bluuebunny/crossref_metadata_2025 huggingface dataset:
Implementation of the European Water Framework Directive: procedures and a simple model for the identification of the most cost-effective measures in eutrophicated catchments
Authors: Zanou Barbara , Bellas Christodoulos , Skourtos Michalis
Published: April 2010

According to the European Water Framework Directive (WFD), cost-effectiveness analysis (CEA) should be used for measuring the cost and the environmental effectiveness of a measure in water quality management. The purpose of this paper is to argue that, beyond the calculation of the cost efficiency of the measures, additional information related to the cost and the environmental characteristics is required. Such information provides important data for the decision makers to assess the feasibility of measures and renders the application of CEA more reliable. Moreover, considering that the WFD requires the encouragement of the active involvement of the stakeholders in the planning processes, a practical algorithm could be used for a user-friendly presentation and discussion of CEA results. Furthermore, if the evaluated measures are independent of each other, a simple model of integer programming solved by a simple software program is proposed as an alternative mathematical tool for evaluating a combined set of measures which meet a predetermined environmental objective at the lowest cost.
Mandates vs markets: addressing over-allocation of Pacific Northwest River Basins
Authors: Slaughter Richard A. , Hamlet Alan F. , Huppert Daniel , Hamilton Joel , Mote Philip W.
Published: April 2010

Water has always been the key element of human development, quality of life, and transportation in the Pacific Northwest (PNW). While seemingly abundant when irrigation was first developed in the 19th Century, today many PNW rivers are fully allocated, leading to conflict in times of drought, a situation which may be exacerbated by the effects of climate change. In the PNW, water is managed by an array of Federal, State, and non-governmental entities, each with its own perspective and mission. This paper discusses the relative merits of solutions based on supporting market mechanisms through improved definition of water rights on the one hand, and authoritative mandates on the other.
Multiple conceptions of sustainable urban water systems: problem or asset?
Authors: Palme Ulrika
Published: April 2010

This paper examines various conceptions that researchers and practitioners in the sector have about sustainable urban water systems, to discern what these conceptions are and whether they are complementary or divergent. The study is based on a literature review and field studies, including semi-structured interviews. The results show that the conceptions held by the various actors are largely complementary, the most important divergence between them concerning time. The time perspective of local politicians is shorter than that of researchers and practitioners. A long-term perspective needs to be reinforced in decision making and planning to encourage research and development (R&D) for both technology and organizational structures to be better able to meet the sustainability challenges that urban water systems face. This reinforcement partly concerns fostering better understanding between different groups of actors, for example, through the joint (re)development of visions of and strategies for sustainable development, but also concerns clarifying at the national level how R&D in the Swedish water sector should be organized and financed.
Rapid Response Fault Drilling Past, Present, and Future
Authors: Brodsky E. E. , Ma K.-F. , Mori J. , Saffer D. M. ,   the participants of the ICDP/SCEC International Workshop
Published: April 2010

Abstract. No abstract available. doi:10.2204/iodp.sd.8.11.2009
Thermal degradation, antioxidant and antimicrobial activity of the synthesized allicin and allicin incorporated in gel
Authors: Ilic Dusica , Nikolic Vesna , Nikolic Ljubisa , Stankovic Mihajlo , Stanojevic Ljiljana
Published: April 2010

The main carriers of the pharmacological activity of garlic (Allium sativum L.) are organic sulfur compounds, the most important among them being allicin, a sulfenic acid thioester, or allylthiosulfonate. In this paper, the identification of synthesized and purified allicin was determined by using various spectroscopic methods (UV/VIS, FTIR, NMR). A HPLC method was developed for the detection and determination of the allicin content. The thermal degradation of allicin by using FTIR method was monitored. The method for the production of allicin gel based on Carbopol 940 (poly(acrylic acid)) was elaborated. The antimicrobial activity of pure allicin and allicin incorporated into gel by using a disk diffusion method was determined. In order to determine the antioxidant activity of allicin DPPH test was done and it was proved that with low concentrations (1 mgcm-3) a high DPPH radicals scavenging capacity (90%) was achieved.
Electrochemical behavior of Ag-Cu alloy in alkaline media
Authors: Grekulovic Vesna , Rajcic-Vujasinovic Mirjana , Stevic Zoran
Published: April 2010

Results of the investigation of electrochemical behaviour of Ag-Cu alloy containing 50 mass% Ag and 50 mass% Cu are presented in this paper. Pure silver and copper were investigated, too. Working electrodes were prepared by metallurgical process. 1 mol dm-3 and 0.5 mol dm-3 solutions of NaOH are chosen as the electrolyte. On the cyclic voltammograms, some current waves corresponding to number and quantity of phases present in the investigated electrodes appeared and they can be used for characterization of investigated alloy. On the voltammogram recorded for pure silver, two anodic and two cathodic peaks appeared. First peak consisted of two joined current waves which can be ascribed to the formation of the two different types of silver(I) oxide, Ag2O. Second peak should correspond to the formation of silver(II) oxide, AgO. Voltammogram obtained for pure copper exhibits one broad current wave corresponding to the formation of copper oxides, followed by a wide potential area in which copper is completely passive. At 0.4 V vs. SCE, current starts to increase again due to oxygen evolution and probably due to simultaneous dissolution of copper with formation of CuO22- as a product. In alkaline solutions copper has no significant influence on the shape and current values of the voltammograms recorded for Ag-Cu alloy; however, it has an influence only on the anodic and cathodic peak potentials, which are shifted to more negative values in comparison to Ag. It could mean an easier formation of oxides and their harder reduction. Comparing voltammograms recorded for Ag-Cu alloy in 0.5 moldm-3 NaOH and in 1 moldm-3 NaOH solutions, one can see that current waves appear at more positive potentials on the voltammograms obtained in the solution of lower concentration and with much higher current densities than those on the voltammograms obtained in the solution of higher concentration.
Thermodynamic analysis and phase equilibria investigation in Pb−Zn−Ag system
Authors: Mitovski Aleksandra , Zivkovic Dragana , Manasijevic Dragan , Minic Dusko , Balanovic Ljubisa , Strbac Nada
Published: April 2010

Physico-chemical processes that take place during the refining process in the extractive metallurgy of lead, are connected with ternary Pb?Zn?Ag system, which is necessary to study from the theoretical practical and aspects. Such investigation is important from production point of view, because of the phenomena that occur during desilvering of lead which is one of the important stages during lead refining process. Process of lead desilvering binds to ternary system Pb?Zn?Ag, which was the reason for numerous investigations, both from thermodynamic point of view and in terms of testing and determining the phase diagram, bearing in mind the theoretical, and practical importance of knowledge about the processes which are going in investigated system. The paper presents the results of thermodynamic analysis and investigation of phase equilibria of the Pb?Zn?Ag ternary system using the method of thermodynamic predictions and phase diagrams calculations, respectively, and the experimental results of metalography obtained by optical microscopy. Phase diagram of the vertical section Pb?Zn80Ag20 is presented, obtained by CALPHAD calculation methodology, and using PANDAT thermodynamic software, compared to experimental results obtained by DTA analysis. The results show a pronounced break in solubility, which is characteristic for the whole ternary Pb?Zn?Ag system. Also, it can be noticed that the thermodynamic properties follow the behavior of this system, which is expressed through positive deviation of Raoult?s law, pointing to the lack of lead affinity compared to the other two components in the system. The optical microscopy results of the investigated system show the following: - Sample L1 (weight% Pb = 98): the structure of the observed section shows double eutectic (Pbsol+Zn?Agsol) which lies in the base of the primary crystals of lead (Pbsol) - Samples L2?L5: the structure consists of a dual eutectic (Pbsol+Zn?Agsol) and primary crystals Zn?Agsol Also, it can be noticed certain structural inhomogenity, as a consequence of stratification that occurs in the ternary Pb?Zn?Ag system. However the metalography investigation results confirm the results obtained by defining the phase diagram and mutually agree relatively well in accordance with existing literature data.
Level set simulations of the anisotropic wet etching process for device fabrication in nanotechnologies
Authors: Radjenovic Branislav , Radmilovic-Radjenovic Marija
Published: April 2010

Chemical etching is employed as micromachining manufacturing process to produce micron-size components. As a semiconductor wafer is extremely expensive due to many processing steps involved in the making thereof, the need to critically control the etching end point in an etching process is highly desirable. It was found that not only the etchant and temperature determine the exact anisotropy of etched silicon. The angle between the silicon surface and the mask was also shown to play an important role. In this paper, angular dependence of the etching rate is calculated on the base of the silicon symmetry properties, by means of the interpolation technique using experimentally obtained values of the principal <100>, <110>, <111> directions in KOH solutions. The calculations are performed using an extension of the sparse field method for solving three dimensional (3D) level set equations that describe the morphological surface evolution during etching process. The analysis of the obtained results confirm that regardless of the initial shape the profile evolution ends with the crystal form composed of the fastest etching planes, {110} in our model.
Heterogeneous base-catalyzed methanolysis of vegetable oils: State of art
Authors: Miladinovic Marija , Lukic Ivana , Stamenkovic Olivera , Veljkovic Vlada , Skala Dejan
Published: April 2010

Today, homogeneous base-catalyzed methanolysis is most frequently used method for industrial biodiesel production. High requirements for the quality of feedstocks and the problems related to a huge amount of wastewaters have led to the development of novel biodiesel production technologies. Among them, the most important is heterogeneous base-catalyzed methanolysis, which has been intensively investigated in the last decade in order to develop new catalytic systems, to optimize the reaction conditions and to recycle catalysts. These studies are a base for developing continuous biodiesel production on industrial scale in near future. The present work summarizes up-to-date studies on biodiesel production by heterogeneous base-catalyzed methanolysis. The main goals were to point out the application of different base compounds as catalysts, the methods of catalyst preparation, impregnation on carriers and recycling as well as the possibilities to improve existing base-catalyzed biodiesel production processes and to develop novel ones.
Simultaneous Detection of Circulating Autoreactive CD8+ T-Cells Specific for Different Islet Cell–Associated Epitopes Using Combinatorial MHC Multimers
Authors: Velthuis Jurjen H. , Unger Wendy W. , Abreu Joana R.F. , Duinkerken Gaby , Franken Kees , Peakman Mark , Bakker Arnold H. , Reker-Hadrup Sine , Keymeulen Bart , Drijfhout Jan Wouter , Schumacher Ton N. , Roep Bart O.
Published: April 2010

OBJECTIVE

Type 1 diabetes results from selective T-cell–mediated destruction of the insulin-producing β-cells in the pancreas. In this process, islet epitope–specific CD8+ T-cells play a pivotal role. Thus, monitoring of multiple islet–specific CD8+ T-cells may prove to be valuable for measuring disease activity, progression, and intervention. Yet, conventional detection techniques (ELISPOT and HLA tetramers) require many cells and are relatively insensitive.

RESEARCH DESIGN AND METHODS

Here, we used a combinatorial quantum dot major histocompatibility complex multimer technique to simultaneously monitor the presence of HLA-A2 restricted insulin B10–18, prepro-insulin (PPI)15–24, islet antigen (IA)-2797–805, GAD65114–123, islet-specific glucose-6-phosphatase catalytic subunit–related protein (IGRP)265–273, and prepro islet amyloid polypeptide (ppIAPP)5–13–specific CD8+ T-cells in recent-onset diabetic patients, their siblings, healthy control subjects, and islet cell transplantation recipients.

RESULTS

Using this kit, islet autoreactive CD8+ T-cells recognizing insulin B10–18, IA-2797–805, and IGRP265–273 were shown to be frequently detectable in recent-onset diabetic patients but rarely in healthy control subjects; PPI15–24 proved to be the most sensitive epitope. Applying the “Diab-Q-kit” to samples of islet cell transplantation recipients allowed detection of changes of autoreactive T-cell frequencies against multiple islet cell–derived epitopes that were associated with disease activity and correlated with clinical outcome.

CONCLUSIONS

A kit was developed that allows simultaneous detection of CD8+ T-cells reactive to multiple HLA-A2–restricted β-cell epitopes requiring limited amounts of blood, without a need for in vitro culture, that is applicable on stored blood samples.
PYY3–36 and Oxyntomodulin Can Be Additive in Their Effect on Food Intake in Overweight and Obese Humans
Authors: Field Benjamin C.T. , Wren Alison M. , Peters Veronique , Baynes Kevin C.R. , Martin Niamh M. , Patterson Michael , Alsaraf Sara , Amber Vian , Wynne Katie , Ghatei Mohammad A. , Bloom Stephen R.
Published: April 2010

OBJECTIVE

Peptide YY3–36 (PYY3–36), a Y2 receptor agonist, and oxyntomodulin, a glucagon-like peptide 1 (GLP-1) receptor agonist, are cosecreted by intestinal L-cells after each meal. Separately each hormone acts as an endogenous satiety signal and reduces appetite in humans when infused intravenously. The aim of the current study was to investigate whether the anorectic effects of PYY3–36 and oxyntomodulin can be additive.

RESEARCH DESIGN AND METHODS

Twelve overweight or obese human volunteers underwent a randomized, double-blinded, placebo-controlled study. An ad libitum test meal was used to measure energy intake during intravenous infusions of either PYY3–36 or oxyntomodulin or combined PYY3–36/oxyntomodulin.

RESULTS

Energy intake during coadministration of PYY3–36 and oxyntomodulin was reduced by 42.7% in comparison with the saline control and was significantly lower than that during infusions of either hormone alone.

CONCLUSIONS

The anorectic effects of PYY3–36 and oxyntomodulin can be additive in overweight and obese humans. Coadministration of Y2 receptor agonists and GLP-1 receptor agonists may be a useful treatment strategy for obesity.
Racial Disparities in Health Status
Authors: O'Connell Joan , Yi Rong , Wilson Charlton , Manson Spero M. , Acton Kelly J.
Published: April 2010

OBJECTIVE

American Indians and Alaska Natives are 2.3 times more likely to have diabetes than are individuals in the U.S. general population. The objective of this study was to compare morbidity among American Indian and U.S. adults with diabetes.

RESEARCH DESIGN AND METHODS

We extracted demographic and health service utilization data for an adult American Indian population aged 18–64 years (n = 30,121) served by the Phoenix Service Unit from the Indian Health Service clinical reporting system. Similar data for a U.S. population (n = 1,500,002) with commercial health insurance, matched by age and sex to the American Indian population, were drawn from the MartketScan Research Database. We used Diagnostic Cost Groups to identify medical conditions for which each individual was treated and to assign a risk score to quantify his or her morbidity burden. We compared the prevalence of comorbidities and morbidity burden of American Indian and U.S. adults with diabetes.

RESULTS

American Indians with diabetes had significantly higher rates of hypertension, cerebrovascular disease, renal failure, lower-extremity amputations, and liver disease than commercially insured U.S. adults with diabetes (P < 0.05). The American Indian prevalence rates were 61.2, 6.9, 3.9, 1.8, and 7.1%, respectively. The morbidity burden among the American Indian with diabetes exceeded that of the insured U.S. adults with diabetes by 50%.

CONCLUSIONS

The morbidity burden associated with diabetes among American Indians seen at the Phoenix Service Unit far exceeded that of commercially insured U.S. adults. These findings point to the urgency of enhancing diabetes prevention and treatment services for American Indians/Alaska Natives to reduce diabetes-related disparities.
A Single Nucleotide Polymorphism in STK11 Influences Insulin Sensitivity and Metformin Efficacy in Hyperinsulinemic Girls With Androgen Excess
Authors: López-Bermejo Abel , Díaz Marta , Morán Erica , de Zegher Francis , Ibáñez Lourdes
Published: April 2010

OBJECTIVE

Serine-threonine kinase STK11 catalyzes the AMP-activated protein kinase complex. We tested the hypothesis that a gene variant in STK11 contributes to variation in insulin sensitivity and metformin efficacy.

RESEARCH DESIGN AND METHODS

We studied the effects of a single nucleotide polymorphism (SNP) (rs8111699) in STK11 on endocrine-metabolic and body composition indexes before and after 1 year of metformin in 85 hyperinsulinemic girls with androgen excess, representing a continuum from prepuberal girls with a combined history of low birth weight and precocious pubarche over to postmenarchial girls with hyperinsulinemic ovarian hyperandrogenism. Metformin was dosed at 425 mg/day in younger girls and 850 mg/day in older girls. STK11 rs8111699 was genotyped. Endocrine-metabolic features were assessed in the fasting state; body composition was estimated by absorptiometry.

RESULTS

Genotype effects were similar in younger and older girls. At baseline, the mutated G allele in STK11 rs8111699 was associated with higher insulin and IGF-I levels (both P < 0.005). The response to metformin differed by STK11 genotype: GG homozygotes (n = 24) had robust metabolic improvements, GC heterozygotes (n = 38) had intermediate responses, and CC homozygotes (n = 23) had almost no response. Such differences were found for 1-year changes in body composition, circulating insulin, IGF-I, free androgen index, and lipids (all P < 0.005).

CONCLUSIONS

In hyperinsulinemic girls with androgen excess, the STK11 rs8111699 SNP influences insulin sensitivity and metformin efficacy, so that the girls with the least favorable endocrine-metabolic profile improve most with metformin therapy.
Glycemic Control, Coping, and Internalizing and Externalizing Symptoms in Adolescents With Type 1 Diabetes
Authors: Luyckx Koen , Seiffge-Krenke Inge , Hampson Sarah E.
Published: April 2010

OBJECTIVE

This study examines how active coping and withdrawal, psychological (internalizing and externalizing) symptoms, and glycemic control (A1C values) influence each other across time in adolescents with type 1 diabetes.

RESEARCH DESIGN AND METHODS

One hundred and nine adolescents participated in a four-wave longitudinal study spanning four years (mean age at Time 1 was 13.77). Patients were visited at home and completed questionnaires measuring coping and psychological symptoms. The treating physicians were contacted to obtain A1C values. Cross-lagged path analysis from a structural equation modeling approach was used for data analysis.

RESULTS

Clinically meaningful pathways between coping and glycemic control were found across time. Active coping prospectively predicted lower A1C levels, which, in turn, predicted active coping. Higher A1C levels and higher psychological symptoms consistently predicted avoidance coping across time. Finally, psychological symptomatology constituted an important link in the observed longitudinal chain of effects. More specifically, higher A1C values and symptomatology at Time 1 positively predicted withdrawal at Time 2, which, in turn, positively predicted symptomatology at Time 3. Next, symptomatology at Time 3 positively predicted higher A1C values at Time 4, thus coming full circle.

CONCLUSIONS

Coping with everyday stress, psychological symptoms, and glycemic control were interrelated across time. Evidence was obtained for reciprocal pathways and mutually reinforcing mechanisms, indicating the need to monitor coping strategies and psychological symptoms along with glycemic control in optimizing clinical care in adolescents with type 1 diabetes.
Plasma Growth Differentiation Factor-15 Independently Predicts All-Cause and Cardiovascular Mortality As Well As Deterioration of Kidney Function in Type 1 Diabetic Patients With Nephropathy
Authors: Lajer Maria , Jorsal Anders , Tarnow Lise , Parving Hans-Henrik , Rossing Peter
Published: April 2010

OBJECTIVE

Growth deferentiation factor-15 (GDF-15) is involved in inflammation and apoptosis. Expression is induced in the heart in response to ischemia and in atherosclerotic plaques. The aim of this study was to investigate GDF-15 levels in relation to all-cause mortality, cardiovascular mortality and morbidity, decline in glomerular filtration rate (GFR), and progression toward end-stage renal disease (ESRD).

RESEARCH DESIGN AND METHODS

The study was a prospective observational follow-up study including 451 type 1 diabetic patients with diabetic nephropathy (274 men, aged 42.1 ± 0.5 years [means ± SD], diabetes duration 28.3 ± 8.9 years, GFR 76 ± 33 ml/min/1.73 m2) and a control group of 440 patients with longstanding type 1 diabetes and persistent normoalbuminuria (232 men, aged 45.4 ± 11.5 years, duration of diabetes 27.7 ± 10.1 years). The patients were followed for 8.1 (0.0–12.9) years (median [range]).

RESULTS

Among normoalbuminuric patients, GDF-15 above the median predicted an adjusted (age, systolic blood pressure [sBP], and estimated GFR) increased risk of all-cause mortality (hazard ratio [HR] 3.6 [95% CI 1.3–10.3]; P = 0.014). Among patients with diabetic nephropathy, higher (fourth quartile) versus lower (first quartile) GDF-15 levels predict all-cause mortality (covariate-adjusted [sex, age, smoking, blood pressure, A1C, cholesterol, GFR, N-terminal prohormone B-type natriuretic peptide, antihypertensive treatment, and previous cardiovascular events]; HR 4.86 [95% CI 1.37–17.30]) as well as fatal and nonfatal cardiovascular events (adjusted HR 5.59 [1.23–25.43] and 3.55 [1.08–11.64], respectively). In addition, higher GDF-15 levels predict faster decline in GFR (P < 0.001) but not development of ESRD.

CONCLUSIONS

Higher levels of GDF-15 are a predictor of all-cause and cardiovascular mortality and morbidity in patients with diabetic nephropathy. Furthermore, higher levels of GDF-15 are associated with faster deterioration of kidney function.
Further Improvement in Postprandial Glucose Control With Addition of Exenatide or Sitagliptin to Combination Therapy With Insulin Glargine and Metformin
Authors: Arnolds Sabine , Dellweg Sibylle , Clair Janina , Dain Marie-Paule , Nauck Michael A. , Rave Klaus , Kapitza Christoph
Published: April 2010

OBJECTIVE

To assess the effect of a 4-week adjunctive therapy of exenatide (EXE) (5–10 μg b.i.d.) or sitagliptin (SITA) (100 mg once daily) in response to a standardized breakfast meal challenge in 48 men or women with type 2 diabetes receiving insulin glargine (GLAR) + metformin (MET).

RESEARCH DESIGN AND METHODS

This was a single-center, randomized, open-label, active comparator–controlled study with a three-arm parallel group design, consisting of: screening, 4- to 8-week run-in period, 4-week treatment period, and follow-up. In all three groups, the GLAR dose was titrated according to an algorithm (fasting blood glucose ≤100 mg/dl).

RESULTS

The unadjusted 6-h postprandial blood glucose excursion of both GLAR + MET + EXE and GLAR + MET + SITA was statistically significantly smaller than that of GLAR + MET (606 ± 104 vs. 612 ± 133 vs. 728 ± 132 mg/dl/h; P = 0.0036 and 0.0008). A1C significantly decreased in all three groups (P < 0.0001), with the greatest reduction of −1.9 ± 0.7 under GLAR + MET + EXE (GLAR + MET + SITA −1.5 ± 0.7; GLAR + MET −1.2 ± 0.5%-points; GLAR + MET + EXE vs. GLAR + MET P = 0.0154). The American Diabetes Association A1C target of <7.0% was reached by 80.0, 87.5, and 62.5% of subjects, respectively. GLAR + MET + EXE had the highest number (47) of adverse events, mostly gastrointestinal (56%) with one dropout. GLAR + MET or GLAR + MET + SITA only had 10 and 12 adverse events, respectively, and no dropouts. Hypoglycemia (blood glucose <50 mg/dl) rates were low and comparable among groups. Weight decreased with GLAR + MET + EXE (−0.9 ± 1.7 kg; P = 0.0396) and increased slightly with GLAR + MET (0.4 ± 1.5 kg; NS; GLAR + MET + EXE vs. GLAR + MET P = 0.0377).

CONCLUSIONS

EXE or SITA added to GLAR + MET further substantially reduced postprandial blood glucose excursions. Longer-term studies in a larger population are warranted to confirm these findings.
Psychosocial Well-Being and Functional Outcomes in Youth With Type 1 Diabetes 12 years After Disease Onset
Authors: Northam Elisabeth A. , Lin Ashleigh , Finch Sue , Werther George A. , Cameron Fergus J.
Published: April 2010

OBJECTIVE

Type 1 diabetes in youth and community controls were compared on functional outcomes. Relationships were examined between psychosocial variables at diagnosis and functional outcome 12 years later.

RESEARCH DESIGN AND METHODS

Participants were subjects with type 1 diabetes (n = 110, mean age 20.7 years, SD 4.3) and control subjects (n = 76, mean age 20.8 years, SD 4.0). The measures used included the Youth Self-Report and Young Adult Self-Report and a semi-structured interview of functional outcomes. Type 1 diabetes participants also provided information about current diabetes care and metabolic control from diagnosis.

RESULTS

Type 1 diabetes participants and control subjects reported similar levels of current well-being but for the youth with type 1 diabetes, the mental health referral rates over the previous 12 years were higher by 19% and school completion rates were lower by 17%. Over one-third of clinical participants were not currently receiving specialist care and this group had higher mental health service usage in the past (61 vs. 33%) and lower current psychosocial well- being. Within the type 1 diabetes group, behavior problems, high activity, and low family cohesion at diagnosis predicted lower current well-being, but were not associated with metabolic control history. Poorer metabolic control was associated with higher mental health service usage.

CONCLUSIONS

Type 1 diabetes participants report similar levels of current psychosocial well-being compared with control subjects, but higher levels of psychiatric morbidity since diagnosis and lower school completion rates. Psychiatric morbidity was associated with poor metabolic control and failure to transition to tertiary adult diabetes care.
No Effect of the 1α,25-Dihydroxyvitamin D3 on β-Cell Residual Function and Insulin Requirement in Adults With New-Onset Type 1 Diabetes
Authors: Walter Markus , Kaupper Thomas , Adler Kerstin , Foersch Johannes , Bonifacio Ezio , Ziegler Anette-G.
Published: April 2010

OBJECTIVE

To determine whether daily intake of 1α,25-dihydroxyvitamin D3 [1,25(OH)2D3] is safe and improves β-cell function in patients with recently diagnosed type 1 diabetes.

RESEARCH DESIGN AND METHODS

Safety was assessed in an open study of 25 patients aged 18–39 years with recent-onset type 1 diabetes who received 0.25 μg 1,25(OH)2D3 daily for 9 months. An additional 40 patients were randomly assigned to 0.25 μg 1,25(OH)2D3 or placebo daily for 9 months and followed for a total of 18 months for safety, β-cell function, insulin requirement, and glycemic control.

RESULTS

Safety assessment showed values in the normal range in nearly all patients, regardless of whether they received 1,25(OH)2D3 or placebo. No differences in AUC C-peptide, peak C-peptide, and fasting C-peptide after a mixed-meal tolerance test between the treatment and placebo groups were observed at 9 and 18 months after study entry, with ∼40% loss for each parameter over the 18-month period. A1C and daily insulin requirement were similar between treatment and placebo groups throughout the study follow-up period.

CONCLUSIONS

Treatment with 1,25(OH)2D3 at a daily dose of 0.25 μg was safe but did not reduce loss of β-cell function.
Improving Diabetes Care Among Patients Overdue for Recommended Testing: A Randomized Controlled Trial of Automated Telephone Outreach
Authors: Simon Steven R. , Trinacty Connie Mah , Soumerai Stephen B. , Piette John D. , Meigs James B. , Shi Ping , Ensroth Arthur , Ross-Degnan Dennis
Published: April 2010

OBJECTIVE

The study's objective was to assess the effects of automated telephone outreach with speech recognition (ATO-SR) on diabetes-related testing.

RESEARCH DESIGN AND METHODS

We identified 1,200 health plan members who were overdue for diabetes-related testing and randomly allocated 600 to ATO-SR and 600 to usual care (no intervention). The intervention included three interactive calls encouraging recommended testing. The primary outcome was retinopathy testing, since this was the health plan's principal goal. Tests for glycemia, hyperlipidemia, and nephropathy were secondary outcomes.

RESULTS

In total, 232 participants (39%) verbally responded to the calls. There was no difference between the intervention and the usual care groups in the primary outcome (adjusted hazard ratio 0.93 [95% CI 0.71–1.22]) and no effect of the intervention on any of the secondary outcomes.

CONCLUSIONS

Fewer than 40% of the patients randomized to ATO-SR interacted verbally with the system. The intervention had no effect on the study's outcomes.
Effects of early exercise on metacarpophalangeal joints in horses
Authors: Kawcak Chris E. , McIlwraith C. Wayne , Firth Elwyn C.
Published: April 2010

Objective—To determine the effects of exercise at an early age on tissues in the metacarpophalangeal joints of horses.

Animals—Twelve 18-month-old horses.

Procedures—All horses were pasture reared, but 6 horses had additional exercise starting at 3 weeks of age until 18 months of age. At that time, computed tomography, articular cartilage metabolism evaluation, and histologic assessments of synovial membrane, articular cartilage, and subchondral bone were performed.

Results—Exercised horses had fewer gross lesions, less articular cartilage matrix staining in the dorsal aspect of the condyle, greater bone fraction in the dorsolateral aspect of the condyle, and higher bone formation rate, compared with nonexercised horses.

Conclusions and Clinical Relevance—Exercise at a young age may be protective to joints, although more research is needed to characterize changes in articular cartilage matrix. Results suggested that exercise can be safely imposed at an early age.
Effects of dietary medium-chain triglycerides on plasma lipids and lipoprotein distribution and food aversion in cats
Authors: Trevizan Luciano , de Mello Kessler Alexandre , Bigley Karen E. , Anderson Wendy H. , Waldron Mark K. , Bauer John E.
Published: April 2010

Objective—To determine possible diet aversion and lipid and lipoprotein alterations in cats fed diets containing medium-chain triglycerides (MCTs).

Animals—19 clinically normal adult female cats.

Procedures—Cats were assigned to 2 groups (low MCT diet [n = 10] and high MCT diet [9]) and fed the diets for 9 weeks according to metabolic body weight (100 kcal of metabolizable energy [ME] × kg−0.67/d). Daily consumption records and weekly body weight and body condition score (BCS) were used to adjust amounts fed and calculate daily ME factors for each cat to maintain ideal BCS. Blood samples were obtained after withholding food on days 0, 14, 28, and 56 for measurement of plasma triglyceride and total cholesterol concentrations and lipoprotein-cholesterol distributions. Repeated-measures ANOVA and Tukey multiple comparison tests were performed.

Results—No diet differences were found for food consumption, body weight, BCS, and ME factors. A significant increase in plasma triglyceride concentration was detected for the high MCT diet; however, values were within the reference ranges. No diet effects were observed for total cholesterol concentrations or lipoprotein-cholesterol distributions, although increases over time were observed.

Conclusions and Clinical Relevance—Inclusion of MCT in diets of cats did not result in feed refusal and had minimal effects on lipid metabolism. Such diets may be useful for both clinically normal cats and cats with metabolic disorders. The MCT oils are an example of a bioactive dietary lipid that may benefit feline metabolism and can serve as a useful functional food ingredient for cats.
Pharmacokinetics of voriconazole after oral administration of single and multiple doses in Hispaniolan Amazon parrots (Amazona ventralis)
Authors: Sanchez-Migallon Guzman David , Flammer Keven , Papich Mark G. , Grooters Amy M. , Shaw Shannon , Applegate Jeff , Tully Thomas N.
Published: April 2010

Objective—To determine the pharmacokinetics and safety of voriconazole administered orally in single and multiple doses in Hispaniolan Amazon parrots (Amazona ventralis).

Animals—15 clinically normal adult Hispaniolan Amazon parrots.

Procedures—Single doses of voriconazole (12 or 24 mg/kg) were administered orally to 15 and 12 birds, respectively; plasma voriconazole concentrations were determined at intervals via high-pressure liquid chromatography. In a multiple-dose trial, voriconazole (18 mg/kg) or water was administered orally to 6 and 4 birds, respectively, every 8 hours for 11 days (beginning day 0); trough plasma voriconazole concentrations were evaluated on 3 days. Birds were monitored daily, and clinicopathologic variables were evaluated before and after the trial.

Results—Voriconazole elimination half-life was short (0.70 to 1.25 hours). In the single-dose experiments, higher drug doses yielded proportional increases in the maximum plasma voriconazole concentration (Cmax) and area under the curve (AUC). In the multiple-dose trial, Cmax, AUC, and plasma concentrations at 2 and 4 hours were decreased on day 10, compared with day 0 values; however, there was relatively little change in terminal half-life. With the exception of 1 voriconazole-treated parrot that developed polyuria, adverse effects were not evident.

Conclusions and Clinical Relevance—In Hispaniolan Amazon parrots, oral administration of voriconazole was associated with proportional kinetics following administration of single doses and a decrease in plasma concentration following administration of multiple doses. Oral administration of 18 mg of voriconazole/kg every 8 hours would require adjustment to maintain therapeutic concentrations during long-term treatment. Safety and efficacy of voriconazole treatment in this species require further investigation.
Use of a combination of prednisolone and rosuvastatin for treatment of a pyogranuloma in a dog
Authors: Yuki Masashi , Hirano Takashi
Published: April 2010

Case Description—A 6-year-old spayed female Miniature Dachshund was examined because of a 3-day history of anorexia and diarrhea.

Clinical Findings—A lump was detected during abdominal palpation. Biochemical abnormalities included increases in serum concentrations of total protein, globulin, and C-reactive protein (CRP). Abdominal radiography and abdominal ultrasonography revealed a mass on the caudal aspect of the right kidney. Exploratory laparotomy confimed the mass; however, it could not be excised because it was strongly adhered to surrounding tissues. Histologic examination of a tissue sample from the mass led to a diagnosis of pyogranuloma.

Treatment and Outcome—The dog was treated with rosuvastatin, but no improvement was evident. Administration of a high dose of prednisolone (1 mg/kg [0.45 mg/lb], PO, q 12 h) was initiated. The CRP concentration returned to within reference limits, and the mass gradually decreased in size. The prednisolone dosage was tapered to 0.14 mg/kg (0.064 mg/lb), PO, every 12 hours. However, once the low dosage of prednisolone was reached, CRP concentration and size of the mass increased. Rosuvastatin was subsequently combined with the low dosage of prednisolone. After 1 week of the combination treatment, the CRP concentration returned to within reference limits, and the mass was reduced in size. The mass eventually could not be detected ultrasonographically.

Clinical Relevance—A low dose of prednisolone was not effective against the pyogranuloma. However, administration of a low dose of prednisolone in combination with rosuvastatin caused decreases in CRP concentration and size of the pyogranuloma. Thus, statins may act as immunosuppressants.
Effects of oral L-arginine supplementation on vasodilation and O2max in male soccer players
Authors: Yaman Hülya , Tiryaki- Sönmez Gül , Gürel Kamil
Published: April 2010

Effects of oral L-arginine supplementation on vasodilation and O2max in male soccer players

Study aim: To determine the effects of oral L-arginine supplementation on vasodilation, blood flow and maximum oxygen uptake (O2max) in soccer players.

Material and methods: A group of 24 healthy male soccer players aged 20 - 26 years volunteered to participate in the study. The subjects were randomly assigned into 3 groups: experimental, placebo and control. Experimental group was given L-arginine (6 g orally) and the placebo group - starch (6 g orally) daily for a week; subjects from the control group remained untreated. Before the test and at the end of the week blood samples were collected, and systemic blood pressures, blood flows and maximal oxygen uptake (O2max, by Queens College step test) were recorded. Blood samples were assayed for HDL, LDL, triglyceride and urea concentrations. The study was conducted in a randomised, single-blinded, placebo-controlled fashion consisting of 7-day treatment periods.

Results: Oral supplementation of L-arginine significantly (p<0.01) decreased blood pressure indices and increased O2max (p<0.01), blood flow (p<0.05), femoral artery diameter (p<0.05) and urea levels (p<0.05). There was no change in blood lipid levels (p<0.05). No significant changes were noted in the placebo and control groups.

Conclusions: Oral supplementation of L-arginine may have beneficial effect on vasodilation and O2max, therefore may increase the exercise capacity of soccer players.
Single-stage bilateral choroid plexectomy for choroid plexus papilloma in a patient presenting with high cerebrospinal fluid output
Authors: Nimjee Shahid M. , Powers Ciaran J. , McLendon Roger E. , Grant Gerald A. , Fuchs Herbert E.
Published: April 2010

Cerebrospinal fluid overproduction resulting in communicating hydrocephalus is observed in patients who have choroid plexus papilloma or choroid plexus carcinoma. Less often, patients with these conditions have diffuse villous hyperplasia. Prior studies report CSF production greater than 3 L per day in these patients. These patients are treated with CSF shunting or by either unilateral choroid plexectomy or staged bilateral choroid plexectomy. The authors present a patient who had a number of congenital anomalies and a karyotype that revealed balanced translocations, 5 to 7 and 9 to 11. She presented with hydrocephalus and had CSF production of 5 L per day, greater output than ever previously reported. She was treated with a single-stage bilateral choroid plexectomy. Histopathological analysis revealed a bilateral choroid plexus papilloma. Postoperatively, the patient responded well clinically and showed radiographic improvement of her hydrocephalus. Bilateral choroid plexus papilloma has been reported in the literature as a cause for neonatal and congenital hydrocephalus. It can result in high CSF output and can be successfully treated with a single-stage bilateral choroid plexectomy. Further studies are ongoing to identify genes involved in embryogenesis of the choroid plexus.
Craniofrontonasal dysplasia associated with Chiari malformation
Authors: Mahore Amit , Shah Abhidha , Nadkarni Trimurti , Goel Atul
Published: April 2010

Craniofrontonasal dysplasia (CFND) is a rare developmental anomaly associated with an X-linked inheritance. It is predominantly expressed in females. A Chiari malformation (CM) has not been reported in such patients earlier. The authors report on a family with 3 female members who have marked and generalized CFND. The generalized bone dysplasia/hypertrophy resulted in reduction in the posterior cranial fossa volume in all 3 patients, and in a CM associated with syringomyelia in 2 of them. One of the 2 affected family members who had a CM and syringomyelia was symptomatic and was treated by foramen magnum decompression surgery. The 3 family members had remarkable similarity in their external facial features and in their radiologically revealed morphological features. A review of the relevant literature, genetic abnormalities, and pattern of inheritance is presented.
Hydrocephalus associated with cystic dilation of the foramina of Magendie and Luschka
Authors: Takami Hirokazu , Shin Masahiro , Kuroiwa Masafumi , Isoo Ayako , Takahashi Kan , Saito Nobuhito
Published: April 2010

Cystic malformations in the posterior cranial fossa result from developmental failure in the paleocerebellum and meninges. The authors present the case of an infant with hydrocephalus associated with cystic dilation of the foramina of Magendie and Luschka.

This 7-month-old female infant presented with sudden onset of tonic-clonic seizures. Computed tomography revealed tetraventricular hydrocephalus. Magnetic resonance imaging demonstrated a cyst communicating with the fourth ventricle and projecting to the cisterna magna and the cerebellopontine cisterns through the foramina of Magendie and Luschka. A suboccipital craniotomy was performed for removal of the cyst wall, and the transparent membrane covering the foramen of Magendie was removed under a microscope. After the surgery, the patient's hydrocephalus improved and a phase contrast cine MR imaging study showed evidence of normal CSF flow at the level of the third and fourth ventricles. Three weeks later, however, the hydrocephalus recurred. An endoscopic third ventriculocisternostomy was performed to address the possibility of stagnant CSF flow in the posterior cranial fossa, but the hydrocephalus continued. Finally the patient underwent placement of a ventriculoperitoneal shunt, resulting in improvement of her symptoms and resolution of the hydrocephalus.

On the basis of this experience and previously published reports, the authors speculate that the cystic malformation in their patient could be classified in a continuum of persistent Blake pouch cysts. Hydrocephalus was caused by a combination of obstruction of CSF flow at the outlets of the fourth ventricle and disequilibrium between CSF production and absorption capacity.
Precision of navigated stereotactic probe implantation into the brainstem
Authors: Giese Henrik , Hoffmann Karl-Titus , Winkelmann Andreas , Stockhammer Florian , Jallo George I. , Thomale Ulrich-W.
Published: April 2010

Object

The indications for stereotactic biopsies or implantation of probes for local chemotherapy in diffuse brainstem tumors have recently come under debate. The quality of performing these procedures significantly depends on the precision of the probes' placement in the brainstem. The authors evaluated the precision of brainstem probe positioning using a navigated frameless stereotactic system in an experimental setting.

Methods

Using the VarioGuide stereotactic system, 33 probes were placed into a specially designed model filled with agarose. In a second experimental series, 8 anatomical specimens were implanted with a total of 32 catheters into the pontine brainstem using either a suboccipital or a precoronal entry point. Before intervention in both experimental settings, a thin-sliced CT scan for planning was obtained and fused to volumetric T1-weighted MR imaging data. After the probe positioning procedures, another CT scan and an MR image were obtained to compare the course of the catheters versus the planned trajectory. The deviation between the planned and the actual locations was measured to evaluate the precision of the navigated intervention.

Results

Using the VarioGuide system, mean total target deviations of 2.8 ± 1.2 mm on CT scanning and 3.1 ± 1.2 mm on MR imaging were detected with a mean catheter length of 151 ± 6.1 mm in the agarose model. The catheter placement in the anatomical specimens revealed mean total deviations of 1.95 ± 0.6 mm on CT scanning and 1.8 ± 0.7 mm on MR imaging for the suboccipital approach and a mean catheter length of 59.5 ± 4.1 mm. For the precoronal approach, deviations of 2.2 ± 1.2 mm on CT scanning and 2.1 ± 1.1 mm on MR imaging were measured (mean catheter length 85.9 ± 4.7 mm).

Conclusions

The system-based deviation of frameless stereotaxy using the VarioGuide system reveals good probe placement in deep-seated locations such as the brainstem. Therefore, the authors believe that the system can be accurately used to conduct biopsies and place probes in patients with brainstem lesions.
Thrombosis and subsequent recanalization of a ruptured intracranial aneurysm in 2 children, demonstrating the value of repeating catheter angiography after an initial negative study
Authors: Valle Edison P. , Tamargo Rafael J. , Gailloud Philippe
Published: April 2010

The cases of 2 children with true aneurysmal subarachnoid hemorrhages (SAHs) and initial false-negative angiograms are reported. In both cases, the initial angiogram was of adequate technical quality and included the projections on which aneurysms were later documented. There was no significant vasospasm at the time of initial angiography; therefore, transient aneurysm sac thrombosis was the most likely explanation for the initial false-negative studies. It is particularly interesting to note that 1 of the 2 patients had a pattern of hemorrhage compatible with the most limited definition of a perimesencephalic SAH, that is, a small prepontine cistern hemorrhage. If a second angiogram had been deemed unnecessary based on that criterion alone, a ruptured basilar tip aneurysm would have escaped detection and treatment.