bluuebunny/crossref_metadata_2025 huggingface dataset:
Relationship Between A1C and Glucose Levels in the General Dutch Population
Authors: van 't Riet Esther , Alssema Marjan , Rijkelijkhuizen Josina M. , Kostense Piet J. , Nijpels Giel , Dekker Jacqueline M.
Published: October 2009

OBJECTIVE

To investigate the relationship among A1C, fasting plasma glucose (FPG), and 2-h postload plasma glucose in the Dutch general population and to evaluate the results of using A1C for screening and diagnosis of diabetes.

RESEARCH DESIGN AND METHODS

In 2006–2007, 2,753 participants of the New Hoorn Study, aged 40–65 years, who were randomly selected from the population of Hoorn, the Netherlands, underwent an oral glucose tolerance test (OGTT). Glucose status (normal glucose metabolism [NGM], intermediate hyperglycemia, newly diagnosed diabetes, and known diabetes) was defined by the 2006 World Health Organization criteria. Spearman correlations were used to investigate the agreement between markers of hyperglycemia, and a receiver operating characteristic (ROC) curve was calculated to evaluate the use of A1C to identify newly diagnosed diabetes.

RESULTS

In the total population, the correlations between fasting plasma glucose and A1C and between 2-h postload plasma glucose and A1C were 0.46 and 0.33, respectively. In patients with known diabetes, these correlations were 0.71 and 0.79. An A1C level of ≥5.8%, representing 12% of the population, had the highest combination of sensitivity (72%) and specificity (91%) for identifying newly diagnosed diabetes. This cutoff point would identify 72% of the patients with newly diagnosed diabetes and include 30% of the individuals with intermediate hyperglycemia.

CONCLUSIONS

In patients with known diabetes, correlations between glucose and A1C are strong; however, moderate correlations were found in the general population. In addition, based on the diagnostic properties of A1C defined by ROC curve analysis, the advantage of A1C compared with OGTT for the diagnosis of diabetes is limited.
Validation of the Chinese Version of the Problem Areas in Diabetes (PAID-C) Scale
Authors: Huang Min-Feng , Courtney Mary , Edwards Helen , McDowell Jan
Published: October 2009

OBJECTIVE

To examine the psychometric properties of a Chinese version of the Problem Areas In Diabetes (PAID-C) scale.

RESEARCH DESIGN AND METHODS

The reliability and validity of the PAID-C were evaluated in a convenience sample of 205 outpatients with type 2 diabetes. Confirmatory factor analysis, Bland-Altman analysis, and Spearman's correlations facilitated the psychometric evaluation.

RESULTS

Confirmatory factor analysis confirmed a one-factor structure of the PAID-C (χ2/df ratio = 1.894, goodness-of-fit index = 0.901, comparative fit index = 0.905, root mean square error of approximation = 0.066). The PAID-C was associated with A1C (rs = 0.15; P < 0.05) and diabetes self-care behaviors in general diet (rs = −0.17; P < 0.05) and exercise (rs = −0.17; P < 0.05). The 4-week test-retest reliability demonstrated satisfactory stability (rs = 0.83; P < 0.01).

CONCLUSIONS

The PAID-C is a reliable and valid measure to determine diabetes-related emotional distress in Chinese people with type 2 diabetes.
Effects of Exenatide Alone and in Combination With Daclizumab on β-Cell Function in Long-Standing Type 1 Diabetes
Authors: Rother Kristina I. , Spain Lisa M. , Wesley Robert A. , Digon Benigno J. , Baron Alain , Chen Kim , Nelson Patric , Dosch H.-Michael , Palmer Jerry P. , Brooks-Worrell Barbara , Ring Michael , Harlan David M.
Published: October 2009

OBJECTIVE

In patients with long-standing type 1 diabetes, we investigated whether improved β-cell function can be achieved by combining intensive insulin therapy with agents that may 1) promote β-cell growth and/or limit β-cell apoptosis and 2) weaken the anti–β-cell autoimmunity.

RESEARCH DESIGN AND METHODS

For this study, 20 individuals (mean age 39.5 ± 11.1 years) with long-standing type 1 diabetes (21.3 ± 10.7 years) were enrolled in this prospective open-label crossover trial. After achieving optimal blood glucose control, 16 subjects were randomized to exenatide with or without daclizumab. Endogenous insulin production was determined by repeatedly measuring serum C-peptide.

RESULTS

In 85% of individuals with long-standing type 1 diabetes who were screened for participation in this trial, C-peptide levels ≥0.05 ng/ml (0.02 nmol/l) were found. Residual β-cells responded to physiological (mixed-meal) and pharmacological (arginine) stimuli. During exenatide treatment, patients lost 4.1 ± 2.9 kg body wt and insulin requirements declined significantly (total daily dose on exenatide 0.48 ± 0.11 vs. 0.55 ± 0.13 units · kg−1 · day−1 without exenatide; P = 0.0062). No signs of further activation of the underlying autoimmune disease were observed. Exenatide delayed gastric emptying, suppressed endogenous incretin levels, but did not increase C-peptide secretion.

CONCLUSIONS

In long-standing type 1 diabetes, which remains an active autoimmune disease even decades after its onset, surviving β-cells secrete insulin in a physiologically regulated manner. However, the combination of intensified insulin therapy, exenatide, and daclizumab did not induce improved function of these remaining β-cells.
A1C Is Associated With Intima-Media Thickness in Individuals With Normal Glucose Tolerance
Authors: Bobbert Thomas , Mai Knut , Fischer-Rosinský Antje , Pfeiffer Andreas F.H. , Spranger Joachim
Published: October 2009

OBJECTIVE

One-hour glucose during an oral glucose tolerance test (OGTT) was recently proposed as a valuable marker to identify individuals with normal glucose tolerance (NGT) and increased intima-media thickness (IMT). However, central markers of glycemic control were not considered. The aim of this study was to identify which marker of glycemic control is most informative with respect to the variation of IMT in individuals with NGT.

RESEARCH DESIGN AND METHODS

Cardiovascular risk factors, glucose metabolism (OGTT), and IMT were determined in 1,219 nondiabetic individuals (851 women, 368 men; 558 with NGT).

RESULTS

One-hour glucose and A1C levels were significantly correlated to carotid IMT in individuals with NGT, whereas fasting and 2-h glucose levels were not informative. Only A1C was associated with IMT independent of other confounders, whereas 1-h glucose was not informative. Comparable results were found in the total cohort, including individuals with IFG and IGT.

CONCLUSIONS

A1C was the most informative glycemic marker with respect to IMT in individuals with NGT.
Randomized Placebo-Controlled Double-Blind Clinical Trial of Cannabis-Based Medicinal Product (Sativex) in Painful Diabetic Neuropathy
Authors: Selvarajah Dinesh , Gandhi Rajiv , Emery Celia J. , Tesfaye Solomon
Published: October 2009

OBJECTIVE

To assess the efficacy of Sativex, a cannabis-based medicinal extract, as adjuvant treatment in painful diabetic peripheral neuropathy (DPN).

RESEARCH DESIGN AND METHODS

In this randomized controlled trial, 30 subjects with painful DPN received daily Sativex or placebo. The primary outcome measure was change in mean daily pain scores, and secondary outcome measures included quality-of-life assessments.

RESULTS

There was significant improvement in pain scores in both groups, but mean change between groups was not significant. There were no significant differences in secondary outcome measures. Patients with depression had significantly greater baseline pain scores that improved regardless of intervention.

CONCLUSIONS

This first-ever trial assessing the efficacy of cannabis has shown it to be no more efficacious than placebo in painful DPN. Depression was a major confounder and may have important implications for future trials on painful DPN.
Osteocalcin Is Related to Enhanced Insulin Secretion in Gestational Diabetes Mellitus
Authors: Winhofer Yvonne , Handisurya Ammon , Tura Andrea , Bittighofer Christina , Klein Katharina , Schneider Barbara , Bieglmayer Christian , Wagner Oswald F. , Pacini Giovanni , Luger Anton , Kautzky-Willer Alexandra
Published: October 2009

OBJECTIVE

There is growing evidence that osteocalcin, an osteoblast-derived protein locally acting on bone formation, can increase insulin secretion as well as insulin sensitivity and thus prevent the development of obesity and diabetes in experimental animals. In humans, osteocalcin has been reported to be decreased in patients with type 2 diabetes. Because gestational diabetes mellitus (GDM) can serve as a model of pre–type 2 diabetes, the aim of this study was to investigate osteocalcin in GDM.

RESEARCH DESIGN AND METHODS

Osteocalcin measurement and an oral glucose tolerance test were performed in 78 pregnant women (26 women had GDM and 52 women had normal glucose tolerance [NGT] during pregnancy; women were matched for age and BMI) and in 34 women postpartum.

RESULTS

During pregnancy osteocalcin was significantly higher in the women with GDM than in the women with NGT (15.6 ± 6.4 vs. 12.6 ± 4.0 ng/ml; P < 0.015), whereas no difference was observed between the two groups at 12 weeks postpartum (36.2 ± 10.2 vs. 36.2 ± 13.0 ng/ml), when osteocalcin was found to be increased compared with the level in the pregnant state in all women (+145 ± 102% in GDM vs. +187 ± 119% in NGT; P < 0.0001). Moreover, osteocalcin showed a significant correlation with basal and total insulin secretion in the whole study group (R = 0.3, P < 0.01).

CONCLUSIONS

In GDM osteocalcin was higher and thus less restrained than in women with NGT during pregnancy and furthermore correlated with insulin secretion parameters. Therefore, it could be hypothesized that osteocalcin can enhance insulin secretion in insulin-resistant states; alternatively an effect of hyperinsulinemia on osteocalcin secretion cannot be excluded.
Specific Relation Between Abdominal Obesity and Early-Phase Hyperglycemia Is Modulated by Hepatic Insulin Resistance in Healthy Older Women
Authors: DiPietro Loretta , Dziura James , Yeckel Catherine W.
Published: October 2009

OBJECTIVE

To describe the impact of abdominal obesity and hepatic insulin resistance on phase-specific glycemic responses in older women.

RESEARCH DESIGN AND METHODS

We studied 23 healthy older women (60–88 years old). Abdominal obesity was defined by an abdominal circumference ≥95 cm. Plasma glucose and insulin were measured in response to a 3-h oral glucose tolerance test. Insulin suppression of hepatic glucose production was determined using in vivo clamp techniques.

RESULTS

Despite identical prevailing insulin concentrations, glucose excursions 30 min postchallenge (but not later) were greater in women with abdominal obesity than in those without (162 ± 19 vs. 132 ± 16 mg/dl; P < 0.01). There was a strong correlation between hepatic glucose production suppression under low-dose insulin infusion and early-phase glucose excursions from the oral glucose tolerance test (r = −0.83; P < 0.001) in women with abdominal obesity, but not in women without (r = 0.44; P < 0.11).

CONCLUSIONS

Abdominal obesity relates specifically to early-phase hyperglycemia via hepatic insulin resistance, even in healthy older women.
Rosiglitazone Decreases C-Reactive Protein to a Greater Extent Relative to Glyburide and Metformin Over 4 Years Despite Greater Weight Gain
Authors: Kahn Steven E. , Haffner Steven M. , Viberti Giancarlo , Herman William H. , Lachin John M. , Kravitz Barbara G. , Yu Dahong , Paul Gitanjali , Holman Rury R. , Zinman Bernard ,   for A Diabetes Outcome Progression Trial (ADOPT) Study Group
Published: October 2009

OBJECTIVE

C-reactive protein (CRP) is closely associated with obesity and cardiovascular disease in both diabetic and nondiabetic populations. In the short term, commonly prescribed antidiabetic agents have different effects on CRP; however, the long-term effects of those agents are unknown.

RESEARCH DESIGN AND METHODS

In A Diabetes Outcome Progression Trial (ADOPT), we examined the long-term effects of rosiglitazone, glyburide, and metformin on CRP and the relationship among CRP, weight, and glycemic variables in 904 subjects over 4 years.

RESULTS

Baseline CRP was significantly correlated with homeostasis model assessment of insulin resistance (HOMA-IR), A1C, BMI, waist circumference, and waist-to-hip ratio. CRP reduction was greater in the rosiglitazone group by −47.6% relative to glyburide and by −30.5% relative to metformin at 48 months. Mean weight gain from baseline (at 48 months) was 5.6 kg with rosiglitazone, 1.8 kg with glyburide, and −2.8 kg with metformin. The change in CRP from baseline to 12 months was correlated positively with change in BMI in glyburide (r = 0.18) and metformin (r = 0.20) groups but not in the rosiglitazone (r = −0.05, NS) group. However, there was no longer a significant correlation between change in CRP and change in HOMA-IR, A1C, or waist-to-hip ratio in any of the three treatment groups.

CONCLUSIONS

Rosiglitazone treatment was associated with durable reductions in CRP independent of changes in insulin sensitivity, A1C, and weight gain. CRP in the glyburide and metformin groups was positively associated with changes in weight, but this was not the case with rosiglitazone.
Utilization of solid phase spectrophotometry for the determination of trace amounts of copper using 5-(2-benzothiazolylazo)-8-hydroxyquinoline
Authors: Amin Alaa
Published: October 2009

A simple, selective, highly sensitive and accurate procedure for the determination of trace amounts of copper has been developed based on solid-phase spectrophotometry. Copper reacts with 5-(2-benzothiazolylazo)-8-hydroxyquinoline (BTAHQ) to give a complex with high molar absorptivity (3.17 × 107 L mol−1 cm−1, 3.07 × 108 L mol−1 cm−1, 1.22 × 109 L mol−1 cm−1, and 1.80 × 109 L mol−1 cm−1), fixed on a Dowex 1-X8 type anion-exchange resin for 10 mL, 100 mL, 500 mL, and 1000 mL, respectively. The absorbance at 667 nm and 800 nm packed in a 1.0 mm cell was measured directly. Calibration is linear over the range 0.2–3.7 µg L−1 with RSD of < 1.28 % (n = 10). The detection and quantification limits of the 500 mL sample method are 79 ng L−1 and 260 ng L−1 when using 60 mg of Dowex 1-X8. For a 1000 mL sample, the detection and quantification limits are 67 ng L−1 and 220 ng L−1 using 60 mg of the exchanger. Increasing the sample volume can enhance the sensitivity. The proposed method was applied to the determination of copper in different environmental water samples (tap, pit, spring, and river), food products (rice, corn flour, and tea), and mushrooms, using the standard addition technique.
A graph theoretical approach to the effect of mutation on the flexibility of the DNA binding domain of p53 protein
Authors: Rauf Shah , Ismael Mohamed , Sahu Kamlesh , Suzuki Ai , Sahnoun Riadh , Koyama Michihisa , Tsuboi Hideyuki , Hatakeyama Nozomu , Endou Akira , Takaba Hiromitsu , Carpio Carlos , Kubo Momoji , Miyamoto Akira
Published: October 2009

Tumor suppressor protein p53 becomes inactive due to mutation on its DNA binding core domain leading to misbehavior of this protein and preventing its interaction with DNA. In the present study, changes of the protein conformation by five hot spot mutations of T-p53C were assessed preventing the mutants wild-type (WT) behavior. While studies of this nature were undertaken both experimentally and theoretically, the focus is fundamentally on the effects of the mutation on the dynamics of the protein. Hence, the basic concept underlying this study is the change in flexibility or rigidity of the protein. It was found that stable variant T-p53C (PDB-ID: 1uol) that is structurally and functionally very close to wild-type p53 is the most rigid structure and each single carcinogenic mutation on it makes the structure more flexible. We hypothesize that these changes of the molecule’s flexibility disrupt the network of hydrogen bonds associated with the interaction of WT not only at interaction but in the internal structures of the mutants as well, which prevents them from interacting in the WT fashion loosing the anti-cancer properties of WT.
Spectrophotometric methods for sertraline hydrochloride and/or clidinium bromide determination in bulk and pharmaceutical preparations
Authors: Amin Alaa , Dessouki Hassan , Moustafa Moustafa , Ghoname Mohammed
Published: October 2009

A spectrophotometric procedure for the determination of sertraline hydrochloride (Sert) and/or clidinium bromide (Clid) in bulk sample and in dosage forms was developed. The purpose of this work was to develop a rapid, simple, inexpensive, precise, and accurate visible spectrophotometric method. The procedure is based on formation of an ion-pair complex by their reaction with bromocresol green (BCG), bromophenol blue (BPB), and bromothymol blue (BTB) in buffered aqueous solution at pH 3. The colored products are extracted into a polar solvent and measured spectrophotometrically at the optimum λmax for each complex. Optimization of different experimental conditions is described. Regression analysis of Beer-Lambert plots showed good correlation in the concentration range of 1–30 µg mL−1. The apparent molar absorptivity, Sandell sensitivity, detection and quantification limits were calculated. For more accurate analysis, Ringbom optimum concentration range of 2–27 µg mL−1 was used. The developed methods were successfully applied for the determination of sertraline hydrochloride and clidinium bromide in bulk in pharmaceutical formulations without any interference from common excipients. The procedure has the advantage of being highly sensitive and simple for the determination of the studied drugs, weak UV-absorbing compounds.
Synthesis and isolation of methyl bismuth cysteine and its definitive identification by high resolution mass spectrometry
Authors: Hippler Joerg , Hollmann Markus , Juerling Heinrich , Hirner Alfred
Published: October 2009

After the synthesis and isolation of methylated bismuth cysteine, its initial identification by IR-spectroscopy was performed, whereas for definitive identification, high resolution mass spectrometry (ESI-TOF-MS and LTQ Orbitrap) was carried out.
Rheological properties of doughs with buckwheat and quinoa additives
Authors: Jancurová Michala , Minarovičová Lucia , Dandár Alexander
Published: October 2009

Rheological properties of doughs prepared from wheat flour with buckwheat and quinoa flour addition (2.5 mass %, 5.0 mass %, 7.5 mass %, and 10 mass %) were investigated using a farinograph and compared with those of standard dough (without addition of pseudocereals). The following characteristics were determined: water absorption capacity, water consumption, dough growth time, level of dough softening, dough stability, mechanical resistance, and dough elasticity. Dough stability showed a linear decrease with the increasing content of pseudocereals. Doughs containing quinoa flour were more stable than those with buckwheat flour addition. Dough growth time was reduced with increasing amounts of buckwheat flour but it was not affected in the case of quinoa flour addition. From the comparison of the studied characteristics it can be concluded that an addition of lower amounts of quinoa (up to 5.0 mass %) to wheat flour will not significantly impair rheological properties of the dough but provides for enhanced nutritional value of the prepared bakery products.
Spectroscopic study of protonation of oligonucleotides containing adenine and cytosine
Authors: Vojtylová Terézia , Dospivová Dana , Třísková Olga , Pilařová Iveta , Lubal Přemysl , Farková Marta , Trnková Libuše , Táborský Petr
Published: October 2009

Acidobasic properties of purine and pyrimidine bases (adenine, cytosine) and relevant nucleosides (adenosine, cytidine) were studied by means of glass-electrode potentiometry and the respective dissociation constants were determined under given experimental conditions (I = 0.1 M (NaCl), t = (25.0 ± 0.1) °C): adenine (pK HL = 9.65 ± 0.04, pK H2L = 4.18 ± 0.04), adenosine (pK H2L = 3.59 ± 0.05), cytosine (pK H2L = 4.56 ± 0.01), cytidine (pK H2L = 4.16 ± 0.02). In addition, thermodynamic parameters for bases: adenine (ΔH 0 = (−17 ± 4) kJ mol−1, ΔS 0 = (23 ± 13) J K−1 mol−1), cytosine (ΔH 0 = (−22 ± 1) kJ mol−1, ΔS 0 = (13 ± 5) J K−1 mol−1) were calculated. Acidobasic behavior of oligonucleotides (5′CAC-CAC-CAC3′ = (CAC)3, 5′AAA-CCC-CCC3′ = A3C6, 5′CCC-AAA-CCC3′ = C3A3C3) was studied under the same experimental conditions by molecular absorption spectroscopy. pH-dependent spectral datasets were analyzed by means of advanced chemometric techniques (EFA, MCR-ALS) and the presence of hemiprotonated species concerning (C+-C) a non-canonical pair (i-motif) in titled oligonucleotides was proposed in order to explain experimental data obtained according to literature.
The Importance of Vanillylmandelic Acid Determination in Opiate Users
Authors: Janićević-Ivanovska Danijela , Spasovska-Trajkovska Aneta , Stefanovski Branko , Subeska-Stratrova Slavica , Jovcevska Jasmina
Published: October 2009

The Importance of Vanillylmandelic Acid Determination in Opiate Users

Although knowledge about the etiology of heroin dependence is rather poor, it is known that the influence of opiates on the opioid, adrenergic and indirectly of GABA on the dopaminergic receptors leads to changes of catecholamine levels in brain structures, which are supposed to be essential in explaining the etiology of the opioid dependence. It is well-known that by analyzing catecholamine, we get vanillylmandelic acid (VMA), which is found in the urine as a final product. Thus, by an indirect determination of VMA it is also possible to define the catecholamine concentration in the brain, which is the aim of this study. This prospective study included 51 dependent heroin users divided into 3 groups, depending on the length of the medical treatment with a conventional detox method (without treatment, second day of the treatment, and after the 10th day of treatment) as well as a control group consisting of 20 healthy subjects. We used the Pissano method chromatographic-spectrophotometric determination - for estimating the level of vanillylmandelic acid, and a scale for defining the severity of symptoms of the withdrawal syndrome (WS). The results showed that the highest average values of the urinary level of VMA were found in the subjects in withdrawal crisis with a high WS scale score in comparison with the other examined groups (statistically significant) as a result of the high adrenergic level. The average score on the scale of depression was high in the subjects in withdrawal crisis where we also found low values of the VMA urinary level. Being aware of the neurobiology of heroin dependence is of great importance for finding new pharmacological treatments for heroin addiction.
Hyperhomocysteinemia and Smoking in Primary Antiphospholipid Syndrome
Authors: Bećarević Mirjana , Mirković Duško , Majkić-Singh Nada
Published: October 2009

Hyperhomocysteinemia and Smoking in Primary Antiphospholipid Syndrome

The thrombotic tendency in antiphospholipid syndrome (APS) shares several pathways with atherosclerosis. Atherothrombosis (atherosclerosis superimposed with thromboses) is influenced by nonmodifiable and some modifiable risk factors (smoking, obesity, physical inactivity, alcohol abuse, hyperhomocysteinemia). Therefore, we investigated the association among clinical and serological features of patients with primary APS and potentially modifiable risk factors for the development of atherothrombosis. Also, we compared the analyzed parameters with those in control subjects. Homocysteine concentrations were detected by HPLC (high performance liquid chromatography), while antiphospholipid antibodies were detected by ELISA. Smokers had elevated levels of homocysteine (χ2= 6.22, p < 0.05). Independently of patients' age, the association between increased levels of homocysteine and history of myocardial infarctions was found (χ2= 4.61, p < 0.05). Hyperhomocysteinemia and smoking are the most important modifiable risk factors for atherothrombosis in primary APS.
Think Globally Act Locally
Authors: Editor The
Published: October 2009

doi: 10.3126/jnhrc.v7i1.2266 Journal of Nepal Health Research Council Vol. 7, No. 1, 2009 April
Hysterosalpingography Vs Hysteroscopy in the Detection of Intrauterine Pathology in Infertility
Authors: Shakya B
Published: October 2009

Background: This study was to compare the accuracy of hysterosalpingography (HSG) with hysteroscopy (HSC) in detection of uterine pathology in patients with infertility. Methods: This is a prospective comparative study done among 50 new cases of primary and secondary infertility presenting to infertility clinic of Tribhuvan University Teaching Hospital from March 2006 - 2007. HSG was performed in the proliferative phase of menstrual cycle followed by HSC in the proliferative phase of the same or the following cycle. Intra uterine findings on HSG were evaluated and compared with hysteroscopic findings. Results: Out of 50 cases, HSG revealed normal findings in 49 cases (98%) and HSC demonstrated normal uterine cavity in 44 of the cases (88%). There was one abnormality (2%) shown on HSG (subseptate uterus) which was confirmed at HSC. HSC demonstrated six cases (12%) of intrauterine pathologies and these were endometrial polyps, subseptate uterus and submucous myoma. HSG in the detection of intrauterine pathology had a sensitivity (SV) of 16.7% (95% CI 0.9-63.5), specificity (SP) 100% (95% CI 90-100), positive predictive value (PPV) 100% (95% CI 5.5-100), negative predictive value (NPV) 89.8% (95% CI 77-96.2), false negative rate (FNR) 83.3% and accuracy rate (AR) 90%. Conclusion: HSG is a specific, but not sensitive predictor of uterine pathology. However, HSG did not provide any additional finding in comparison to HSC. Therefore, HSG is not advisable in the detection of uterine pathology in infertility patients.Key words: diagnostic hysteroscopy, hysterosalpingography, infertility, uterine cavity.   DOI: 10.3126/jnhrc.v7i1.2271 Journal of Nepal Health Research Council Vol. 7, No. 1, 2009 April 6-9
Early Experience with Low Profile Plate Osteosynthesis for Metacarpal Fractures
Authors: Joshi A , K.C. BR , Chand P , Thapa BB
Published: October 2009

Background: Among various fixation methods for metacarpal fractures, plate osteosynthesis is the most rigid and allows early rehabilitation leading to early return to work. Many authors have reported high complication rates and most of them were because of thick plate. The aim of this study was to report early results of plate osteosynthesis of metacarpal fractures with low profile miniplate. Methods: This was a hospital based prospective study. Unstable and irreducible fractures were managed by open reduction and internal fixation with low profile miniplate and were followed up for 6 months. The functional outcome after fracture treatment was assessed by ability to perform acts of daily life and calculating American Society for Surgery of the Hand Total Active Flexion (ASSH TAF) score. Results: There were 16 patients with 17 metacarpal fractures, 87.5% were male with mean age of 31.50±9.02 years. Fourteen (87.5%) patients could perform their activities of daily living at four weeks. The mean Total Active Flexion was 261.76±24.87 at final follow up. Fourteen (87.5%) patients had excellent, one (6.25%) good and one (6.25%) poor out come at the end of 6 months. Conclusion: Low severity metacarpal fractures can be treated successfully by open reduction internal fixation with low-profile miniplate, allowing early and safe mobilization. Key words: low-profile plate, metacarpal fractures, plate osteosynthesis   DOI: 10.3126/jnhrc.v7i1.2274 Journal of Nepal Health Research Council Vol. 7, No. 1, 2009 April 19-24
Antibiotic Susceptibility Pattern of Mycobacterium tuberculosis
Authors: Subba S , Singh S , Khagi AR , Tuladhar R , Lekhak B , Khadka DK , Shrestha KB
Published: October 2009

Background: The emergence and spread of DR and MDR-TB threat global TB control. The susceptibility patterns of M. tuberculosis isolates against anti-tuberculosis drugs informs an important aspect of TB controls and surveillance and analysis of local rates of TB drug resistance helps in the detection and monitoring of the extent of DR and MDR strains, indicating the quality of TB control in the country. Methods: A cross sectional study was conducted to find out antibiotic susceptibility pattern of Mycobacterium tuberculosis in pulmonary tuberculosis patients at national tuberculosis center. All the samples were stained by auramine fluorochrome method; processed by NaOH Ogawa Method; primary cultured; subcultured in 2% Ogawa media; cultured in drug LJ media and finally results observed and interpreted. Here Drug susceptibility test was done on M. tuberculosis isolate from each patient by Proportion method as standard protocol. Results: Ethambutol (66.10%) was found to be the most effective anti-TB drug according to the susceptibility test followed by RMP (60.33%), SM (59.66%) and INH (41.69%) against M. tuberculosis. Among 45 isolated untreated patients, primary drug resistance was observed in 20%, to two drugs in 17.77%, to three drugs in 11.11%, to four drugs in 6.66% and primary Multi-drug resistant in 22.22%. Among 250 isolated from previous treated patients, acquired resistance to one drug was found in 23.60%, to two drugs in 12.40%, to three drugs in 16.40%, to four drugs in 18.80% an acquired Multi-drug resistant in 37.20%. Among 250 treated 68.40% (n=171) were relapse,18% ( n=45) were chronic, 7.6% (n=19) were follow-up, 3.2% (n=8) were defaulter, and 2.8% (n=7) were treatment failure. MDR-TB was found the highest in chronic cases (64.44%) followed by follow-up case (47.36%), treatment failure cases (42.85%), relapse cases (27.48%) and default cases (12.5%). A statistical analysis reveals significant relationship between prior history of treatment and the development of drug resistance. However, no significant relationship between age and sex with the emergence of drug resistance isolates. Conclusion: MDR-TB was found the highest in chronic cases (64.44%) followed by follow-up case (47.36%), treatment failure cases (42.85%), relapse cases (27.48%) and Default cases (12.5%). Key words: multi drug, relapse, resistant, sensitivity, tuberculosis   DOI: 10.3126/jnhrc.v7i1.2277 Journal of Nepal Health Research Council Vol. 7, No. 1, 2009 April 33-41
Rationale of Unfractionated heparin during elective Coronary Angiography
Authors: Malla R , Sharma R , Rauniyar B , K.C. MB , Maskey A , Joshi D , Hamal S
Published: October 2009

Background: Unfractionated heparin (UFH) has been conventionally used during coronary angiography (CAG). Whether to use unfractionated heparin or not, has been unanswered. Methods: Hundred patients who underwent CAG through femoral route were assessed. CAG was performed without using unfractionated heparin and embolic or thrombotic event and vascular complications were observed during and after procedure. Results: The right femoral approach was used in 92% of cases and the left in 8%. Those patients who underwent radial route were excluded. Male (65%) were exceeded the female and smoking (50%) was the major predisposing factor. There were no embolic or thrombotic event and vascular complications such as bleeding, heamatoma, pseudoaneurysm formation, A-V fistula and retroperitoneal bleeding during or after procedure. Conclusions: Routine elective CAG have shown no significant complication during or after the procedure without UFH. Key words: angiography, coronary angiography, unfractionated heparin   DOI: 10.3126/jnhrc.v7i1.2278 Journal of Nepal Health Research Council Vol. 7, No. 1, 2009 April 42-44
Health Sciences Research in Medical Education
Authors: Maskey MK
Published: October 2009

DOI: 10.3126/jnhrc.v7i1.2296 Journal of Nepal Health Research Council Vol. 7, No. 1, 2009 April 54-57
Psychosocial Care: Emerging Need for the Cancer Patients in Nepal
Authors: Shah T , Subba S , Shah SP
Published: October 2009

Cancer has an unsetting reminder of the stubborn grain of unpredictability, uncertainty and injustice in the human condition. It forces us to confront our lack of control over our own or others' death. The aim of this review was to acquire new knowledge on the scientific evidence based for an effect of psychosocial care on survival from cancer and well-being. The different books, journals and web sites were searched for data base information on psychological and social aspects of cancer. In the developed part of the world, there are well established psychosocial care unit, counseling services, support group concept, palliative care, home hospice, etc but in Nepal where risk for developing cancer is nevertheless. Diagnosis and treatment is being done, but no separate psychosocial unit attached to cancer hospitals. Life expectancy of cancer patients can be prolonged by early diagnosis, appropriate treatment and psychosocial services to the patients. Key words: Cancer, Emerging needs, Nepal, Psychosocial care   DOI: 10.3126/jnhrc.v7i1.2297   Journal of Nepal Health Research Council Vol. 7, No. 1, 2009 April 58-61
The International Publication Productivity of Malaysia in Social Sciences
Authors: Davarpanah Mohammad Reza
Published: October 2009

The purpose of this study is to evaluate publication output and citation impact in the social sciences in Malaysia, based on Social Science Citation Index (SSCI) data, for the period 1999–2008. In addition to the analysis of trends in publication and citation patterns and national publication profiles, an attempt is made to explore the strengths and weakness of different fields, using a new mathematical index, the scientific power index (PI). The findings indicate that publication output in the social sciences has been on the increase since 1999. Mostpapers have been published in median-impact-factor journals (mean impact factor of 2.72 per paper). Internationally co-authored publications represented 77 per cent of all citations. Most of the prolific authors are from the highly productive institutions; however, none of highly cited first authors are from highly productive institutions. Psychology, economics, management, and environmental studies are the dominant fields in Malaysian social sciences.
Improving Usability of a Complex Household Travel Survey
Authors: Schulz Angelika , Nobis Claudia , Follmer Robert , Jesske Birgit , Gruschwitz Dana
Published: October 2009

Data quality refers not only to statistical characteristics of a respective data set but also includes further dimensions that are closely related to user requirements in regard to content, convenience of access, comprehensibility, and usability. Especially with respect to data sets designated for multiple secondary analyses by heterogeneous users, particular attention must be given to data processing, data documentation, and supplementary information. Within the context of a large-scale national household travel survey, a two-stage evaluation approach was developed to get a better understanding of a data set's usability for various parties. The evaluation process consisted of two parts: first, a retrospective online user survey was completed to get a general overview of the user community, the respective context of data usage, and the users’ overall satisfaction. Subsequently, a one-day user workshop was held. While the survey was designed mainly as an exploratory instrument for effectively revealing the majority of relevant issues, the workshop was intended to discuss complex or controversial matters with highly qualified and committed stakeholders. Both the survey and the workshop revealed the crucial role of a user-centered approach when a survey is conducted. In fact, quite a few survey adjustments can be accomplished with reasonable effort while ensuring comparability and keeping within a given budget. Mostly, these adjustments are related to data processing, documentation, and information. On the basis of the findings, general recommendations were made, with special emphasis on the essential consideration of different user requirements.
Processing Raw Data from Global Positioning Systems without Additional Information
Authors: Schuessler Nadine , Axhausen Kay W.
Published: October 2009

Since the first Global Positioning System (GPS) studies in the mid-1990s, this method of surveying individual travel behavior has gained attention in transport research. Compared with classic travel survey methods, GPS studies offer researchers benefits of more accurate and reliable information. At the same time, the participants’ burden is reduced substantially if the GPS data collection does not involve time-consuming questions. However, without additional information, such as modes and trip purposes, extensive postprocessing is required to derive data that can be used for analysis and model estimation. The corresponding procedures are an ongoing research issue. This paper describes a postprocessing procedure needing no input other than the most basic GPS raw data: three-dimensional positions and the corresponding time stamps. First, the data are thoroughly cleaned and smoothed. Second, trips and activities are determined. Third, the trips are segmented into single-mode stages, and the transport mode for each of the stages is identified. The procedure is applied to GPS records collected in the Swiss cities of Zurich, Winterthur, and Geneva. A total of 4,882 participants carried an on-person GPS receiver for an average of 6.65 days. The results are compared with the Swiss Microcensus 2005 to demonstrate that derived data are ready for further applications, such as discrete choice model estimations.
Household Travel Surveys with GPS
Authors: Bricka Stacey , Zmud Johanna , Wolf Jean , Freedman Joel
Published: October 2009

This paper documents the results of a pilot test done for the Oregon Household Travel Survey. The pilot was designed to enable the Oregon Department of Transportation to determine the role of a Global Positioning System (GPS) in the upcoming survey effort. Specifically, a three-pronged approach was employed. Households were randomly selected for inclusion in the study and then assigned to one of three groups: ( a) the traditional survey approach, ( b) the traditional approach with GPS, and ( c) GPS only. A total of 299 households from the city of Portland, Oregon, were recruited into the pilot, with 235 completing all required activities. A comprehensive evaluation of the similarities and differences in results across the three groups showed differences in respondent burden, completeness of travel details obtained, and costs. Results from this experiment also showed differences in nonresponse bias. The traditional survey had an expected nonresponse for the large households, low-income households, and young adults. Minority participation was on par with census figures. The GPS groups showed higher participation rates for young adults and nonminorities. These data confirmed the general thought that GPS was an effective tool for mitigating nonresponse among young adults. However, the minority nonresponse bias increased significantly with technology, suggesting that other methods would be more appropriate. With regard to completeness of data, geocoding rates are higher for the GPS groups, and there are significant differences in trip departure times, which could affect peak hour and time-of-day modeling. As expected, the costs were higher for the GPS groups, but the expectation is that these costs will fall as processes are standardized across studies and new technologies are introduced.
Model-Based Synthesis of Household Travel Survey Data in Small and Midsize Metropolitan Areas
Authors: Long Liang , Lin Jie (Jane) , Pu Wenjing
Published: October 2009

Household travel data synthesis–simulation has become a promising alternative or supplement to survey data from both small urban areas and large metropolitan regions in which data are expensive to collect or the data required to support the planning process have become outdated. This paper proposes and applies model-based approaches [i.e., small area estimation (SAE) methods] to synthesize household travel characteristics. The proposed methods address the sampling-bias concerns in the existing methods. Specifically, three SAE methods–-the generalized regression estimators method, the empirical best linear unbiased predictor (EBLUP) method, and the synthetic method (an EBLUP without random area effects)–-are applied to synthesize household travel characteristics at both census tract and individual levels. The SAE framework of synthesizing household travel characteristics is demonstrated with the National Household Travel Survey data and the Census Transportation Planning Package data in the Des Moines metropolitan area in central Iowa. Results indicate that SAE methods are promising approaches to synthesize unbiased aggregate and disaggregate household travel characteristics by incorporating population auxiliary information and local, small-household travel survey data. The proposed data synthesis methods and analysis findings will provide a useful tool for practitioners, planners, and policy makers in transportation analyses. The paper also points out that by linking population synthesis with the travel data simulation framework described here, this method could be of broad application in transportation planning.
Development of Geolocation Data Compression for Transportation Target Identification
Authors: Liu Xiaoyue , Yu Lei
Published: October 2009

Applications of an intelligent transportation system (ITS) often require wireless communication networks to support navigation and location identification, which is emerging as an important research issue in ITS. Of the various infrastructures for supporting ITS development, the wireless sensor network is the most commonly used medium to transmit data from a target source to the receiving sensors, between sensors, or both. Such data, often referred to as geolocation data, can then be used to calculate the time difference of arrival (TDOA) to the various sensors for the purpose of precise location identification. However, the limitation on the system bandwidth and energy resources motivates the use of data compression within the network when data are transmitted between sensors. This paper presents three data compression approaches specifically designed for geolocation data transmitted between sensors within a wireless communication network for the purposes of transportation target identification and location-finding. The approaches include the wavelet transform with arithmetic encoding method, the wavelet packet analysis with the Fisher-information method, and the Texas Southern University model (the monotone increase method). The effectiveness of each presented method is evaluated by calculation of the precision of TDOA from the decompressed data, which are used for determination of source location. Sensitivity analysis is conducted on all the presented methods in relation to compression ratio, signal-to-noise ratio, and computational time. A comparison of the three methods permits recommendation of the optimal compression tool for various applications.
Participatory Geographic Information Systems and Active Transportation
Authors: Schlossberg Marc , Brehm Christo
Published: October 2009

This paper discusses the approach, results, and keys to success in using new mobile geographic information system (GIS) technology in a public involvement context to assess the transportation infrastructure of most relevance to livable and healthy communities. Research on active transportation and the built environment is a fairly recent area of inquiry, accelerated over the past 10 years by an increased interest in the relationship between urban form and public health. As the research has progressed, so has the interest in developing ways to collect data at a fine scale–-the streetscape level–-and link these data to transportation behavior. This paper discusses the development and implementation of two mobile GIS-based tools that communities can use or adapt for quick, georeferenced, and useful local area analysis; one tool focuses on safe routes to school and the other on more complete local street networks. The public involvement component can help to create a political coalition that becomes active in translating data into political or technical action by appropriate public departments. Both tools were developed specifically to include a general, nontechnical public in the data-gathering and data analysis processes and have been tested in a variety of communities across the country. This paper summarizes both tools and some results from their use in different settings. It also discusses how the tools can be used in research investigating the relationship between the layperson's subjective perception of pedestrian and bicycle environments and objective design variables.
Transport and Surveillance Aspects of Location-Based Services
Authors: Wigan Marcus , Clarke Roger
Published: October 2009

Transport is a series of movements between locations, and considerable efforts are spent to secure details of such movements for planning and modeling purposes. This paper considers the issues raised when such information is secured too well, as well as the accompanying implications for surveillance and privacy. Location is a critical aspect of both privacy and surveillance. A detailed record of locations allows all sorts of other information to be linked together, adding to information about the subject and his or her associates in the same way that a unique identifier allows dataveillance to be expanded swiftly and extensively. In this case, the information comes from allowing the linking together of both the activities and records of many people. Location technologies have far outstripped both public awareness and legal and policy attention. Addressing this gap between the public's awareness and the technological possibilities will require careful use of precise language to ensure that unexpected side effects do not occur when the problem is finally faced. This paper explores both this essential language and some of the applications and linkages that need addressing. A wider public and policy understanding of the implications of expanding capacities to track, record, and monitor location is an urgent need, because it is difficult to reverse capacities once they are integrated into a wide range of commercial, enforcement, and intelligence systems–-as is already happening.
Forecasting Network Data
Authors: Wang Xiaokun , Kockelman Kara M.
Published: October 2009

Annual average daily traffic (AADT) values have long played an important role in transportation design, operations, planning, and policy making. However, AADT values are almost always rough estimates that are based on the closest short-period traffic counts and are factored by using permanent automatic traffic recorder data. This study develops Kriging-based methods for mining network and count data over time and space. With the use of Texas highway count data, the method forecasts AADT values at locations where no traffic detectors are present. While low-volume road counts remain difficult to predict, available explanatory variables are few, and extremely high-count outlier sites skew predictions in the data set used here, overall AADT-weighted median prediction error is 31% (across all Texas network sites). Here, Kriging performed far better than other options for spatial extrapolation, such as assigning AADT on the basis of a point's nearest sampling site, which yields errors of 80%. Beyond AADT estimation, Kriging is a promising way to explore spatial relationships across a wide variety of data sets, including, for example, pavement conditions, traffic speeds, population densities, land values, household incomes, and trip generation rates. Further refinements, including spatial autocorrelation functions based on network (rather than Euclidean) distances and inclusion of far more explanatory variables are possible, and will further enhance estimation.