bluuebunny/crossref_metadata_2025 huggingface dataset:
Modeling the Independent Effects of Gestational Diabetes Mellitus on Maternity Care and Costs
Authors: Gillespie Paddy , Cullinan John , O’Neill Ciaran , Dunne Fidelma ,   For the ATLANTIC DIP Collaborators
Published: December 2012

OBJECTIVE

To explore the independent effects of gestational diabetes mellitus (GDM) on maternity care and costs.

RESEARCH DESIGN AND METHODS

Estimates for maternity care resource activity and costs for 4,372 women, of whom 354 (8.1%) were diagnosed with GDM, were generated from data from the Atlantic Diabetes in Pregnancy (ATLANTIC DIP) database. Multivariate regression analysis was applied to explore the effects of GDM on 1) mode of delivery, 2) neonatal unit admission, and 3) maternity care cost, while controlling for a range of other demographic and clinical variables.

RESULTS

Women with a diagnosis of GDM had significantly higher levels of emergency caesarean section (odds ratio [OR] 1.75 [95% CI 1.08–2.81]), their infants had significantly higher levels of neonatal unit admission (3.14 [2.27–4.34]), and costs of care were 34% greater (25–43) than in women without GDM. Other variables that significantly increased costs were weight, age, primiparity, and premature delivery.

CONCLUSIONS

GDM plays an independent role in explaining variations in rates of emergency caesarean section, neonatal unit admission, and costs of care, placing a substantial economic burden on maternity care services. Interventions that prevent the onset of GDM have the potential to yield substantial economic and clinical benefits.
Older Subjects With Diabetes and Prediabetes Are Frequently Unaware of Having Distal Sensorimotor Polyneuropathy
Authors: Bongaerts Brenda W.C. , Rathmann Wolfgang , Heier Margit , Kowall Bernd , Herder Christian , Stöckl Doris , Meisinger Christa , Ziegler Dan
Published: December 2012

OBJECTIVE

Distal sensorimotor polyneuropathy (DSPN) is a severe complication of type 2 diabetes. This study aimed to assess the prevalence of unawareness of DSPN in prediabetes and diabetes in a sample of the older population of Augsburg, Germany.

RESEARCH DESIGN AND METHODS

Glucose tolerance status was determined in 61- to 82-year-old participants of the population-based KORA F4 Study (2006–2008) (n = 1,100). Clinical DSPN was defined as the presence of bilaterally impaired foot-vibration perception and/or bilaterally impaired foot-pressure sensation. DSPN case subjects were considered unaware of their condition when answering “no” to the question, “Has a physician ever told you that you are suffering from nerve damage, neuropathy, polyneuropathy, or diabetic foot?”

RESULTS

Clinical DSPN was prevalent in 154 (14%) participants, 140 of whom were unaware of their disorder. At a prevalence of 23.9% (95% CI 12.6–38.8), participants with combined impaired fasting glucose and impaired glucose tolerance had the highest prevalence of DSPN. Of these, 10 of 11 (91%) were unaware of having clinical DSPN. Participants with known diabetes had an equally high prevalence of DSPN [22.0% (16.2–28.9)], with 30 of the 39 (77%) DSPN case subjects unaware of having the disorder. Among subjects with known diabetes who reported to have had their feet examined by a physician, 18 of 25 (72%) clinical DSPN case subjects emerged unaware of having DSPN.

CONCLUSIONS

Our findings showed a high prevalence of unawareness of having clinical DSPN among the prediabetic and diabetic groups and an insufficient frequency of professional foot examinations, suggesting inadequate attention to diabetic foot prevention practice.
Effects of Type 2 Diabetes on 12-Year Cognitive Change
Authors: Spauwen Peggy J.J. , Köhler Sebastian , Verhey Frans R.J. , Stehouwer Coen D.A. , van Boxtel Martin P.J.
Published: December 2012

OBJECTIVE

To examine the effects of baseline and incident diabetes on change in cognitive function over 12 years.

RESEARCH DESIGN AND METHODS

A sample of 1,290 individuals aged ≥40 years at baseline, participating in the Maastricht Aging Study, were cognitively tested at baseline, after 6 years, and after 12 years. Of these, 68 participants had type 2 diabetes at baseline, and 54 and 57 had incident diabetes at the 6- and 12-year follow-up, respectively. Changes in performance on tests of information-processing speed, executive function, and verbal memory from baseline to 6- and 12-year follow-up were compared between groups using linear mixed models. Effects of diabetes on cognitive decline were adjusted for demographic variables, history of smoking, alcohol intake, and comorbid conditions, including hypertension, cardiovascular disease, BMI, and depression.

RESULTS

Participants with baseline diabetes showed larger decline in information-processing speed (estimate −7.64; P < 0.01), executive function (21.82; P < 0.01), and delayed word recall (−1.35; P < 0.05) over the 12-year follow-up compared with control subjects. No significant difference in decline was observed for immediate word recall. Compared with control subjects, participants with incident diabetes showed subtle early decline in information-processing speed only. Interestingly, they did not show larger decline in any other cognitive domain.

CONCLUSIONS

Individuals with baseline type 2 diabetes show accelerated cognitive decline, particularly in information-processing speed and executive function, compared with individuals without diabetes. In incident diabetes, decline in speed becomes detectable first, and cognitive decline seems to increase with increasing exposure time.
Predicting Development of Proliferative Diabetic Retinopathy
Authors: Harris Nwanyanwu Kristen , Talwar Nidhi , Gardner Thomas W. , Wrobel James S. , Herman William H. , Stein Joshua D.
Published: December 2012

OBJECTIVE

Identifying individuals most at risk for diabetic retinopathy progression and intervening early can limit vision loss and reduce the costs associated with managing more advanced disease. The purpose of this study was to identify factors associated with progression from nonproliferative diabetic retinopathy (NPDR) to proliferative diabetic retinopathy (PDR).

RESEARCH DESIGN AND METHODS

This was a retrospective cohort analysis using a claims database of all eye care recipients age ≥30 years enrolled in a large managed-care network from 2001 to 2009. Individuals with newly diagnosed NPDR were followed longitudinally. Multivariable Cox regression analyses identified factors associated with progression to PDR. Three- and five-year probabilities of retinopathy progression were determined.

RESULTS

Among the 4,617 enrollees with incident NPDR, 307 (6.6%) developed PDR. After adjustment for confounders, every 1-point increase in HbA1c was associated with a 14% (adjusted hazard ratio 1.14 [95% CI 1.07–1.21]) increased hazard of developing PDR. Those with nonhealing ulcers had a 54% (1.54 [1.15–2.07]) increased hazard of progressing to PDR, and enrollees with nephropathy had a marginally significant increased hazard of progressing to PDR (1.29 [0.99–1.67]) relative to those without these conditions. The 5-year probability of progression for low-risk individuals with NPDR was 5% (range 2–8) and for high-risk patients was 38% (14–55).

CONCLUSIONS

Along with glycemic control, nonophthalmologic manifestations of diabetes mellitus (e.g., nephropathy and nonhealing ulcers) are associated with an increased risk of diabetic retinopathy progression. Our retinopathy progression risk score can help clinicians stratify patients who are most at risk for disease progression.
Zinc-α2-Glycoprotein Is Associated With Insulin Resistance in Humans and Is Regulated by Hyperglycemia, Hyperinsulinemia, or Liraglutide Administration
Authors: Yang Mengliu , Liu Rui , Li Shu , Luo Yu , Zhang Yali , Zhang Lili , Liu Dongfang , Wang Yaxu , Xiong Zhengai , Boden Guenther , Chen Shirong , Li Ling , Yang Gangyi
Published: December 2012

OBJECTIVE

Zinc-α2-glycoprotein (ZAG) has been proposed to play a role in the pathogenesis of insulin resistance. Previous studies in humans and in rodents have produced conflicting results regarding the link between ZAG and insulin resistance. The objective of this study was to examine the relationships between ZAG and insulin resistance in cross-sectional and interventional studies.

RESEARCH DESIGN AND METHODS

Serum ZAG (determined with ELISA) was compared with various parameters related to insulin resistance in subjects with normal glucose tolerance, impaired glucose tolerance (IGT), and newly diagnosed type 2 diabetes mellitus (T2DM), and in women with or without polycystic ovary syndrome (PCOS). Euglycemic-hyperinsulinemic clamps were performed in healthy and PCOS women. Real-time RT-PCR and Western blotting were used to assess mRNA and protein expression of ZAG. The effect of a glucagon-like peptide-1 agonist on ZAG was studied in a 12-week liraglutide treatment trial.

RESULTS

Circulating ZAG was lower in patients with IGT and newly diagnosed T2DM than in controls. Circulating ZAG correlated positively with HDL cholesterol and adiponectin, and correlated inversely with BMI, waist-to-hip ratio, body fat percentage, triglycerides, fasting blood glucose, fasting insulin, HbA1c, and homeostasis model assessment of insulin resistance (HOMA-IR). On multivariate analysis, ZAG was independently associated with BMI, HOMA-IR, and adiponectin. ZAG mRNA and protein were decreased in adipose tissue of T2DM patients. Moreover, circulating ZAG levels were lower in women with PCOS than in women with high insulin sensitivity. Liraglutide treatment for 12 weeks significantly increased circulating ZAG levels.

CONCLUSIONS

We conclude that ZAG may be an adipokine associated with insulin resistance.
Nicotinuric Acid
Authors: Huang Chun-Feng , Cheng Mei-Ling , Fan Chun-Ming , Hong Chuang-Ye , Shiao Ming-Shi
Published: December 2012

OBJECTIVE

Metabolic syndrome is a multiplex disorder and puts patients on the road to type 2 diabetes and atherosclerotic cardiovascular diseases. However, a surrogate biomarker in plasma or urine in fully reflecting features of metabolic syndrome has not been explored.

RESEARCH DESIGN AND METHODS

Urine metabolomics has potential utility in metabolic profiling because urine metabolites analysis reflects global outflux of metabolic change. Accordingly, we collected data on subjects (n = 99) with overweight, dyslipidemia, hypertension or impaired glucose tolerance and took a metabolomics approach to analyze the metabolites of urine revealed in metabolic syndrome by high-performance liquid chromatography–time-of-flight mass spectrometry and elicit potential biomarkers to picture metabolic syndrome.

RESULTS

Our results revealed that the urine nicotinuric acid value of subjects with diabetes (HbA1c ≥6.5% or those receiving diabetes medications) (n = 25) was higher than subjects without diabetes (n = 37) (221 ± 31 vs. 152 ± 13 × 103 mAU, P = 0.0268). Moreover, urinary nicotinuric acid level was positively correlated with body mass index, blood pressure, total cholesterol, low-density lipoprotein cholesterol, triacylglycerol and high sensitivity C-reactive protein, but negatively correlated with high-density lipoprotein cholesterol.

CONCLUSIONS

This is the first study, to our knowledge, to propose that nicotinuric acid represents an important pathogenic mechanism in process from metabolic syndrome to diabetes and atherosclerotic cardiovascular disease.
Peripheral Neuropathy Defined by Monofilament Insensitivity and Diabetes Status
Authors: Katon Jodie G. , Reiber Gayle E. , Nelson Karin M.
Published: December 2012

OBJECTIVE

To determine whether diabetes status, including prediabetes, is associated with increased risk of peripheral neuropathy as defined by monofilament insensitivity.

RESEARCH DESIGN AND METHODS

This study used data from the 1999–2004 National Health and Nutrition Examination Survey (n = 7,818). Peripheral neuropathy was defined as one or more insensate sites detected by a Semmes-Weinstein 10-g monofilament. Generalized linear models were used to directly estimate relative risks (RRs) for the association of diabetes status and peripheral neuropathy.

RESULTS

After adjustment compared with no diabetes, prediabetes [RR 1.11 (95% CI 0.92–1.34)] and undiagnosed diabetes [1.08 (0.73–1.61)] were associated with modest increases in risk of peripheral neuropathy, and diabetes was associated with a 74% higher risk of peripheral neuropathy [1.74 (1.50–2.01)].

CONCLUSIONS

Diabetes is associated with increased risk of peripheral neuropathy defined by monofilament insensitivity, but prediabetes and undiagnosed diabetes may be associated with only a modest increase in risk.
Temporal Validation of the UKPDS Outcomes Model Using 10-Year Posttrial Monitoring Data
Authors: Leal Jose , Hayes Alison J. , Gray Alastair M. , Holman Rury R. , Clarke Philip M.
Published: December 2012

OBJECTIVE

To evaluate the accuracy of the UK Prospective Diabetes Study Outcomes Model (UKPDS-OM) in predicting clinical outcomes during the UKPDS posttrial monitoring (PTM) period.

RESEARCH DESIGN AND METHODS

At trial end in 1997, the 4,031 surviving UKPDS patients, of the 5,102 originally enrolled in the study, returned to their usual care providers, with no attempts made to maintain them in their randomized therapy groups. PTM risk factor data were collected for 5 years and clinical outcome data for 10 years. The UKPDS-OM was used firstly to forecast likely progression of HbA1c, systolic blood pressure, total-to-HDL cholesterol ratio, and smoking status and secondly to estimate the likely first occurrence of seven major diabetes-related complications or death from any cause. Model predictions were compared against observed PTM data for risk factor time paths and survival probabilities for major diabetes complications.

RESULTS

UKPDS-OM–forecasted risk factor time paths were similar to those observed for HbA1c (up to 3 years) and total-to-HDL cholesterol ratio but underestimated for systolic blood pressure and smoking status. Predicted 10-year event probabilities were similar to those observed for blindness, ischemic heart disease, myocardial infarction, and renal failure but were higher for heart failure and death from any cause and lower for stroke and amputation.

CONCLUSIONS

The UKPDS-OM has good predictive accuracy for two of four risk factor time paths and for 10-year clinical outcome probabilities with the exception of stroke, amputation, heart failure, and death from any cause. An updated version of the model incorporating PTM data is being developed.
Glucose-Independent Ethnic Differences in HbA1c in People Without Known Diabetes
Authors: Hare Matthew J.L. , Magliano Dianna J. , Zimmet Paul Z. , Söderberg Stefan , Joonas Noorjehan , Pauvaday Vassen , Larhubarbe José , Tuomilehto Jaakko , Kowlessur Sudhir , Alberti K. George M.M. , Shaw Jonathan E.
Published: December 2012

OBJECTIVE

To determine whether glucose-independent differences in HbA1c exist between people of African, South Asian, and Chinese ethnicities.

RESEARCH DESIGN AND METHODS

Data from 6,701 people aged 19–78 years, without known diabetes, from Mauritius, and participating in the population-based Non-Communicable Disease Surveys of the main island and the island of Rodrigues were included. Participants were African (n = 1,219 from main island, n = 1,505 from Rodrigues), South Asian (n = 3,820), and Chinese (n = 157). Survey data included HbA1c, plasma glucose during oral glucose tolerance testing (OGTT), anthropometry, demographics, and medical and lifestyle history.

RESULTS

Mean HbA1c, after adjustment for fasting and 2-h plasma glucose and other factors known to influence HbA1c, was higher in Africans from Rodrigues (6.1%) than in South Asians (5.7%, P < 0.001), Chinese (5.7%, P < 0.001), or Africans from the main island of Mauritius (5.7%, P < 0.001). The age-standardized prevalence of diabetes among Africans from Rodrigues differed substantially depending on the diagnostic criteria used [OGTT 7.9% (95% CI 5.8–10.0); HbA1c 17.3% (15.3–19.2)]. Changing diagnostic criteria resulted in no significant change in the prevalence of diabetes within the other ethnic groups.

CONCLUSIONS

People of African ethnicity from Rodrigues have higher HbA1c than those of South Asian or African ethnicity from the main island of Mauritius for reasons not explained by plasma glucose during an OGTT or traditional factors known to affect glycemia. Further research should be directed at determining the mechanism behind this disparity and its relevance to clinical outcomes.
Translating the Diabetes Prevention Program Into American Indian and Alaska Native Communities
Authors: Jiang Luohua , Manson Spero M. , Beals Janette , Henderson William G. , Huang Haixiao , Acton Kelly J. , Roubideaux Yvette ,   the Special Diabetes Program for Indians Diabetes Prevention Demonstration Project
Published: December 2012

OBJECTIVE

The landmark Diabetes Prevention Program (DPP) showed that lifestyle intervention can prevent or delay the onset of diabetes for those at risk. We evaluated a translational implementation of this intervention in a diverse set of American Indian and Alaska Native (AI/AN) communities.

RESEARCH DESIGN AND METHODS

The Special Diabetes Program for Indians Diabetes Prevention (SDPI-DP) demonstration project implemented the DPP lifestyle intervention among 36 health care programs serving 80 tribes. A total of 2,553 participants with prediabetes were recruited and started intervention by 31 July 2008. They were offered the 16-session Lifestyle Balance Curriculum and underwent a thorough clinical assessment for evaluation of their diabetes status and risk at baseline, soon after completing the curriculum (postcurriculum), and annually for up to 3 years. Diabetes incidence was estimated. Weight loss, changes in blood pressure and lipid levels, and lifestyle changes after intervention were also evaluated.

RESULTS

The completion rates of SDPI-DP were 74, 59, 42, and 33% for the postcurriculum and year 1, 2, and 3 assessments, respectively. The crude incidence of diabetes among SDPI-DP participants was 4.0% per year. Significant improvements in weight, blood pressure, and lipid levels were observed immediately after the intervention and annually thereafter for 3 years. Class attendance strongly correlated with diabetes incidence rate, weight loss, and change in systolic blood pressure.

CONCLUSIONS

Our findings demonstrate the feasibility and potential of translating the lifestyle intervention in diverse AI/AN communities. They have important implications for future dissemination and institutionalization of the intervention throughout the Native American health system.
Once-Weekly Exenatide Versus Once- or Twice-Daily Insulin Detemir
Authors: Davies Melanie , Heller Simon , Sreenan Seamus , Sapin Hélène , Adetunji Omolara , Tahbaz Arash , Vora Jiten
Published: December 2012

OBJECTIVE

This multicenter, open-label, parallel-arm study compared the efficacy and safety of exenatide once weekly (EQW) with titrated insulin detemir in patients with type 2 diabetes inadequately controlled with metformin (with or without sulfonylureas).

RESEARCH DESIGN AND METHODS

Patients were randomized to EQW (2 mg) or detemir (once or twice daily, titrated to achieve fasting plasma glucose ≤5.5 mmol/L) for 26 weeks. The primary outcome was proportion of patients achieving A1C ≤7.0% and weight loss ≥1.0 kg at end point, analyzed by means of logistic regression. Secondary outcomes included measures of glycemic control, cardiovascular risk factors, and safety and tolerability.

RESULTS

Of 216 patients (intent-to-treat population), 111 received EQW and 105 received detemir. Overall, 44.1% (95% CI, 34.7–53.9) of EQW-treated patients compared with 11.4% (6.0–19.1) of detemir-treated patients achieved the primary outcome (P < 0.0001). Treatment with EQW resulted in significantly greater reductions than detemir in A1C (least-square mean ± SE, −1.30 ± 0.08% vs. −0.88 ± 0.08%; P < 0.0001) and weight (−2.7 ± 0.3 kg vs. +0.8 ± 0.4 kg; P < 0.0001). Gastrointestinal-related and injection site–related adverse events occurred more frequently with EQW than with detemir. There was no major hypoglycemia in either group. Five (6%) patients in the EQW group and six (7%) patients in the detemir group experienced minor hypoglycemia; only one event occurred without concomitant sulfonylureas (detemir group).

CONCLUSIONS

Treatment with EQW resulted in a significantly greater proportion of patients achieving target A1C and weight loss than treatment with detemir, with a low risk of hypoglycemia. These results suggest that EQW is a viable alternative to insulin detemir treatment in patients with type 2 diabetes with inadequate glycemic control using oral antidiabetes drugs.
Measurement of Waist Circumference
Authors: Ma Wen-Ya , Yang Chung-Yi , Shih Shyang-Rong , Hsieh Hong-Jen , Hung Chi Sheng , Chiu Fu-Chun , Lin Mao-Shin , Liu Pi-Hua , Hua Cyue-Huei , Hsein Yenh-Chen , Chuang Lee-Ming , Lin Jou-Wei , Wei Jung-Nan , Li Hung-Yuan
Published: December 2012

OBJECTIVE

Waist circumference (WC) is used to define central obesity. This study aimed to compare the performance of two recommended locations of WC measurement.

RESEARCH DESIGN AND METHODS

A cohort of 1,898 subjects who were without diabetes from 2006 to 2012 were followed for a median of 31 months (Taiwan Lifestyle Study). The WC-IC, recommended by the National Cholesterol Education Program Third Adult Treatment Panel, was measured at the superior border of the iliac crest, and the WC-mid, recommended by World Health Organization and International Diabetes Federation, was measured midway between the lowest ribs and the iliac crest. The abdominal subcutaneous fat area (SFA) and visceral fat area (VFA) were assessed by computed tomography.

RESULTS

There was greater difference between WC-IC and WC-mid measurements in women than in men (P < 0.001). Both WC-IC and WC-mid correlated significantly with BMI, VFA, and SFA (all P < 0.001). WC-mid was better correlated to VFA than WC-IC, particularly in women, and it correlated more strongly to blood pressure, plasma glucose, hemoglobin A1c, triglyceride levels, HDL cholesterol, and C-reactive protein (all P < 0.05). The association of WC-mid with hypertension, diabetes, and metabolic syndrome was slightly better than that of WC-IC (area under the receiver operator curve 0.7 vs. 0.69, 0.71 vs. 0.68, and 0.75 vs. 0.7, respectively; all age-adjusted P < 0.05). With 90 cm (male)/80 cm (female) as criteria for central obesity, WC-mid, but not WC-IC, predicted the incidence of diabetes development (age-adjusted P = 0.003).

CONCLUSIONS

WC-mid is a better measurement to define central obesity than WC-IC, particularly in women.
Impact of Diabetes on Long-Term Outcome After Primary Angioplasty
Authors: De Luca Giuseppe , Dirksen Maurits T. , Spaulding Christian , Kelbæk Henning , Schalij Martin , Thuesen Leif , van der Hoeven Bas , Vink Marteen A. , Kaiser Christoph , Musto Carmine , Chechi Tania , Spaziani Gaia , Diaz de la Llera Luis Salvador , Pasceri Vincenzo , Di Lorenzo Emilio , Violini Roberto , Suryapranata Harry , Stone Gregg W. ,   for the DESERT cooperation
Published: December 2012

OBJECTIVE

Diabetes has been shown to be associated with worse survival and repeat target vessel revascularization (TVR) after primary angioplasty. The aim of the current study was to evaluate the impact of diabetes on long-term outcome in patients undergoing primary angioplasty treated with bare metal stents (BMS) and drug-eluting stents (DES).

RESEARCH DESIGN AND METHODS

Our population is represented by 6,298 ST-segment elevation myocardial infarction (STEMI) patients undergoing primary angioplasty included in the DESERT database from 11 randomized trials comparing DES with BMS.

RESULTS

Diabetes was observed in 972 patients (15.4%) who were older (P < 0.001), more likely to be female (P < 0.001), with higher prevalence of hypertension (P < 0.001), hypercholesterolemia (P < 0.001), and longer ischemia time (P < 0.001), and without any difference in angiographic and procedural characteristics. At long-term follow-up (1,201 ± 441 days), diabetes was associated with higher rates of death (19.1% vs. 7.4%; P < 0.0001), reinfarction (10.4% vs. 7.5%; P < 0.001), stent thrombosis (7.6% vs. 4.8%; P = 0.002) with similar temporal distribution—acute, subacute, late, and very late—between diabetic and control patients, and TVR (18.6% vs. 15.1%; P = 0.006). These results were confirmed in patients receiving BMS or DES, except for TVR, there being no difference observed between diabetic and nondiabetic patients treated with DES. The impact of diabetes on outcome was confirmed after correction for baseline confounding factors (mortality, P < 0.001; repeat myocardial infarction, P = 0.006; stent thrombosis, P = 0.007; TVR, P = 0.027).

CONCLUSIONS

This study shows that among STEMI patients undergoing primary angioplasty, diabetes is associated with worse long-term mortality, reinfarction, and stent thrombosis in patients receiving DES and BMS. DES implantation, however, does mitigate the known deleterious effect of diabetes on TVR after BMS.
Measuring β-Cell Function Relative to Insulin Sensitivity in Youth
Authors: Sjaarda Lindsey , Lee SoJung , Tfayli Hala , Bacha Fida , Bertolet Marnie , Arslanian Silva
Published: December 2012

OBJECTIVE

To compare β-cell function relative to insulin sensitivity, disposition index (DI), calculated from two clamps (2cDI, insulin sensitivity from the hyperinsulinemic-euglycemic clamp and first-phase insulin from the hyperglycemic clamp) with the DI calculated from the hyperglycemic clamp alone (hcDI).

RESEARCH DESIGN AND METHODS

Complete data from hyperglycemic and hyperinsulinemic-euglycemic clamps were available for 330 youth: 73 normal weight, 168 obese with normal glucose tolerance, 57 obese with impaired glucose tolerance, and 32 obese with type 2 diabetes. The correlation between hcDI and 2cDI and Bland-Altman analysis of agreement between the two were examined.

RESULTS

Insulin sensitivity and first-phase insulin from hcDI showed a hyperbolic relationship. The hcDI correlated significantly with 2cDI in the groups combined (r = 0.85, P < 0.001) and within each group separately (r ≥ 62, P < 0.001). Similar to 2cDI, hcDI showed a declining pattern of β-cell function across the glucose-tolerance groups. Overall, hcDI values were 27% greater than 2cDI, due to the hyperglycemic versus euglycemic conditions, reflected in a positive bias with Bland-Altman analysis.

CONCLUSIONS

β-Cell function relative to insulin sensitivity could be accurately evaluated from a single hyperglycemic clamp, obviating the need for two separate clamp experiments, when lessening participant burden and reducing research costs are important considerations.
Grape Polyphenols Prevent Fructose-Induced Oxidative Stress and Insulin Resistance in First-Degree Relatives of Type 2 Diabetic Patients
Authors: Hokayem Marie , Blond Emilie , Vidal Hubert , Lambert Karen , Meugnier Emmanuelle , Feillet-Coudray Christine , Coudray Charles , Pesenti Sandra , Luyton Cedric , Lambert-Porcheron Stéphanie , Sauvinet Valerie , Fedou Christine , Brun Jean-Frédéric , Rieusset Jennifer , Bisbal Catherine , Sultan Ariane , Mercier Jacques , Goudable Joelle , Dupuy Anne-Marie , Cristol Jean-Paul , Laville Martine , Avignon Antoine
Published: December 2012

OBJECTIVE

To assess the clinical efficacy of nutritional amounts of grape polyphenols (PPs) in counteracting the metabolic alterations of high-fructose diet, including oxidative stress and insulin resistance (IR), in healthy volunteers with high metabolic risk.

RESEARCH DESIGN AND METHODS

Thirty-eight healthy overweight/obese first-degree relatives of type 2 diabetic patients (18 men and 20 women) were randomized in a double-blind controlled trial between a grape PP (2 g/day) and a placebo (PCB) group. Subjects were investigated at baseline and after 8 and 9 weeks of supplementation, the last 6 days of which they all received 3 g/kg fat-free mass/day of fructose. The primary end point was the protective effect of grape PPs on fructose-induced IR.

RESULTS

In the PCB group, fructose induced 1) a 20% decrease in hepatic insulin sensitivity index (P < 0.05) and an 11% decrease in glucose infusion rate (P < 0.05) as evaluated during a two-step hyperinsulinemic-euglycemic clamp, 2) an increase in systemic (urinary F2-isoprostanes) and muscle (thiobarbituric acid–reactive substances and protein carbonylation) oxidative stress (P < 0.05), and 3) a downregulation of mitochondrial genes and decreased mitochondrial respiration (P < 0.05). All the deleterious effects of fructose were fully blunted by grape PP supplementation. Antioxidative defenses, inflammatory markers, and main adipokines were affected neither by fructose nor by grape PPs.

CONCLUSIONS

A natural mixture of grape PPs at nutritional doses efficiently prevents fructose-induced oxidative stress and IR. The current interest in grape PP ingredients and products by the global food and nutrition industries could well make them a stepping-stone of preventive nutrition.
Early-Onset, Coexisting Autoimmunity and Decreased HLA-Mediated Susceptibility Are the Characteristics of Diabetes in Down Syndrome
Authors: Aitken Rachel J. , Mehers Kay L. , Williams Alistair J. , Brown Jamie , Bingley Polly J. , Holl Reinhard W. , Rohrer Tilman R. , Schober Edith , Abdul-Rasoul Majedah M. , Shield Julian P.H. , Gillespie Kathleen M.
Published: December 2012

OBJECTIVE

Down syndrome (DS) is associated with an increased risk of diabetes, particularly in young children. HLA-mediated risk is however decreased in children with DS and diabetes (DSD). We hypothesized that early-onset diabetes in children with DS is etiologically different from autoimmune diabetes.

RESEARCH DESIGN AND METHODS

Clinical and immunogenetic markers of autoimmune diabetes were studied in 136 individuals with DSD and compared with 194 age- and sex-matched individuals with type 1 diabetes, 222 with DS, and 671 healthy controls. HLA class II was analyzed by sequence-specific primed PCR. Islet autoantibodies were measured by radioimmunoassay.

RESULTS

Age at onset of diabetes was biphasic, with 22% of DS children diagnosed before 2 years of age, compared with only 4% in this age-group with type 1 diabetes in the general population (P < 0.0001). The frequency of the highest-risk type 1 diabetes–associated HLA genotype, DR3-DQ2/DR4-DQ8, was decreased in both early- and later-onset DSD compared with age-matched children with type 1 diabetes (P < 0.0001), although HLA DR3-DQ2 genotypes were increased (P = 0.004). Antibodies to GAD were observed in all five samples tested from children diagnosed at ≤2 years of age, and persistent islet autoantibodies were detected in 72% of DSD cases. Thyroid and celiac disease were diagnosed in 74 and 14%, respectively, of the DSD cohort.

CONCLUSIONS

Early-onset diabetes in children with DS is unlikely to be etiologically different from autoimmune diabetes occurring in older DS children. Overall, these studies demonstrate more extreme autoimmunity in DSD typified by early-onset diabetes with multiple autoimmunity, persistent islet autoantibodies, and decreased HLA-mediated susceptibility.
The Effects of n-3 Long-Chain Polyunsaturated Fatty Acid Supplementation on Biomarkers of Kidney Injury in Adults With Diabetes
Authors: Miller Edgar R. , Juraschek Stephen P. , Anderson Cheryl A. , Guallar Eliseo , Henoch-Ryugo Karen , Charleston Jeanne , Turban Sharon , Bennett Michael R. , Appel Lawrence J.
Published: December 2012

OBJECTIVE

Long-chain n-3 polyunsaturated fatty acid (n-3 PUFA) supplements may have renoprotective effects in patients with diabetes, but previous trials have been inconsistent. We performed a randomized controlled trial of n-3 PUFA supplementation on urine albumin excretion and markers of kidney injury in adults with type 2 diabetes.

RESEARCH DESIGN AND METHODS

We conducted a randomized, placebo-controlled, two-period crossover trial to test the effects of 4 g/day of n-3 PUFA supplementation on markers of glomerular filtration and kidney injury in adults with adult-onset diabetes and greater than or equal to trace amounts of proteinuria. Each period lasted 6 weeks and was separated by a 2-week washout. The main outcome was urine albumin excretion and, secondarily, markers of kidney injury (kidney injury molecule-1, N-acetyl β-d-glucosaminidase [NAG], neutrophil gelatinase-associated lipocalin [NGAL], and liver fatty acid–binding protein [LFABP]), serum markers of kidney function (cystatin C, β2-microglobulin, and creatinine), and estimated glomerular filtration rate (eGFR).

RESULTS

Of the 31 participants, 29 finished both periods. A total of 55% were male, and 61% were African American; mean age was 67 years. At baseline, mean BMI was 31.6 kg/m2, median eGFR was 76.9 mL/min/1.73 m2, and median 24-h urine albumin excretion was 161 mg/day. Compared with placebo, n-3 PUFA had nonsignificant effects on urine albumin excretion (−7.2%; 95% CI −20.6 to 8.5; P = 0.35) and significant effects on urine NGAL excretion (−16% [−29.1 to −0.5%]; P = 0.04). There was no effect on serum markers of kidney function or eGFR. In subgroup analyses, there were significant decreases in 24-h urinary excretion of albumin, NGAL, LFABP, and NAG among participants taking medications that block the renin-angiotensin-aldosterone system (RAAS).

CONCLUSIONS

These results suggest a potential effect of n-3 PUFA supplementation on markers of kidney injury in patients with diabetes and early evidence of kidney disease. In the context of prior studies, these results provide a strong rationale for long-term trials of n-3 PUFA on chronic kidney disease progression.
Food Insecurity in Relation to Changes in Hemoglobin A1c, Self-Efficacy, and Fruit/Vegetable Intake During a Diabetes Educational Intervention
Authors: Lyles Courtney R. , Wolf Michael S. , Schillinger Dean , Davis Terry C. , DeWalt Darren , Dahlke Allison R. , Curtis Laura , Seligman Hilary K.
Published: December 2012

OBJECTIVE

Food insecurity is hypothesized to make diabetes self-management more difficult. We conducted a longitudinal assessment of food insecurity with several diabetes self-care measures.

RESEARCH DESIGN AND METHODS

We conducted a secondary, observational analysis of 665 low-income patients with diabetes, all of whom received self-management support as part of a larger diabetes educational intervention. We analyzed baseline food insecurity (measured by the U.S. Department of Agriculture Food Security module) in relation to changes in hemoglobin A1c (HbA1c) as well as self-reported diabetes self-efficacy and daily fruit and vegetable intake. We examined longitudinal differences using generalized estimating equation linear regression models, controlling for time, age, sex, race, income, and intervention arm.

RESULTS

Overall, 57% of the sample had an income <$15,000. Participants who were food insecure (33%) were younger, had less income, and were more likely to be unemployed compared with participants who were food secure. At baseline, those who were food insecure had higher mean HbA1c values (8.4% vs. 8.0%) and lower self-efficacy and fruit and vegetable intake than those who were food secure (all P < 0.05). Compared with food-secure individuals, participants who were food insecure had significantly greater improvements in HbA1c over time (0.38% decrease compared with 0.01% decrease; P value for interaction <0.05) as well as in self-efficacy (P value for interaction <0.01). There was no significant difference in HbA1c by food security status at follow-up.

CONCLUSIONS

Participants experiencing food insecurity had poorer diabetes-related measures at baseline but made significant improvements in HbA1c and self-efficacy. Low-income patients who were food insecure may be particularly receptive to diabetes self-management support, even if interventions are not explicitly structured to address finances or food security challenges.
An IMEX scheme for reaction-diffusion equations: application for a PEM fuel cell model
Authors: Faragó István , Izsák Ferenc , Szabó Tamás , Kriston Ákos
Published: December 2012

An implicit-explicit (IMEX) method is developed for the numerical solution of reaction-diffusion equations with pure Neumann boundary conditions. The corresponding method of lines scheme with finite differences is analyzed: explicit conditions are given for its convergence in the ‖·‖∞ norm. The results are applied to a model for determining the overpotential in a proton exchange membrane (PEM) fuel cell.
Harmonic interpolation based on Radon projections along the sides of regular polygons
Authors: Georgieva Irina , Hofreither Clemens , Koutschan Christoph , Pillwein Veronika , Thanatipanonda Thotsaporn
Published: December 2012

Given information about a harmonic function in two variables, consisting of a finite number of values of its Radon projections, i.e., integrals along some chords of the unit circle, we study the problem of interpolating these data by a harmonic polynomial. With the help of symbolic summation techniques we show that this interpolation problem has a unique solution in the case when the chords form a regular polygon. Numerical experiments for this and more general cases are presented.
Monte Carlo simulation and analytic approximation of epidemic processes on large networks
Authors: Nagy Noémi , Simon Péter
Published: December 2012

Low dimensional ODE approximations that capture the main characteristics of SIS-type epidemic propagation along a cycle graph are derived. Three different methods are shown that can accurately predict the expected number of infected nodes in the graph. The first method is based on the derivation of a master equation for the number of infected nodes. This uses the average number of SI edges for a given number of the infected nodes. The second approach is based on the observation that the epidemic spreads along the cycle graph as a front. We introduce a continuous time Markov chain describing the evolution of the front. The third method we apply is the subsystem approximation using the edges as subsystems. Finally, we compare the steady state value of the number of infected nodes obtained in different ways.
Two-dimensional motion of a parabolically confined charged particle in a perpendicular magnetic field
Authors: Ciftja Orion
Published: December 2012

The classical two-dimensional motion of a parabolically confined charged particle in presence of a perpendicular magnetic is studied. The resulting equations of motion are solved exactly by using a mathematical method which is based on the introduction of complex variables. The two-dimensional motion of a parabolically charged particle in a perpendicular magnetic field is strikingly different from either the two-dimensional cyclotron motion, or the oscillator motion. It is found that the trajectory of a parabolically confined charged particle in a perpendicular magnetic field is closed only for particular values of cyclotron and parabolic confining frequencies that satisfy a given commensurability condition. In these cases, the closed paths of the particle resemble Lissajous figures, though significant differences with them do exist. When such commensurability condition is not satisfied, path of particle is open and motion is no longer periodic. In this case, after a sufficiently long time has elapsed, the open paths of the particle fill a whole annulus, a region lying between two concentric circles of different radii.
Density of nerve fibres in eutopic endometrium in women with endometriosis
Authors: Liutkeviciene Ruta , Bumbuliene Zana , Zakareviciene Jolita
Published: December 2012

Endometriosis is the disease which usually takes a wide range of time to be diagnosed. Recently, the investigators found that endometriosis could be diagnosed using the density of nerve fibers in eutopic endometrium after taking endometrium bioptate. The aim of the article is to summarize the existing literature on density of nerve fibers in eutopic endometrium in women with and without endometriosis. In this review were involved only those studies which used the same exclusion criteria and the same technology to detect nerve fibers in eutopic endometrium. Our review confirmed the position of all studies’ results that detection of specific nerve fibers within eutopic endometrium using minimally invasive endometrial biopsy technique could be widely used in clinical practice to diagnose endometriosis with high specificity and sensitivity.
Effects of Rhodiola rosea extract on passive avoidance tests in rats
Authors: Getova Damianka , Mihaylova Anita
Published: December 2012

The purpose was to evaluate the effects of extract of Rhodiola rosea on learning and memory processes on rats. The two series of experiments were carried out — on naïve rats and on rats with scopolamine-impaired memory. The passive avoidance tests were performed — step-down and step-through. The latency of reactions in seconds was observed in both tests. Naïve rats treated with the extract in showed the prolongation of latency of reaction of both step-down and step-through passive avoidances compared to the controls. Rats with scopolamine-impaired memory showed shorter latency of reaction in both passive avoidance tests compared to the controls. Rats treated with the extract of Rh. Rosea with scopolamine-impaired memory prolonged the latency in both passive avoidance tests compared to scopolamine group. It was found that the extract of Rh. Rosea improved performance during learning session, short and long memory retrieval tests in naïve rats. Scopolamine impaired the learning and memory retrieval of rats, but Rh. Rosea pretreatment improved performance and turned off the deterioration effect of scopolamine on these brain functions probably by non-specific mechanisms on cholinergic neurons. The studied plant extract can be a candidate for treatment of dementia and other memory disturbances.
Spectral analysis of naringenin deprotonation in aqueous ethanol solutions
Authors: Farajtabar Ali , Gharib Farrokh
Published: December 2012

The deprotonation of 5,7-dihydroxy-2-(4-hydroxyphenyl)chroman-4-one (naringenin) was studied in aqueous solutions of ethanol and 0.1 mol L−1 sodium perchlorate at 25°C. The chemical species that contributed to deprotonation were evaluated together with their pure spectral characteristics and concentration profiles by some chemometric methods. The deprotonation constants assigned by pK 1, pK 2, and pK 3 were determined by multivariate curve analysis of spectral data at different pcH values. The pure spectral analysis concordant with the theoretical prediction of deprotonation constants indicates that the acidity of hydroxyl groups in naringenin decreases in the order: 7-OH, 4′-OH, 5-OH. The effects of the solvent on deprotonation were analysed in terms of the linear solvation energy relationships using the model of Kamlet, Abboud, and Taft (KAT). Multiple linear regressions were aimed towards correlating the deprotonation constants with the microscopic parameters containing hydrogen-bond acidity (α), dipolarity/polarisability (π*), and hydrogen-bond basicity (β). The most significant parameter was found to be the hydrogen-bond acidity of binary mixtures.
Wide-angle vision for road views
Authors: Huang F. , Fehrs K. , Hartmann G. , Klette R.
Published: December 2012

The field-of-view of a wide-angle image is greater than (say) 90 degrees, and so contains more information than available in a standard image. A wide field-of-view is more advantageous than standard input for understanding the geometry of 3D scenes, and for estimating the poses of panoramic sensors within such scenes. Thus, wide-angle imaging sensors and methodologies are commonly used in various road-safety, street surveillance, street virtual touring, or street 3D modelling applications. The paper reviews related wide-angle vision technologies by focusing on mathematical issues rather than on hardware.
The Effects of NCLB on School Resources and Practices
Authors: Dee Thomas S. , Jacob Brian , Schwartz Nathaniel L.
Published: December 2012

A number of studies have examined the impact of school accountability policies, including No Child Left Behind (NCLB), on student achievement. However, there is relatively little evidence on how school accountability reforms and NCLB, in particular, have influenced education policies and practices. This study examines the effects of NCLB on multiple district, school, and teacher traits using district-year financial data and pooled cross sections of teacher and principal surveys. Our results indicate that NCLB increased per-pupil spending by nearly $600, which was funded primarily through increased state and local revenue. We find that NCLB increased teacher compensation and the share of elementary school teachers with advanced degrees but had no effects on class size. We also find that NCLB did not influence overall instructional time in core academic subjects but did lead schools to reallocate time away from science and social studies and toward the tested subject of reading.
International Society for Extracellular Vesicles: first annual meeting, April 17–21, 2012: ISEV‐2012
Authors: Araldi Elisa , Krämer‐Albers Eva‐Maria , Hoen Esther Nolte‐‘t , Peinado Hector , Psonka‐Antonczyk Katarzyna Maria , Rao Pooja , van Niel Guillaume , Yáñez‐Mó María , Nazarenko Irina
Published: December 2012

Extracellular micro‐ and nano‐scale membrane vesicles produced by different cells are recognised as an essential entity of physiological fluids in a variety of organisms and function as mediators of intercellular communication employed for the regulation of multiple systemic and local processes. In the last decade, an exponential amount of experimental work was dedicated to exploring the biogenesis and secretion mechanisms, physiological and pathological functions and potential applications of the extracellular vesicles (EVs). Noteworthy is the large heterogeneity of in vitro and in vivo models applied, technical approaches developed in these studies and the diversity of designations assigned to different or similar types of EVs. Hence, there is a clear necessity for a uniform nomenclature and standardisation of methods to isolate and characterise these vesicles. In April 2012, the first meeting of the International Society for Extracellular Vesicles (ISEV) took place bringing together this exponentially grown scientific community. The University of Gothenburg (Krefting Research Centre) together with the Interim Board of the Society created in September 2011 (Jan Lötvall, Clotilde Théry, Xandra Breakefield, Marca Wauben, Yong Song Gho, Lawrence Rajendran, Graça Raposo, Douglas Taylor, Margareta Sjöstrand and Esbjörn Telemo) organised this fantastic event that counted 488 registered and contributing participants. This meeting report provides a retrospective summary of the broad spectrum of ISEV‐2012 sessions. Again, we emphasise novel findings, discussions and decisions met by the community during the meeting.
More than Words: Analyzing the Media Discourses Surrounding Dance Music Events
Authors: Jaimangal-Jones Dewi
Published: December 2012

Over recent decades the number of festivals occurring annually has grown exponentially, with one area of events witnessing significant growth being dance music festivals—outdoor events that feature various genres of electronic dance music. This article contributes to the academic
study of festivals by exploring the discourses surrounding the construction and consumption of dance music events within the niche media that support and inform the various scenes represented under the umbrella term "dance culture." A central tenant of this article is that the positive and
sensationalist reporting of events by the media and the discourses they construct surrounding events is a driver of demand for large scale events. Through studying the lexicon of the dance music media this article reveals and dissects pertinent discourses surrounding the reporting of events,
which emphasize cultural significance and the centrality of events to contemporary dance music culture through a variety of means.