirin) for 6 or 12 months according to genotype. Cumulative incidence of glucose abnormalities was evaluated by using the Kaplan-Meier method comparing subjects with and without a SVR to antiviral treatment. A multivariate Cox proportional hazards analysis was performed to explore the variables independently associated with the development of glucose abnormalities.

RESULTS—During follow-up, 14 of 96 (14.6%) patients with SVR and 47 of 138 (34.1%) nonsustained responders developed glucose abnormalities (P = 0.001). Patients with SVR did not develop diabetes during follow-up, whereas nine cases of diabetes were detected in nonsustained responders (P = 0.007). After adjustment for the recognized predictors of type 2 diabetes, the hazard ratio for glucose abnormalities in patients with SVR was 0.48 (95% CI [0.24–0.98], P = 0.04).

CONCLUSIONS—Our results provide evidence that eradication of HCV infection significantly reduces the incidence of glucose abnormalities in chronic hepatitis C patients. In addition, this study supports the concept that HCV infection causes type 2 diabetes.
Association of Pro12Ala Polymorphism in Peroxisome Proliferator–Activated Receptor γ With Pre-Diabetic Phenotypes
Authors: Tönjes Anke , Scholz Markus , Loeffler Markus , Stumvoll Michael
Published: October 2006

OBJECTIVE—The provariant of the Pro12Ala polymorphism in peroxisome proliferator–activated receptor (PPAR)γ has been identified as a risk allele for type 2 diabetes. The purpose of the present study was to reveal a significant association with pre-diabetic phenotypes in nondiabetic individuals based on a systematic meta-analysis of all available published evidence.

RESEARCH DESIGN AND METHODS—We performed a classical meta-analysis of data from ∼32,000 nondiabetic subjects in 57 studies to assess the effect of the Pro12Ala polymorphism on pre-diabetic traits.

RESULTS—In the global comparison, there were no differences in BMI, glucose, insulin, or homeostasis model assessment of insulin resistance between the Pro/Pro and X/Ala genotype. However, in the Caucasian subgroup, the X/Ala genotype was associated with significantly increased BMI. In the obese subgroup (BMI >30 kg/m2), fasting glucose (P = 0.041) and insulin resistance (by homeostasis model analysis) (P = 0.020) were significantly greater in the Pro/Pro group. In subjects with the homozygous Ala/Ala genotype, fasting insulin was significantly lower compared with the Pro/Pro genotype (P = 0.040, NAla/Ala = 154).

CONCLUSIONS—Across all studies, the Pro12Ala polymorphism had no significant effect on diabetes-related traits. Only in selected subgroups, such as Caucasians and obese subjects, did we see an association of the Ala allele with greater BMI and greater insulin sensitivity. This demonstrates the importance for appropriate stratification of analyses by environmental or other genetic factors. Meta-analysis of Ala/Ala homozygotes more clearly demonstrated the association with greater insulin sensitivity of carriers of the Ala allele.
Incidence of Type 1 Diabetes in Philadelphia Is Higher in Black Than White Children From 1995 to 1999
Authors: Lipman Terri H. , Jawad Abbas F. , Murphy Kathryn M. , Tuttle Alan , Thompson Rebecca L. , Ratcliffe Sarah J. , Levitt Katz Lorraine E.
Published: October 2006

OBJECTIVE—To determine the epidemiology of type 1 diabetes in children in Philadelphia, Pennsylvania, from 1995 through 1999 and compare these data with previous cohorts.

RESEARCH DESIGN AND METHODS—This is a report of a retrospective population-based registry maintained since 1985. Hospital records meeting the following criteria were reviewed: newly diagnosed type 1 diabetes, age 0–14 years, residing in Philadelphia at the time of diagnosis, and diagnosed from 1 January 1995 to 31 December 1999. The secondary source of validation was the School District of Philadelphia. Incidence rates by race and age were compared with 1985–1989 and 1990–1994 cohorts.

RESULTS—A total of 234 case subjects were identified, and the registry was determined to be 96% complete. The overall age-adjusted incidence rate in Philadelphia was 14.8 per 100,000/year. Incidence rates in Hispanic children (15.5 per 100,000/year) and white children (12.8 per 100,000/year) have been relatively stable over 15 years. The incidence in black children (15.2 per 100,000/year), however, has increased dramatically, rising 64% in children 5–9 years of age (14.9 per 100,000/year) and 37% in the 10- to 14-year age-group (26.9 per 100,000/year).

CONCLUSIONS—The overall incidence of type 1 diabetes in Philadelphia is increasing and is similar to other U.S. registries. These are the first data reporting a higher incidence in black children in a registry of children 0–14 years of age. The etiology of the marked increase in incidence in the black population is unknown and underscores the need to establish type 1 diabetes as a reportable disease, so that environmental risk factors may be thoroughly investigated.
Design and Validation of a Population-Based Definition of the Metabolic Syndrome
Authors: Aguilar-Salinas Carlos A. , Rojas Rosalba , Gonzalez-Villalpando Clicerio , Gómez-Pérez Francisco J. , Mehta Roopa , Olaiz Gustavo , Rull Juan A. , Cox David R.
Published: October 2006

OBJECTIVE—The National Cholesterol Education Program (NCEP) definition of the metabolic syndrome was modified to be described as a continuous variable and adapted to the characteristics of a Hispanic population.

RESEARCH DESIGN AND METHODS—Age/sex population percentiles for every component of the NCEP criteria were included in this approach using population-based data from a Mexican nationwide survey (2,158 subjects). One point was given per decile for every component. The total number of points accumulated was used to classify subjects. The predictive power for incident diabetes was evaluated using the 7-year follow-up results of the Mexico City Diabetes Study.

RESULTS—Our population-based method had a significantly better prognostic power compared with the original and the updated NCEP definitions (area under the receiver operating characteristic curve 0.746 vs. 0.697 and 0.723, respectively, P < 0.05). Using individuals with ≤1 component of the NCEP definition as reference, the odds ratio was greater in the upper quartile of the points scale (≥39 points) (12.71 [95% CI 5.67–28.49]) compared with that calculated for the original (9.52 [4.69–19.31]) and the updated (11.14 [5.33–23.30]) NCEP criteria. The major advantage of our approach is the detection of subjects at the extremes of the range of diabetes risk and the ability to estimate this risk as a continuum.

CONCLUSIONS—Our method adapts the NCEP criteria to the characteristics of a Hispanic population. It improves the predictive power of the NCEP criteria for future diabetes.
Analysis of Efficacy and Safety in Patients Aged 65–75 Years at Randomization
Authors: Neil H. Andrew W. , DeMicco David A. , Luo Don , Betteridge D. John , Colhoun Helen M. , Durrington Paul N. , Livingstone Shona J. , Fuller John H. , Hitman Graham A. ,   on behalf of the CARDS Study Investigators
Published: October 2006

OBJECTIVE—Rates of cardiovascular disease are highest in the elderly. Lipid-lowering statin therapy reduces the proportional risk as effectively in older patients as in younger individuals; however, limited data are available for elderly patients with type 2 diabetes. We conducted a post hoc analysis to compare the efficacy and safety of atorvastatin among 1,129 patients aged 65–75 years at randomization with 1,709 younger patients in the Collaborative Atorvastatin Diabetes Study (CARDS).

RESEARCH DESIGN AND METHODS—CARDS was a randomized placebo-controlled trial of 10 mg/day atorvastatin for primary prevention of cardiovascular disease in patients aged 40–75 years with LDL cholesterol concentrations ≤4.14 mmol/l followed for a median of 3.9 years. The primary end point was time to first occurrence of acute coronary heart disease events, coronary revascularizations, or stroke.

RESULTS—Atorvastatin treatment resulted in a 38% reduction in relative risk ([95% CI −58 to −8], P = 0.017) of first major cardiovascular events in older patients and a 37% reduction ([−57 to −7], P = 0.019) in younger patients. Corresponding absolute risk reductions were 3.9 and 2.7%, respectively (difference 1.2% [95% CI −2.8 to 5.3], P = 0.546); numbers needed to treat for 4 years to avoid one event were 21 and 33, respectively. All-cause mortality was reduced nonsignificantly by 22% ([−49 to 18], P = 0.245) and 37% ([−64 to 9], P = 0.98), respectively. The overall safety profile of atorvastatin was similar between age-groups.

CONCLUSIONS—Absolute and relative benefits of statin therapy in older patients with type 2 diabetes are substantial, and all patients warrant treatment unless specifically contraindicated.
Hematocrit, Independent of Chronic Kidney Disease, Predicts Adverse Cardiovascular Outcomes in Chinese Patients With Type 2 Diabetes
Authors: Tong Peter C.Y. , Kong Alice P.S. , So Wing-Yee , Ng Margaret H.L. , Yang Xilin , Ng Maggie C.Y. , Ma Ronald C.W. , Ho Chung-Shun , Lam Christopher W.K. , Chow Chun-Chung , Cockram Clive S. , Chan Juliana C.N.
Published: October 2006

OBJECTIVE—Anemia and chronic kidney disease (CKD) are risk factors for cardiovascular diseases in diabetes. We examined the association between hematocrit, stratified by the presence of CKD, and cardiovascular events in a cohort of Chinese subjects with type 2 diabetes.

RESEARCH DESIGN AND METHODS—A total of 3,983 patients who underwent assessment for diabetes complications were recruited. Subjects were categorized into five groups. Group I included subjects with hematocrit below the normal sex-specific range. The cutoff points for groups II–V were selected to represent the distribution of the hematocrit for each sex. CKD was defined by the estimated glomerular filtration rate <60 ml/min per 1.73 m2. Cardiovascular events were defined as cardiovascular mortality and morbidity, including new onset of myocardial infarction, acute coronary syndrome, revascularization, heart failure, and stroke requiring hospitalization.

RESULTS—A total of 294 subjects (7.4%) developed cardiovascular events during the median of 36.4 months. The rate of cardiovascular events was highest in subjects with low hematocrit (group I, 18.6%) compared with group V (3.4%, P < 0.001). The multivariate-adjusted hazard ratio for cardiovascular events diminished with increasing hematocrit (group I, 1.0; group II, 0.73 [95% CI 0.51–1.04]; group III, 0.57 [0.39–0.83]; group IV, 0.61 [0.39–0.95]; and group V, 0.36 [0.17–0.79]). After stratifying by the presence of CKD, the previously observed reduction in the risk of developing cardiovascular events with increasing hematocrit was abolished in the cohort with CKD but persisted in the non-CKD cohort.

CONCLUSIONS—In Chinese subjects with type 2 diabetes, low levels of hematocrit and the presence of CKD are associated with increased risk of developing adverse cardiovascular events.
Associations of Adiponectin Levels With Incident Impaired Glucose Metabolism and Type 2 Diabetes in Older Men and Women
Authors: Snijder Marieke B. , Heine Robert J. , Seidell Jacob C. , Bouter Lex M. , Stehouwer Coen D.A. , Nijpels Giel , Funahashi Tohru , Matsuzawa Yuji , Shimomura Iichiro , Dekker Jacqueline M.
Published: October 2006

OBJECTIVE—Adiponectin is an adipose tissue–derived protein. Low levels are associated with obesity, insulin resistance, and type 2 diabetes. Our objective was to investigate the prospective association between adiponectin levels and the 6.4-year risk of type 2 diabetes and of impaired glucose metabolism (IGM).

RESEARCH DESIGN AND METHODS—The Hoorn Study is a cohort study among Caucasians, aged 50–75 years. BMI, waist-to-hip ratio (WHR), fasting glucose, 2-h glucose, triglycerides, HDL cholesterol, LDL cholesterol, alanine aminotransferase, leptin, and adiponectin were measured at baseline. Lifestyle (alcohol intake, smoking, and physical activity) was assessed by questionnaires. After a mean follow-up of 6.4 years, glucose tolerance was assessed by a 75-g oral glucose tolerance test. Analyses were performed in 1,264 subjects (584 men and 680 women) without type 2 diabetes at baseline. For analyses of incident IGM, 239 subjects with IGM at baseline and/or type 2 diabetes at follow-up were excluded.

RESULTS—Age- and lifestyle-adjusted odds ratios and 95% CIs comparing highest with lowest adiponectin quartile were 0.52 (0.23–1.18) in men and 0.15 (0.06–0.39) in women for type 2 diabetes and 0.90 (0.51–1.61) and 0.28 (0.16–0.48) for IGM, respectively. The risks were only slightly reduced after adjustment for WHR and leptin as markers of (abdominal) adiposity. Adjustment for baseline fasting and postload glucose levels (potential mediators) substantially diminished these inverse associations with type 2 diabetes (0.79 [0.32–1.91] and 0.62 [0.21–1.81]) and with IGM (1.20 [0.61–2.35] and 0.48 [0.26–0.90]), respectively.

CONCLUSIONS—A high adiponectin level was strongly associated with a lower risk of IGM and type 2 diabetes, particularly in women. These results suggest that adiponectin is involved in the pathophysiology linking obesity to type 2 diabetes.
The Burden and Treatment of Diabetes in Elderly Individuals in the U.S.
Authors: Selvin Elizabeth , Coresh Josef , Brancati Frederick L.
Published: October 2006

OBJECTIVE—To assess the prevalence of diabetes, distinguishing between elderly individuals with diabetes diagnosed in middle age (“middle age–onset diabetes”) from elderly individuals with recently diagnosed diabetes (“elderly onset diabetes”) and to assess the burden of complications and control of cardiovascular risk factors in these groups.

RESEARCH DESIGN AND METHODS—We analyzed data from 2,809 elderly individuals from the 1999–2002 National Health and Nutrition Examination Survey, a cross-sectional nationally representative survey of the civilian noninstitutionalized population of the U.S.

RESULTS—Among adults aged ≥65 years, the prevalence of diagnosed diabetes was 15.3%, representing 5.4 million individuals in the U.S. The prevalence of undiagnosed diabetes was 6.9% or 2.4 million individuals. Elderly individuals with middle age–onset diabetes had a much greater burden of microvascular disease but have a similar burden of macrovascular disease compared with individuals with elderly onset diabetes. Elderly individuals with middle age–onset diabetes had substantially worse glycemic control (proportion of individuals with HbA1c >7% = 59.9%) compared with either elderly onset (41.6%) or nonelderly individuals with diabetes (55.3%). Individuals with elderly onset diabetes were also less likely to be taking glucose-lowering medications.

CONCLUSIONS—In this study, we documented a high prevalence of diabetes among elderly individuals and high rate of poor glycemic control in this population. Individuals with middle age–and elderly onset diabetes appear to represent distinct groups with differing burdens of disease and possibly differing treatment goals. Future studies of diabetes in elderly individuals may need to consider stratification based on age of diagnosis.
Does Coffee Consumption Reduce the Risk of Type 2 Diabetes in Individuals With Impaired Glucose?
Authors: Smith Besa , Wingard Deborah L. , Smith Tyler C. , Kritz-Silverstein Donna , Barrett-Connor Elizabeth
Published: October 2006

OBJECTIVE—The purpose of this study was to investigate the association between coffee intake and incident diabetes based on an oral glucose tolerance test (OGTT) and examine coffee habits in those with impaired glucose separately from those with normal glucose at baseline.

RESEARCH DESIGN AND METHODS—In this prospective study, 910 adults aged ≥50 years without diabetes at baseline in 1984–1987 were followed to 1992–1996, an average of 8 years after assessment of coffee intake. Logistic regression models were adjusted for sex, age, physical activity, BMI, smoking, alcohol, hypertension, and baseline fasting plasma glucose.

RESULTS—Past and current coffee drinkers had a reduced risk of incident diabetes (odds ratio 0.38 [95% CI 0.17–0.87] and 0.36 [0.19–0.68], respectively) compared with those who never drank coffee. The 317 participants with baseline impaired glucose who were past or current coffee drinkers were also at reduced risk for incident diabetes (0.31 [0.11–0.87] and 0.36 [0.16–0.83], respectively).

CONCLUSIONS—This study confirms a striking protective effect of caffeinated coffee against incident diabetes and extends these findings to incident diabetes based on OGTT independent of multiple plausible confounders.
Oral Treatment With α-Lipoic Acid Improves Symptomatic Diabetic Polyneuropathy
Authors: Ziegler Dan , Ametov Alexander , Barinov Alexey , Dyck Peter J. , Gurieva Irina , Low Phillip A. , Munzel Ullrich , Yakhno Nikolai , Raz Itamar , Novosadova Maria , Maus Joachim , Samigullin Rustem
Published: October 2006

OBJECTIVE—The aim of this trial was to evaluate the effects of α-lipoic acid (ALA) on positive sensory symptoms and neuropathic deficits in diabetic patients with distal symmetric polyneuropathy (DSP).

RESEARCH DESIGN AND METHODS—In this multicenter, randomized, double-blind, placebo-controlled trial, 181 diabetic patients in Russia and Israel received once-daily oral doses of 600 mg (n = 45) (ALA600), 1,200 mg (n = 47) (ALA1200), and 1,800 mg (ALA1800) of ALA (n = 46) or placebo (n = 43) for 5 weeks after a 1-week placebo run-in period. The primary outcome measure was the change from baseline of the Total Symptom Score (TSS), including stabbing pain, burning pain, paresthesia, and asleep numbness of the feet. Secondary end points included individual symptoms of TSS, Neuropathy Symptoms and Change (NSC) score, Neuropathy Impairment Score (NIS), and patients’ global assessment of efficacy.

RESULTS—Mean TSS did not differ significantly at baseline among the treatment groups and on average decreased by 4.9 points (51%) in ALA600, 4.5 (48%) in ALA1200, and 4.7 (52%) in ALA1800 compared with 2.9 points (32%) in the placebo group (all P < 0.05 vs. placebo). The corresponding response rates (≥50% reduction in TSS) were 62, 50, 56, and 26%, respectively. Significant improvements favoring all three ALA groups were also noted for stabbing and burning pain, the NSC score, and the patients’ global assessment of efficacy. The NIS was numerically reduced. Safety analysis showed a dose-dependent increase in nausea, vomiting, and vertigo.

CONCLUSIONS—Oral treatment with ALA for 5 weeks improved neuropathic symptoms and deficits in patients with DSP. An oral dose of 600 mg once daily appears to provide the optimum risk-to-benefit ratio.
Obese Women and the Relation Between Cardiovascular Risk Profile and Hormone Therapy, Glucose Tolerance, and Psychosocial Conditions
Authors: Lidfeldt Jonas , Samsioe Göran , Agardh Carl-David
Published: October 2006

OBJECTIVE— To evaluate the relation between cardiovascular disease (CVD) risk factors and hormone therapy, serum hormone levels, glucose tolerance, and psychosocial and psychological conditions in subjectively healthy obese female subjects.

RESEARCH DESIGN AND METHODS— The study included 606 women, aged 50–64 years, with BMI 30–40 kg/m2 and no history of cardiovascular or other severe diseases. One group with a CVD risk profile (n = 473) (i.e., cholesterol >7.0 mmol/l, HDL cholesterol <1.2 mmol/l, triglycerides >2.0 mmol/l, systolic or diastolic blood pressure >140/90 mmHg, or waist-to-hip ratio >0.85) was compared with women without such risk (n = 133). Steroid hormones, leptin, insulin, and oral glucose tolerance tests (OGTTs) were analyzed. A subgroup of women with baseline impaired glucose tolerance (IGT) completed a 2.5-year follow-up OGTT.

RESULTS— Fewer obese postmenopausal women with CVD risk had ever used hormone therapy (odds ratio 0.24 [95% CI 0.07–0.75]), after multivariate adjustments. Furthermore, women with CVD risk had a higher testosterone index (1.07 [1.01–1.13]) and more had insulin resistance (1.04 [1.00–1.08]) and IGT (2.92 [1.50–5.69]), while OGTT was similar at follow-up. No differences were observed regarding family history or lifestyle, except that fewer women with CVD risk consumed fruits, boiled vegetables, or whole-grain cereals. More women with CVD risk lived alone (3.26 [1.28–8.31]) and had more mental problems (1.16 [1.05–1.28]).

CONCLUSIONS— Previously healthy obese women with a CVD risk profile seemed to have a high risk of diabetes, as well as psychosocial or psychological problems. Hormone therapy was associated with reduced CVD risk. Obesity’s growing burden on society makes it more important to further target individuals that are at greatest risk of future health hazards.
Treatment of Onychomycosis in Diabetic Patients
Authors: Winston Jason A. , Miller Jami L.
Published: October 2006

IN BRIEF

Onychomycosis is more common in diabetic than nondiabetic patients. It is more than a cosmetic problem, and diabetic patients have a greater risk of serious complications from the disease, including limb amputations. This article reviews the various diagnostic and therapeutic options available for onychomycosis with an emphasis on their roles in diabetic patients.
Imputation
Authors: Cook Samantha R. , Rubin Donald B.
Published: October 2006

Missing data are a common problem with datasets in clinical trials. Imputation, or filling in the missing values, is an intuitive and flexible way to handle incomplete data. Here the authors present several imputation strategies and their theoretical background, as well as some current examples and advice on computation. Multiple imputation is a statistically valid strategy for handling missing data.
Allocation Concealment
Authors: Schulz Kenneth F.
Published: October 2006

Allocation concealment, as an integral part of randomization, implements an allocation sequence. Inadequate allocation concealment can lead to exaggerated estimates of treatment effect, but with scope for bias in both directions. Without adequate allocation concealment, even proper random assignment sequences can be subverted. Investigators must recognize the inquisitiveness and ingeniousness of human nature and “immunize” trials against selection and confounding biases with proper allocation concealment.
Combination Therapy
Authors: Darbyshire Janet
Published: October 2006

Combination therapy regimens most commonly combine two or more drugs which have additive or synergistic action to treat a disease more effectively, frequently infections or cancer, with the aim of producing more effective regimens and preventing the emergence of resistance of the micro‐organism or the tumour to the drugs. However combinations of drugs are widely used to treat many other diseases such as hypertension, asthma, diabetes and arthritis. Combinations of drugs and other modalities, such as surgery or radiotherapy, are also used in certain disease areas, such as cancer.
Obsessive‐compulsive disorder is not a clinical manifestation of the DYT1 dystonia gene
Authors: Heiman Gary A. , Ottman Ruth , Saunders‐Pullman Rachel J. , Ozelius Laurie J. , Risch Neil J. , Bressman Susan B.
Published: October 2006

Prior studies suggest that obsessive‐compulsive symptoms (OCS) and disorder (OCD) are co‐morbid with dystonia. We tested if OCS/OCD is a clinical manifestation of the DYT1 dystonia mutation by interviewing members of families with an identified DYT1 mutation, and classifying by manifesting carriers (MC), non‐manifesting carriers (NMC), and non‐carriers (NC). We found that OCD/OCS are not increased in DYT1 mutation carriers compared with NC, nor is OCD associated with manifesting DYT1 dystonia. © 2006 Wiley‐Liss, Inc.
Uncertainty inBRCA1cancer susceptibility testing
Authors: Baty Bonnie J. , Dudley William N. , Musters Adrian , Kinney Anita Y.
Published: October 2006

This study investigated uncertainty in individuals undergoing genetic counseling/testing for breast/ovarian cancer susceptibility. Sixty‐three individuals from a single kindred with a knownBRCA1mutation rated uncertainty about 12 items on a five‐point Likert scale before and 1 month after genetic counseling/testing. Factor analysis identified a five‐item total uncertainty scale that was sensitive to changes before and after testing. The items in the scale were related to uncertainty about obtaining health care, positive changes after testing, and coping well with results. The majority of participants (76%) rated reducing uncertainty as an important reason for genetic testing. The importance of reducing uncertainty was stable across time and unrelated to anxiety or demographics. Yet, at baseline, total uncertainty was low and decreased after genetic counseling/testing (P = 0.004). Analysis of individual items showed that after genetic counseling/testing, there waslessuncertainty about the participant detecting cancer early (P = 0.005) and coping well with their result (P < 0.001). Our findings support the importance to clients of genetic counseling/testing as a means of reducing uncertainty. Testing may help clients to reduce the uncertainty about items they can control, and it may be important to differentiate the sources of uncertainty that are more or less controllable. Genetic counselors can help clients by providing anticipatory guidance about the role of uncertainty in genetic testing. © 2006 Wiley‐Liss, Inc.
Magnetic resonance imaging profiles predict clinical response to early reperfusion: The diffusion and perfusion imaging evaluation for understanding stroke evolution (DEFUSE) study
Authors: Albers Gregory W. , Thijs Vincent N. , Wechsler Lawrence , Kemp Stephanie , Schlaug Gottfried , Skalabrin Elaine , Bammer Roland , Kakuda Wataru , Lansberg Maarten G. , Shuaib Ashfaq , Coplin William , Hamilton Scott , Moseley Michael , Marks Michael P.
Published: October 2006

Objective

To determine whether prespecified baseline magnetic resonance imaging (MRI) profiles can identify stroke patients who have a robust clinical response after early reperfusion when treated 3 to 6 hours after symptom onset.

Methods

We conducted a prospective, multicenter study of 74 consecutive stroke patients admitted to academic stroke centers in North America and Europe. An MRI scan was obtained immediately before and 3 to 6 hours after treatment with intravenous tissue plasminogen activator 3 to 6 hours after symptom onset. Baseline MRI profiles were used to categorize patients into subgroups, and clinical responses were compared based on whether early reperfusion was achieved.

Results

Early reperfusion was associated with significantly increased odds of achieving a favorable clinical response in patients with a perfusion/diffusion mismatch (odds ratio, 5.4; p = 0.039) and an even more favorable response in patients with the Target Mismatch profile (odds ratio, 8.7; p = 0.011). Patients with the No Mismatch profile did not appear to benefit from early reperfusion. Early reperfusion was associated with fatal intracranial hemorrhage in patients with the Malignant profile.

Interpretation

For stroke patients treated 3 to 6 hours after onset, baseline MRI findings can identify subgroups that are likely to benefit from reperfusion therapies and can potentially identify subgroups that are unlikely to benefit or may be harmed. Ann Neurol 2006
Regio‐ and stereo‐selectivity in the silylation of 2,6‐diethyl‐3,4,7,8‐tetramethyl‐1,5‐dihydro‐s‐indacene
Authors: Dahrouch M. , Burgos F. , Castel A. , Chavez I. , Gornitzka H. , Manriquez J. M. , Rivière P. , Rivière‐Baudet M. , Alvarez J. , Onyszchuk M.
Published: October 2006

Disilylation of 2,6‐diethyl‐3,4,7,8‐tetramethyl‐1,5‐dihydro‐s‐indacene is regioselective and stereoselective. The stereoselectivity was modified by changing the experimental conditions, allowing an understanding of the reaction mechanism. The structure of the ‘meso’ diastereoisomer was established by X‐ray diffraction. Copyright © 2006 John Wiley & Sons, Ltd.
Boryl‐substituted 1‐silacyclobutenes. Formation and molecular structure
Authors: Wrackmeyer Bernd , Khan Ezzat , Kempe Rhett
Published: October 2006

The 1,2‐hydroboration of the chloro(hexyn‐1‐yl)‐ (1a) and chloro(phenylethyn‐1‐yl)diphenylsilanes (1b) with 9‐borabicyclo[3.3.1]nonane afforded selectively the alkenylsilanes 2a, b, in which the boryl and the silyl groups are linked to the same olefinic carbon atom. In case of 2a, treatment with phenylethynyl lithium gave a mixture of the alkyn‐1‐ylborate 3a and the alkenyl(phenylethynyl)diphenylsilanes 4a. In the case of 2b, only the alkyn‐1‐ylsilane 4b was identified as an intermediate. Both 4a, b slowly rearranged by intramolecular 1,1‐vinylboration into the silacyclobutenes 5a, b. The intermediates were characterized by 1H, 11B, 13C and 29Si NMR spectroscopy in solution, and the molecular structure of the 1‐silacyclobutene 5a was determined by X‐ray analysis. The gas phase geometries of model molecules corresponding to 5a were optimized by MO calculations using DFT methods [B3LYP/6‐311 + G(d,p) level of theory], found to be in reasonable agreement with the results of the crystal structure determination, and NMR parameters were calculated at the same level of theory. Copyright © 2006 John Wiley & Sons, Ltd.
Preparation and morphology study of microporous poly(HEMA–MMA) particles
Authors: Fang Dongyu , Pan Qinmin , Rempel Garry L.
Published: October 2006

Porous poly(2‐hydroxyethyl methacrylate‐methyl methacrylate) particles crosslinked with ethylene glycol dimethacrylate were synthesized by free‐radical suspension copolymerization in an aqueous phase initiated by an oil‐soluble initiator, 2,2‐azobisisobutyronitrile. 1‐octanol was used as a pore forming agent (porogen). The porous structures, the particle morphology, and the swelling capacity of the resultant polymer in water at room temperature were studied at different crosslink densities and under various porogen concentrations. The analysis via Scanning Electronic Microscopy (SEM) indicated that permanent pores remained in the dried polymeric particles prepared in the presence of the porogen at certain crosslink densities. According to the studies via the SEM pictures and the pore size distributions, higher porogen concentration promotes the formation of more pores, and higher crosslink density results in narrower pore size distribution. The swelling capacity of the particles in water at room temperature decreases with an increase in the crosslink density, and the existence of the highly porous structures enhances the swelling capacity of the porous particles of poly(2‐hydroxyethyl methacrylate‐methyl methacrylate). © 2006 Wiley Periodicals, Inc. J Appl Polym Sci 103: 707–715, 2007
Microbial synthesis of ethyl (R)‐4,4,4‐trifluoro‐3‐hydroxybutanoate by asymmetric reduction of ethyl 4,4,4‐trifluoroacetoacetate in an aqueous‐organic solvent biphasic system
Authors: He Junyao , Mao Xudong , Sun Zhihao , Zheng Pu , Ni Ye , Xu Yan
Published: October 2006

In this study, whole cells of Saccharomyces uvarum SW‐58 were applied in an aqueous‐organic solvent biphasic system for the asymmetric reduction of ethyl 4,4,4‐trifluoroacetoacetate to ethyl (R)‐4,4,4‐trifluoro‐3‐hydroxybutanoate [(R)‐2]. The results of reduction in different aqueous‐organic solvent biphasic systems showed that dibutylphthalate provided the best compromise between the biocompatibility and the partition of substrate and product among the solvents tested. To optimize the reaction, several factors such as reaction pH, temperature, shaking speed, volume ratio of the aqueous phase to the organic phase and ratio of biomass/substrate were investigated. It was found that the change of these factors obviously influenced the conversion and initial reaction rate, and had a minor effect on the enatiomeric excess of the product. Under the optimal conditions, 85.0% of conversion and 85.2% of enatiomeric excess were achieved. The bioconversion in the biphasic system was more efficient compared with that in the monophasic aqueous system, and product concentration as high as 54.6 g/L was reached in the organic phase without addition of co‐enzyme.
Challenging the stigma of sex work in India: material context and symbolic change
Authors: Cornish Flora
Published: October 2006

Stigmatization and discrimination against social groups raise obstacles to the participation of their members in community interventions. Internalized stigma and a lack of empowering experiences promote fatalistic expectations that little can be achieved. This paper discusses how the Sonagachi Project in Kolkata, India, challenges stigma as part of its community development and health promotion efforts with sex workers, drawing on interviews with 19 sex workers involved in the Project and one group discussion among the Project's leaders. The internalized stigma of prostitution is challenged (1) by asserting that sex workers have rights which should be respected, (2) by claiming equivalence to other oppressed but politically successful groups and (3) by providing evidence of sex workers' positive achievements. These arguments are made plausible to sex workers by a material context that provides evidence and experience of the possibility of change. I conclude that interventions designed to problematize stigma and discrimination should back up the conceptual alternatives that they present by producing concrete changes to a community's living conditions. Copyright © 2006 John Wiley & Sons, Ltd.
Towards a sustainable theory of health‐related stigma: lessons from the HIV/AIDS literature
Authors: Deacon Harriet
Published: October 2006

Stigma has been identified as a major barrier to health care and quality of life in illness management. But unfortunately there is no common theoretical perspective on stigma. We need a sustainable theory of health‐related stigma. This would start with a coherent definition of stigma that brings together both individual and social dimensions of this complex phenomenon. It would reassesses the existence of ‘types’ of stigma and explain how stigma relates to disadvantage. A sustainable theory would help researchers to move from theory into practice: to develop a comprehensive measurement tool for stigma and related disadvantage, and inform design, monitoring and evaluation of anti‐stigma interventions. This paper draws on two recent literature reviews on HIV/AIDS stigma to introduce several key issues in developing a sustainable theory of stigma. We suggest limiting the definition of stigma to the process of othering, blaming and shaming (often called symbolic stigma). We argue that there is value in analytically separating stigma from discrimination in order to better understand the relationship between them. We also suggest the need to understand discrimination caused by stigma as only one element of stigma‐related disadvantage. Copyright © 2006 John Wiley & Sons, Ltd.