bluuebunny/crossref_metadata_2025 huggingface dataset:
Construindo Critérios de Julgamento em Avaliação: especialistas e satisfação dos usuários com a dispensação do tratamento do HIV/Aids
Authors: Esher Ângela , Santos Elizabeth Moreira dos , Magarinos-Torres Rachel , Azeredo Thiago Botelho
Published: January 2012

Critério é uma ferramenta típica da avaliação e pode ser definido como uma dimensão-padrão em função da qual a realidade do objeto da avaliação receberá julgamento qualitativo e/ou quantitativo. Em uma avaliação, o procedimento de elaborar, esclarecer, negociar e aplicar critérios para determinar o valor (ou mérito) do objeto avaliado faz parte de um exercício metodológico que deve ser cuidadoso. Este artigo apresenta critérios de julgamento para avaliar a satisfação dos usuários com a dispensação dos medicamentos para o tratamento do HIV/Aids e seu processo de construção por meio de consenso entre diferentes atores sociais. Para estabelecer o consenso utilizou-se técnica de Delfos, uma técnica formal utilizada para consenso de especialistas com metodologia e processos estruturados. Neste estudo, foram considerados especialistas aqueles com experiência acadêmica e em gestão, bem como ativistas informados e comprometidos com a questão. Os achados foram sistematizados sob a forma de uma nova estrutura de satisfação, sob a qual os critérios construídos são articulados hierarquicamente. Buscou-se contribuir para o desenvolvimento de uma estratégia metodológica participativa em avaliação e ampliar o conhecimento sobre a satisfação dos usuários e a dispensação dos medicamentos para HIV/Aids.
A satisfação com o serviço de esterilização cirúrgica entre os usuários do sistema único de saúde em um município paulista
Authors: Vieira Elisabeth Meloni , Souza Luiz de
Published: January 2012

OBJETIVO: Avaliar a satisfação dos usuários com a esterilização cirúrgica realizada pelo Sistema Único de Saúde (SUS) e detectar fatores que possam influenciar a escolha entre laqueadura e vasectomia. MÉTODOS: Foram entrevistados 235 mulheres e 78 homens esterilizados em um período de cinco anos. As variáveis estudadas incluíram as características sociodemográficas, os motivos para esterilizar-se, a facilidade para a obtenção do procedimento, o aconselhamento, a assistência hospitalar e a satisfação com a esterilização. RESULTADOS: A maioria dos entrevistados era casada ou coabitava com um companheiro(a) e tinha em média 3,4 filhos vivos. Frequentaram a escola por 6,7 anos em média e declararam renda familiar per capita média de R$ 212,81 mensais, pertenciam à categoria social C, eram brancos e católicos. Consideraram fácil obter a cirurgia e adequado o tempo de espera, ficaram satisfeitos com o aconselhamento e com a esterilização. No entanto, cerca de um quarto ainda pensava, equivocadamente, ser a esterilização de fácil reversão. Estudando-se os casais, observaram-se diferenças importantes na escolha de vasectomia e laqueadura. CONCLUSÕES: Os resultados apontam para a necessidade de melhoria na informação fornecida aos candidatos ao procedimento que, embora estejam satisfeitos no momento, poderão não estar no futuro. A avaliação realizada na perspectiva do usuário deve levar em consideração não apenas a sua opinião, mas também seus interesses.
Absenteísmo-doença, modelo demanda-controle e suporte social: um estudo caso-controle aninhado em uma coorte de trabalhadores de hospitais, Santa Catarina, Brasil
Authors: Santos Kleber dos , Kupek Emil , Cunha Jane Cléia Cardoso Bittencourt , Blank Vera Lúcia Guimarães
Published: January 2012

O objetivo do estudo foi identificar a contribuição do Modelo Demanda-Controle (MDC) e do suporte social para duração do absenteísmo-doença segundo Licenças para Tratamento de Saúde (LTS) nos trabalhadores de hospitais (servidores públicos) da Secretaria de Estado da Saúde de Santa Catarina (SES/SC), Brasil. Entre as secretarias deste estado, a SES/SC tem a segunda maior frequência de LTS, com destaque nos hospitais. Este é um estudo caso-controle aninhado em uma coorte de trabalhadores de hospitais da SES/SC, com acompanhamento entre 01/07/2008 e 30/06/2009. Os casos foram aqueles que apresentaram LTS nesse período, os critérios de pareamento foram sexo, faixa etária e setor de trabalho. O desfecho foi o total de dias de LTS, as variáveis de exposição foram MDC e o suporte social do supervisor e do colega. Utilizou-se dados primários e secundários, nas análises a regressão Zero-inflado Binomial Negativa, e as variáveis socioeconômicas e ocupacionais nos ajustes. O banco de dados para as análises teve 425 (144 casos; 281 controles) participantes. O baixo suporte do colega aumentou a expectativa de dias de LTS em 2,04 (IC95%: 1,05-3,93), unido ao trabalho de baixa exigência aumentou 2,68 (IC95%: 1,37-5,27) e ao de alta exigência (iso-strain) 78% (IC95%: 1,02-3,12) mais do que o MDC com alto suporte do colega. Este estudo mostrou a importância do suporte do colega sobre a duração absenteísmo-doença, e auxiliou conjeturar que a variável tempo nos trabalhadores de hospital leva a adaptação às exigências das tarefas e a monotonia. Intervenções no relacionamento entre os trabalhadores provavelmente diminuirão a duração de LTS.
Age-Specific Nonpersistence of Endocrine Therapy in Postmenopausal Patients Diagnosed with Hormone Receptor–Positive Breast Cancer: A TEAM Study Analysis
Authors: Water Willemien , Bastiaannet Esther , Hille Elysée T.M. , Meershoek-Klein Kranenbarg Elma M. , Putter Hein , Seynaeve Caroline M. , Paridaens Robert , Craen Anton J.M. , Westendorp Rudi G.J. , Liefers Gerrit-Jan , Velde Cornelis J.H.
Published: December 2011

Background.

Early discontinuation of adjuvant endocrine therapy may affect the outcome of treatment in breast cancer patients. The aim of this study was to assess age-specific persistence and age-specific survival outcome based on persistence status.

Methods.

Patients enrolled in the Tamoxifen Exemestane Adjuvant Multinational trial were included. Nonpersistence was defined as discontinuing the assigned endocrine treatment within 1 year of follow-up because of adverse events, intercurrent illness, patient refusal, or other reasons. Endpoints were the breast cancer–specific and overall survival times. Analyses were stratified by age at diagnosis (<65 years, 65–74 years, ≥75 years).

Results.

Overall, 3,142 postmenopausal breast cancer patients were included: 1,682 were aged <65 years, 951 were aged 65–74 years, and 509 were aged ≥75 years. Older age was associated with a higher proportion of nonpersistence within 1 year of follow-up. In patients aged <65 years, nonpersistent patients had lower breast cancer–specific and overall survival probabilities. In patients aged 65–74 years and patients aged ≥75 years, the survival times of persistent and nonpersistent patients were similar.

Conclusion.

Nonpersistence within 1 year of follow-up was associated with lower breast cancer–specific and overall survival probabilities in patients aged <65 years, but it was not associated with survival outcomes in patients aged 65–74 years or in patients aged ≥75 years. These results suggest that extrapolation of outcomes from a young to an elderly breast cancer population may be insufficient and urge age-specific breast cancer studies.
Bevacizumab in Clinical Practice: Prescribing Appropriateness Relative to National Indications and Safety
Authors: Bonifazi Martina , Rossi Marta , Moja Lorenzo , Scigliano Vincenzo Davide , Franchi Matteo , La Vecchia Carlo , Zocchetti Carlo , Negri Eva
Published: December 2011

The aim of this study was to describe the clinical use of bevacizumab in Lombardy (9.5 million inhabitants), Italy, during 2006–2007 in patients with metastatic colorectal cancer (mCRC) to evaluate compliance with the Italian Medicine Agency (AIFA) indications, the incidence of adverse events, and the survival rate.

We performed computerized record linkage among three different Lombardy health care databases: File F registry, Regional discharge database, and Registry Office records. Patients were classified into approved and off-label uses according to the AIFA indications.

Treatment with bevacizumab was administered to 780 patients, of whom 81.7% (n = 637) had mCRC. Among these, 37.8% (n = 241) of patients received the drug in observance of AIFA indications. Overall, ∼10% of patients had serious treatment-related toxicities (fistula, 3.5%; venous thromboembolism, 2.8%; hemorrhage, 1.9%; intestinal perforation and arterial thromboembolism, <1%). The 1-year survival rate was 74.3% and the 2-year survival rate was 39.2%. The median survival time was 20.5 months, and there were no meaningful differences between gender and age groups.

There was a gap between the bevacizumab approved indication and clinical practice pattern: overall, less than one half of the patients received bevacizumab in observance with the regulatory indication. The main reason for nonadherence to the indication was use as a second-line or advanced line of therapy. The incidence of serious adverse events and the survival rates of mCRC patients were similar to those reported in clinical trials.
Telephone Survey Respondents’ Reactions to Questions Regarding Interpersonal Violence
Authors: Black Michele C. , Kresnow Marcie-Jo , Simon Thomas R. , Arias Ileana , Shelley Gene
Published: December 2011

Concerns have been raised regarding the appropriateness of asking about violence victimization in telephone interviews and whether asking such questions increases respondents’ distress or risk for harm. However, no large-scale studies have evaluated the impact of asking such questions during a telephone interview. This study explored respondents’ reactions to questions regarding violence in two large recently completed telephone surveys. After respondents were asked about violence, they were asked if they thought surveys should ask such questions and whether they felt upset or afraid because of the questions. In both surveys, the majority of respondents (regardless of their victimization history) were willing to answer questions about violence and were not upset or afraid because of the questions. More than 92% of respondents thought such questions should be asked. These results challenge commonly held beliefs and assumptions and provide some assurance to those concerned with the ethical collection of data on violent victimization.
Medicaid and Ethnic Networks
Authors: Gee Emily R. , Giuntella G. Osea
Published: December 2011

Many low-income immigrants are uninsured yet eligible for public health insurance. In this paper, we examine whether language barriers and network effects can explain disparities in insurance Medicaid participation. Using the 2008 and 2009 American Community Survey, we show that linguistic networks facilitate Medicaid enrollment among non-English speaking adults. Our identification method follows Bertrand et al. (2000) and employs local variation in the density of immigrant populations and nationwide variation in Medicaid participation among ethnic groups. Given a hypothetical policy to increase Medicaid enrollment, for every 1 percentage point of direct increase, networks generate a multiplier effect that boosts participation by an additional 0.26 percentage points. Networks have greatest influence on individuals who are not proficient in English or who arrived in the United States more recently. Our results are robust to alternative specifications, including using an ex ante indicator of group-level participation. We also find that the availability of foreign-language Medicaid information online is associated with significantly higher participation.
Entrepreneurship and Community Culture: A Place-Based Study of Their Interdependency
Authors: Huggins Robert , Thompson Piers
Published: January 2012

Cultural factors are often absent from analyses of economic change and development, divorcing the nature of social places from the economic spaces within which they are situated. However, the cultural community traits of places may influence the prevailing entrepreneurial culture of these places in the form, for example, of entrepreneurial capacity. As a means of examining the missing link between placed-based community and economy, this study establishes a number of community culture measures and assesses how these are associated with place-based measures of entrepreneurship. The study finds significant links between community culture and attitudes to entrepreneurship at the local level. For instance, it is found that caring and more feminine attitudes and activities are negatively associated with stronger local entrepreneurial cultures. Observance of social rules, social cohesion and embracement of work and education, on the other hand, are positively associated with stronger, more enterprising business cultures, suggesting that a cohesive community increases the entrepreneurial confidence of individuals. It is concluded that community cultural characteristics such as social cohesion represent a potential strength which policymakers can potentially enhance as an economic development tool to stimulate entrepreneurship.
Bcl-2–Modifying Factor Induces Renal Proximal Tubular Cell Apoptosis in Diabetic Mice
Authors: Lau Garnet J. , Godin Nicolas , Maachi Hasna , Lo Chao-Sheng , Wu Shyh-Jong , Zhu Jian-Xin , Brezniceanu Marie-Luise , Chénier Isabelle , Fragasso-Marquis Joelle , Lattouf Jean-Baptiste , Ethier Jean , Filep Janos G. , Ingelfinger Julie R. , Nair Viji , Kretzler Matthias , Cohen Clemens D. , Zhang Shao-Ling , Chan John S.D.
Published: December 2011

This study investigated the mechanisms underlying tubular apoptosis in diabetes by identifying proapoptotic genes that are differentially upregulated by reactive oxygen species in renal proximal tubular cells (RPTCs) in models of diabetes. Total RNAs isolated from renal proximal tubules (RPTs) of 20-week-old heterozygous db/m+, db/db, and db/db catalase (CAT)-transgenic (Tg) mice were used for DNA chip microarray analysis. Real-time quantitative PCR assays, immunohistochemistry, and mice rendered diabetic with streptozotocin were used to validate the proapoptotic gene expression in RPTs. Cultured rat RPTCs were used to confirm the apoptotic activity and regulation of proapoptotic gene expression. Additionally, studies in kidney tissues from patients with and without diabetes were used to confirm enhanced proapoptotic gene expression in RPTs. Bcl-2–modifying factor (Bmf) was differentially upregulated (P < 0.01) in RPTs of db/db mice compared with db/m+ and db/db CAT-Tg mice and in RPTs of streptozotocin-induced diabetic mice in which insulin reversed this finding. In vitro, Bmf cDNA overexpression in rat RPTCs coimmunoprecipated with Bcl-2, enhanced caspase-3 activity, and promoted apoptosis. High glucose (25 mmol/L) induced Bmf mRNA expression in RPTCs, whereas rotenone, catalase, diphenylene iodinium, and apocynin decreased it. Knockdown of Bmf with small interfering RNA reduced high glucose–induced apoptosis in RPTCs. More important, enhanced Bmf expression was detected in RPTs of kidneys from patients with diabetes. These data demonstrate differential upregulation of Bmf in diabetic RPTs and suggest a potential role for Bmf in regulating RPTC apoptosis and tubular atrophy in diabetes.
Histone Deacetylase 6 (HDAC6) Is an Essential Modifier of Glucocorticoid-Induced Hepatic Gluconeogenesis
Authors: Winkler Robin , Benz Verena , Clemenz Markus , Bloch Mandy , Foryst-Ludwig Anna , Wardat Sami , Witte Nicole , Trappiel Manuela , Namsolleck Pawel , Mai Knut , Spranger Joachim , Matthias Gabriele , Roloff Tim , Truee Oliver , Kappert Kai , Schupp Michael , Matthias Patrick , Kintscher Ulrich
Published: December 2011

In the current study, we investigated the importance of histone deacetylase (HDAC)6 for glucocorticoid receptor–mediated effects on glucose metabolism and its potential as a therapeutic target for the prevention of glucocorticoid-induced diabetes. Dexamethasone-induced hepatic glucose output and glucocorticoid receptor translocation were analyzed in wild-type (wt) and HDAC6-deficient (HDAC6KO) mice. The effect of the specific HDAC6 inhibitor tubacin was analyzed in vitro. wt and HDAC6KO mice were subjected to 3 weeks’ dexamethasone treatment before analysis of glucose and insulin tolerance. HDAC6KO mice showed impaired dexamethasone-induced hepatic glucocorticoid receptor translocation. Accordingly, dexamethasone-induced expression of a large number of hepatic genes was significantly attenuated in mice lacking HDAC6 and by tubacin in vitro. Glucose output of primary hepatocytes from HDAC6KO mice was diminished. A significant improvement of dexamethasone-induced whole-body glucose intolerance as well as insulin resistance in HDAC6KO mice compared with wt littermates was observed. This study demonstrates that HDAC6 is an essential regulator of hepatic glucocorticoid-stimulated gluconeogenesis and impairment of whole-body glucose metabolism through modification of glucocorticoid receptor nuclear translocation. Selective pharmacological inhibition of HDAC6 may provide a future therapeutic option against the prodiabetogenic actions of glucocorticoids.
Regulated and Reversible Induction of Adult Human β-Cell Replication
Authors: Takane Karen K. , Kleinberger Jeffery W. , Salim Fatimah G. , Fiaschi-Taesch Nathalie M. , Stewart Andrew F.
Published: December 2011

Induction of proliferation in adult human β-cells is challenging. It can be accomplished by introduction of cell cycle molecules such as cyclin-dependent kinase 6 (cdk6) and cyclin D1, but their continuous overexpression raises oncogenic concerns. We attempted to mimic normal, transient, perinatal human β-cell proliferation by delivering these molecules in a regulated and reversible manner. Adult cadaveric islets were transduced with doxycycline (Dox)-inducible adenoviruses expressing cdk6 or cyclin D1. End points were cdk6/cyclin D1 expression and human β-cell proliferation, survival, and function. Increasing doses of Dox led to marked dose- and time-related increases in cdk6 and cyclin D1, accompanied by a 20-fold increase in β-cell proliferation. Notably, Dox withdrawal resulted in a reversal of both cdk6 and cyclin D1 expression as well as β-cell proliferation. Re-exposure to Dox reinduced both cdk/cyclin expression and proliferation. β-Cell function and survival were not adversely affected. The adenoviral tetracycline (tet)-on system has not been used previously to drive human β-cell proliferation. Human β-cells can be induced to proliferate or arrest in a regulated, reversible manner, temporally and quantitatively mimicking the transient perinatal physiological proliferation that occurs in human β-cells.
l-Leucine Alters Pancreatic β-Cell Differentiation and Function via the mTor Signaling Pathway
Authors: Rachdi Latif , Aïello Virginie , Duvillié Bertrand , Scharfmann Raphaël
Published: December 2011

Leucine (Leu) is an essential branched-chain amino acid, which activates the mammalian target of rapamycin (mTOR) signaling pathway. The effect of Leu on cell differentiation during embryonic development is unknown. Here, we show that Leu supplementation during pregnancy significantly increased fetal body weight, caused fetal hyperglycemia and hypoinsulinemia, and decreased the relative islet area. We also used rat embryonic pancreatic explant culture for elucidating the mechanism of Leu action on β-cell development. We found that in the presence of Leu, differentiation of pancreatic duodenal homeobox-1–positive progenitor cells into neurogenin3-positive endocrine progenitor cells was inefficient and resulted in decreased β-cell formation. Mechanistically, Leu increases the intracellular levels of hypoxia-inducible factor 1-α, a repressor of endocrine fate in the pancreas, by activating the mTOR complex 1 signaling pathway. Collectively, our findings indicate that Leu supplementation during pregnancy could potentially increase the risk of type 2 diabetes mellitus by inhibiting the differentiation of pancreatic endocrine progenitor cells during a susceptible period of fetal life.
Strong Parent–Offspring Association of Metabolic Syndrome in Korean Families
Authors: Yoo Eun-Gyong , Park Sang Shin , Oh Sang Woo , Nam Gi-Byoung , Park Mi Jung
Published: December 2011

OBJECTIVE

To investigate the associations of metabolic syndrome (MetS) and its components between adolescents and their parents in Korea.

RESEARCH DESIGN AND METHODS

We analyzed data for 4,657 subjects (1,404 fathers, 1,404 mothers, 957 sons, and 892 daughters) from the Korean National Health and Nutrition Examination Surveys conducted between 1998 and 2008.

RESULTS

Compared with adolescents whose parents did not have MetS, the odds ratio (95% CI) for MetS in adolescents with MetS in one parent was 4.2 (2.1–8.5) and 8.7 (3.4–22.3) in those with MetS in both parents. Among obese adolescents, the prevalence of MetS was 18.2% without parental MetS, whereas 29.2% of obese adolescents with MetS in one parent and 53.9% with MetS in both parents also had MetS (P = 0.01 for trend).

CONCLUSIONS

The risk of MetS increased significantly in adolescents with parental MetS and was especially high in those with coexisting obesity and parental MetS.
Pioglitazone and Bladder Cancer
Authors: Tseng Chin-Hsiao
Published: December 2011

OBJECTIVE

The association between pioglitazone and bladder cancer has not been investigated in Asians. We aimed to investigate this association.

RESEARCH DESIGN AND METHODS

A total of 1,000,000 individuals were randomly sampled from the National Health Insurance database, and incident cases of bladder cancer during the period from 1 January 2006 to 31 December 2009 were analyzed among 54,928 patients with type 2 diabetes and without previous bladder cancer.

RESULTS

Among 165 incident case subjects, 10 (0.39%) were ever users and 155 (0.30%) were never users of pioglitazone (adjusted hazard ratio in full model 1.305 [95% CI 0.661–2.576]). All bladder cancer in ever users occurred within a duration of therapy <24 months, suggesting an early effect of pioglitazone on bladder cancer or late use of pioglitazone in high-risk patients.

CONCLUSIONS

The association between pioglitazone and bladder cancer was not significant. However, confirmation of this finding is required because of the possible lack of statistical power owing to the small number of events.
Short Sleep Duration and Poor Sleep Quality Increase the Risk of Diabetes in Japanese Workers With No Family History of Diabetes
Authors: Kita Toshiko , Yoshioka Eiji , Satoh Hiroki , Saijo Yasuaki , Kawaharada Mariko , Okada Eisaku , Kishi Reiko
Published: December 2011

OBJECTIVE

To investigate whether a difference in the risk for diabetes exists in Japanese workers with regard to sleep duration/quality and the presence or absence of a family history of diabetes (FHD).

RESEARCH DESIGN AND METHODS

The researchers conducted a prospective, occupational-based study of local government employees in Sapporo, Japan. Between April 2003 and March 2004, 3,570 nondiabetic participants, aged 35–55 years, underwent annual health checkups and completed a self-administered questionnaire that included information on sleep duration/quality and FHD at baseline. Having diabetes was defined as taking medication for diabetes or a fasting plasma glucose level of ≥126 mg/dL at follow-up (2007–2008).

RESULTS

A total of 121 (3.4%) new cases of diabetes were reported. In multivariate logistic regression models of workers without an FHD, and after adjustment for potential confounding factors, the odds ratio (95% CI) for developing diabetes was 5.37 (1.38–20.91) in those with a sleep duration of ≤5 h compared with those with a sleep duration of >7 h. Other risk factors were awakening during the night (5.03 [1.43–17.64]), self-perceived insufficient sleep duration (6.76 [2.09–21.87]), and unsatisfactory overall quality of sleep (3.71 [1.37–10.07]). In subjects with an FHD, these associations were either absent or weaker.

CONCLUSIONS

The current study shows that poor sleep is associated with a higher risk of developing diabetes in workers without an FHD. Promoting healthy sleeping habits may be effective for preventing the development of diabetes in people without an FHD.
Serum 1,5-Anhydroglucitol Concentrations Are a Reliable Index of Glycemic Control in Type 2 Diabetes With Mild or Moderate Renal Dysfunction
Authors: Kim Won Jun , Park Cheol-Young , Lee Kyu-Beck , Park Se Eun , Rhee Eun Jung , Lee Won Young , Oh Ki Won , Park Sung Woo
Published: December 2011

OBJECTIVE

To assess the relationship between 1,5-anhydroglucitol (AG) levels, which are a marker of glycemic control, and stages of chronic kidney disease (CKD).

RESEARCH DESIGN AND METHODS

This was a cross-sectional study with 269 subjects with type 2 diabetes who were divided into four groups based on estimated glomerular filtration rate (eGFR) using Modification of Diet in Renal Disease (eGFRMDRD) formula: 57 in control, 111 in CKD stages 1–2, 78 in stage 3, and 23 in stages 4–5.

RESULTS

The study groups differed significantly with respect to 1,5-AG and fasting plasma glucose (FPG), age, duration of diabetes, blood pressure, HDL, and percentage of antihypertension or antidyslipidemia medication use. Stepwise multivariate regression analyses showed that 1,5-AG levels in the control group, the CKD stages 1–2 group, and the CKD stage 3 group could be explained by HbA1c, age, duration of diabetes, FPG, and antihypertension medication. However, eGFRMDRD was the only independent determinant of 1,5-AG levels in CKD stages 4–5. Logarithmic transformed 1,5-AG values (ln[1,5-AG]) had significant inverse correlations with HbA1c and FPG levels for CKD stages 1–2 and CKD stage 3 (all P < 0.001). However, associations between ln(1,5-AG) and HbA1c or FPG were insignificant for CKD stages 4–5 (P = 0.274 and P = 0.080, respectively).

CONCLUSIONS

This study demonstrated that 1,5-AG levels do not appear to be influenced by mild or moderate renal dysfunction, suggesting it is a reliable glycemic marker in type 2 diabetes with CKD stages 1–3.
Clinical and Metabolic Features of Adult-Onset Diabetes Caused by ABCC8 Mutations
Authors: Riveline Jean-Pierre , Rousseau Elise , Reznik Yves , Fetita Sabrina , Philippe Julien , Dechaume Aurélie , Hartemann Agnès , Polak Michel , Petit Catherine , Charpentier Guillaume , Gautier Jean-François , Froguel Philippe , Vaxillaire Martine
Published: December 2011

OBJECTIVE

Gain-of-function ABCC8/sulfonylurea (SU) receptor 1 mutations cause neonatal diabetes mellitus (NDM) or late-onset diabetes in adult relatives. Given the effectiveness of SU treatment in ABCC8-NDM patients, we further characterized late-onset ABCC8-associated diabetes.

RESEARCH DESIGN AND METHODS

Seven adult subjects from three NDM families and one family with type 2 diabetes were studied. Insulin secretion and insulin sensitivity were assessed using clamp techniques. We screened 139 type 2 diabetic patients who were well controlled by SU for ABCC8 mutations.

RESULTS

ABCC8 mutation carriers exhibited glucose intolerance, frank diabetes, or insulin-requiring diabetes since diagnosis. HbA1c improved in five SU-treated patients. Insulin secretion capacity was impaired in three patients compared with adult control subjects but was restored after a 4-week SU trial in two patients. Cohort screening revealed four SU-treated patients with ABCC8 mutations, two of which are likely causal.

CONCLUSIONS

Although of rare occurrence, recognition of adult-onset ABCC8-associated diabetes may help in targeting patients for SU therapy.
Association of C-Reactive Protein With Cardiovascular Disease Mortality According to Diabetes Status
Authors: Kengne Andre Pascal , Batty G. David , Hamer Mark , Stamatakis Emmanuel , Czernichow Sébastien
Published: December 2011

OBJECTIVE

C-reactive protein (CRP) is associated with the risk of cardiovascular disease (CVD); whether the effects are modified by diabetes status still is unclear. This study investigated these issues and assessed the added value of CRP to predictions.

RESEARCH DESIGN AND METHODS

Participants were drawn from representative samples of adults living in England and Scotland. Cox proportional hazards regression models were used to relate baseline plasma CRP with all-cause and CVD mortality during follow-up in men and women with and without diabetes. The added value of CRP to the predictions was assessed through c-statistic comparison and relative integrated discrimination improvement.

RESULTS

A total of 25,979 participants (4.9% with diabetes) were followed for a median of 93 months, during which period there were 2,767 deaths (957 from CVD). CRP (per SD loge) was associated with a 53% (95% CI 43–64) and 43% (38–49) higher risk of cardiovascular and all-cause mortality, respectively. These associations were log linear and did not differ according to diabetes status (both P ≥ 0.08 for interaction), sex, and other risk factors. Adding CRP to conventional risk factors improved predictions overall and separately by diabetes status but not for CVD mortality, although such improvements only were marginal based on several discrimination statistics.

CONCLUSIONS

The association between CRP and CVD was similar across diabetes status, and the effects are broadly similar across levels of other conventional risk factors.
Food Insecurity and Glycemic Control Among Low-Income Patients With Type 2 Diabetes
Authors: Seligman Hilary K. , Jacobs Elizabeth A. , López Andrea , Tschann Jeanne , Fernandez Alicia
Published: December 2011

OBJECTIVE

To determine whether food insecurity—the inability to reliably afford safe and nutritious food—is associated with poor glycemic control and whether this association is mediated by difficulty following a healthy diet, diabetes self-efficacy, or emotional distress related to diabetes.

RESEARCH DESIGN AND METHODS

We used multivariable regression models to examine the association between food insecurity and poor glycemic control using a cross-sectional survey and chart review of 711 patients with diabetes in safety net health clinics. We then examined whether difficulty following a diabetic diet, self-efficacy, or emotional distress related to diabetes mediated the relationship between food insecurity and glycemic control.

RESULTS

The food insecurity prevalence in our sample was 46%. Food-insecure participants were significantly more likely than food-secure participants to have poor glycemic control, as defined by hemoglobin A1c ≥8.5% (42 vs. 33%; adjusted odds ratio 1.48 [95% CI 1.07–2.04]). Food-insecure participants were more likely to report difficulty affording a diabetic diet (64 vs. 49%, P < 0.001). They also reported lower diabetes-specific self-efficacy (P < 0.001) and higher emotional distress related to diabetes (P < 0.001). Difficulty following a healthy diet and emotional distress partially mediated the association between food insecurity and glycemic control.

CONCLUSIONS

Food insecurity is an independent risk factor for poor glycemic control in the safety net setting. This risk may be partially attributable to increased difficulty following a diabetes-appropriate diet and increased emotional distress regarding capacity for successful diabetes self-management. Screening patients with diabetes for food insecurity may be appropriate, particularly in the safety net setting.
Type 1 Diabetes Increases the Expression of Proinflammatory Cytokines and Adhesion Molecules in the Artery Wall of Candidate Patients for Kidney Transplantation
Authors: Triñanes Javier , Salido Eduardo , Fernández Julián , Rufino Margarita , González-Posada José Manuel , Torres Armando , Hernández Domingo
Published: December 2011

OBJECTIVE

Diabetes may accelerate atheromatosis in uremic patients. Our aim was to assess the influence of type 1 diabetes on the atheromatosis-related inflammation in patients with chronic kidney disease (CKD).

RESEARCH DESIGN AND METHODS

We analyzed the expression of proinflammatory cytokines and adhesion molecules in the inferior epigastric artery walls of type 1 diabetic patients with CKD (n = 22) and compared it with nondiabetic uremic patients (n = 92) at the time of kidney transplantation. We evaluated the expression of interleukin (IL)-6, monocyte chemotractant protein (MCP)-1, vascular cell adhesion molecule (VCAM)-1, intercellular adhesion molecule-1, and the activation of nuclear factor-κβ p65 (NFkB-p65). Common carotid intima-media thickness (c-IMT) was determined by conventional echography.

RESULTS

IL-6, MCP-1, and VCAM-1 proteins were elevated in type 1 diabetic patients compared with nondiabetic subjects (P < 0.05). The nuclear localization of NFkB-p65 was higher in type 1 diabetic patients (P < 0.01) and correlated with the levels of MCP-1 in this group (r = 0.726, P < 0.001). Arterial fibrosis correlated with IL-6 and MCP-1 levels (r = 0.411, P < 0.001 and r = 0.378, P = 0.001). A significant correlation was observed between VCAM-1 levels and both the degree of arterial narrowing and c-IMT.

CONCLUSIONS

Type 1 diabetes produces a proinflammatory state in the arteries of end-stage CKD patients, with increased levels of IL-6, MCP-1, and VCAM-1, as well as a greater degree of p65 activation, which are associated with more severe vascular lesions and higher c-IMT. Although causality is not demonstrated, these findings support the major role of inflammation in type 1 diabetic patients with CKD.
A Randomized Clinical Trial to Assess the Efficacy and Safety of Real-Time Continuous Glucose Monitoring in the Management of Type 1 Diabetes in Young Children Aged 4 to <10 Years
Authors: Mauras Nelly , Beck Roy , Xing Dongyuan , Ruedy Katrina , Buckingham Bruce , Tansey Michael , White Neil H. , Weinzimer Stuart A. , Tamborlane William , Kollman Craig ,   the Diabetes Research in Children Network (DirecNet) Study Group
Published: December 2011

OBJECTIVE

Continuous glucose monitoring (CGM) has been demonstrated to improve glycemic control in adults with type 1 diabetes but less so in children. We designed a study to assess CGM benefit in young children aged 4 to 9 years with type 1 diabetes.

RESEARCH DESIGN AND METHODS

After a run-in phase, 146 children with type 1 diabetes (mean age 7.5 ± 1.7 years, 64% on pumps, median diabetes duration 3.5 years) were randomly assigned to CGM or to usual care. The primary outcome was reduction in HbA1c at 26 weeks by ≥0.5% without the occurrence of severe hypoglycemia.

RESULTS

The primary outcome was achieved by 19% in the CGM group and 28% in the control group (P = 0.17). Mean change in HbA1c was −0.1% in each group (P = 0.79). Severe hypoglycemia rates were similarly low in both groups. CGM wear decreased over time, with only 41% averaging at least 6 days/week at 26 weeks. There was no correlation between CGM use and change in HbA1c (rs = −0.09, P = 0.44). CGM wear was well tolerated, and parental satisfaction with CGM was high. However, parental fear of hypoglycemia was not reduced.

CONCLUSIONS

CGM in 4- to 9-year-olds did not improve glycemic control despite a high degree of parental satisfaction with CGM. We postulate that this finding may be related in part to limited use of the CGM glucose data in day-to-day management and to an unremitting fear of hypoglycemia. Overcoming the barriers that prevent integration of these critical glucose data into day-to-day management remains a challenge.
Nonalcoholic Fatty Liver Disease Is Associated With Left Ventricular Diastolic Dysfunction in Patients With Type 2 Diabetes
Authors: Bonapace Stefano , Perseghin Gianluca , Molon Giulio , Canali Guido , Bertolini Lorenzo , Zoppini Giacomo , Barbieri Enrico , Targher Giovanni
Published: December 2011

OBJECTIVE

Data on cardiac function in patients with nonalcoholic fatty liver disease (NAFLD) are limited and conflicting. We assessed whether NAFLD is associated with abnormalities in cardiac function in patients with type 2 diabetes.

RESEARCH DESIGN AND METHODS

We studied 50 consecutive type 2 diabetic individuals without a history of ischemic heart disease, hepatic diseases, or excessive alcohol consumption, in whom NAFLD was diagnosed by ultrasonography. A tissue Doppler echocardiography with myocardial strain measurement was performed in all patients.

RESULTS

Thirty-two patients (64%) had NAFLD, and when compared with the other 18 patients, age, sex, BMI, waist circumference, hypertension, smoking, diabetes duration, microvascular complication status, and medication use were not significantly different. In addition, the left ventricular (LV) mass and volumes, ejection fraction, systemic vascular resistance, arterial elasticity, and compliance were also not different. NAFLD patients had lower e′ (8.2 ± 1.5 vs. 9.9 ± 1.9 cm/s, P < 0.005) tissue velocity, higher E-to-e′ ratio (7.90 ± 1.3 vs. 5.59 ± 1.1, P < 0.0001), a higher time constant of isovolumic relaxation (43.1 ± 10.1 vs. 33.2 ± 12.9 ms, P < 0.01), higher LV–end diastolic pressure (EDP) (16.5 ± 1.1 vs. 15.1 ± 1.0 mmHg, P < 0.0001), and higher LV EDP/end diastolic volume (0.20 ± 0.03 vs. 0.18 ± 0.02 mmHg, P < 0.05) than those without steatosis. Among the measurements of LV global longitudinal strain and strain rate, those with NAFLD also had higher E/global longitudinal diastolic strain rate during the early phase of diastole (E/SRE). All of these differences remained significant after adjustment for hypertension and other cardiometabolic risk factors.

CONCLUSIONS

Our data show that in patients with type 2 diabetes and NAFLD, even if the LV morphology and systolic function are preserved, early features of LV diastolic dysfunction may be detected.
Fabrication of microtransmittance grating using laser induced backside dry etching
Authors: Chao He , Furong Liu , Weiping Zhou , Jimin Chen
Published: December 2011

Laser induced backside dry etching (LIBDE) is a novel technique, which applied in the micromachining and nanomachining of transparent dielectric materials used for optical elements by direct laser irradiation with the assistance of solid mediums as an absorbed layer. On the basis of exploring two different solid mediums, i.e. Al2O3 powder and alumina ceramic wafer as absorbers, LIBDE with 1064 nm central wavelength pulsed ytterbium doped fiber laser as the irradiation source was successfully applied for the fabrication of periodical microscaled structures on fused silica. The threshold of laser fluence to etch fused silica was 7.47 J/cm2 extrapolated from the experimental data. By using alumina ceramic wafer as the absorber, a microbinary dimensional transmittance grating with the constant of 25 μm was obtained on the silica. The depth of the trench is 4.2 μm, and the root mean square roughness of the trench bottom is below 40 nm according to the measurement of 3D profiler. Additionally, diffraction patterns were observed by the normal incidence of a 532 nm diode indicator laser to examine the optical features of the microbinary grating etched under the different laser fluences.
Silicon(IV) phthalocyanine-loaded-nanoparticles for application in photodynamic process
Authors: Simioni Andreza Ribeiro , Primo Fernando L. , Tedesco Antonio Claudio
Published: December 2011

The aim of this study was to evaluate the potential application of biodegradable nanoparticles containing a photosensitizer in photodynamic therapy. The poly (D,L lactic-co-glycolic acid) nanoparticles were studied by steady-state techniques, time-resolved fluorescence, and laser flash photolysis. The external morphology of the nanoparticles was established by scanning electron microscopy, and the biological activity was evaluated by in vitro cell culture by 3-(4,5 dimethyl-thiazol-2,5 biphenyl) tetrazolium bromide assay. The particles were spherical in shape exhibiting a 435 nm diameter with a low tendency to aggregate. The loading efficiency was 77%. The phthalocyanine-loaded-nanoparticles maintained their photophysical behavior after encapsulation. The cellular viability was determined, obtaining 70% of cellular death. All the performed physical–chemical, photophysical, and photobiological measurements indicated that the phthalocyanine-loaded-nanoparticles are a promising drug delivery system for photodynamic therapy and photoprocesses.
Evaluation of plasma N-terminal pro-B-type natriuretic peptide concentrations in dogs with and without cardiac disease
Authors: Ettinger Stephen J. , Farace Giosi , Forney Scott D. , Frye Michelle , Beardow Andrew
Published: January 2012

Objective—To evaluate plasma N-terminal pro-B-type natriuretic peptide (NT-proBNP) concentrations in a large, diverse population of dogs with and without cardiac disease and to define the upper reference limit for the biomarker in this species.

Design—Cross-sectional single center study.

Animals—1,134 dogs.

Procedures—Dogs underwent blood sample collection, physical examination, ECG, and echocardiographic and thoracic radiographic evaluations. Cardiac status was graded by use of a 9-grade cardiac disease classification system and a simplified 4-stage cardiac scoring system. Vertebral heart score (VHS) was assessed in 280 dogs. Associations of plasma NT-proBNP concentrations with multiple variables were evaluated via univariate and multivariate linear regression analysis. Sensitivity and specificity of NT-proBNP concentrations and of VHS to discriminate between dogs with and without clinical signs of cardiac disease were evaluated via receiver-operating characteristic curve analysis.

Results—974 dogs had cardiac disease, 37 had noncardiac-related disease, and 123 were healthy. Plasma NT-proBNP concentrations correlated with cardiac grade and stage; VHS was also associated with cardiac grade. At a cutoff of 874 pmol/L, sensitivity and specificity of NT-proBNP concentration to detect clinical signs of cardiac disease were 70% and 83%, respectively; for VHS, sensitivity and specificity were 56% and 85%, respectively, at a cutoff of 11.5. Mean NT-proBNP concentration was significantly increased in dogs with cardiac-related dyspnea or coughing, compared with dogs in which these signs were noncardiac related.

Conclusions and Clinical Relevance—Results suggested that 900 pmol/L is the upper reference limit of plasma NT-proBNP concentration in dogs. This biomarker may be a useful tool for staging of cardiac disease and identifying cardiac-related coughing or dyspnea in this species.
Safety and efficacy of laparoscopic hepatic biopsy in dogs: 80 cases (2004–2009)
Authors: Petre Sarah L. , McClaran Janet Kovak , Bergman Philip J. , Monette Sebastien
Published: January 2012

Objective—To evaluate the safety and efficacy of laparoscopic hepatic biopsy in dogs.

Design—Retrospective case series.

Animals—80 client-owned dogs.

Procedures—Medical records of dogs that underwent laparoscopic hepatic biopsy between 2004 and 2009 because of suspected hepatic disease were reviewed to obtain information on signalment, intraoperative and postoperative complications, and histologic diagnosis. Follow-up information was obtained through medical records and telephone conversations with owners.

Results—76 of the 80 (95%) dogs survived to hospital discharge. Three (4%) dogs required conversion to laparotomy, but in none of the dogs was conversion to laparotomy needed to control hemorrhage associated with the laparoscopic biopsy procedure. Another 3 (4%) dogs required a blood transfusion; all 3 had been anemic prior to surgery. All laparoscopic biopsy samples were considered to be of sufficient size and to contain a sufficient number of portal triads to obtain a histologic diagnosis. However, disagreements in histologic diagnoses were identified for 7 of the 49 (14%) dogs for which multiple slides were available for review.

Conclusions and Clinical Relevance—Results suggested that laparoscopic hepatic biopsy is a safe procedure in dogs, with low morbidity and mortality rates, that typically yields sufficient samples for histologic examination. However, because of the possibility of disagreement among histologic diagnoses, multiple samples should be obtained.
Echocardiographic evaluation of changes in left ventricular size and valvular regurgitation associated with physical training during and after maturity in Standardbred trotters
Authors: Buhl Rikke , Ersbøll Annette Kjær
Published: January 2012

Objective—To assess whether physical training induces cardiac hypertrophy and valvular regurgitation in maturing Standardbred trotters and to establish a prediction model for the size of the left ventricle.

Design—Longitudinal observational study.

Animals—53 Standardbred trotters.

Procedures—Each horse underwent 2-D, M-mode, and color flow Doppler echocardiography at 5.5 years of age; previously, each horse had been examined at 2, 2.5, 3, and 3.5 (time of maturity) years of age. Horses were or were not in training or racing for variable periods during the entire assessment period; data for a given horse were assigned to 1 of 2 groups on the basis of the horse's status at the fifth examination (racing [n = 40] or not racing [13]). At each examination, left ventricular (LV) internal diameter in diastole (LVIDd), LV mass, and mean and relative LV wall thicknesses were measured. Prevalence and severity of tricuspid, pulmonary, mitral, and aortic valve regurgitation were determined.

Results—During the assessment period, LVIDd, LV mass, and mean LV wall thickness increased; body weight was significantly associated with those variables. Prediction of LV mass was possible when sex and weight were included in the model. Prevalence of valvular regurgitation increased for all valves. An increased risk of development of tricuspid and pulmonary valve regurgitation for horses in racing was observed.

Conclusions and Clinical Relevance—The LV mass and prevalence of valvular regurgitation increased (indicative of development of exercise-induced cardiac hypertrophy and valvular regurgitation) in young horses, even during the latter part of the assessment period, when maturity was attained.
Clean energy from a carbon fuel cell
Authors: Kacprzak Andrzej , Kobyłecki Rafał , Bis Zbigniew
Published: January 2012

Clean energy from a carbon fuel cell

The direct carbon fuel cell technology provides excellent conditions for conversion of chemical energy of carbon-containing solid fuels directly into electricity. The technology is very promising since it is relatively simple compared to other fuel cell technologies and accepts all carbon-reach substances as possible fuels. Furthermore, it makes possible to use atmospheric oxygen as the oxidizer. In this paper the results of authors' recent investigations focused on analysis of the performance of a direct carbon fuel cell supplied with graphite, granulated carbonized biomass (biocarbon), and granulated hard coal are presented. The comparison of the voltage-current characteristics indicated that the results obtained for the case when the cell was operated with carbonized biomass and hard coal were much more promising than those obtained for graphite. The effects of fuel type and the surface area of the cathode on operation performance of the fuel cell were also discussed.